Experiences of returning to work after acquired brain injury

The purpose of this qualitative study was to explore experiences of returning to work after rehabilitation, from the viewpoint of people with acquired brain injury. A purposive sampling of eight informants was made, and data were collected through personal interviews with open questions. The data were then analysed through qualitative content analyses in five steps, resulting in four main categories of experiences: “A new person”, “Stimulants and fellowship”, “Understanding and support”, and “To reach insight” with appurtenant sub-categories. The overarching theme was “Returning to work after acquired brain injury is a long process”. The conclusion of this study is that returning to work after acquired brain injury requires motivated individuals, flexible work, accommodating labour management, and prolonged environmental support. This study also shows that the informants need support for a long period of time to reach a balance and to obtain a functional working role. In order to achieve this, client-centred rehabilitation, professional teamwork, and longer follow-up periods than those of today are required.     

基于“微课”的翻转课堂在超声住院医师规范化培训中的初步应用

随着住院医师规范化培训体系日趋完善,培训质量日益受到关注与重视。传统超声医学教学模式已不能满足规范化培训的最新需求,更新教学理念、改革教学模式成为必然。"微课"因其快速、方便、可重复性的特点,在现代教学活动中发挥了积极作用,我科尝试在"微课"中引入翻转课堂,让学员充当教员角色,主动参与"微课"的构思、设计、制作及讲解,着重培养其自主学习、交流沟通及团队合作等综合能力,以提高培训质量。     

Rehabilitation and orthotic management of congenital and acquired meromelia in the lower limbs of children

Children with limb deficiencies or amputations of the lower extremities should be enabled to stand or walk according to their state of development, because standing and walking are among the most important preconditions for the best possible integration. Supplying them with a prosthesis, orthosis and orthoprosthesis is therefore indispensable for rehabilitation. While a prosthesis replaces parts of the extremities, an orthosis stabilizes the existing extremity. Orthoprostheses compensate longitudinal malformations, have a supporting effect, allow growth to be controlled and compensate for shortening. Just as important as the remedy is early medical treatment. The medical team taking care of the patient works out a treatment plan where responsible cooperation with the parents is of utmost importance. The focus of all efforts is, of course, the handicapped child. Examples are used to demonstrate the course of successful rehabilitation of children and adolescents with damaged limbs. Equally the psychological situation of the parents and child is taken into consideration.     

Heparin-induced thrombocytopenia associated with pulmonary embolism after total knee arthroplasty： a case report and review of literatures

Type II heparin-induced thrombocytopenia (HIT) is a life-threatening adverse drug reaction initiated by heparin administration. We described a rare case of LMWH-induced HIT complicated with proven pulmonary embolism (PE) in a 75-year-old male patient who hospitalized with diagnose of right knee osteoarthritis and was underwent total knee arthroplasty. The patient was successfully treated with argatroban. Early recognition and timely alternative therapy are of great importance in the treatment of this severe disorder.     

Quantitative EEG Findings Among Men Convicted of Murder

Abstract

Quantitative EEG data were collected from 20 men convicted of murder and sentenced to death. Measures of coherence, phase, amplitude asymmetry, and relative power from 19 scalp electrode sites during an eyes closed, resting condition were compared to a normative database. Measures significantly different from normal were tallied to determine electrode site locations with greatest concentrations of abnormalities. There were more right than left hemisphere abnormalities of coherence, phase, and amplitude asymmetry, and more anterior than posterior abnormalities of phase, amplitude asymmetry, and relative power. Bilateral frontal, right temporal, and parietal sites had the greatest concentrations of multiple abnormalities. Increased coherence and longer neural conduction times characterized the majority of coherence and phase abnormalities. The concentrations of frontal and right hemisphere abnormalities are discussed as relating to impairment, in executive functions, modulation of affect, and perception of affect in others. Such impairments perhaps in conjunction with adverse environmental events, are suggested as placing one at risk for violent behaviors. Relevance of these findings for future research, forensic neuropsychological assessments, and neurofeedback treatment is mentioned.     

Patient Preference for ln-Exsufflation for Secretion Management with Spinal Cord Injury

Abstract

An important aspect of respiratory management in patients with acute spinal cord injury (SCI) is the elimination of secretions. Methods utilized for secretion management in patients with SCI includes endotracheal suctioning and mechanical in-exsufflation (MI-E). Surveyed here is a group of patients with SCI who have had experience with both endotracheal suctioning and MI-E via tracheostomy, to determine patient opinions and experiences regarding the 2 techniques. The survey was administered to 18 patients with traumatic SCI, with an average age of 34. 72% were ASIA A, 22% percent were ASIA B, and 6% were ASIA C, with neurological level of injury ranging from C-1-T-3. Results indicate that patients found MI-E significantly less irritating (p < 0.001 ), less painful (p < 0.001 ), less tiring (p = 0.01 ), and less uncomfortable (p < 0.001) than endotracheal suctioning. In a direct comparison, 89% of patients preferred mechanical in-exsufflation to suctioning. In addition, 89% of patients found MI-E faster, 78% found MI-E more convenient, and 72% found MI-E more effective than suctioning. This study demonstrates that all measured aspects of patient experience are more positive for MI-E than for endotracheal suctioning.