Exeley Inc.

Villegas, Rehabilitation Technician, Esther Gallego

International Journal of Orientation & Mobility • Volume 7, Number 1, 201596
Basic Spanish for Orientation 
and Mobility: A Phrase Book and 
Dictionary
ISBN: 978-0-89128-662-2
soft cover.
Brenda J. Naimy and Matthew W. Hogel (Eds.). (2014). New York: 
AFB Press
As a Spanish/English-speaking O&M specialist since 1990, I applaud and appreciate 
this important text. Prior to 1990, the vast majority of O&M specialists in the US were 
primarily English speaking and many Spanish-speaking individuals with vision impairment 
waited years for an instructor who spoke their language or to access an interpreter. More 
than two decades have passed since the publication of the first text English/Spanish Basics 
for Orientation and Mobility Instructors (Foy, 1991) and although there are more bilingual 
O&M specialists today, there are many more specialists whose first language is English. In 
2010, three percent of Hispanics in the US reported a vision disability and it appears that 
Hispanics develop vision impairment at a higher rate than any other ethnic group in the US 
(National Eye Institute, 2015). Thus, this text can potentially assist English-speaking O&M 
specialists provide O&M services to an increasing number of Hispanic people with vision 
impairment.
Basic Spanish for Orientation and Mobility (2014) is a user-friendly, valuable tool for 
communicating O&M instruction to students (and their families) who primarily speak 
Spanish. The text contains six chapters (223 pages) and provides O&M lessons in a sequential 
step-by-step and side-by-side format in English and Spanish. This format makes reading 
very fast, comfortable, and easy to understand. It also provides conversational sentences 
that can be directly used with a student. This book is available in print and  download with 
iBooks on a Mac or iOS device, and with iTunes on a computer.
The text includes phrases and O&M terminology needed to convey instruction and easy-
to-read vocabulary lists. The chapters commence with an ‘at a glance’ summary briefly 
listing the topics within the chapter. The six chapters focus on (i) basic O&M skills (ii) 
basic skills, canes, and cane techniques (iii) residential travel (iv) business travel (v) using 
public transit (vi) skills for travellers with low vision. There are also translations of specific 
terms for example, (a) vision, disability, and medical terminology; (b) concept development 
in O&M (c) and a guide to Spanish that provides information about pronunciation and 
grammar.
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International Journal of Orientation & Mobility • Volume 7, Number 1, 2015 97
Some of the strengths of this text are that it is succinct and easy to read. In addition, 
the publication can be easily enlarged for students with low vision; and a braille version 
can be printed from the electronic text. A limitation, however, is the lack of graphics or 
photographs to illustrate techniques that would be especially useful for interpreters and 
families of people with vision impairment.  
The editors of this text are leaders in the O&M profession being both technicians and 
academics. First, Brenda J. Naimy is a certified Orientation and Mobility specialist; and 
lecturers in the O&M specialist training program, California State University. She is also an 
appeals specialist for ADA Paratransit Eligibility at Access Services. She has co-authored a 
number of textbook chapters about O&M assessment and program planning; and services 
for children and youth; as well as developed online instructional modules. 
Second, Matthew William Hogel is also a certified orientation and mobility specialist 
and low vision therapist. He is a practicing blind rehabilitation therapist at the Blind 
Rehabilitation Center, Veterans Affairs Medical Center, San Juan, Puert Rico. He is on the 
Board of Directors at the Association for Education and Rehabilitation of the Blind and 
Visually Impaired (AER) where he assisted to edit the first Spanish newsletters. At national 
and international conference Hogel advocates for increasing the number of Spanish-speaking 
O&M specialists in the US.
Basic Spanish for Orientation and Mobility: A Phrase Book and Dictionary is an essential 
resource for O&M instructors, families, and interpreters in their endeavor to provide quality 
services to Spanish-speaking individuals with vision impairment. 
Esther Gallego Villegas, Rehabilitation Technician O.N.C.E (Spanish Organization of the Blind).
References
Foy, C. J. (1991). English/Spanish basics for 
orientation and mobility instructors (pp. 
1-78). New York: AFB Press.
National Eye Institute. (2015). U.S. Latinos 
have high rates of developing vision loss 
and certain eye conditions. Retrieved 
from https://www.nei.nih.gov/news/press 
releases/050110


Basic Spanish for Orientation and Mobility: A Phrase Book and Dictionary

Gentle, Ph.D., Frances

International Journal of Orientation & Mobility • Volume 7, Number 1, 201598
This delightful book is a love story that explores the unique relationship between a woman 
who is blind and her guide dog. The reader is first introduced to Bev, whose blindness limits 
her appreciation and connectedness with the world around her. The reader is then introduced 
to Henry, a rollicking, frolicking, mischievous puppy that undertakes guide dog training and 
is eventually assigned to Bev as a “working dog”.  From here, the love story begins. With 
Henry at her side, Bev bursts out into the world around her with confidence and a spirit of 
adventure.
Bev Larsson and MaryBeth Gundrum have created a story that will resonate with all 
readers who know the joy of owing a dog. Child and adult readers alike will appreciate 
the simplicity and melodic nature of the rhyming prose and the beautiful watercolour 
illustrations that brim with life and capture Bev’s changing moods. 
Importantly, this story book could have many uses. It could inform a young audience on a 
topic about which they would have no prior knowledge. Further, the book could be useful in 
preschool, kindergarten, or during the early primary school years to educate young children 
about the existence of vision impairment, with positive imagery and messages around 
disability and accessibility. These are important messages, particularly in mainstream 
educational environments where students with and without disability study together.    
At the time of writing, Bev Larsson lived in Northern New South Wales, Australia with 
her guide dog Henry. Her co-author MaryBeth Gundrum was a Brisbane-based public 
relations and communications consultant in Australia. The book’s illustrator, Annette Lodge 
was a Sydney-based painter, author and illustrator of children’s books. The book is available 
for purchase from InHouse Publishing www.inhousebookstore.com.au 
Frances Gentle Ph.D.
Lecturer, RIDBC Renwick Centre & The University of Newcastle NSW, Australia; 
President, South Pacific Educators in Vision Impairment (SPEVI); 
2nd Vice President, International Council for Education of People with Visual Impairment (ICEVI).
Along Came Henry: 
A Guide Dog Story
ISBN 978-0-9923336-0-7
Juvenile fiction, soft cover
MaryBeth Gundrum and Bev Larsson. (2012). Underwood, QLD: 
Inhouse Publishing. Illustrated by Annette Lodge
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Along Came Henry: A Guide Dog Story

Volume 8, Number 1, 201610
Editorial
We join Dr Nora Griffin-Shirley in welcoming you to IJOM’s eighth volume. Nora’s 
emphasis on research to inform O&M practice is highly important and we hope that IJOM 
goes some way in disseminating research-based findings that positively influences O&M 
education and practice. An O&M research colleague once said that if surgeons were to 
lose their base of medical knowledge, then they would have to stop working. They would 
have no idea about the way to effectively treat patients as they would lack research-based 
knowledge about for example, anaesthesia, the meaning of symptoms, and the likely risks of 
particular surgical procedures. Although it seems unrealistic to draw similar comparisons 
to the practice of O&M, without O&M research to inform practice, the profession risks 
stagnation and lost opportunity to harness the new technology and innovation that might 
improve the lifestyles of people who are blind or vision impaired.
There is risk in the O&M work that we do. For instance, we teach people who are blind 
or have vision impairment to use and rely on guide dogs, long canes, and technology; cross 
roads in complex environments; walk through unfamiliar environments; and access public 
transport. We must consider, for example, such questions as: does this guide dog have a 
suitable temperament to undertake this work? Is there a safer way for this person to move 
about? Are we teaching a reliable technique so that this client can cross the road safely? 
Does this type of long cane with this particular tip actually benefit the client? Is this the 
safest way to teach a person who is blind to board a train, bus, or ferry? Is this technology 
reliable enough so that the client can depend on it when travelling at all times of day, under 
all weather conditions? To answer any question truthfully and reliably, we need evidence 
and answers that only quality research can provide.
As indicated in the Editorial IJOM 7, 2015, we have included some papers submitted 
by authors that presented at the International Mobility Conference (IMC) 15, Montreal, 
Canada. Excitingly, we are on the verge of IMC16 that will take place in Dublin in June 
2017 (imc16.com) after which IJOM will publish the innovative and outstanding work 
by some conference presenters. As Dr Nurit Neustadt-Noy shared at the opening of 
IMC15, this conference commenced in 1979 in a ‘bar’ in Germany by a group of O&M 
specialists with the intention of sharing knowledge that would assist the expansion and 
improvement of services worldwide. Thirty-seven years and 16 vibrant conferences later, 
their vision continues and we intend to develop their vision of promoting more research 
Volume 8, Number 1, 2016 11
INTERNATIONAL JOURNAL OF ORIENTATION & MOBILITY
and networking at conferences such as this. Networking at IMCs has resulted in some 
significant collaborative projects for example, devising ways to deliver O&M programs 
remotely in hard-to-get-to regions in Australia, Canada, and the United States. Such initial 
work could possibly be the forerunner to more mainstream remote services becoming 
available in the future within countries as well as between countries. Why isn’t it possible 
for an O&M specialist in a particular country, sitting at his or her work desk, to deliver an 
O&M program to a person with vision impairment in another country? I refer you to the 
work of Barrett-Lennard that is presented in this volume.
Within this volume the lead article by Bourquin, Wall Emerson, Sauerburger, and Barlow 
investigated the effect of various types of pedestrian gazing toward drivers to observe 
driver yielding (stopping) behaviour. Remarkably, they found no significant difference in 
the driver’s yielding behaviour between gazing at the driver and not gazing at the driver. 
This discovery is somewhat surprising and perhaps a little confronting since many O&M 
specialists believe that when a client looks toward a driver it will reduce their speed or they 
will stop for the person with vision impairment. The authors discuss the reasons why this 
discovery is not necessarily a negative finding. The implications for teaching individuals 
with vision impairment road crossing skills are also discussed.
Lane, Matthews, Ellison, and Palmer examined the health benefits of dog guides on 
their handlers. Their study involved three focus groups of dog guide handlers from three 
Australian states. They identified that there were numerous positive changes that dog 
guides had on the handler’s life. These findings are important and contribute to a small 
but increasing body of research indicating similar findings. IMC15 provided a visual 
presentation about the reliable use of robotics to assist a person’s O&M. These robots 
accessed a variety of environments at a variety of speeds across any surface or terrain. 
Although there has been no research on this topic, it would be interesting to discover 
whether dog guide handlers reported similar positive life changes using robots while 
enjoying a companion animal as well.
Gallimore, Keay, and Tinsley reported on the five-year development of the Client 
Evaluation Tool (CET). The CET is an outcome measure designed to evaluate the progress 
of adult clients who undertake O&M programs. Also included are the results of the tool 
having been used by 361 clients. The CET appears valid and reliable. It can be applied to 
all types of O&M programs including guide dog programs, and can be administered in a 
relatively short period of time.
Ambrose-Zaken reviewed 50 US state education websites and surveyed US personnel 
preparation programs training teachers of learners with vision impairment (TVI) to teach 
O&M skills and related services. It appears that TVIs’ education in O&M is limited and she 
discusses the implications of this limited education on the O&M profession.
Volume 8, Number 1, 201612
INTERNATIONAL JOURNAL OF ORIENTATION & MOBILITY
Hallak and Aguerrevere have investigated the face validity of the Texas 2 STEPS 
Evaluation Tool. The tool guides O&M practitioners in assessing the O&M skills of children 
from birth to five years of age. Thirty certified O&M specialists (COMS) used the tool and 
provided feedback about its effectiveness.
Continuing with O&M in young children, Sankako, Marília, Lucareli, de Carvalho, and 
Braccialli investigated the gait differences between children (5-7 years of age) who were 
blind to those with vision impairment. A significant difference was found between the two 
groups with regard to their stride length. The authors discuss this important finding and 
its implications for O&M training.
Providing O&M programs in remote regions has always been challenging for O&M 
specialists and costly for O&M service provider organisations. Accessing remote regions is 
also time consuming. Barrett-Lennard discusses her use of video conferencing to provide 
O&M services in remote regions of Australia. Although in its early phase, these trials have 
been successful and she is currently working on refining and expanding this much needed 
service.
Stitt describes a pilot study about an organisation’s peer support program for clients 
with vision impairment. Information about vision impairment and O&M-related topics 
is provided over the telephone by volunteers with vision impairment. These volunteers 
are also very capable travellers and use a range of mobility devices (canes, technology, 
guide dogs). Seventy-one clients who received support participated in the study and they 
provided feedback that the information and support was outstanding.
Finally, a significant issue experienced by dog guide handlers is interference or 
discrimination against their dog guides. Thomas tested a new measure of attitudes to 
service dogs: The People’s Attitude to Dogs in Service Scale (PADS) to determine whether 
or not the public’s behaviour might be related to dogmatism rather than a lack of education 
about dog guides and the way to treat them. The findings suggest that strategies other than 
public awareness campaigns might be required to change public opinion and behaviour 
toward service dogs. This finding is significant, especially for those organisations which at 
great expense fund public awareness campaigns.
Thank you to all who submitted articles for this volume. We, the editors and our 
distinguished editorial advisory panel members sincerely appreciate the time, hard work, 
and effort that is spent in article preparation and editing. No idea is ridiculous if it is 
qualified by conclusive research and contributes to improving the lives of people with 
vision impairment.
Desirée Gallimore & Mike Steer
Editors


Editorial

Engel, Larissa J.

Ryan, Mandy J.

Australasian Journal of Neuroscience Volume 27 ● Number 1 ● May 2017 
 19 
The Patient/Background 
Mr X was a male in his mid-twenties, 
of Asian descent. He moved to New Zealand 
with his new wife in mid-2015, and returned 
to his home country for a short holiday in late 
2015. Mr X was admitted to Christchurch 
Hospital on January 16th, 2016. He had no 
documented medical history, and the only 
known family history was from his mother – 
an insulin-dependent diabetic – which be-
came another issue we had to address for 
this family throughout the course of the pa-
tient’s care. 
On January 18th, Mr X was given a 
potential diagnosis of Tuberculosis (TB), with 
confirmation of this diagnosis on January 
19th. Mr X was also confirmed to have a mil-
iary strain of TB, starting in his lungs, only to 
spread and cause TB Meningitis. 
Throughout the course of his admis-
sion, Mr X was transferred between various 
wards, including an Intensive Care Unit ad-
mission, before eventually transferring to our 
neurosciences ward for neurological obser-
vation postoperatively following a ventriculop-
eritoneal (VP) shunt insertion. 
Pictured above is the patient’s admission MRI, which 
also showed subtle changes indicative of TB Meningitis. 
Whilst on our ward, Mr X remained 
under the care of the General Medical team, 
as well as neurosurgery, while also receiving 
regular consults from neurology, infectious 
Abstract 
This case study introduces Mr X, who was diagnosed with Tuberculosis (TB) in early 2016. Alt-
hough the TB originated in his lungs it spread causing Miliary TB in his brain. The case study 
focuses on the nursing issues identified during the collaboration of different specialities and dis-
ciplines, while ensuring the patient’s and family’s needs are met. 
This particular case was especially challenging for the authors due to cultural differences, diffi-
culties with communication with both family, specialties and multidisciplinary team (MDT), and 
the challenges of each team involved to work together and giving differing information to all in-
volved. Due to the rare diagnosis for this patient, this was not something we had come across 
before. 
This case study was developed through information gained from nursing the patient directly, 
discussions with the surgical and medical teams involved, research articles, personal reflec-
tions, and viewing the patient’s clinical notes and scans. 
Nursing considerations will be discussed throughout the case study including the obstacles in 
nursing a patient who required complex care with several different MDT. 
Keywords: Miliary tuberculosis, tuberculosis meningitis, cultural challenges, multiple 
teams, nursing care  
Questions or comments about this article should be 
directed to Larissa Engal, Registered Nurse, Christ-
church Public Hospital 
 Larissa.engel@cdhb.health.nz 
Copyright © 2017 ANNA 
Caring and Collaborating 
A case study on a complex patient under multiple teams 
Larissa J. Engel, Mandy J. Ryan 
Australasian Journal of Neuroscience Volume 27 ● Number 1 ● May 2017 
 20 
diseases, and standard multidisciplinary 
teams such as physiotherapy, speech and 
language therapy, and dieticians. 
Miliary Tuberculous and Tuberculous 
Meningitis 
Milary TB is a form TB where bacteria 
first enters the host by droplet inhalation 
(Ramachandran, 2014). This, at first a local-
ised infection, usually starts within the lungs 
causing tiny tubercles that appear like “millet 
seeds” in size and appearance, hence the 
name “miliary” (Sharma, Mohan & Sharma, 
2012). These seed-like infective sites can 
spread to other regions through the blood-
stream that eventually reach the brain caus-
ing small abscesses that burst in the sub-
arachnoid space resulting in TB Meningitis 
(TBM) (Ramachandran, 2014). The abscess-
es appear on MRI’s as small lesions (Cherian 
& Thomas, 2011), such as in the scan on the 
previous slide. 
Patients with Miliary TB usually pre-
sent with fever, anorexia, weightless, weak-
ness and a cough (Man et al., 2010; Sharma, 
Mohan & Sharma, 2012). Often small skin 
lesions exist and can help with the diagnosis. 
Suspected TBM patients can present with 
headaches, seizures and signs of intracranial 
pressure (Cherian & Thomas, 2011). Hypo-
natraemia may indicate the presence of TBM 
and can also be a predictor of mortality 
(Sharma, Mohan & Sharma, 2012). 
Pictured above is one of the scans the patient had during 
February showing enlarged ventricles indicative of hy-
drocephalus from the blocked shunt. 
Complications of TBM include obstruc-
tive hydrocephalus, caused by the release of 
a thick exudate from the bacteria which caus-
es blockages in cerebrospinal fluid (CSF) 
flow (Rock, Olin, Baker, Molitor & Peterson, 
2008) leading to neurological deterioration. 
The fluid from the burst abscesses commonly 
cause vasculitis which also can lead to cere-
bral infarction or stroke (Rock, Olin, Baker, 
Molitor & Peterson, 2008; Man et al., 2010; 
Sheu et al., 2010; Radwan & Sawaya, 
2011.). Vasculitis is inflammation of the blood 
vessels. This causes them to narrow, leading 
to loss of perfusion to the brain (NHLBI- NIH, 
2014). 
Treatments and Explanations 
The treatments for Mr X included the 
TB specific medications Rifampacin, Is-
onazid, Pyrazinamide and Ethambutol, which 
are the four main anti-TB drugs, and are gen-
erally used for a duration of 12 months (Man 
et al., 2010; Horsburgh, Clifton & Lange, 
2015; Heemskerk et al., 2016.). Dexame-
thasone was also used as steroid therapy to 
reduce cerebral oedema and inflammation, 
and attempt to prevent CSF blockage (Sheu 
et al., 2010; Horsburgh, Clifton & Lange, 
2015; Heemskerk et al., 2016).  
Unfortunately, despite the use of dexa-
methasone, Mr X did develop hydrocephalus, 
and a VP shunt was inserted. Due to excess 
protein in the CSF, the shunt continued to 
block and it was replaced with a short term 
external ventricular drain (EVD) with the hope 
that the protein would reduce or a bigger 
shunt could be found from India, where TB 
prevalence is higher. 
In addition, Mr X also had persistent 
hyponatraemia, and due to this he was put 
on constant fluid restrictions of 600-800ml 
per day. Towards the end of his stay, Mr X’s 
sodium normalised and further hydration was 
able to be given. 
Pictured above is a scan of the patient’s brain. The white 
area circled in red shows the placement of the shunt 
following the first surgery. 
Furthermore, throughout Mr X’s time 
on our ward, he suffered small strokes, lead-
ing to decreased GCS and swallow ability, 
resulting in the insertion of a nasogastric tube 
for both nutrition and medications. 
Australasian Journal of Neuroscience Volume 27 ● Number 1 ● May 2017 
 21 
Final day 
The final day commenced on the night 
shift of 1st-2nd March. It began with the previ-
ous shift handing over that Mr X’s current 
GCS was 10 (E4 V1 M5), with a high respira-
tory and heart rate. During the night shift, Mr 
X’s GCS dropped further, eventually reaching 
a GCS of 6, with sluggish pupils and vitals 
increasing significantly. At this point, another 
medical review was called. Throughout this 
period, the patient’s EVD remained patent, 
ruling out further hydrocephalus as the 
cause. Despite reluctance from teams, an 
intensive care team was eventually called, 
and an urgent CT head was arranged. To 
note, at this point, the patient was still for full 
resuscitation despite the potential poor out-
comes. The patient’s wife was then contact-
ed, she was informed of her husband’s sta-
tus, and she arrived at the hospital to join his 
parents at his bedside. By 0645hrs, the pa-
tient’s GCS remained at 6, however he had 
become vitally more unstable, with a notable 
temperature of 39.5°C and heart rate of 189 
beats per minute, with a non-responsive right 
pupil. Shortly after, he was accompanied to 
his CT scan. 
On arrival back to the ward the neuro-
surgery team had arrived and we requested a 
review but were told his status was ‘not an 
acute concern’. We then rang his general 
medical team who were unaware of his dete-
rioration. They quickly arrived at the ward 
and the results of the CT were discussed be-
tween teams. The CT showed a large brain 
stem stroke. The decision was made to have 
an urgent family meeting and a Chinese doc-
tor was asked to translate for Mr X’s parents. 
The extremely unwell status of the patient 
was explained to the family and they were 
told “given his current clinical condition and 
context we do not believe he will recover”. 
The family were told that there was a high 
chance he would pass away today, and that 
no intervention would be beneficial. At this 
point Mr X’s wife became distraught and 
fainted. Resuscitation status was finally dis-
cussed with the family soon after and despite 
his parents wish for him to be resuscitated no 
matter the outcome; the final decision was 
made by his wife, as his next of kin, for him to 
be not for resus (NFR). The NFR status form 
was then filled out and Mr X confirmed offi-
cially as NFR. Throughout the day treatment 
was continued, the EVD was still patent, in-
travenous antibiotics and medications were 
still given with patients vitals decreasing 
throughout the day. At 1230 vitals were una-
ble to be obtained, the patient was noted to 
be posturing, and at 1258 Mr X took a last 
breath and passed away surrounded by his 
family.  
Challenges 
During Mr X’s treatment, one of our 
major challenges as nurses was the issue of 
attempting to communicate information and 
concerns to all the appropriate medical 
teams.  
Pictured above is the result of the patient’s urgent CT 
head taken the morning that the patient passed away. It 
shows a large bilateral basal ganglia and thalamic in-
farct. 
Within our hospital there is a clear-cut 
difference between teams such as medical 
and surgical, especially out of normal hours, 
so making the right people aware was diffi-
cult. There was a lack of clear guidelines 
around which issue needed to be reviewed 
by which team, leading to delays in decisions 
by the appropriate people. 
Collaborating between the teams in-
volved was also difficult, and the family was 
unfortunately told differing information from 
Mr X’s health teams, as each team reiterated 
their own specialty. For example, the neuro-
surgical consultant told the family early on 
that the patient could die, but the family at-
tributed this information to the upcoming sur-
gery, not the illness as a whole. Also on the 
day before his death, Mr X was told that his 
TB was well controlled and improving, how-
ever this was in reference to the pulmonary 
TB and not the TBM occurring in his brain 
which was still a serious concern. 
Language barriers were also an issue 
due to the family not speaking much English. 
Mr X’s wife, however, spoke English well, 
and as a nurse herself understood most of 
what was happening, but as his parents 
spoke little to no English, they unfortunately 
used his wife as a translator. This put her in a 
difficult situation, often translating information 
they did not want to hear. 
Australasian Journal of Neuroscience Volume 27 ● Number 1 ● May 2017 
 22 
The cultural differences between our 
health system and that of their native country 
meant the family did not always understand 
or agree with some health interventions. Un-
fortunately they felt the need to get the em-
bassy of their country to be involved and 
come to the hospital demanding health infor-
mation legally they could not be given. They 
also gained advice from an expert on TB in 
their country and asked the surgeons to 
change treatments accordingly, despite the 
fact they were not aware of the specifics of 
the case. The parents requested a traditional 
herbal medication to be given, however on 
discussion with the pharmacist this was 
found to interact with other medications the 
patient was on and was toxic to the body.  
The family found this difficult to under-
stand despite the translators used. The day 
the patient died the family were found to be 
preparing this medication for the patient and 
despite the above interactions, due to the 
patient’s condition, approval was given for 
this medication to be administered via naso-
gastric tube, and not orally like the family was 
attempting to give in desperation. 
On reflection and discussion around 
their culture following this case we now un-
derstand that their actions were all very nor-
mal for them but were foreign to us. Nurses 
need to remember that different cultural be-
liefs can influence preferences, prioritisations 
of needs, communication between family and 
their understanding of diagnoses and out-
comes and to take this into account when 
nursing patients of different cultures 
(Singleton & Krause, 2009). 
Mr X’s mother disclosed that she had 
brittle diabetes and was running low on insu-
lin, as she did not expect to be in the country 
that long. The issue was raised many times 
from staff and her husband that she was not 
adequately caring for her nutrition and rest 
needs leading to further family stress. She 
also needed to be referred onto a GP for an 
insulin refill, incurring high costs for the fami-
ly.  
Mr X was nursed in an isolated envi-
ronment in a side room due to his diagnosis, 
resulting in one-on-one care for weeks on 
end. Because of this we felt quite isolated in 
nursing this patient leading to our colleagues 
not fully understanding the severity of the 
situation and our response when he passed 
away. 
Reflections 
On reflection, this was an incredibly 
difficult case that we both struggled with at 
times, resulting in this case study. Working 
with this patient so intensely caused us to 
learn a lot about our practice as nurses. We 
have both learned a lot regarding cultural 
difficulties in supporting different cultures and 
their health, especially when it comes outside 
“the norm”. It made us more aware of just 
how much our culture can influence our nurs-
ing care. 
Advocacy was also a huge issue in this 
case, and helped us to learn to become 
stronger in making ourselves heard when we 
feel we need to voice what our patient can-
not. Resuscitation status was a particularly 
big issue in this instance as we both believed 
we should have gone that little bit further to 
make sure this issue was discussed earlier 
and not in the unfortunate scenario of being 
discussed mere hours before Mr X passed 
away. 
When we called Mr X’s wife in her 
home country for consent prior to this case 
study she expressed the concerns that we 
had already felt around the collaboration of 
teams and the information being given. She 
felt conflicting information was quite frequent-
ly given especially in the days leading up to 
his death and she was questioning why the 
family was informed that he was stable the 
day before he died.   
We had expressed concerns around 
this during a debrief for this case and there 
was a plan for the teams involved to have 
further discussion around ensuring infor-
mation given was the same across teams. 
Implications for Practice: 
The aim of this case study was to bring 
awareness of how multiple teams contrib-
uting to a patient’s case can bring complica-
tions, without even realising it.  We wanted to 
promote the importance of communication 
between teams and to show an example of 
where this went wrong. We also wanted to 
educate about cultural differences and how 
important they are to consider when nursing 
patients.  
Acknowledgements: 
· Mr Claudio De Tommasi, consultant Neurosurgeon
· Canterbury District Health Board (CDHB)
· CDHB Hospital Volunteers
· Department of Nursing
· Department of Neurosurgery
· Department of Neurology
Australasian Journal of Neuroscience Volume 27 ● Number 1 ● May 2017 
 23 
References:
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system tuberculosis’, African Health Sciences, 
vol. 11, no. 1: pp. 116–127 
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NH, Loc, PP, Chau, NVV, Hien, TT, Dung, NH, 
Lan, NTN, Lan, NH, Lan, NN, Phong, LT, Vien, 
NN, Hien, NQ, Yen, NTB, Ha, DTM, Day, JN, 
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Abstracts are open! 
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Caring and Collaborating A case study on a complex patient under multiple teams

Mackinnon, Rachael Elizabeth

Australasian Journal of Neuroscience  Volume 27 ● Number 2 ● Oct 2017 
  
Background: 
 
An 80 year old man with advanced Parkin-
son’s disease (PD) was admitted to the neu-
roscience unit with a worsening decline in 
mobility. Medical management was the com-
mencement and titration of the levodopa-
carbidopa intestinal gel (LCIG) Duodopa ® 
via a naso-jejunal tube, which had been in-
serted under fluoroscopy in Interventional 
Radiology. Over a ten day trial period the pa-
tient responded well to the administration of 
the LCIG with much less periods of difficulty 
with movement (known as OFF times) alt-
hough he did continue to experience periods 
of dyskinesia, some paranoid behaviours and 
notable episodes of ‘punding’ (repetitive non-
purposeful movements). Following these 
promising results from the LCIG infusion, the 
patient consented to proceed to the insertion 
of a direct jejunostomy for permanent trans-
jejunal intestinal infusion by a upper gastroin-
testinal surgeon. On day 2 post insertion of 
the jejunostomy tube the patient complained 
of nausea and vomiting and overnight he was 
transferred to the intensive care unit (ICU) 
with a suspected bowel obstruction and an 
aspiration pneumonia.  
 
 
 
 
 
 
 
 
Do the benefits of Duodopa eclipse the 
complications? 
 
Duodopa ® has been increasingly accepted 
as an effective treatment for troublesome mo-
tor fluctuations and dyskinesia for patients 
with advanced Parkinson’s Disease (Lang et 
al., 2016; Nyholm et al., 2008; Olanow et al., 
2014).Oral administration of levodopa leads 
to variable plasma levels from erratic gastric 
emptying (Nyholm et al., 2008).The intraduo-
denal delivery of levodopa connected to a 
portable pump provides a relatively steady 
plasma level of levodopa (Chang et al. 2016).    
The usual delivery of LCIG is via a percutane-
ous endoscopic gastrostomy/ jejunostomy 
tube (PEG/J). This system uses a percutane-
ous gastrostomy tube with fine bore jejunal 
extension, so that the gel can be directly in-
fused into the jejunum where absorption of 
the medication will be  optimized (Tsui, 2014). 
For the  patients the neurologists opted for 
the insertion of a direct jejunostomy tube, with 
the placement of the tube directly into the 
small intestine for the administration of the 
gel. This decision was based on the reported 
complications associated with the PEG/J de-
livery system (Kimber & Shoeman (2014). It 
also highlighted the notion that persistence in 
focusing on the clinical benefits of Duodopa 
has the potential to eclipse the challenges 
and complications of introducing a new jeju-
nostomy tube for patients with an already de-
bilitating disease (Bianco et al., 2012).  
Abstract:  
 
The use of Duodopa ® Levodopa-Carbidopa intestinal gel offers patients with advanced Parkin-
son’s disease (PD) an effective alternative therapy for the treatment of severe motor fluctuations 
and dyskinesia. This therapy requires the use of percutaneous endoscopic gastrostomy/
jejunostomy tube (PEG/J) to deliver gel directly into the jejunum which poses new challenges for 
neuroscience nurses for the care and management of patients with PD.  Due to the reported num-
ber of complications associated with PEG/J our facility opted to use a direct jejunostomy tube for 
the first of two PD patients which resulted in an adverse outcome for our 80 year old patient. This 
experience highlighted that the neuroscience nurses need to increase knowledge and understand-
ing of PEG/J and jejunostomy care as more future patients will be treated with Duodopa, and that 
future studies regarding the safety and value of the direct jejunostomy tubes are warranted. 
 
Key Words: Parkinson’s disease, percutaneous endoscopic gastrostomy/jejunostomy (PEG/J), 
Direct Endoscopic Jejunostomy (DEJ), Jejunostomy, Duodopa, complications  
 
Questions or comments about this article should be   
directed to Rachael Mackinnon, Clinical  Nurse Educator, 
St Vincent’s Hospital Darlinghurst NSW . 
Rachael.Mackinnon@svha.org.au 
DOI: 10.21307/ajon-2017-001 
Copyright © 2017ANNA 
The complications of jejunostomy tubes for patients re-
ceiving Duodopa: New challenges for neuroscience 
nurses 
                                                                                                                             
Rachael Elizabeth Mackinnon 
Australasian Journal of Neuroscience  Volume 27 ● Number 2 ● Oct 2017 
 2 
Complications related to the use of the 
PEG/J tube: 
 
Within the studies on the benefits of Duodopa 
are reports of tube/stoma complications. Ny-
holm et al (2008) reports the most common 
complication for the PEG/J tube was disloca-
tion of the tube from the small intestine to the 
stomach. Another two studies noted that the 
main safety issue of the LCIG related to the 
infusion system with technical problems as-
sociated with kinking and blocking of the tube 
(Senek & Nyholm, 2014; Zibetti et al., 2014). 
Zibetti et al (2014) reported one duodenal 
perforation out of 59 patients, while Kimber & 
Shoeman (2014) report two gastric perfora-
tions out of 17 patients which required lapa-
rotomy to repair. Recurrent minor problems 
were  tube malfunction and dislocation sec-
ondary to punding (Chang et al., 2016).  A 
constantly dislodged tube requires repeated 
re-siting of the jejunal tube (Foltynie et al., 
2013), which exposes patients to a return to 
the endoscopy suite  and the increased risks 
of hospitalization and general anaesthesia 
(Kimber & Schoeman, 2014). 
 
Complications are also related to infection 
around the stoma, (van Laar, Nyholm, & Ny-
man, 2016) with reports of excessive granu-
lation tissue, incision site erythema, ab-
dominal pain, peritonitis and pneumoperito-
neum (Fernandez et al., 2015; Zibetti et al., 
2014). Zibetti et al (2014) noted infection 
tended to occur within one month of the PEG/
J procedure and were successfully treated 
with antibiotic therapy, however device com-
plications were the contributing reason for 
discontinuation of the infusion for a propor-
tion of patients. 
 
A study of 85 patients undergoing Duodopa 
infusion was conducted regarding nutritional 
status and weight loss in patients and deter-
mined that those without tube complications 
had significant weight gain over a 6 month 
period (Galletti et al., 2011). 
Major complications of PEG/J - Buried 
Bumper Syndrome:  
 
Buried bumper syndrome (BBS) occurs when 
there is an overgrowth of the gastric mucosa 
over the inner bumper of the gastrostomy 
tube. Predisposing factors for BBS are tight 
fitting gastrostomy tubes, weight gain and no 
mobilization of the tube for the first month 
(Santos García et al., 2016). BBS was report-
ed to have a higher incidence of occurrence 
in Freka PEG tubes (which is the preferred 
PEG/J tube for Duodopa),  compared with a 
Corflo PG tube in one study (Dowman et al., 
2015). Although another similar sized study 
claims a low incidence of BBS from Freka 
tubes published in October this year (Clarke 
& Lewis, 2016). Notably both studies exam-
ined the incidence of BBS in PEG/J tube that 
had been required for the purposes of enteral 
feeding and not for Duodopa administration. 
Bezoars and Phytobezoars: 
 
Bezoars are composed of undigested food 
material that has been orally ingested 
(Altintoprak et al., 2012) and are classiﬁed 
based on the type of material they contain.  
Phytobezoars are described as occurring in 
patients who consume high amounts of fi-
brous and long fibre foods such as aspara-
gus or spinach that may be difficult to digest 
(Altintoprak et al. 2012). In a case of a 21 
year old male who had received LCIG for 6 
months a blockage of his tubing was discov-
ered  to be jejunal tube being knotted in the 
stomach around a bezoar (Negreanu et al., 
2010). 
 
 A 70 year old man presented with abrupt 
motor deterioration from tube obstruction 
from a bezoar. He was treated with a liquid 
diet and the use of Coca-Cola ® over four 
days until the bezoar was successfully dis-
solved (Stathis, Tzias, Argyris, Barla, & 
Maltezou, 2014). 
 In another case it was reported that a phy-
tobezoar entrapped the tip of a 71 year old 
male patient’s jejunal tube and resulted in a 
jejunal wall perforation and fistulisation of 3 
intestinal loops. Unfortunately the patient was 
reported to have died post-operatively follow-
ing repair of the fistula (Vuolo et al., 2012). 
Given the non-motor symptoms of Parkin-
son’s disease that include poor gut motility 
and constipation (Fasano, Visanji, Liu, Lang, 
& Pfeiffer, 2015) it would seem that the risk of  
bezoars would be higher when coupled with  
reduced gastrointestinal motility caused by 
the PEG/J.  
 
A long term PEG/J study determined that the 
procedural outcomes and adverse rates in 
patients treated using the PEG-J drug deliv-
ery system were acceptable,  and that bene-
fits of the therapy outweighed these compli-
cations (Epstein et al., 2016). Kimber & 
Shoeman (2104) felt that the high number of 
PEG/J complications was justification to intro-
duce the use of the DEJ tube.  
Small bowel obstruction secondary to Je-
junostomy tube: 
 
An abdominal CT scan reported that our 80 
year old patient had a jejunal obstruction due 
Australasian Journal of Neuroscience  Volume 27 ● Number 2 ● Oct 2017 
 3 
to kinking at the level of the jejunostomybal-
loon; a distended stomach and fluid filled oe-
sophagus, with consolidation in the lung ba-
ses secondary to aspiration. The balloon of 
the jejunal tube was deflated and a Salem 
sump nasogastric tube was inserted. Blood 
cultures returned an Enterobacter bacterae-
mia which was treated with IV antibiotics. He 
was given a beta-blocker for a new onset of 
atrial fibrillation secondary to his aspiration 
pneumonia and returned to the ward after 3 
days in ICU. Once on the ward a new jeju-
nostomy tube was inserted under fluoroscopy 
and sutured into place, following dislodge-
ment of the first Jejunostomy without the bal-
lon inflated for securement of the tube. He 
was restarted on the LCIG again with good 
motor results, less punding and no further 
hallucinations or paranoia. Two days after 
insertion of the second Jejunostomy tube, 
oozing around the tube necessitated review 
by the Stoma Clinical Nurse Consultant and 
the placement of an ileostomy bag. He was 
eventually discharged to a rehabilitation hos-
pital and eighteen months later the patient 
reports fluctuations in the amount of ooze/
leaks around the stoma site, which is tempo-
rarily alleviated with reductions in faecal load-
ing through the use of regular aperients.  
PEG, PEG/J and Jejunostomy tubes: 
 
The nurses on the neurological ward are fa-
miliar with percutaneous endoscopic jejunos-
tomy (PEG) tubes which are used routinely 
for enteral nutrition for patients at high risk of 
aspiration typically following stroke or trau-
matic brain injury. PEG/J feeding tubes are 
rarely used on our ward, but were reported to 
be developed for jejunal feeding to reduce 
gastroesophageal reflux occurring in PEG 
feeding. These tubes presented new chal-
lenges with PEG/J malfunction due to clog-
ging and proximal migration of the extension 
tube back into the stomach (Panagiotakis, 
DiSario, Hilden, Ogara, & Fang, 2008), which 
was also noted in the studies for Duodopa. 
The same authors studied the benefit of a 
direct percutaneous endoscopic jejunostomy 
tube (DPEJ) to PEG/J and determined in a 
retrospective study of 75 patients a decrease 
in the overall incidence of aspiration pneumo-
nia. 
 
A search of the hospital’s protocol on PEG 
and jejunostomy tube returned guidelines for 
the role in enteral nutrition only with limited 
information for the care of a direct Jejunosto-
my for the sole purpose of medication admin-
istration. A search on CINAHL to compare 
rates of complications between DEJ to PEG/J 
retrieved only one retrospective study of 560 
patients where the tubes were used for the 
purposes of enteral feeding indicated in pa-
tients with GIT / Head and Neck cancers, 
Stroke and other neurologic conditions which 
were not specifically identified (Ao, Sebas-
tianski, Selvarajah, & Gramlich, 2015). Ao et 
al. (2015) concluded that there was a higher 
risk of tube related complications, particularly 
the requirement of tube replacement in the 
patients with the DEJ tubes (48.4%) than that 
of the PEG group (21.5%). To date the only 
other study which directly compares the two 
devices is a small study of 17 patients for 
Duodopa ® infusion where the authors advo-
cated DEJ as a feasible alternative to the 
PEG/J tubes. This study reported a lower 
incidence in tube malfunction when compar-
ing 8 patients undergoing PEG/J to 9 patients 
who received DEJ devices (Kimber & Schoe-
man, 2014).  
 
Conclusion: 
 
The administration of the LCIG has provided 
patients with advanced Parkinson’s disease 
with great benefits in motor fluctuations and 
dyskinesia. The delivery of the intestinal gel 
requires an invasive PEG/J tube which brings 
a new set of challenges for these patients 
and the nurses caring for them.  There is a 
lack of compelling evidence to support the 
introduction of the direct Jejunostomy tube 
having greater benefits, as opposed to the 
PEG/J. Further future studies are warranted 
not only to compare the safety and the rates 
of complications between the two devices, 
but also to increase knowledge and develop 
sound protocols for patients/families and 
nursing staff when using the direct Jejunosto-
my device to reduce complications and ad-
verse outcomes. 
 
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The complications of jejunostomy tubes for patients receiving Duodopa: New challenges for neuroscience nurses

Kus, Krzysztof

Ratajczak, Piotr

Czaja, Natasza

Zaprutko, Tomasz

Nowakowska, Elżbieta

Effect of combined administration of aripiprazole and fluoxetine on cognitive functions in female rats exposed to ethyl alcohol

Przewłocki, Ryszard

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PROFESSOR JERZY VETULANI (1936–2017)
Professor Jerzy Vetulani was born in Krakow on January 21th 1936 in the family of scientists of the Jagiellonian 
University. His father was an outstanding historian and theorist of canon law, and his mother was a biologist. He 
spent his childhood in Krakow and after the second world war attended the prestigious Nowodworski High School. In 
year 1952 he began his studies in biology at the Faculty of Biology and Earth Sciences of the Jagiellonian University. 
He graduated in 1957 obtaining master’s degree in biology. In the same year he was employed in the Department 
of Pharmacology of the Polish Academy of Sciences as an assistant and at the same time he started a second study 
in chemistry at the Jagiellonian University. His academic career throughout the highly active scientific life was 
connected with the Institute of Pharmacology. He obtained Ph.D. degree in natural sciences in 1966 from Ludwik 
Hirszfeld Institute of Immunology and Experimental Therapy of the Polish Academy of Sciences in Wroclaw. In the 
same year he began his postgraduate training at the University of Cambridge in the United Kingdom, where he 
learned spectrofluorometric methods. After returning to Poland he introduced these at that time very innovative 
methods to study effects of psychotropic drugs on levels of biogenic amines in various rat brain structures. He 
studied the effects of neuroleptics, MAO and dopamine β‑hydroxylase inhibitors on metabolism of biogenic amines. 
These issues were subject of his habilitation work, which he prepared before leaving for sabbatical in the USA in 1973. 
He joined laboratory of professor Frydolin Sulser at Vanderbilt University, where he spent two years working on the 
central mechanisms of action of antidepressants, and in particular on their effects on the noradrenergic system. The 
results of these studies were published in 1975 in the most influential scientific journal, Nature. This discovery led 
professors Vetulani and Sulser to formulate a „β‑downregulation” hypothesis on the mode of action of antidepressants. 
Obituary
Acta Neurobiol Exp 2017, 77: i–iii
photo by Franciszek Vetulani
1_Obituary_v3.indd   1 22/06/17   21:44
ii Obituary Acta Neurobiol Exp 2017, 77: i–iii
After returning in 1976 to his laboratory Jerzy Vetulani obtained a D.Sc. (habilitation) degree from the Institute of 
Immunology and Experimental Therapy of the Polish Academy of Sciences in Wroclaw. In the same year, he assumed 
the leadership of the Department of Biochemistry in the Institute of Pharmacology of Polish Academy of Sciences. 
Professor Vetulani directed the Department for more than 30 years until 2007. In 1983 he obtained an associate 
professorship, and a full professorship in 1989. His research on antidepressants has become an inspiration to the 
Department of Biochemistry and many of the world’s research centers. His research group focused on mechanisms 
of action of antidepressants and biochemical mechanisms of experimental “antidepressant” therapy. At that time 
a phenomenon opposite to “β‑downregulation” was discovered – “upregulation” of the α1‑adrenergic receptor and 
accompanying increase in expression of the gene encoding this receptor and, on the other hand, decrease in density 
of α2‑adrenergic receptors. The results of these studies have allowed him to formulate a general hypothesis that 
antidepressant therapy leads to multidirectional and dynamic molecular changes in the brain adrenergic system and 
in result the adrenergic transmission is enhanced and therapeutic effects occur.
Jerzy Vetulani’s scientific interests encompassed also mechanisms and potential therapies for drug addiction. 
Professor Vetulani with his team demonstrated for example that clonidine, calcium channel blockers (especially 
L‑type channels) and tetrahydroisoquinoline derivatives inhibit morphine abstinence. Another important area of 
interest for Professor Vetulani was the dopaminergic system and its role in reward and drug addiction, as well as in 
neurodegenerative diseases, particularly in Parkinson’s disease. 
Professor Vetulani promoted nine doctoral students and four members of his team received D.Sc. degree 
(habilitation). Most of his pupils continue research work in the Institute of Pharmacology. His former cooperators 
are now professors and heads of four departments of the Institute. Their research interests are largely inspired by the 
ideas and experiences that have arisen and developed in collaboration with the professor Vetulani.
Professor Jerzy Vetulani also inspired the research of the entire institute as a Scientific Director of the Institute 
of Pharmacology from 1994 to 2002. He also was the Editor‑in‑Chief of the Polish Journal of Pharmacology and 
Pharmacy (now “Pharmacological Reports”) and has contributed significantly to its scientific quality. After retiring 
prof. Jerzy Vetulani continued to work at the Department of Brain Biochemistry and was elected to the position of 
Vice‑President of the Scientific Council of the Institute. 
Scientific achievements prof. Vetulani are impressive. He was the author of about 240 original papers, 27 chapters 
in books, 13 books, and around 100 review papers and more than 90 popular science papers.
Recognition for the scientific achievements of prof. Jerzy Vetulani has found expression in a whole range of 
distinctions and honors awarded by various bodies and organizations. Professor Vetulani received a honorary 
doctorate of two universities. In 2004 he received the title from the Silesian Medical University and in 2008 from the 
Medical University of Lodz. In 1983 he received the prestigious international Anna‑Monika Award for contribution to 
the understanding of the underlining neurobiological mechanisms of depression. He was a laureate of many national 
awards; two awards from the Scientific Secretary and three awards of the Medical Sciences of the Polish Academy 
of Sciences. In 2006 he was awarded the Jędrzej Śniadecki medal and the Nicolaus Copernicus Prize from the Polish 
Academy of Science and Art. He received the Prime Minister Award for his scientific achievements and the Knight’s 
Cross of the Order of Polonia Restituta for outstanding contributions to Polish science in pharmacology.
Professor Vetulani was a member of the Polish Academy of Arts (since 1991) and the Polish Academy of Sciences 
(since 2008). He served as a secretary of the Committee of Physiological Sciences of the Polish Academy of Sciences 
(1978–1981) and chairman of the Committee of Neurobiology, Polish Academy of Sciences (2007–2011). He was 
a member of the Scientific Councils of the Institute of Pharmacology, Nencki Institute of Experimental Biology, and 
Mossakowski Medical Research Center of Polish Academy of Sciences. He was an active member of many national and 
international scientific societies: the Polish Neuroscience Society, the Polish Pharmacological Society, Polish Copernicus 
Society of Naturalists, the Warsaw Scientific Society, the Polish Society of Bioethics and the European College of 
Neuropsychopharmacology (ECNP) and the Collegium Internationale Neuro‑Psychopharmacologicum (CINP).
He has collaborated with a number of research centers in Poland and abroad, of whom over 20 years of collaborative 
research of the Polish and Italian Academies of Science (PAN/CNR) with the Istituto di Biología Cellulare e Neurobiologia 
1_Obituary_v3.indd   2 22/06/17   21:44
Obituary iiiActa Neurobiol Exp 2017, 77: i–iii
(IBCN) in Rome. This cooperation coordinated by him concerned research on neurobiological mechanisms of central 
nervous system pathology. This collaboration also included the extra‑curricular interests of Professor Vetulani: 
monuments and the art of ancient Rome. He was a great expert and lover of the Rome. He was for many friends 
“cicerone” on Roman streets and churches and always found some interesting part of the city that he could tell the 
story of. He was in this an absolute master.
Professor Jerzy Vetulani was an outstanding and talented lecturer and academic teacher. These talents woke 
up quite late, around the year 2000. Initially he ran monographs on psychopharmacology at the Faculty of Biology 
and Earth Sciences and then he taught courses in neurobiology at the Medical School for Foreigners Collegium 
Medicum and for psychology students at the Departments of Psychology of the Jagiellonian University and 
Pontifical University of John Paul II in Krakow. Since 2007, he was employed as a professor at the Higher Vocational 
School of Malopolska in Krakow. Professor Vetulani possessed an extraordinary ability to give an inspirational and 
straightforward talks about the structure and functions of the brain. His lectures alongside the content were full of 
passion and anecdotes of all kinds. The students were fascinated by the intimacy and simplicity of his lectures on 
the complex and secret knowledge of the brain. As one of the few university lecturers, he conducted examinations 
personally without using popular test exams because he appreciated the conversation with the students and was 
curious about their way of thinking. The extraordinary ability to speak clearly about complex mechanisms of 
brain functioning has made him one of the most eminent popularizer of neuroscience in recent years in Poland. 
Since 1999 he has been promoting brain science as a lecturer at the annual Brain Weak in Krakow, but also in other 
Polish cities. His lectures were attended by hundreds of listeners. He was also the organizer of “Science Café” – the 
monthly scientific meetings for the general public in the Polish Academy of Science and Arts. He also lectured for 
junior high school students. Over the last 15 years, he has delivered around 500 different lectures, lectures and 
talks at medical education conferences, colleges and conferences, universities of the third century and universities 
for children. In a very clear way he presented both the professionals and the laymen with the latest discoveries in 
the field of neuroscience and the significance of these discoveries for functions, pathologies and brain therapies, 
and in a broader context for social consequences.
For his popularization activities he has won many awards and distinctions. In 2012 he received a special prize 
for the whole of popularization activities in the competition “Popularizers of Science” organized by the Ministry 
of Science and Higher Education and the Polish Press Agency. His activities in this field were awarded by the Polish 
Academy of Sciences, which appointed him a member of the Board of Scientific Dissemination at the Presidium of 
the Polish Academy of Sciences. He has also been selected a member of the European Dana Alliance for Brain (EDAB), 
a European organization dedicated to promoting brain education. Professor Vetulani wrote popular science articles 
and books that were very successful and widely read. The titles of some of them are: The Beauty of Neurobiology, 
Today and Tomorrow’s Neurobiology, How to improve memory, Brain: fascination, problems, secrets, How does the 
brain govern us?
For the last 17 years prof. Vetulani wrote a popular blog ‘The Beauty of Neurobiology’ at the Word Press site where 
he described, commented and analyzed the latest findings in the field of brain research. 
Professor Jerzy Vetulani advocated the legalization of cannabinoids. He published press articles, did interviews 
and was taking active part in various demonstrations. He pointed to the therapeutic effect of cannabinoids in many 
conditions such as glaucoma or multiple sclerosis, appetite disorders, certain types of drug‑resistant epilepsy in 
children, and the promotion of their analgesic properties, especially in terminal conditions. Acting in the Civic Medical 
Committee Marijuana advocated the need for changes in the Polish drug law. He participated in demonstrations and 
organized the collection of signatures in favor of the draft law allowing the use of “medical marijuana” in Poland. 
Professor Jerzy Vetulani died on April 6, 2017 in Krakow, at the age of 81. He was extremely active until the 
last days before the tragic accident. It is hard to believe he is gone. We miss him and his wide knowledge, humor, 
witty comments and positive attitude toward life.
Ryszard Przewłocki
Institute of Pharmacology – Polish Academy of Sciences
1_Obituary_v3.indd   3 22/06/17   21:44


Professor Jerzy Vetulani (1936–2017)

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