Acquired brain injury

获得性脑损伤
  • 文章类型: Journal Article
    获得性脑损伤(ABI),由于中风或创伤性脑损伤,引起一系列神经心理损伤,许多患者在发病后数年继续出现神经心理缺陷。人口平均年龄的增加凸显了有效管理策略对ABI后果的重要性。尽管康复干预措施的影响有据可查,神经心理康复的成本效益在很大程度上仍然未知.这项研究进行了范围审查,以更新Stolwyk等人的发现。(神经心理康复,2021,31,316),重点是ABI患者神经心理康复的经济评估。遵循PIO框架,PRISMAScR指南,和系统审查报告清单,该综述筛选了1027篇文章,包括2019年至2024年间发表的8项研究。这些研究包括语言康复或一般神经心理学项目,包括神经心理学干预。经济分析,包括两个成本效益,五个成本效用,和一项成本效益研究,主要遵守CHEERS准则,提高报告的透明度和方法的严谨性。这些研究表明,针对卒中后语言障碍和ABI的神经心理康复的干预措施具有不同程度的成本效益。观察到显著的成本节约和健康益处,特别是家庭康复干预。纳入的研究时间很短,限制捕捉干预措施的长期经济影响和有效性的能力。未来的研究应侧重于长期随访数据,并包括更广泛的搜索策略,以增进理解和优化医疗保健干预措施。全面实施这些经济分析对于告知决策者至关重要,使他们能够根据确凿的证据引入康复干预措施。
    Acquired brain injuries (ABI), resulting from stroke or traumatic brain injury, cause a range of neuropsychological impairments and many patients continue to experience neuropsychological deficits years after onset. The increasing average age of the population highlights the importance of effective management strategies for the consequences of ABI. Despite the well-documented impact of rehabilitation interventions, the cost-effectiveness of neuropsychological rehabilitation remains largely unknown. This study conducted a scoping review to update the findings of Stolwyk et al. (Neuropsychological Rehabilitation, 2021, 31, 316), focusing on the economic evaluations of neuropsychological rehabilitation for individuals with ABI. Following the PIO framework, PRISMA ScR guidelines, and systematic review reporting checklist, the review screened 1027 articles and included eight studies published between 2019 and 2024. The studies encompassed either language rehabilitation or general neuropsychological programs, including neuropsychological interventions. The economic analyses, including two cost-effectiveness, five cost-utility, and one cost-benefit study, mostly adhered to CHEERS guidelines, enhancing the transparency and methodological rigour of their reporting. These studies demonstrated varying degrees of cost-effectiveness for interventions targeting post-stroke language disorders and neuropsychological rehabilitation for ABI, with significant cost savings and health benefits observed, particularly for home-based rehabilitation interventions. The included studies suffered from a short time horizon, limiting the ability to capture the long-term economic impacts and effectiveness of the interventions. Future research should focus on longer-term follow-up data and include broader search strategies to enhance understanding and optimise health care interventions. A comprehensive implementation of these economic analyses is crucial for informing policymakers, enabling them to introduce rehabilitative interventions based on solid evidence.
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  • 文章类型: Journal Article
    这项研究试图了解协作护理网络中知识的力量,通过结合交叉性和认知(正义)来为设计护理网络中的成功协作提供见解。成为患有获得性脑损伤(ABI)的人的非正式照顾者会对日常生活造成严重破坏。具有迁移背景的专业人员和护理人员之间的合作可能会导致护理网络中的不公正和不公平情况。护理者的经验是由多样性的各个方面形成的,这些方面受护理网络中的权力结构和社会(正义)过程的影响。在这项研究中,交叉性被用来对照顾者经验的不同活动层产生复杂的深入见解,并专注于组内差异。交叉性与认知(正义)的理论概念相结合,以解开协作护理网络中的潜在动力,从而理解了具有迁移背景的护理人员通常不被视为现实的知识。这项在2019年至2022年期间在荷兰进行的定性研究纳入了三次非正式小组对话(N=32),半结构化访谈(N=21),和三个对话会议(N=7),照顾者照顾有ABI的人。一个关键的朋友和实践社区,和照顾者在一起,专业人士,和护理接受者(N=8),为分析做出了贡献。三个相互关联的主题被确定为构成照顾者经验的不同层次:(a)我需要继续前进,专注于照顾者的个人经历以及经历与照顾者的社会定位如何相关;(b)共同照顾的斗争,显示家庭成员对照顾者的期望如何增加照顾者的负担;和(C)信任是一种平衡行为,围绕专业人员的支持如何塑造护理人员的经验,在这种情况下,信任专业人员的支持对护理人员来说是具有挑战性的,以及这种信任如何受到组织和政策层面的环境因素的影响。总的来说,护理组织内部对多样性响应政策的需求是显而易见的。有迁移背景的照顾者需要被倾听,这样他们才能有意义地定制照顾,以满足接受者的需求。
    This study tries to understand the power of knowledge within collaborative care networks to provide insights for designing successful collaboration within care networks by combining intersectionality and epistemic (in)justice. Becoming an informal carer for someone with an acquired brain injury (ABI) causes a dramatic disruption of daily life. Collaboration between professionals and carers with a migration background may result in unjust and unfair situations within care networks. Carer experiences are shaped by aspects of diversity which are subject to power structures and processes of social (in)justice in care networks. In this study, intersectionality was used to both generate complex in-depth insights into the different active layers of carer experiences and focus on within-group differences. Intersectionality was combined with the theoretical concept of epistemic (in)justice to unravel underlying dynamics in collaborative care networks contributing to the understanding that carers with a migration background are often not seen as \'knowers of reality.\' This qualitative study conducted in the Netherlands between 2019 and 2022 incorporated three informal group conversations (N = 32), semi-structured interviews (N = 21), and three dialogue sessions (N = 7) with carers caring for someone with an ABI. A critical friend and a community of practice, with carers, professionals, and care recipients (N = 8), contributed to the analysis. Three interrelated themes were identified as constituting different layers of the carer experience: (a) I need to keep going, focusing on carers\' personal experiences and how experiences were related to carers social positioning; (b) the struggle of caring together, showing how expectations of family members towards carers added to carer burden; and (c) trust is a balancing act, centering on how support from professionals shaped carers\' experiences, in which trusting professionals\' support proved challenging for carers, and how this trust was influenced by contextual factors at organizational and policy levels. Overall, the need for diversity-responsive policies within care organizations is apparent. Carers with a migration background need to feel heard so they can meaningfully tailor care to meet recipients\' needs.
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  • 文章类型: Journal Article
    背景:患有获得性脑损伤(ABI)的人可能会遇到并发疾病,例如,心理健康和物质使用问题,这需要专门的护理。有些服务旨在分别为患有ABI和这些疾病的人提供支持;但是,对这些服务的促进者和障碍知之甚少。因此,本研究的目的是让利益相关者参与调查ABI和并发问题的医疗服务的促进因素和障碍.
    方法:半结构化焦点小组是亲自进行的,并且几乎与ABI患者进行,看护者,医疗保健专业人员,和政策制定者在不列颠哥伦比亚省举行的为期一天的活动中,加拿大。清单内容分析以建构主义的观点用于分析数据。
    结果:90名参与者(包括34名ABI患者)在15个同时进行的焦点小组中提供了见解。确定了三个类别:(1)ABI的复杂性,(2)支架,(3)护理结构。ABI的复杂性概述了ABI之后持续的基本需求,并强调了公众对ABI认识的必要性。支持概述的医疗保健专业和基于社区的支持。护理结构描述了ABI患者需要满足支持标准,通过系统导航的经验和综合服务的必要性。
    结论:这些发现突出了ABI和并发疾病的医疗服务的促进因素和障碍,并提供了对可能需要的变化的见解。这样做可以提高ABI医疗保健服务的可及性和质量。
    BACKGROUND: People with acquired brain injury (ABI) may experience concurrent conditions such as, mental health and substance use concerns, that require specialized care. There are services that aim to support people with ABI and these conditions separately; however, little is known about the facilitators and barriers of these services. Therefore, the purpose of this study was to engage stakeholders to investigate the facilitators and barriers of healthcare services for ABI and concurrent issues.
    METHODS: Semi-structured focus groups were conducted in-person and virtually with people with ABI, caregivers, healthcare professionals, and policy makers during a one-day event in British Columbia, Canada. Manifest content analysis was used with a constructivist perspective to analyze data.
    RESULTS: 90 participants (including 34 people with ABI) provided insights during 15 simultaneous focus groups. Three categories were identified: (1) complexity of ABI, (2) supports, (3) structure of care. Complexity of ABI outlined the ongoing basic needs after ABI and highlighted the need for public awareness of ABI. Supports outlined healthcare professional and community-based supports. Structure of care described people with ABI needing to meet criteria for support, experiences of navigating through the system and necessity of integrated services.
    CONCLUSIONS: These findings highlight the facilitators and barriers of healthcare services for ABI and concurrent conditions and provide insights into the changes that may be needed. Doing so can improve the accessibility and quality of ABI healthcare services.
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  • 文章类型: Journal Article
    患有获得性脑损伤(ABI)的人通常具有社会认知(SC)缺陷。SC受损会导致个人在日常工作中遇到困难,并可能导致社会孤立。针对ABI患者的SC康复的研究很少,几乎总是仅针对这种能力的一个组成部分。
    这项试点研究旨在评估新的“SocialMind”计划在改善ABI患者SC的所有核心组成部分方面的有效性。
    该研究包括31名患有ABI的参与者,分为实验组和对照组。这项研究历时44周,涉及初次会议,评估,培训,和最终评估阶段。SocialMind计划,分为四个模块,每个持续时间为30小时,通过量身定制的练习针对每个SC组件。该程序解决了情感识别,社会意识,ToM,和同理心。
    SocialMind小组在情感识别方面表现出显着改善(p=0.017),社会知识(p<0.001),与对照组相比,同理心(p=0.001)。ToM还显示出接近显著性的显著改善(p=0.057)。
    这项初步研究表明,SocialMind计划有效地增强了ABI患者的SC四个核心组成部分中的三个。
    UNASSIGNED: People with acquired brain injury (ABI) often have Social Cognition (SC) deficits. Impairment of SC causes the individual to have difficulties in daily functioning and can lead to social isolation. Research aimed at rehabilitation of SC in individuals with ABI is scarce and almost always addresses only one component of this ability.
    UNASSIGNED: This pilot study aimed to assess the effectiveness of the new \"SocialMind\" program in improving all core components of SC in people with ABI.
    UNASSIGNED: The study included 31 participants with ABI, divided into experimental and control groups. The study spanned 44 weeks, involving an initial meeting, evaluation, training, and final assessment phases. The SocialMind program, structured into four modules, each with a duration of 30 h, targeted each SC component through tailored exercises. The program addressed emotion recognition, social awareness, ToM, and empathy.
    UNASSIGNED: The SocialMind group demonstrated significant improvements in emotion recognition (p = 0.017), social knowledge (p < 0.001), and empathy (p = 0.001) compared to the control group. ToM also showed a notable improvement that approached significance (p = 0.057).
    UNASSIGNED: This pilot study suggests that the SocialMind program effectively enhances three of the four core components of SC in individuals with ABI.
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  • 文章类型: Journal Article
    疲劳在儿科获得性脑损伤(ABI)后很常见,会对生活质量产生负面影响。尽管如此,目前,临床医生对康复治疗中疲劳的评估和管理方法了解有限.这项研究探讨了澳大利亚康复临床医生如何认识,评估,并管理儿科ABI后的疲劳。使用定性研究设计,我们对11名临床医师进行了半结构化访谈,这些医师与ABI患儿(0-18岁)一起从事康复治疗.使用建构主义扎根理论方法对访谈笔录进行了分析。制定了两个主要主题和子主题:(1)达成共同的理解:识别和理解疲劳;与儿童及其家人一起打开疲劳;(2)利用共同的理解:临床医生合作管理疲劳;通过过渡计划和支持儿童及其家庭;预测和解决问题的速度颠簸。参与者反映了在每个孩子的独特背景下达成对疲劳的共同理解的重要性,需要孩子的共同努力,家庭,学校,和跨学科康复团队,随着时间的推移,一起解决问题和管理疲劳。这些发现从康复临床医生的角度提供了对评估和管理疲劳过程的见解,并强调了合作方法在儿童康复期间支持个人需求的重要性。
    Fatigue is common following paediatric acquired brain injury (ABI) and can negatively impact quality of life. Despite this, there is limited understanding of how clinicians currently assess and manage fatigue in rehabilitation. This study explored how Australian rehabilitation clinicians recognize, assess, and manage fatigue following paediatric ABI. Using a qualitative research design, semi-structured interviews were conducted with 11 clinicians who work with children (0-18 years) with ABI in rehabilitation. Interview transcripts were analysed using constructivist grounded theory methods. Two main themes and sub-themes were developed: (1) Reaching a shared understanding: Identifying and understanding fatigue; Unpacking fatigue with children and their families; and (2) Using the shared understanding: Clinicians working collaboratively to manage fatigue; Planning for and supporting children and their family through transitions; Anticipating and problem-solving speedbumps. Participants reflected on the importance of reaching a shared understanding of fatigue within each child\'s unique context, requiring the collaborative effort of the child, family, school, and interdisciplinary rehabilitation team, to problem-solve and manage fatigue together over time. These findings provide insights into the processes of assessing and managing fatigue from rehabilitation clinicians\' perspectives and highlight the importance of a collaborative approach to support the individual needs of the child during their rehabilitation.
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  • 文章类型: Journal Article
    目的:确定并绘制促进获得性脑损伤(ABI)或恶性脑肿瘤(MBT)患者亲属受累的干预措施的证据。
    背景:ABI或MBT是严重的疾病,对患者及其亲属的生活产生深远影响。病人的健康状况可能会恶化,和亲戚可能会经历一个新的角色和变化的照顾任务。亲属的参与似乎是必不可少的,并且有必要确定促进参与的干预措施。
    方法:范围审查。
    方法:本综述使用了JoannaBriggsInstitute方法,并根据PRISMA扩展范围审查报告了该综述。
    方法:文献检索在MEDLINE,Embase,CINAHL和Cochrane图书馆。纳入研究的参考清单,还搜索了GoogleScholar和WebofScience。
    结果:总计,纳入46项研究,其中36项(78%)涉及卒中患者。研究干预的中位持续时间为8周,在23项(50%)研究中,护士作为干预提供者参与.30项(65%)研究使用了多组分干预。使用60个独特的结果测量结果确定了35个独特的结果。
    结论:促进亲属参与的干预措施在研究干预措施的关键特征上存在重要差异,以及与使用它们的上下文有关。在结果选择和结果测量方面没有达成共识。我们的结果强调了该领域干预措施的复杂性。
    据我们所知,这是第一次范围审查,检查促进获得性脑损伤或恶性脑肿瘤患者亲属参与的干预措施。这篇综述提出了在未来研究中对“参与”的明确定义,并且需要开发用于促进参与的干预措施的核心结果集。
    范围审查是根据PRISMA范围审查扩展报告的。
    作者决定在没有患者和公众贡献的情况下进行这项范围审查。然而,该方案是在审查之前发布的,并向公众开放,但我们没有收到任何意见。
    OBJECTIVE: To identify and map the evidence on interventions facilitating the involvement of relatives of patients with an acquired brain injury (ABI) or a malignant brain tumour (MBT).
    BACKGROUND: An ABI or a MBT are severe diseases that have profound impact on the lives of patients and their relatives. The well-being of the patient may be deteriorated, and relatives may experience a new role and changing caregiving tasks. Involvement of relatives seems essential, and there is a need for identifying interventions facilitating the involvement.
    METHODS: Scoping review.
    METHODS: The Joanna Briggs Institute methodology was used in this review and the review was reported in accordance with the PRISMA extension for scoping reviews.
    METHODS: The literature search was conducted in MEDLINE, Embase, CINAHL and Cochrane Library. Reference lists of included studies, Google Scholar and Web of Science were also searched.
    RESULTS: In total, 46 studies were included of which 36 (78%) involved patients with stroke. Median duration of study interventions were 8 weeks, and nurses were involved as providers of the intervention in 23 (50%) studies. Thirty (65%) studies used a multicomponent intervention. Thirty-five unique outcomes were identified using 60 unique outcome measurements.
    CONCLUSIONS: Interventions facilitating the involvement of relatives differed importantly in key characteristics of study interventions, and in relation to the context in which they were used. There was no consensus regarding choice of outcomes and outcome measurements. Our results highlight the complexity of interventions in this field.
    UNASSIGNED: To our knowledge this is the first scoping review examining interventions facilitating the involvement of relatives of patients with an acquired brain injury or a malignant brain tumour. This review suggests a clear definition of \'involvement\' in future research and there is a need of development of a core outcome set for use in interventions facilitating the involvement.
    UNASSIGNED: The scoping review was reported in accordance with the PRISMA extension for scoping reviews.
    UNASSIGNED: The authors decided to undertake this scoping review without patient and public contribution. However, the protocol was published prior to review conduct and available to the public but we did not receive any comments on it.
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  • 文章类型: Journal Article
    获得性脑损伤(ABI)社区支持计划旨在通过信息和社会心理支持来帮助支持长期需求。由于COVID-19大流行,许多支持程序采用虚拟程序交付。然而,参与虚拟支持计划的主持人和ABI患者的经验未得到充分研究。这项研究旨在描述ABI患者和参与虚拟ABI社区支持计划的计划促进者的经历。
    这是一项定性的描述性研究。与ABI人员和参与虚拟ABI社区支持计划的计划主持人进行了半结构化访谈。采用归纳主题分析法对数据进行分析。
    总共,16名参与者被纳入本研究。在16名参与者中,14人是ABI患者(其中3人也是项目主持人),2人是没有ABI的项目主持人。我们的分析产生了三个主题,包括感知收益(主题1),感知的挑战(主题2),以及提高节目质量的考虑(主题3)。每个主题都概述了传达参与者经验的子主题。
    这些发现强调了利益相关者需要为计划主持人和虚拟ABI支持计划的参与者实施指南和培训,以最大程度地提高可访问性,可用性,包容性和安全性。对康复的影响本研究描述了患有获得性脑损伤的人和参与虚拟支持计划的促进者的经历。虚拟支持计划的好处包括与对等方连接,增加对资源的访问,并增强了可行性和可及性。虚拟支持计划的困难包括内部人(例如,副作用增加),人际关系(例如,沟通障碍),以及环境和上下文(例如,隐私问题)挑战。改善计划质量的建议包括创造一个安全和尊重的环境,促进参与和管理具有挑战性的情况,并增强可达性和包容性。
    UNASSIGNED: Acquired brain injury (ABI) community support programs aim to help support long-term needs through informational and psychosocial support. Due to the COVID-19 pandemic, many support programs adopted virtual program delivery. However, the experiences of facilitators and people with ABI who participate in virtual support programs are understudied. This study aimed to describe the experiences of people with ABI and program facilitators participating in virtual ABI community support programs.
    UNASSIGNED: This was a qualitative descriptive study. Semi-structured interviews were conducted with people with ABI and program facilitators who participated in virtual ABI community support programs. Data were analyzed using inductive thematic analysis.
    UNASSIGNED: In total, 16 participants were included in this study. Of the 16 participants, 14 were people with ABI (three of whom were also program facilitators) and two were program facilitators without ABI. Our analysis generated three themes including perceived benefits (theme 1), perceived challenges (theme 2), and considerations to improve program quality (theme 3). Each theme outlines subthemes relaying the experiences of participants.
    UNASSIGNED: These findings highlight the need for stakeholders to implement guidelines and training for program facilitators and attendees of virtual ABI support programs to maximize accessibility, usability, inclusivity and safety.IMPLICATIONS FOR REHABILITATIONThis study described the experiences of people with acquired brain injury and facilitators who participated in virtual support programs.Benefits of virtual support programs include connecting with peers, increased access to resources, and enhanced feasibility and accessibility.Difficulties with virtual support programs include intrapersonal (e.g., increased side effects), interpersonal (e.g., communication barriers), and environmental and contextual (e.g., privacy concerns) challenges.Suggestions to improve program quality include creating a safe and respectful environment, fostering engagement and managing challenging situations, and enhancing accessibility and inclusivity.
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  • 文章类型: Journal Article
    背景/目的:获得性脑损伤(ABI)是全球残疾的主要原因。许多ABI患者表现出影响其日常生活和康复结果的动眼功能障碍。当前用于动眼功能(OMF)评估的临床工具在其可用性方面受到限制。在这项原理证明研究中,我们的目标是开发一种有效的OMF筛查工具,并评估其可行性,可接受性,以及在ABI和对照参与者的小样本中的相关性。方法:我们通过回顾现有的OMF评估创建了康复眼动筛查评估(ROSE)。对ABI患者(n=10)和年龄匹配的对照(n=10)进行了ROSE的初步测试。有关评估特征的数据,比如持续时间,参与者的理解水平,还收集了参与者的经验。结果:ROSE需要<20分钟(x'=12.5),很容易完成(协议x并=4.6/5),并且是公认的(x'=4.8/5)。患者在所有子测试和总分中均得分较高(ABI与ABI的x'=34.88.9用于控件)。大多数子测试没有引起任何症状,尤其是控制。症状激发的组间差异无统计学意义。这项原理验证研究表明,ROSE是可行的,可接受,与成人ABI患者相关。结论:ROSE需要进一步评估,以便在更大的样本和不同的神经系统疾病中进行可靠性测试和验证。建立各种年龄的规范,性别,应考虑将ROSE部署为OMF临床工具。
    Background/Objectives: Acquired brain injury (ABI) is a major cause of global disability. Many ABI patients exhibit oculomotor dysfunctions that impact their daily life and rehabilitation outcomes. Current clinical tools for oculomotor function (OMF) assessment are limited in their usability. In this proof-of-principle study, we aimed to develop an efficient tool for OMF screening and to assess the feasibility, acceptability, and relevance in a small sample of ABI and control participants. Methods: We created the Rehabilitation Oculomotor Screening Evaluation (ROSE) by reviewing existing OMF assessments. ROSE was pilot-tested on ABI patients (n = 10) and age-matched controls (n = 10). Data regarding the characteristics of the assessment, such as the duration, level of participant comprehension, and participant experience were also collected. Results: ROSE takes <20 min (x¯ = 12.5), is easy to complete (agreement x¯ = 4.6/5), and is well-accepted (x¯ = 4.8/5). Patients scored higher in all subtests and total score (x¯ = 34.8 for ABI vs. 8.9 for controls). Most subtests did not provoke any symptoms, especially for controls. There were no significant between-group differences in symptom provocation. This proof-of-principle study shows that ROSE is feasible, acceptable, and relevant for adult ABI patients. Conclusions: ROSE needs further evaluation for reliability testing and validation in larger samples and diverse neurological conditions. Establishing norms for various ages, sexes, and populations should be considered for the deployment of ROSE as an OMF clinical tool.
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  • 文章类型: Journal Article
    尽管有迹象表明,由于故意自我伤害而导致的获得性脑损伤(ABI)患者的表现更为复杂,康复效果较低(Brenner,2009)1,有一些名义上发表的文献考虑了对这些个体的护理调整。一个多层面和情感触发的主题,结合了临床和伦理考虑,缺乏已发表的文章可能表明围绕这一主题的复杂性。
    这个案例研究反映了一名在专科脑损伤病房的年轻人的护理,他在严重药物过量后出现了毁灭性的身体和认知障碍。因为患者无法做出明智的治疗选择,所有的医疗服务都是为了患者的最佳利益而提供的,同时人们对继续挽救生命的治疗和升级计划的价值存在疑问和怀疑。
    本文不是为了捍卫或质疑在该患者护理期间做出的决定,但反映了这些情况对患者的复杂性和影响,家庭,和护理团队。患者的父亲批准了此病例审查出版物。
    需要进一步调查,以更好地了解该人群面临的挑战,并确定定制途径和治疗考虑因素是否有必要解决这些具体情况。
    UNASSIGNED: Despite indications that patients with Acquired Brain Injury (ABI) as a result of deliberate self-harm have more complex presentations and lower rehabilitation outcomes (Brenner, 2009)1, there is nominal published literature that considers adjustments to care for these individuals. A multifaceted and emotionally triggering subject, laced with clinical and ethical considerations, the lack of published articles may indicate the complexities surrounding this topic.
    UNASSIGNED: This case study reflects on the care of a young man on a specialist brain injury unit who had devastating physical and cognitive disabilities after a significant drug overdose. Because the patient was unable to make informed treatment choices, all medical care was delivered in the patient\'s best interest amidst questions and doubts about the value of continuing life-saving treatments and escalation plans.
    UNASSIGNED: This article is not to defend or challenge the decisions made during this patient\'s care, but reflects on the complexity and impact of these situations on the patient, the family, and the care team. The patient\'s father gave permission for this case review publication.
    UNASSIGNED: Further investigation is needed to better understand the challenges faced by this population and to determine if bespoke pathways and therapy considerations are necessary to address these specific circumstances.
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  • 文章类型: Journal Article
    低维生素D(VD)与几种神经系统疾病的临床病程不良有关。有人建议补充以改善结果。重度获得性脑损伤(sABI)受试者具有低VD水平和需要康复的致残状况。本研究的目的是评估在康复期间,补充VD是否在sABI中产生了更好的临床过程和更好的功能结果。进行随机单盲研究。sABI受试者被随机分为VD补充组(VDsG)(初始剂量为50.000UI和每日1.000)和常规护理对照组(CG)。残疾评定量表(DRS),格拉斯哥结果量表(GOS),和认知功能水平(LCF)用于评估残疾。共有73名受试者(42M和31F;平均年龄53.2±15.7)被随机分配:36(21M和15F;平均年龄57.52±14.88)至VDsG,37(20M和17F;平均年龄48.28±17.47)至CG。两组患者康复后均有明显改善,组间无差异。DRS的平均得分值,GOS,入院和出院时VDsG的LCF分别为18.83±4.27和9.42±5.83;2.89±0.32和3.78±0.80;4.81±1.70和7.53±1.28,分别。同样,DRS的平均值,GOS,CG和LCF分别为18.57±4.80和9.84±6.34;2.84±0.37和3.81±0.94;和4.97±2.01和7.41±1.32。在康复治疗期间,补充VD并不能改善sABI的功能结局。
    Low vitamin D (VD) has been associated with poor clinical course in several neurological diseases. Supplementation has been suggested to improve outcomes. Severe acquired brain injury (sABI) subjects have low VD levels and disabling conditions requiring rehabilitation. The aim of the present study was to evaluate if VD supplementation produced a better clinical course and a better functional outcome in sABI during rehabilitation. A randomized single-blind study was performed. sABI subjects were randomized to the VD supplementation group (VDsG) (initial dose of 50.000 UI and 1.000 daily) and usual care control group (CG). Disability Rating Scale (DRS), Glasgow Outcome Scale (GOS), and Level of Cognitive Functioning (LCF) were used in assessing disability. A total of 73 subjects (42 M and 31 F; mean age 53.2 ± 15.7) were randomized: 36 (21 M and 15 F; mean age 57.52 ± 14.88) to VDsG and 37 (20 M and 17 F; mean age 48.28 ± 17.47) to CG. Both groups significantly improved after rehabilitation, and no between-group difference was observed. The mean score values for DRS, GOS, and LCF in VDsG were 18.83 ± 4.27 and 9.42 ± 5.83; 2.89 ± 0.32 and 3.78 ± 0.80; and 4.81 ± 1.70 and 7.53 ± 1.28, at admission and discharge, respectively. Likewise, mean values for DRS, GOS, and LCF in CG were 18.57 ± 4.80 and 9.84 ± 6.34; 2.84 ± 0.37 and 3.81 ± 0.94; and 4.97 ± 2.01 and 7.41 ± 1.32, respectively. VD supplementation did not improve functional outcomes in sABI during rehabilitation treatment.
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