Neuropsychological changes following electrical injury.

The clinical presentation of electrical injury commonly involves physical, cognitive, and emotional complaints. Neuropsychological studies, including case reports, have indicated that electrical injury (EI) survivors may experience a broad range of impaired neuropsychological functions, although this has not been clarified through controlled investigation. In this study, we describe the neuropsychological test findings in a series of 29 EI patients carefully screened and matched to a group of 29 demographically similar healthy electricians. Participants were matched by their estimated premorbid intellectual ability. Multivariate analysis of variance was used to assess group differences in the following neuropsychological domains: attention and mental speed, working memory, verbal memory, visual memory, and motor skills. EI patients performed significantly worse on composite measures of attention/mental speed and motor skills, which could not be explained by demographic differences, injury parameters, litigation status, or mood disturbance. Results suggest that cognitive changes do occur in patients suffering from electrical injury.     

Exercise and global well-being in community-dwelling adults with fibromyalgia: a systematic review with meta-analysis

Background  

Exercise has been recommended for improving global-well being in adults with fibromyalgia. However, no meta-analysis has determined the effects of exercise on global well-being using a single instrument and when analyzed separately according to intention-to-treat and per-protocol analyses. The purpose of this study was to fill that gap.     

Injection of perfluoropropane gas to prevent hypotony in eyes undergoing tube implant surgery

Hypotony after fistulizing surgery is common, and most cases resolve without complications. Occasionally, a flat anterior chamber in phakic or pseudophakic eyes may lead to corneal decompensation or cataract formation. In aphakic eyes that have undergone previous vitreous surgery, flat anterior chambers will not develop, but large choroidal detachments and delayed suprachoroidal hemorrhage may occur while the eye is soft. To maintain intraocular pressure (IOP) in the early postoperative period, the authors used a technique to seal the drainage tube with a Vicryl tie, combined with injection of sodium hyaluronate, sulfur hexafluoride (SF6), or perfluoropropane (C3F8), perioperatively in 28 eyes undergoing glaucoma tube implant surgery. Eight eyes were treated with injection of sodium hyaluronate, 8 with SF6, and 12 eyes with C3F8. Hypotony was significantly less frequent in eyes treated with C3F8 compared with sodium hyaluronate (P less than 0.05). Mean IOP was significantly higher for eyes treated with C3F8 injection compared with sodium hyaluronate for the first 4 days after surgery (P less than 0.05).     

BUILDING COMMUNITY: Developing Skills for Interprofessional Health Professions Education and Relationship-Centered Care

In 1995, the National League for Nursing commissioned a Panel on Interdisciplinary/Transdisciplinary Education. The focus of the Panel's work was to examine educational issues that transcend the health professions and to make recommendations for future implementation of an interdisciplinary approach to addressing them. This article is being simultaneously published by several professional journals. The goal is to seek as much feedback as possible.     

Hemorrhagic cerebral infarction in pediatric patients

Two patients with ischemic strokes, presumably due to embolism, developed spontaneous hemorrhagic cerebral infarctions which were detected by follow-up cranial computed tomography. Clinical deterioration was associated with hemorrhagic transformation in one patient. In each case, immediate anticoagulant therapy was considered but was deferred. Implications of the use of anticoagulant therapy in pediatric patients with acute embolic stroke are discussed.     

Outcomes of Project Wall Talk: an HIV/AIDS peer education program implemented within the Texas State Prison system.

We report select outcomes from an evaluation of Project Wall Talk, a community-based, peer-led HIV prevention education program implemented in 36 Texas State prison units. Peer educators completed questionnaires prior to receipt of a 40-hour intensive training (N = 590) and at 9-month follow-up (N = 257). Students (N = 2506) completed questionnaires pre- and post-receipt of peer educator-led HIV education sessions. Peer educators and their students showed significant increases in HIV-related knowledge. Peer educators showed significant increases in assessment of their skills as educators. For both peer educators and students, significant differences in HIV-related knowledge were indicated across categories of prior educational level attained and race/ethnicity; no such differences were indicated at follow-up. Compared with baseline, a significantly greater proportion of peer educators reported ever having had an HIV test. After receiving peer-led education, a significantly smaller proportion of students reported they knew their HIV status and more indicated plans to take an HIV test. Additionally, in months 12 and 18 following program implementation, the numbers of HIV tests at the five units that implemented the peer education program were roughly twice that of five, matched comparison units without the peer education program. Based on peer educator reports, we projected that peer educators (N = 257) may have as many as 84,000 or more annual opportunities to share HIV-related knowledge with other prisoners outside the classroom.