Axone (Dartmouth, N.S.)最新文献

In this era of health care reform and restraint, there is a resurgence of interest in health promotion and injury prevention. This renewal has added another dimension to the practice of nursing--the expectation that health teaching is included in our interactions with families. This paper will explore submersion injuries in children which, according to Brill, (1987) are uniquely preventable. The ultimate aim of discussing this topic is an increased commitment by nurses to the prevention of submersion injuries.

At least four percent of children have recurrent headaches and migraine is the most frequent cause. Migraine and tension-type headaches may co-exist. A variety of factors, specifically dietary and stressors (at home and at school) have been recognized as triggers. We have reviewed the role of the Neurosciences Nurse Clinician in the management of children with recurrent headaches in our Pediatric Neurology Outpatient Clinic. About 150 children with headache are seen in our clinic annually. The Nurse Clinician complements the Pediatric Neurologist's role in the following ways: 1) Provides educational material and reinforces the benign nature of the headache (i.e. absence of serious cause); 2) Discusses potential role for triggers; 3) Provides and emphasizes the importance of keeping a headache diary: teaches children and caregivers how triggers may be identified; 4) Makes follow-up telephone calls to determine changes in headache frequency/ severity. This approach minimizes the need for prophylactic medication (less than 25% of children we see require such treatment) and reduces the number of follow-up visits to Pediatric Neurologist and other physicians, thus minimizing health care costs.

A healthy conception of oneself is central to coping effectively with the day to day stresses of modern living. The onset of any neurological disease, with either actual visible deficits or potential future disability, threatens the integrity of that concept. This paper explores the concept of self-esteem. Alterations in self-esteem occur as a result of both internal or personal expectations and external or societal expectations. Manifestations of an altered self-esteem include self-negating verbalizations, reduced social interactions, lack of eye contact during interaction, and verbalization of feelings of guilt. While the focus of this paper will be the individual with Multiple Sclerosis, the concepts discussed are applicable across the spectrum of neurological disease.

Due to the advent of antibiotics, mycotic aneurysms, also known as infective aneurysms, now represent only 2.5-5% of all aneurysms. The existing research on this topic is old and scarce. It is highly probably that a neuroscience nurse will care for this type of patient at some point during his/her career. The patient with a mycotic aneurysm is usually critically ill. A 46% mortality has been noted and is related to the multiple problems of these types of patients. Currently, if and when to surgically intervene is controversial. The case of "Mr. C.", a patient at the Montreal Neurological Hospital who developed a mycotic aneurysm secondary to subacute bacterial endocarditis, will be presented. His course in hospital, the medical management and treatment as well as the nursing care and educational needs will be described.

The vision for nursing in Nova Scotia states "We value the worth, dignity and cultural diversity of people. We create mechanisms by which we can continually develop our fullest potential as individuals and as a profession." Networking with community groups to increase health awareness and promote prevention follows this vision. Does a prevention program have an impact on our community? S.C.I.P. Nova Scotia (Spinal Cord Injury Prevention) is a volunteer community based injury prevention program which is continually evolving. Based on epidemiological information this paper will discuss the evolution of our various prevention programs due to these statistics.

Gabapentin represents a significant advance in the management of epilepsy. To date, it appears to be most useful as an add-on therapy for patients with partial seizures uncontrolled by standard anticonvulsants. Side effects are mild and often subside with continued therapy. Unlike traditional anticonvulsants, gabapentin lacks significant drug interactions.

The University of British Columbia Multiple Sclerosis (MS) Clinic was one of 11 North American sites involved in the double-blind, placebo-controlled phase III trial of Betaseron in relapsing-remitting MS. UBC participants as a unique sub-study site which required a rigorous evaluation every six weeks for the first two years. Each visit included extensive blood studies, neurological and physical exams by separate physicians. Magnetic Resonance Imaging (MRI) and evaluation by a research nurse. In addition, participants learned to administer the study medication subcutaneously every second day and keep extensive diaries of possible side effects, concomitant medications, neurological signs and symptoms, and incidental environmental events. The attrition rate was low (8%) despite the gruelling requirements of the study. As patients completed their course of therapy (and before unblinding took place) they were asked to complete a simple questionnaire about various aspects of the study. Questions explored their reasons for participation, helpfulness of preparatory information, positive and negative aspects during the trial, and their "guess" at what they were receiving. This paper will summarize the results of the questionnaires and offer suggestions for consideration when organizing long-term outpatient clinical trials.

AIDS dementia complex is one of the most common neurological problems associated with HIV-related illness. To date, the nursing care of individual with AIDS dementia complex has not been explored to any extent. As a basis for examining aspects of nursing care, the epidemiology, neuropathology, clinical presentation and diagnosis of AIDS dementia complex are reviewed and medical management considered. Using the stages of AIDS dementia complex, guidelines for nursing care are proposed. These guidelines are a basis for developing individualized care to enhance the abilities of persons with AIDS dementia complex and to support caregivers.