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《Disability and rehabilitation》2013,35(12):1107-1112
AbstractPurpose: The objective of this study was to identify and describe management strategies to ensure safe return to activity (RTA) and return to school (RTS) of children with mild traumatic brain injury (MTBI) and determine whether they are evidence-based. Methods: A scoping methodology was conducted using research published between 1990 and 2013, gray literature and clinical expertise. Once the data had been charted, an expert panel of physicians and clinicians was consulted to inform and validate study findings. An analytical and thematic framework was used to examine the study findings. Results: A total of 400 potentially relevant published articles, 100 websites and 24 iPad Applications were found. Ten articles and three web-based resources met inclusion criteria and were included in the final review. Nine articles recommended a more conservative approach to RTA, as well as identified a step-wise or severity-oriented approach. General recommendations were also found regarding safe RTS. One study recommended a stepwise RTS protocol for children. Conclusions: This scoping methodology determined that the most comprehensive guidelines for management are focused on adults. Evidence concerning prolonged recovery patterns in children and the impact of concussion on the developing brain suggests that pediatric-specific guidelines are needed for RTA and RTS after MTBI/concussion.
- Implications for Rehabilitation
Although concussion in children is an increasing concern, it has been determined that the most comprehensive guidelines for management are focused on adults.
These guidelines are primarily consensus-based and are not proven fact through quality research.
Evidence concerning prolonged recovery patterns in youth and the impact of concussion on the developing brain suggest that pediatric guidelines should be more conservative than for adults. Therefore, pediatric-specific guidelines need to be developed for return to activity and return to school after MTBI/concussion.
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At a large teaching hospital with seven oncology units, nurse-educators implement a competency program to ensure that nurses with different backgrounds and patient populations master a unified set of skills and knowledge. 相似文献
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New ways to turn on NKT cells 总被引:1,自引:0,他引:1
Natural killer T (NKT) cells are CD1d-restricted, lipid antigen-reactive T cells with powerful immunoregulatory potential. The prototypic antigen for NKT cells is a marine sponge-derived glycolipid, α-galactosylceramide (α-GalCer), but this is not normally encountered in the mammalian environment. Thus, there is great interest in the identification of more physiological stimuli for NKT cells, and numerous studies have shown that NKT cells are capable of responding to a range of microbial lipid-based antigens. Two new studies expand our understanding of environmental NKT cell stimuli, with one showing that CD1d-restricted NKT cell antigens are present within common house dust extract (HDE), whereas the other shows that NKT cells can respond to innate stimuli irrespective of the presence of foreign microbial antigens. Collectively, these two investigations indicate that NKT cells are far more likely to encounter foreign antigens, or innate activating signals, than previously recognized, suggesting a more central role for these cells in the immune system. 相似文献
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MAGOUN FA 《The American journal of nursing》1946,46(11):751-754
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Orsolini-Hain L 《Nursing outlook》2012,60(2):81-90
Nearly 80% of associate's degree-prepared nurses do not return to school for a more advanced degree in nursing, which is an issue of concern to many nursing leaders. This interpretive phenomenological study investigates what influences associate's degree-prepared nurses to refrain from continuing their professional education and obtain a baccalaureate or higher-level degree. Although these nurses generally wished they had a higher degree, they did not feel pursuing one was necessary. They did not perceive that their standard of patient care would change with further professional training involved in obtaining a higher educational degree. Furthermore, they did not perceive any distinctions in professional ability between themselves and colleagues with more advanced nursing degrees. The culture of service health care organizations in which associate's degree-prepared nurses are employed, as well as other factors, are likely directly responsible for the practicing nurses' lack of appreciation for the relevancy and rewards of returning to school. 相似文献
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Rubel B 《School nurse news》2005,22(1):28-34
This article is from the new 30-hour course book for nurses, Death, dying and bereavement: Providing compassion in a time of need, by Barbara Rubel BS, MA, CBS, BCETS, sold through www.westernschools.com. Western Schools is accredited as a provider of continuing education in Nursing by the American Nurses' Credentialing Center's Commission on Accreditation (ANCC). 相似文献
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M G Gelder 《Annals of medicine》1991,23(2):97-99
The research evidence strongly suggests that the most effective form of treatment for panic disorder is cognitive therapy. It is more practical, however, to initiate treatment with alprazolam or with imipramine. Either drug will suppress symptoms and even a half of the patients will stay well. 相似文献
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The use of analgesic and anti-inflammatory injections in athletics has a long and sometimes controversial history. They have
been and will continue to be utilized to decrease inflammation and pain, improve healing time, and ultimately decrease the
amount of time missed from sports competition. Several authors have evaluated both the positive and negative aspects of various
injectable medicines. Many questions still remain with regard to safety, tolerability, risks, complications, and side effects
of these injectable medicines. This paper reviews some of the current trends regarding the use of injectable medications in
athletic medicine. 相似文献