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PubMed2002

Proceedings of the 10th International Conference on Neuroscience of HIV Infection: emerging issues.

The 10th International Conference on Neuroscience of HIV Infection was held conjointly with the 4th International Symposium on NeuroVirology. This review summarizes a number of important topics addressed at the conference including clinical aspects of HIV-1 associated dementia and peripheral nervous system pathology and their epidemiology in the era of highly active antiretroviral therapy. The neuropathogenesis was discussed with a special focus on different cellular compartments involved, viral and non-viral factors, immune activation, and alterations of the blood-brain barrier, animal models and their relevance for understanding HIV dementia. New aspects of antiretroviral therapy as well as immunization were covered. Neuroradiological approaches including new MR techniques and neuropsychological tests were presented. Viral opportunistic infections (e.g., JCV infection resulting in progressive multifocal leukoencephalopathy) as well as coinfection with hepatitis C represented a further topic.

AIDS Dementia Complex↗

PubMed2003

Techniques for imaging neuroscience.

In the last 20 years, a number of non-invasive spatial mapping techniques have been demonstrated to provide powerful insights into the operation of the brain during task performance. These are, in order of their emergence as robust technologies: positron emission tomography, source localization with EEG and MEG, and functional magnetic resonance imaging. The imaging neuroscience study areas represented in this volume use the first or last of these - PET and fMRI. The physical principles underlying both of these techniques are outlined, and the important assumptions and limitations are made explicit. The range of applications for each is briefly indicated.

Brain↗

PubMed1996

Neuroimaging and the cognitive neuroscience of schizophrenia.

The Carmel Workshop on Cognitive Psychophysiology began in 1980, and the focus of the 1996 workshop was on schizophrenia. Research into schizophrenia is in the midst of a period of unparalleled advance, driven in large part, by improvements in neuroimaging technology that make detailed examination of in vivo brain structure and function possible. Neuroimaging studies may help provide a bridge between investigations demonstrating molecular and cellular abnormalities in schizophrenia and those demonstrating cognitive dysfunction. The workshop brought together experts in different neuroimaging modalities to present the strengths and advantages of each, as well as the insights each modality might bring into normal and schizophrenic cognitition. It began with a series of tutorials to inform participants of the state of the art in various disciplines. It then broke into four panels, each given a very specific topic assignment related to neuroimaging and/or the cognitive neuroscience of schizophrenia. After 1 1/2 days of discussion, each panel reported its conclusions to the workshop. Group I presented cellular models of the pathophysiology of schizophrenia. Group II examined experimental paradigms for studying cognitive function and schizophrenia. Group III examined technical issues in image processing and combining data across different modalities. Group IV sought to survey the current state of knowledge about the pathophysiology of schizophrenia. The conclusions of each of the groups are presented in this report.

California↗

PubMed1999

Continuous EEG monitoring in the neuroscience intensive care unit and emergency department.

This article reviews established, emergent, and potential applications of continuous EEG (CEEG) monitoring in the Neuroscience Intensive Care Unit (NICU) and Emergency Department. In each application, its goal as a neurophysiologic monitor is to extend our powers of observation to detect abnormalities at a reversible stage and to guide timely and physiologically sound interventions. Since this subject was reviewed 5 years ago, the use of CEEG monitoring has become more widespread. In a modern NICU, it is no longer novel to have CEEG data contributing to management decisions. A well-trained CEEG monitoring team is important for its optimal implementation. In the diagnosis and management of convulsive and nonconvulsive status epilepticus, its value appears established. It is finding benefit in the early diagnosis and management of precarious cerebral ischemia, including severe acute cerebral infarctions and post-SAH vasospasms. In comatose patients, it can provide diagnostic and prognostic information which is otherwise unobtainable. More recently, it has been found advantageous for targeting management of acute severe head trauma patients. Networking technology has facilitated the implementation and oversight of CEEG monitoring and promises to expand its availability, credibility, and effectiveness. The maturing of CEEG use is reflected in preliminary efforts to assess its cost benefit, cost effectiveness, and impact on patient outcomes.

Acute Disease↗

PubMed1996

Surgical neurology and clinical neurosciences in Edinburgh, Scotland.

Surgical neurology in Edinburgh started > 70 years ago with Norman Dott, after his apprenticeship with Harvey Cushing. It continued under the chairmanship of John Gillingham, until 1980, and then Douglas Miller, who merged the Departments of Surgical Neurology and Medical Neurology to form the Department of Clinical Neurosciences in 1986. Particular strengths of the Edinburgh program have been the management of intracranial aneurysms, stereotactic and functional neurosurgery, the management of head and spinal injury and stroke, and neuro-oncology.

History, 20th Century↗

PubMed1997

Advanced practice and neuroscience nursing.

In this report Calkin's model of advanced practice is used to contrast generalized/specialized and basic/advanced nursing practices. Examples of specialized and advanced practices in neuroscience nursing are described in the context of environmental forces that influence advanced practice in North America. Finally, a letter from the future is used to speculate and to illustrate visions of nursing practice in the twenty-first century.

Humans↗

PubMedDate not supplied

Neuroscience critical care: the role of the advanced practice nurse in patient safety.

The Institute of Medicine report published in 1999 described a healthcare system in which 44,000 to 98,000 patients die each year from preventable medical errors. The healthcare industry has been charged with identifying and ameliorating risks to patients. The advanced practice nurse is in the optimal position to influence the patient care environment and contribute to a culture of patient safety. This article will review the role of the advanced practice nurse in the care of the neuroscience patient in identifying risks unique to this at-risk population. There will be a discussion of risk factors that contribute to errors, with advanced practice nurse-driven, evidence-based solutions. A case presentation of the role of the advanced practice nurse in reducing the incidence of deep vein thrombosis in the craniotomy patients with malignant tumors will be discussed.

Communication↗

PubMedDate not supplied

Regional orientation program for the department of clinical neurosciences.

A regional orientation program increases the efficient and effective use of resources such as classroom, equipment, and educator time. It provides consistent information to all new nurses and maintains standards of nursing practice throughout the Department of Clinical Neurosciences.

Alberta↗

PubMed2006

Just pretty pictures? What diffusion tractography can add in clinical neuroscience.

PURPOSE OF REVIEW: Diffusion tractography uses non-invasive brain imaging data to trace fibre bundles in the human brain in vivo. This raises immediate possibilities for clinical application but responsible use of this approach requires careful consideration of the scope and limitations of the technique. RECENT FINDINGS: To illustrate the potential for tractography to provide new information in clinical neuroscience we review recent studies in three broad areas: use of tractography for quantitative comparisons of specific white matter pathways in disease; evidence from tractography for the presence of qualitatively different pathways in congenital disorders or following recovery; use of tractography to gain insights into normal brain anatomy that can aid our understanding of the consequences of localised pathology, or guide interventions. SUMMARY: Diffusion tractography opens exciting new possibilities for exploring features of brain anatomy that previously were not visible to us in vivo.

Brain↗

PubMed1985

Neuroscience nursing elective for senior nursing students.

In response to baccalaureate student requests for additional clinical experience and expanded opportunities in neurological and neurosurgical nursing, an experimental course was designed for the winter session semester in cooperation with a local teaching hospital. A three-credit elective, "Discovering Neuroscience Nursing," was offered to senior students for five weeks. The course included thirty hours of lecture and laboratory, field trips, and over 200 hours of clinical experience. A student stipend was provided by the hospital. Goals for the course centered on providing an opportunity for the student to gain competence and confidence in caring for patients with neurological dysfunctions and providing family support. Students were assigned staff nurse preceptors as they rotated to every clinical setting caring for patients with alterations to the nervous system. Evaluations from students and staff preceptors indicated the successful acceptance of the program which will be modified and continued as a senior elective.

Curriculum↗

PubMed1986

Aspects of the historical development of neuroscience nursing.

This article presents a historical review of the development of neuroscience nursing. Landmark events in neurology/neurosurgery are highlighted with particular emphasis on the evolution of nursing specialties in the field.

England↗

PubMed1987

AIDS: impact on neuroscience nursing practice.

Diseases of the central nervous system (CNS) have been recognized as an integral part of acquired immune deficiency syndrome (AIDS) since the beginning of the epidemic. This large patient population has both major physical problems and severe cognitive disabilities. Professional neuroscience nurses who are knowledgeable about and sensitive to the unique physical and emotional needs of these patients can best serve them. This article presents a care plan and case study with interventions for a patient with nervous system dysfunction attributed to AIDS.

Acquired Immunodeficiency Syndrome↗

PubMed1987

Effects of alcohol on the central nervous system: implications for the neuroscience nurse.

Alcoholism is a chronic, progressive disease that devastates the patient and family. The chronic abuse of alcohol results in a multitude of pathological changes, particularly in the central nervous system. The toxic effects of acetaldehyde, a metabolic by-product of alcohol, and alcoholic beverage congeners have been associated with pathological changes in the central nervous system. Toxic effects of alcohol and addiction to alcohol reflect central nervous system changes. The alcohol withdrawal syndrome poses a potential life-threatening complication for the alcoholic patient. This paper discusses the pathological changes in the central nervous system, pharmacology of alcohol, and the alcohol withdrawal syndrome. Nursing implications to assist the neuroscience nurse in providing a highly specialized plan of care for the alcoholic patient are presented.

Alcohol Withdrawal Delirium↗

PubMed1989

Political power for neuroscience nurses.

This article reviews the legislative process at the national level and gives individual and group strategies neuroscience nurses can utilize to influence legislators and become involved in the political arena. In addition, selected current health care legislative issues are presented along with AANN's categories for prioritizing legislative action.

Communication↗

PubMed1989

Percutaneous endoscopic gastrostomy feeding tube in neuroscience patients.

Despite a few associated complications, the PEG is considered an excellent feeding tube for long-term enteral nutritional support, especially in the patient with neurologic dysfunction. The tube can be easily removed if the patient is able to resume oral intake and no longer needs supplemental nutrition. This tube can be easily converted to a gastro-jejunal tube if it is later determined a patient needs to be fed distal to the pylorus. Neuroscience nurses should be aware of this feeding tube, its indications, method of insertion and care in order to better provide adequate and safe nutritional therapy.

Enteral Nutrition↗

PubMed1994

Neuropsychiatric nursing: a useful adjunct to comprehensive neuroscience nursing care.

Neurological illness often influences the patient's behavior either as a direct result of trauma or due to pathophysiological changes to the brain. Neurological patients also experience psychological responses to their illness resulting in a heightened potential for a dual impact on behavior. The neuropsychiatric nurse provides care to patients with severe or unusually persistent behavioral manifestations of illness. Neurologic, psychiatric, cognitive and functional assessments are completed by the neuropsychiatric nurse to obtain an accurate picture of the behavioral problem. Nursing interventions are then developed to improve functional ability and promote independence. If a neuropsychiatric nurse is not available many of these assessment skills can be employed by neuroscience nurses and implemented on neurological and neurosurgical units.

Comprehensive Health Care↗

PubMed1996

Persistent vegetative state: important considerations for the neuroscience nurse.

Persistent vegetative state is a rare condition but one which evokes many emotional, psychosocial, bioethical, legal and economic concerns. Because neuroscience nurses are among the caregivers most likely to be involved in caring for patients in PVS, they need to be knowledgeable in the diagnosis, prognosis and ethical management of these patients and be able to assist families, loved ones and surrogates make informed decisions about treatment choices.

Adult↗

PubMed1999

Organ donation and neuroscience nursing: your role in the process.

The death of a patient is seen by many nurses as the end of their interaction with the patient and family. However, the option of organ donation may extend that interaction and present another opportunity to serve as an advocate for the family, as well as for patients whom the nurse has never met. Patients who have been declared brain dead or from whom life support is going to be withdrawn following a neurological injury are potential organ donors. Although these patients and their families are frequently under the care of neuroscience nurses, all nurses need a thorough understanding of their responsibilities regarding identification and referral of potential organ donors to the designated Organ Procurement Organization (OPO). In addition, it is essential for nurses to understand the clinical presentation and determination of brain death in order to provide patient care and family education. Understanding how consent for organ donation should be obtained from families and how the organ recovery process works enables the nurse to collaborate with OPO staff and support the family in their decision regarding organ donation.

Humans↗