ABSTRACT
The American Academy of Neurology's (AAN) 2017 Gender Disparity Report identified improving mentorship as a key intervention to fill the leadership and pay gaps for women in neurology. Here we summarize the literature on mentoring women, provide an outline of ideal components of programs geared toward closing gender gaps, and present a mentoring program for AAN members. The strategies discussed share similarities with those for closing gaps related to race, ethnicity, and religion. Developing effective mentorship and sponsorship programs is essential to ensure a sufficiently diverse pool of academic faculty and private practitioners and to establish equal representation in leadership roles in this field.
Subject(s)
Mentors , Neurology/trends , Physicians, Women , Cultural Diversity , Gender Identity , Mentoring , United States , WomenABSTRACT
PURPOSE: Previous studies show anti-epileptic drug compliance and seizure control in people with epilepsy (PWE) to be lower among low-income groups and African-Americans. We examined how socio-demographic factors influence seizure control in an inner-city population. METHODS: The clinic records of 193 PWE were analyzed. Good seizure control was defined as no seizures in the previous year. Bivariate and multivariate analyses were performed to examine the effects of race, age, gender, median household income, medication cost, and insurance status on good seizure control. RESULTS: There were 69 Caucasians and 124 African-Americans (age 47.8±16.5 years) in the study. African Americans had a significantly lower income than Caucasians (p<0.001); but did not have inferior seizure control (p=0.18). Seizure control was also not affected by gender (p=0.82), AED costs (p=0.06), insurance type (p=0.20), or race-independent household income (p=0.75). CONCLUSION: Contrary to prior literature, we find that in our population of PWE there were no significant effects of race or family income on seizure outcomes. Our findings add to the existing literature on socio-demographic disparities in PWE and merit further exploration by other groups.
Subject(s)
Epilepsy/epidemiology , Residence Characteristics , Socioeconomic Factors , Adult , Black or African American , Aged , Anticonvulsants/therapeutic use , Epilepsy/drug therapy , Female , Health Status Disparities , Humans , Male , Middle Aged , Multivariate Analysis , Poverty , Young AdultABSTRACT
Cognitive impairment and seizures are common in our aging population. Anticonvulsant treatment is problematic due to sedation, cognitive slowing, and behavioral changes. Levetiracetam has favorable pharmacokinetics, good efficacy in elderly individuals, a favorable side effect profile, and lacks major drug interactions. We conducted a prospective, uncontrolled, phase 4, open label, 12-week study of levetiracetam to better profile its efficacy, safety, and impact on cognitive/behavioral status in 24 cognitively impaired, elderly individuals. In total, 69% were seizure free for the duration of the study; the remaining participants had satisfactory seizure control. Fatigue was the most common side effect (5 participants). Significant overall improvements were observed for the Folstein's Mini-Mental State Examination and the Alzheimer's Disease Assessment Scale-Cognitive. No significant changes were seen in behavioral or functional measures. Levetiracetam is an effective antiepileptic drug in elderly individuals with cognitive impairment. At 3 months, participants who remained on levetiracetam showed excellent cognitive tolerability.
Subject(s)
Aging/psychology , Anticonvulsants/therapeutic use , Cognition Disorders/drug therapy , Cognition/drug effects , Piracetam/analogs & derivatives , Seizures/drug therapy , Aged , Aged, 80 and over , Aging/drug effects , Anticonvulsants/adverse effects , Cognition Disorders/psychology , Disease-Free Survival , Fatigue/chemically induced , Female , Humans , Levetiracetam , Male , Middle Aged , Piracetam/adverse effects , Piracetam/therapeutic use , Prospective Studies , Psychiatric Status Rating Scales , Severity of Illness Index , Treatment OutcomeABSTRACT
The interictal EEG provides information that aids in diagnosis and management of epilepsy. One must remember that the EEG is merely a tool, and its usefulness depends largely upon the skill of the individual who wields it. Like all diagnostic tests, it has significant limitations and cannot substitute for a careful history and exercise of good judgment. Nonetheless, in skilled hands, it provides unique and vital information in many patients, and enhances our understanding of their condition.
