Wir bedanken uns bei den 14-Hirn-Trauma-Patienten, die Mitglieder des &quot;Amazing&quot; Brain Injury Survivor Support Group in Framingham, MA oder den Zugriff auf ambulante Dienste durch Spaulding Rehabilitation Hospital für die Teilnahme an der Studie, die zu diesem Papier geführt werden. Finanzierung und sonstige Unterstützung für die Studie wurden von der Brain Injury Association of Massachusetts, die Statewide Gesundheit Injury Programm des Massachusetts Rehabilitation Kommission und der Agentur für Healthcare Research in Qualität und der Schneider-Institute für Health Policy an der Heller School for Social &amp; Datenschutz und Management, Brandeis University, durch eine Doktorandenausbildung Gemeinschaft im Gesundheitswesen Forschung und politische Analyse.

<ol>
	<li>Berland, G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+view+from+the+other+side+Patients,+doctors,+and+the+power+of+a+camera.">The view from the other side Patients, doctors, and the power of a camera.</a> The New England Journal of Medicine. 357, 2533-2536 (2007).</li><li>Boyle, P. 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A., Jones, R., Jenkins, F. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+discipline+of+strategic+thinking+in+health+care.">The discipline of strategic thinking in health care.</a> Managing and leading in the allied health professions. , 191-226 (2006).</li><li>Entwistle, V., Tritter, J. Q., Calnan, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Researching+experiences+of+cancer:+the+importance+of+methodology.">Researching experiences of cancer: the importance of methodology.</a> European Journal of Cancer Care. 11, 232-2337 (2002).</li><li>Guillemin, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Understanding+illness:+Using+drawings+as+a+research+method.">Understanding illness: Using drawings as a research method.</a> Qualitative Health Research. 14, 272-289 (2004).</li><li>Hagen, C., Malkmus, D., Durham, P., Stenderup, K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> Ranchos Los Amigos cognitive levels of functioning scale (revised). , (1997).</li><li>Institute of Medicine. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> Crossing the quality chasm: A new health system for the 21st century. , (2001).</li><li>Kim, W. C., Mauborgne, R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Fair+process:+Managing+in+the+knowledge+economy.">Fair process: Managing in the knowledge economy.</a> Harvard Business Review. 75, 65-75 (1997).</li><li>Langlois, J. A., Rutland-Brown, W., Thomas, K. E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+incidence+of+traumatic+brain+injury+among+children+in+the+United+States+-+Differences+by+race.">The incidence of traumatic brain injury among children in the United States - Differences by race.</a> Journal of Head Trauma Rehabilitation. 20, 229-238 (2005).</li><li>Langlois, J. A., Rutland-Brown, W., Thomas, K. E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> Traumatic brain injury in the United States: Emergency Department Visits, Hospitalizations, and Deaths. , (2004).</li><li>Levin, T., Scott, B. M., Borders, B., Hurt, K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Aphasia+talks:+Photography+as+a+means+of+communication,+self-expression+and+empowerment+in+persons+with+aphasia.">Aphasia talks: Photography as a means of communication, self-expression and empowerment in persons with aphasia.</a> Topics in Stroke Rehabilitation. 14, 72-84 (2007).</li><li>Lorenz, L. S., Berger, R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Brain+injury+survivors:+Narratives+of+rehabilitation+and+healing.">Brain injury survivors: Narratives of rehabilitation and healing.</a> Disability in Society. , (2010).</li><li>Lorenz, L. S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Discovering+a+new+identity+after+brain+injury.">Discovering a new identity after brain injury.</a> Sociology of Health &#38; Illness. 32, 862-879 (2010).</li><li>Lorenz, L. S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Visual+metaphors+of+living+with+brain+injury:+Exploring+and+communicating+lived+experience+with+an+invisible+injury.">Visual metaphors of living with brain injury: Exploring and communicating lived experience with an invisible injury.</a> Visual Studies. 25, 210-223 (2010).</li><li>Lorenz, L. S., Kolb, B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Involving+the+public+through+participatory+visual+methods.">Involving the public through participatory visual methods.</a> Health Expectations. 12, 262-274 (2009).</li><li>Lorenz, L. S., Kolb, B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Doing+your+own+PhotoVoice+project:+A+guide.">Doing your own PhotoVoice project: A guide.</a> Brainline [Internet]. , (2009).</li><li>Lorenz, L. S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Using+fair+process+to+cross+the+quality+and+health+care+chasm:+Eliciting+the+perspective+of+traumatic+brain+injury+survivors.">Using fair process to cross the quality and health care chasm: Eliciting the perspective of traumatic brain injury survivors.</a> , (2007).</li><li>National Institutes of Health. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Rehabilitation+of+persons+with+traumatic+brain+injury.">Rehabilitation of persons with traumatic brain injury.</a> , (1998).</li><li>Oakley, A., Bendelow, G., Barnes, J., Buchanan, M., Husain, O. A. N. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Health+and+cancer+prevention:+Knowledge+and+beliefs+of+children+and+young+people.">Health and cancer prevention: Knowledge and beliefs of children and young people.</a> British Medical Journal. 310, 1029-1033 (1995).</li><li>Prigatano, G. P., Schacter, D. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> Awareness of deficit after brain injury: Clinical and theoretical issues. , (1991).</li><li>Prigatano, G. P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Work,+love,+and+play+after+traumatic+brain+injury.">Work, love, and play after traumatic brain injury.</a> Bulletin of the Menninger Clinic. 53, 414-431 (1989).</li><li>Prior, L. B. e. l. i. e. f. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=knowledge+and+expertise:+the+emergence+of+the+lay+expert+in+medical+sociology.">knowledge and expertise: the emergence of the lay expert in medical sociology.</a> Sociology of Health &#38; Illness. 25, 41-57 (2003).</li><li>Radley, A., Taylor, D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Images+of+recovery:+a+photo-elicitation+study+on+the+hospital+ward.">Images of recovery: a photo-elicitation study on the hospital ward.</a> Qualitative Health Research. 13, 77-99 (2003).</li><li>Heyden, L. B. V. a. n. d. e. r., Blondel, C., Carlock, R. S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Fair+process:+Striving+for+justice+in+family+business+family+business.">Fair process: Striving for justice in family business family business.</a> Family Business Review. 18, 1-21 (2005).</li><li>Rich, M., Lamola, S., Gordon, J., Chalfen, R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Video+intervention/prevention+assessment:+A+patient-centered+methodology+for+understanding+the+adolescent+illness+experience.">Video intervention/prevention assessment: A patient-centered methodology for understanding the adolescent illness experience.</a> Journal of Adolescent Health. 27, 155-165 (2000).</li><li>Sherry, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> If I only had a brain: Deconstructing brain injury. , (2006).</li><li>Wang, C., Burris, M. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Photovoice:+Concept,+methodology,+and+use+for+participatory+needs+assessment.">Photovoice: Concept, methodology, and use for participatory needs assessment.</a> Health Education &#38; Behavior. 24, 369-387 (1997).</li><li>Yin, R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> Case study research, design and methods. , (2003).</li></ol>

Der erste Autor bietet Schulungen in photovoice und Foto-Auslösung durch medizinische Schulen und anderen Bildungseinrichtungen Veranstaltungsorten. Der zweite Autor hat das nichts zu offenbaren.

Die Befragten werden zu Partnern und spielen die Rolle des &quot;Co-Experte&quot; Rolle in der klinischen Einstellung, wenn ihre gelebte Erfahrung gesucht wird nur der Patient kann wirklich wissen, was es heißt, mit Hirnverletzungen und Erfahrungen im Zusammenhang Pflege zu leben. Darüber hinaus scheint das Gesundheitssystem Ziel für viele Hirnverletzung Überlebenden, um die Heilung, nicht Erholung. Wiederherstellung impliziert einen Wunsch, zu einer vor der Verletzung Status zurückzukehren. Neu verletzten Patienten können in der Hoffnung, von ihren Verletzungen erholen, aber Langzeit-Überlebenden haben akzeptiert, dass sie nicht in der Lage sein, ihre früheren Status zurückzukehren. Sie sehen, wie kognitive, körperliche, emotionale und sogar spirituelle (Lorenz 2010a) Heilung. Sie empfinden, dass sie im Laufe der Zeit entwickeln, auch viele Jahre nach ihrer Verletzung weiter. Diskussion Fotografien ihres Lebens helfen können Patienten und Ärzte zu Mensch-zentrierten Problembereiche identifizieren und zu erkennen und zu schätzen Patient Fortschritte im Laufe der Zeit. Anwendung fairer Prozess der klinischen Versorgung bedeutet, dass die Patienten tief beschäftigt sind, erforscht die Art und Weise, dass ihre Erfahrung verbessert werden kann, das Verständnis der Gründe für alle klinischen Entscheidungen und akzeptieren ihre Rolle und Verantwortung. Messe-Prozess aktiviert Motivation des Patienten zur Rehabilitation Strategien befolgen und Maßnahmen ergreifen, um in ihrem Heilungsprozess. Als einen fairen Prozess gelten für klinische Versorgung, können Patienten und Anbieter Erwartungen und Ziele besser aufeinander abgestimmt werden. Das Foto wird im Mittelpunkt der Interaktion und greift in die berufliche als auch der Patient in der Erforschung Erfahrung und den Aufbau von Beziehungen. Die therapeutische Beziehung verbessert werden kann. Weitere, nach dem Kim und Mauborgne Modell, was Einstellung und Verhalten Veränderungen könnten zu besseren Ergebnissen führen. Mit fairen Prozess, kann Macht in der klinischen Interaktion inzwischen ausgewogener, da die Patienten spüren, dass sie gehört werden. Diskutieren Sie Fotografien und deren Bedeutung kann den Patienten helfen, einen Teil der Lösung, nicht nur das Problem zu werden. Mit Kameras ist nicht der einzige Weg, um ein faires Verfahren zu erreichen, und es ist nicht ein Ansatz für jeden Patienten bzw. jede Kliniker. Es ist ein Werkzeug und Methode, um Patienten engagieren, die Kommunikation zu verbessern unter schwierigen Umständen und erreichen Person-zentrierten Pflege.

using visual and narrative methods to achieve fair process in clinical care

Das Institute of Medicine hat Patienten-Zentriertheit als ein wichtiger Bereich der Verbesserung der Qualität ausgerichtet. Eine wichtige Dimension der Patienten-Bezogenheit ist die Achtung der Patienten Werte, Präferenzen und Bedürfnisse zum Ausdruck. Doch spezifische Ansätze zur Gewinnung dieser Verstehen und Übersetzen es zu einer hochwertigen Gesundheitsversorgung im klinischen Umfeld fehlen. Aus Patientensicht Qualität ist nicht ein einfaches Konzept, aber am besten ist in Bezug auf die fünf Dimensionen verstanden: technische Ergebnisse, Entscheidungs-Effizienz; Annehmlichkeiten und Komfort, Information und emotionale Unterstützung, und die allgemeine Zufriedenheit der Patienten. Andernfalls Qualität aus diesem Fünf-Punkte-Perspektive führt zu einer Fokussierung auf medizinische Ergebnisse in Erwägung ziehen, ohne Rücksicht auf die Prozesse von zentraler Bedeutung für die Qualität von der Sicht des Patienten und für die Erreichung guter Ergebnisse. In diesem Papier argumentieren wir, für die Anwendung des Konzepts des fairen Verfahrens im klinischen Umfeld. Messe-Prozess beinhaltet die Verwendung einer kooperativen Ansatz zur Erforschung diagnostischen Fragestellungen und Behandlungen mit Patienten, erklärt die Gründe für Entscheidungen, Einstellung Erwartungen über Rollen und Verantwortlichkeiten sowie der Implementierung eines zentralen Planung und laufenden Bewertung vor. Messe-Prozess öffnet die Tür zu bringen Patienten Expertise in der klinischen Situation und der Arbeit der Entwicklung von Gesundheits-Ziele und Strategien. Dieses Dokument enthält eine Schritt für Schritt erklärt, eine innovative optische Ansatz, genannt photovoice oder Foto-Erhebung, auf ein faires Verfahren in der klinischen Arbeit mit erworbener Hirnschädigung Überlebenden und anderen das Leben mit chronischen Erkrankungen zu erreichen. Die Anwendung dieses visuelle Werkzeug-und Methodik in der klinischen Einstellung zu verbessern Patienten-Provider Kommunikation; engagieren Patienten als Partner bei der Identifizierung von Herausforderungen, Stärken, Ziele und Strategien sowie die Förderung Bewertung der Fortschritte im Laufe der Zeit. Patienten fragen, Visuelles von ihrem Leben in der klinischen Interaktion bringen kann dazu beitragen, Lücken in der klinischen Wissens beleuchten, Schmiede bessere therapeutische Beziehung mit den Patienten das Leben mit chronischen Erkrankungen wie Hirn-Trauma und identifizieren Patienten-zentrierte Ziele und Möglichkeiten der Heilung. Der Prozess hier abgebildeten von Klinikern, (Hausärzte, Rehabilitationstherapeuten, Neurologen, Neuropsychologen, Psychologen und andere) die Arbeit mit Menschen mit chronischen Erkrankungen wie erworbener Hirnschädigung, psychischen Erkrankungen, körperlichen Behinderungen eingesetzt werden, HIV / AIDS, Drogenmissbrauch oder posttraumatische Belastungsstörungen, und von den Leitern der Selbsthilfegruppen für die Arten von Patienten beschrieben und ihre Familienmitglieder oder Betreuungspersonen.

Watch this Scientific Journal Video about Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care at JoVE.com

Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care

Dieses Papier stellt eine innovative visuelle Ansatz (photovoice oder Foto-Erhebung) auf ein faires Verfahren in der klinischen Versorgung zu erreichen für Patienten mit chronischen Krankheiten, beleuchten Lücken in der klinischen Wissens, Schmiede besseren therapeutischen Beziehungen und identifiziert Patienten-zentrierte Ziele und Möglichkeiten der Heilung .

Mit visuellen und narrativen Methoden auf ein faires Verfahren in der klinischen Versorgung erreichen

The Institute of Medicine has targeted patient-centeredness as an important area of quality improvement. A major dimension of patient-centeredness is ...

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Research

Education

JoVE Journal

JoVE Core

Nursing

Medicine

Unit 1

Ethical and Legal Aspects in Nursing

Healthcare Delivery Systems

SCIENTISTS IN ACTION

23.3K Aufrufe.  Brandeis University. Dieses Papier stellt eine innovative visuelle Ansatz (photovoice oder Foto-Erhebung) auf ein faires Verfahren in der klinischen Versorgung zu erreichen für Patienten mit chronischen Krankheiten, beleuchten Lücken in der klinischen Wissens, Schmiede besseren therapeutischen Beziehungen und identifiziert Patienten-zentrierte Ziele und Möglichkeiten der Heilung .

Serie: Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care

Development of an Audio-based Virtual Gaming Environment to Assist with Navigation Skills in the Blind

Audio-based Environment Simulator (AbES) is virtual environment software designed to improve real world navigation skills in the blind. Using only audio based cues and set within the context of a video game metaphor, users gather relevant spatial information regarding a building's layout. This allows the user to develop an accurate spatial cognitive map of a large-scale three-dimensional space that can be manipulated for the purposes of a real indoor navigation task. After game play, participants are then assessed on their ability to navigate within the target physical building represented in the game. Preliminary results suggest that early blind users were able to acquire relevant information regarding the spatial layout of a previously unfamiliar building as indexed by their performance on a series of navigation tasks. These tasks included path finding through the virtual and physical building, as well as a series of drop off tasks. We find that the immersive and highly interactive nature of the AbES software appears to greatly engage the blind user to actively explore the virtual environment. Applications of this approach may extend to larger populations of visually impaired individuals.

Audio-based Environment Simulator (AbES) is virtual environment software designed to improve real world navigation skills in the blind.

Entwicklung eines Audio-based Virtual Gaming Umwelt mit Navigation Skills in the Blind Assist

Audio-based Environment Simulator (AbES) is virtual environment software designed to improve real world navigation skills in the blind. Using only audio ...

Forschung

Medizin

Dynamic Visual Tests to Identify and Quantify Visual Damage and Repair Following Demyelination in Optic Neuritis Patients

In order to follow optic neuritis patients and evaluate the effectiveness of their treatment, a handy, accurate and quantifiable tool is required to assess changes in myelination at the central nervous system (CNS). However, standard measurements, including routine visual tests and MRI scans, are not sensitive enough for this purpose. We present two visual tests addressing dynamic monocular and binocular functions which may closely associate with the extent of myelination along visual pathways. These include Object From Motion (OFM) extraction and Time-constrained stereo protocols. In the OFM test, an array of dots compose an object, by moving the dots within the image rightward while moving the dots outside the image leftward or vice versa. The dot pattern generates a camouflaged object that cannot be detected when the dots are stationary or moving as a whole. Importantly, object recognition is critically dependent on motion perception. In the Time-constrained Stereo protocol, spatially disparate images are presented for a limited length of time, challenging binocular 3-dimensional integration in time. Both tests are appropriate for clinical usage and provide a simple, yet powerful, way to identify and quantify processes of demyelination and remyelination along visual pathways. These protocols may be efficient to diagnose and follow optic neuritis and multiple sclerosis patients.
In the diagnostic process, these protocols may reveal visual deficits that cannot be identified via current standard visual measurements. Moreover, these protocols sensitively identify the basis of the currently unexplained continued visual complaints of patients following recovery of visual acuity. In the longitudinal follow up course, the protocols can be used as a sensitive marker of demyelinating and remyelinating processes along time. These protocols may therefore be used to evaluate the efficacy of current and evolving therapeutic strategies, targeting myelination of the CNS.

Object From Motion (OFM) and Time-constrained stereo protocols are sensitive tools to identify monocular and binocular dynamic visual function deficits, which are uniquely affected in optic neuritis patients. Furthermore, these tests may be used as quantitative noninvasive tools to assess the extent of myelination along visual pathways.

Dynamische Visuelle Tests zur Identifizierung und Quantifizierung von Visual Schäden und Reparaturen Nach Demyelinisierung in Optikusneuritis Patienten

In order to follow optic neuritis patients and evaluate the effectiveness of their treatment, a handy, accurate and quantifiable tool is required to ...

Catheterization of the Carotid Artery and Jugular Vein to Perform Hemodynamic Measures, Infusions and Blood Sampling in a Conscious Rat Model

The success of a small animal model to study critical illness is, in part, dependent on the ability of the model to simulate the human condition. Intra-tracheal inoculation of a known amount of bacteria has been successfully used to reproduce the pathogenesis of pneumonia which then develops into sepsis. Monitoring hemodynamic parameters and providing standard clinical treatment including infusion of antibiotics, fluids and drugs to maintain blood pressure is critical to simulate routine supportive care in this model but to do so requires both arterial and venous vascular access. The video details the surgical technique for implanting carotid artery and common jugular vein catheters in an anesthetized rat. Following a 72 hr recovery period, the animals will be re-anesthetized and connected to a tether and swivel setup attached to the rodent housing which connects the implanted catheters to the hemodynamic monitoring system. This setup allows free movement of the rat during the study while continuously monitoring pressures, infusing fluids and drugs (antibiotics, vasopressors) and performing blood sampling.

Vascular accesses to measure hemodynamics, provide fluids and perform blood sampling are important to any small animal model study. We present a technique for implanting catheters into the carotid artery and the common jugular vein in an anesthetized rat for connecting to a system to perform monitoring, infusions and sampling.

Katheterisierung der Halsschlagader und Vena jugularis zur hämodynamischen Maßnahmen im Conscious Rattenmodell durchführen, Infusionen und Blutentnahme

The success of a small animal model to study critical illness is, in part, dependent on the ability of the model to simulate the human condition. ...

Instillation and Fixation Methods Useful in Mouse Lung Cancer Research

The ability to instill live agents, cells, or chemicals directly into the lung without injuring or killing the mice is an important tool in lung cancer research. Although there are a number of methods that have been published showing how to intubate mice for pulmonary function measurements, none are without potential problems for rapid tracheal instillation in large cohorts of mice. In the present paper, a simple and quick method is described that enables an investigator to carry out such instillations in an efficient manner. The method does not require any special tools or lighting and can be learned with very little practice. It involves anesthetizing a mouse, making a small incision in the neck to visualize the trachea, and then inserting an intravenous catheter directly. The small incision is quickly closed with tissue adhesive, and the mice are allowed to recover. A skilled student or technician can do instillations at an average rate of 2 min/mouse. Once the cancer is established, there is frequently a need for quantitative histologic analysis of the lungs. Traditionally pathologists usually do not bother to standardize lung inflation during fixation, and analyses are often based on a scoring system that can be quite subjective. While this may sometime be sufficiently adequate for gross estimates of the size of a lung tumor, any proper stereological quantification of lung structure or cells requires a reproducible fixation procedure and subsequent lung volume measurement. Here we describe simple reliable procedures for both fixing the lungs under pressure and then accurately measuring the fixed lung volume. The only requirement is a laboratory balance that is accurate over a range of 1 mg&#8211;300 g. The procedures presented here thus could greatly improve the ability to create, treat, and analyze lung cancers in mice.

The goal of this paper is to describe simple methods that will greatly aid in the setup and analysis of mouse lungs with lung cancer or other pathologies. We present 3 protocols to simply and reliably carry out lung instillations, fixation, and lung volume measurements.

Instillation und Fixationsmethoden Nützlich in Maus Lung Cancer Research

The ability to instill live agents, cells, or chemicals directly into the lung without injuring or killing the mice is an important tool in lung cancer ...

A Simple Mechanical Procedure to Create Limbal Stem Cell Deficiency in Mouse

Limbal stem cell deficiency (LSCD) is a state of malfunction or loss of limbal epithelial stem cells, after which the corneal epithelium is replaced with conjunctiva. Patients suffer from recurrent corneal defects, pain, inflammation, and loss of vision.
Previously, a murine model of LSCD was described and compared to two other models. The goal was to produce a consistent mouse model of LSCD that both mimics the phenotype in humans and lasts long enough to make it possible to study the disease pathophysiology and to evaluate new treatments. Here, the technique is described in more detail.
A motorized tool with a rotating burr has been designed to remove the rust rings from the corneal surface or to smooth the pterygium bed in patients. It is a suitable device to create the desired LSCD model. It is a readily available, easy-to-use tool with a fine tip that makes it appropriate for working on small eyes, as in mice. Its application prevents unnecessary trauma to the eye and it does not result in unwanted injuries, as often is the case with chemical injury models. As opposed to a blunt scraper, it removes the epithelium with the basement membrane. In this protocol, the limbal area was abraded two times, and then the whole corneal epithelium was shaved from limbus to limbus. To avoid stroma injury, care was taken not to brush the corneal surface once the epithelium was already removed.

The following article provides an easy, reproducible technique to effectively create a sustainable mouse model of limbal stem cell deficiency (LSCD). This animal model is useful in testing and comparing the efficacy of treatments for limbal stem cell diseases.

Eine einfache mechanische Verfahren Limbusstammzellinsuffizienzen in der Maus zum Erstellen

Limbal stem cell deficiency (LSCD) is a state of malfunction or loss of limbal epithelial stem cells, after which the corneal epithelium is replaced with ...

A Model to Simulate Clinically Relevant Hypoxia in Humans

In case of apnea, arterial partial pressure of oxygen (pO2) decreases, while partial pressure of carbon dioxide (pCO2) increases. To avoid damage to hypoxia sensitive organs such as the brain, compensatory circulatory mechanisms help to maintain an adequate oxygen supply. This is mainly achieved by increased cerebral blood flow. Intermittent hypoxia is a commonly seen phenomenon in patients with obstructive sleep apnea. Acute airway obstruction can also result in hypoxia and hypercapnia. Until now, no adequate model has been established to simulate these dynamics in humans. Previous investigations focusing on human hypoxia used inhaled hypoxic gas mixtures. However, the resulting hypoxia was combined with hyperventilation and is therefore more representative of high altitude environments than of apnea. Furthermore, the transferability of previously performed animal experiments to humans is limited and the pathophysiological background of apnea induced physiological changes is poorly understood. In this study, healthy human apneic divers were utilized to mimic clinically relevant hypoxia and hypercapnia during apnea. Additionally, pulse-oximetry and Near Infrared Spectroscopy (NIRS) were used to evaluate changes in cerebral and peripheral oxygen saturation before, during, and after apnea.

Hypoxia simulation in humans has usually been performed by inhaling hypoxic gas mixtures. For this study, apneic divers were used to simulate dynamic hypoxia in humans. Additionally, physiological changes in desaturation and re-saturation kinetics were evaluated with non-invasive tools such as Near-Infrared-Spectroscopy (NIRS) and peripheral oxygenation saturation (SpO2).

Ein Modell Simulieren von klinisch relevanter Hypoxie beim Menschen

In case of apnea, arterial partial pressure of oxygen (pO2) decreases, while partial pressure of carbon dioxide (pCO2) increases. To avoid damage to ...

A Clinical Trial Assessing the Safety, Efficacy, and Delivery of Olive-Oil-Based Three-Chamber Bags for Parenteral Nutrition

Limited evidence exists to precisely estimate efficacy and safety differences between parenteral nutrition (PN) prepared using olive-oil-based three-chamber bags (3CBs) and soybean-oil-based compounded bags (CoBs) in hospitalized adult patients. We designed a multicenter, randomized, prospective, open-label, noninferiority protocol to compare the efficacy, safety, and distribution of olive-oil-based 3CBs and soybean-oil-based CoB formulations in adult Chinese patients requiring PN during surgical intervention. Subjects were randomized to receive either one of the study treatments using an interactive voice or web-based recognition system in accordance with the randomization code. Randomization was further stratified based on the study site and surgical category. Both treatment groups received similar amounts of calories and protein. In addition, the two study treatments contained a similar composition of the amino-acid component. The only difference between the two PN formulations was the lipid constitution. The duration of administration of study treatments was a minimum of 5 days up to a maximum of 14 days after the surgical procedure. The primary efficacy endpoint was serum prealbumin levels on day 5 of the study. Noninferiority was proved if the anti-log of the lower bound of the 95% confidence interval (CI) of the treatment difference was at least 0.80. Other efficacy measures included treatment preparation time; duration to achieve tolerability of oral nutrition; associated infectious complications; length of hospitalization; and laboratory assessment of markers of nutrition, inflammation, metabolism, and oxidative stress. A total of 458 patients were enrolled in the study. The results showed that olive-oil-based 3CBs were non-inferior to soybean-based CoBs, besides being well tolerated. The infection rate was found to be significantly lower in the olive-oil-based 3CB group. Thus, this study may be used as a reference for future research on lipid emulsion and 3CBs.

Here, we present a protocol for a study comparing the efficacy, safety, and delivery of olive-oil-based 3CB and soybean-oil-based CoB formulations in adults requiring parenteral nutrition. The results revealed that olive-oil-based 3CBs is non-inferior and well tolerated compared to soybean formulations.

Eine klinische Studie zur Bewertung der Sicherheit, Wirksamkeit und Lieferung von Dreikammerbeuteln auf Olivenölbasis für die parenterale Ernährung

Limited evidence exists to precisely estimate efficacy and safety differences between parenteral nutrition (PN) prepared using olive-oil-based ...

Observational Study Protocol for Repeated Clinical Examination and Critical Care Ultrasonography Within the Simple Intensive Care Studies

Longitudinal evaluations of critically ill patients by combinations of clinical examination, biochemical analysis and critical care ultrasonography (CCUS) may detect adverse events of interventions such as fluid overload at an early stage. The Simple Intensive Care Studies (SICS) is a research line that focuses on the prognostic and diagnostic value of combinations of clinical variables.
The SICS-I specifically focused on the use of clinical variables obtained within 24 h of acute admission for prediction of cardiac output (CO) and mortality. Its sequel, SICS-II, focuses on repeated evaluations during ICU admission. The first clinical examination by trained researchers is performed within 3 h after admission consisting of physical examination and educated guessing. The second clinical examination is performed within 24 h after admission and includes physical examination and educated guessing, biochemical analysis and CCUS assessments of heart, lungs, inferior vena cava (IVC) and kidney. This evaluation is repeated at days 3 and 5 after admission. CCUS images are validated by an independent expert, and all data is registered in an online secured database. Follow-up at 90 days includes registration of complications and survival status according to patient&#39;s medical charts and the municipal person registry. The primary focus of SICS-II is the association between venous congestion and organ dysfunction.
The purpose of publishing this protocol is to provide details on the structure and methods of this on-going prospective observational cohort study allowing answering multiple research questions. The design of the data collection of combined clinical examination and CCUS assessments in critically ill patients are explicated. The SICS-II is open for other centers to participate and is open for other research questions that can be answered with our data.

<meta charset="utf8"></head><body>Beobachtungsstudienprotokoll für die wiederholte klinische Untersuchung und den Intensivsonographie im Rahmen der einfachen Intensivstudien

Structured protocols are necessary to provide answers on research questions in critically ill patients. The Simple Intensive Care Studies (SICS) provides an infrastructure for repeated measurements in critically ill patients including clinical examination, biochemical analysis and ultrasonography. SICS projects have specific focus but the structure is flexible to other investigations.

Beobachtungsstudienprotokoll für die wiederholte klinische Untersuchung und den Intensivsonographie im Rahmen der einfachen Intensivstudien

Longitudinal evaluations of critically ill patients by combinations of clinical examination, biochemical analysis and critical care ultrasonography (CCUS) ...

Clinical Practice Protocol of Creative Music Therapy for Preterm Infants and Their Parents in the Neonatal Intensive Care Unit

Creative music therapy for preterm infants and their parents (CMT) has emerged as a promising family-integrated early intervention involving communicative musicality to improve infant development, parental well-being, and bonding. It aims at relaxing and nurturing the infant as well as promoting safety and social interaction for the parent-infant dyad. A music therapist specially trained in CMT hums or sings in an infant-directed, improvised, lullaby style continually adjusting to the individual needs, expressions, and breathing pattern of the preterm infant. Based on the principles of family-integrated care, the family is incorporated individually in the therapeutic process, namely by delivering CMT during kangaroo care (KC) and by motivating and facilitating parental vocal interaction with their infant to strengthen the parent-infant bonding. CMT aims at relaxing, stimulating, and coregulating premature infants at a time when many other interventions are still risky and can overwhelm the vulnerable patient group. CMT may be advantageous not by educating and teaching parents, but rather by uncovering the intuitive capacities of parenting that are often overshadowed by the traumatic experience of preterm birth. However, CMT can only be provided when the infants are clinically stable. CMT with parental integration is feasible when parents are available and receptive to participate. This paper presents a detailed protocol on how to use CMT to empower preterm infants and their families.

Creative music therapy for preterm infants and their parents has emerged as a promising family-integrated early intervention. We present a detailed protocol on how to use vocal interaction, humming, or singing to empower preterm infants and their families.

Creative music therapy for preterm infants and their parents (CMT) has emerged as a promising family-integrated early intervention involving communicative ...