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Innovative new tools today allow better clinical evaluation. Indeed, new information and communication technology is particularly interesting for the screening, monitoring and management of neuropsychiatric disorders of the elderly. A personalised approach to patients can further enhance their adherence and involvement.

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"Fetal alcohol spectrum disorders" is a nondiagnostic umbrella term encompassing the wide variations in clinical presentation among individuals that are prenatally exposed to alcohol. This article discusses brain development and central nervous system abnormalities and reviews prevention and interventions for these neurologic manifestations.

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In 2007, the Neuroscience Nursing Foundation (NNF) convened a research panel to update NNF's research priorities used to guide funding. The research panel identified leaders in neuroscience nursing and conducted a review of neuroscience nursing research literature and an American Association of Neuroscience Nurses membership survey on research priorities. A workgroup of leaders in neuroscience nursing was then convened to draft and set priorities on the basis of the review of the literature and the membership survey. The updated priorities were submitted to the NNF Board of Trustees for approval. The revised document reviews the mission of NNF and outlines six strategies and five program areas (including specific subareas) that represent priorities for NNF research funding. The purpose of the updated priority document is to provide guidelines for the systematic development of knowledge in neuroscience nursing through the encouragement of selected neuroscience nursing research activities.

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In the past 25 years, remarkable progress has been made in our understanding of genomics and its influence on central nervous system diseases. In this chapter, common diseases of the central nervous system will be reviewed along with the genomics associated with these diseases. The diseases/injuries that will be investigated include neurovascular disorders such as ischemic stroke, hemorrhagic stroke, subarachnoid hemorrhage, and traumatic brain injury. This chapter will also explore Apolipoprotein E (APOE), a 299-aminoacid protein encoded by the APOE gene, and its associations with many of the previously named diseases. APOE was first tied to the risk of Alzheimer's disease and has since then been investigated in traumatic brain injury and hemorrhagic strokes. In addition, we will discuss the future of genomic research in central nervous system diseases.

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This descriptive study evaluated concepts relating to end-of-life care addressed in Journal of Neuroscience Nursing during a 10-year period. An analysis of 377 articles published from 1993 to 2002 found 40 articles addressing some area of end-of-life content. Of 2,558 pages reviewed, 201 pages (7.8%) contained end-of-life content. The primary areas of end-of-life care discussed in the articles were needs assessment for families, coping strategies and support systems, and recognition of family and caregiver needs. The most common diseases and disorders addressed were epilepsy, stroke, traumatic brain injury, multiple sclerosis, and Parkinson's disease. To increase overall content in the field of palliative and end-of-life care, authors can include end-of-life content in articles submitted for publication.

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The evolution of the neuroscience education team has been a very positive development at our institution. In addition to their other daily responsibilities, the team members coordinated the orientation of 80 new staff members hired in a 2-year period. This diverse group presented challenges, but the overall outcome was increased staff retention. The team has seen new staff hires grow into competent neuroscience nurses.

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Hemodynamic monitoring in the care of the critically ill neuroscience patient provides information that assists the clinician in minimizing secondary neuronal injury. Whereas no technology replaces the critical care nurse's physical assessment, hemodynamic and neurological monitoring provides additional data beyond what is possible with the clinical examination alone. If neurological technology, such as intracranial pressure monitoring, is not available, hemodynamic monitoring along with the neurological examination provides limited but useful information essential to minimizing secondary neuronal injury. The use of hemodynamic monitoring in critically ill neuroscience patients is best exemplified in the management of cerebral vasospasm after aneurysmal subarachnoid hemorrhage. Although improved outcomes have not been scientifically substantiated, multimodality monitoring of intracranial dynamics and systemic hemodynamics and manipulation of these parameters during hypertensive hypervolemic hemodilution therapy may lessen the incidence of cerebral infarction secondary to vasospasm. Monitoring systemic hemodynamics and intracranial dynamics simultaneously assists in prevention, prompt recognition, and effective treatment of neurological deterioration.

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Guillain-Barré syndrome is a rare neurological disease that causes paralysis and may necessitate hospitalization for some patients in its acute stages. It primarily affects the peripheral nervous system, though recent research has shown that for some patients, the central nervous system is involved. The acute phase often requires intensive care services. Recognition is growing that recovery is not as smooth and free of symptoms as previously thought. Following "recovery" some people endure long-term residual symptoms, such as fatigue and pain. Nursing input can be of value by providing support, information, explanations, and empathy to reassure patients and families. A greater understanding of the nature and course of the disease and its ramifications can lead to more effective nursing management and a faster rehabilitation process.

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OBJECTIVES: To review the symptoms frequently observed with brain tumors, focusing on the descriptions, causes, treatments, and nursing implications. DATA SOURCES: Research and review articles and textbooks. CONCLUSION: Patients with brain tumors commonly have symptoms caused by the tumor or treatment. Treatment approaches for these symptoms will help the patient cope with those impairments caused by the symptoms. IMPLICATIONS FOR NURSING PRACTICE: The nurse can help move the patient toward a good quality of life by being aware of the symptoms and setting a plan to manage the symptoms with a patient and caregiver. Periodic reassessment is required to maintain continuity of care.

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This study explores the experiences of family members of patients with an emergent admission into a neurological intensive care unit. A descriptive, exploratory, multiple-case design was used. Participant observation and semistructured interviews were used to capture the experiences of families. Analysis revealed the "bedside phenomenon," which offers insight into families' desire to be at the bedside. The phenomenon is twofold, in that families are motivated by two goals to be at the bedside: They want to ensure their loved one is receiving the best care possible, and they want to maintain a connection with the person. Nurses who understand and recognize this phenomenon may be better positioned to work with families to achieve these goals.

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The aim of the study was to determine the degree of psycho-social independence among neurological patients. The study was conducted by means of the Neurological Patients' Psycho-Social Independence Scale developed by the author, and covered 120 patients--51 males and 69 females aged 21-72; unmarried--34 and married--86, with the level of education: elementary--33, secondary school--79 and university--8; who had cerebral stroke--67, multiple sclerosis--31, radicular syndrome--22. During the first stage of the study psycho-social independence remained primarily on the medium level with respect to the knowledge concerning life style, apart from the consumption of alcohol, strong tea and coffee, the patients showing a good knowledge of this problem prior to the implementation of the education programme. With respect to skills and the remaining psycho-social aspects (motivation, self-acceptance, social functioning, intellectual efficiency) the respondents represented primarily a very high or high level during the second study. Unfortunately, a considerable number of patients still showed a medium or low level. Population who represented a very high and high levels of psycho-social independence, increased by 25.0%.

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Both gastric and duodenal feeding tubes are used to provide enteral nutrition. Most studies comparing the two methods have focused primarily on rates of complications, rather than on nutritional outcomes, and show no difference in complications between the two methods. It is not clear which feeding route provides the best nutritional outcomes. The primary purpose of this randomized clinical pilot study was to compare the percentage of recommended calories and protein received by patients with neurological disease being fed enterally via gastric or duodenal feeding tubes. Secondary aims were to compare the following between groups: physiological effects of feeding, reasons for delay in feeding, volume of feeding residual, number of feeding tubes replaced, cost of feeding, and number and types of complications. A convenience sample of 25 neuro intensive care unit patients was randomly assigned to gastric or duodenal feeding. Enteral feeding was ordered by using a standardized prescription formula and provided by the nursing staff. Serum albumin and prealbumin levels were measured at baseline, day 3, and day 10. Nitrogen balance was measured on day 10. Enteral feeding data were collected daily. No significant differences were found between gastric and duodenal groups in nutritional outcomes, including percentage of recommended calories and protein received, physiological effects of feeding, reasons for delay in feeding, feeding residual, number of feeding tubes replaced, cost of feeding, and number and types of complications. Neither group achieved mean recommended caloric or protein intake during the 10 days of the study. Further research is needed to address how recommended nutrients can be provided enterally in a more timely and complete manner in critically ill NICU patients.

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Benign prostatic hypertrophy (BPH) is the most common benign tumor in men. It is a regional nodular growth of the prostate gland causing symptoms of urinary hesitancy and frequency. Transurethral resection of the prostate (TURP) is the definitive treatment for BPH. Absorption of large amounts of irrigating fluid can cause serious cardiovascular and central nervous system complications known as TURP syndrome. Close attention and assessment of the patient's vital signs and mental status by the registered nurse can increase the early detection and treatment of TURP syndrome. This is a US government work. There are no restrictions on its use.

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This study examined the waiting experiences of 12 families following a sudden unexpected neurological intensive care unit (ICU) hospitalization. Using a phenomenological approach, family experiences were collected and analyzed. The major themes of uncertainty and searching for meaning depict the lifeworld of family waiting during critical illness. By understanding and entering a family's experience of waiting, ICU nurses can have a pivotal role in empowering families.

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