Articles: adult.
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Health-related quality of life (HRQOL) is an important parameter after medical treatments. Knowledge of (predictors of) diminished quality of life can help improve medical outcome. The aim of this study was to quantify health loss in patients with burns and to assess the contribution of injury extent, age, gender, and psychologic factors to HRQOL and speed of recovery. A multicenter prospective cohort design was used to address these aims. ⋯ Both injury severity and psychologic problems play a pivotal role in reduced HRQOL and the speed of recovery. The number of surgeries seems to give a practically useful indication of the expected recovery speed that could aid in decision making and provides adequate information for patients in the aftermath of their initial surgical treatment. Screening for traumatic stress is recommended.
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SUMMARY Chronic pain, especially headache and recurrent abdominal pain, affects a sizable number of children and adolescents. In this selective overview, the need and rationale for psychological approaches to the treatment of chronic pediatric pain will be explored, and current developments and open questions will be addressed. Thus far, research has mostly focused on the efficacy of various psychological interventions such as relaxation, biofeedback and cognitive-behavioral interventions, specifically for headaches and recurrent abdominal pain. ⋯ On the other hand, much research has been devoted to self-help treatment formats such as internet-based intervention programs. Rather surprisingly, the role of parents in the treatment of chronic pediatric pain is far from being understood, which may be best accounted for by the fact that psychological interventions were mostly adapted from treatment programs in adults rather than being specifically developed for children and adolescents. Conclusions for clinical practice and research are outlined.
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African health sciences · Sep 2011
Sleep disordered breathing (SDB) experiences associated with snoring in adult Nigerians.
Snorers often experience symptoms of sleep disordered breathing (SDB) which is largely undiagnosed in the population. Information on SDB experiences is needed to target high-risk individuals that may benefit from treatment of snoring. ⋯ Adults that snore habitually had significantly more nighttime and daytime symptoms of SDB compared to those who do not snore habitually. Habitual snoring predisposes adult subjects to experiencing symptoms of SDB.
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Rev Bras Ter Intensiva · Sep 2011
Guidelines for potential multiple organ donors (adult): part II. Mechanical ventilation, endocrine metabolic management, hematological and infectious aspects.
The role of intensive care specialists in the maintenance of deceased potential donors is not restricted to hemodynamics. Appropriate endocrine-metabolic management is fundamental to maintaining energy support and hydroelectrolytic control, which cooperate for hemodynamic stability. ⋯ In addition, this article discusses the role of appropriate protective ventilation to prevent inflammatory responses and to provide more transplantable lungs. Finally, judicious assessment of infections and antibiotic therapy is discussed.
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The bad news is that the BJGP published under such a negative and provocative title without balanced debate, in contrast to the recent BMJ head-to-head debate 'Has child protection become a form of madness'.1,2 One interesting comparison made in that debate is that Sweden and Finland spend 50% more of their gross domestic product on children and families than we do in the UK, we spend 200% more than they do on social problems. In my view these figures help us understand societal attitudes that have knock-on effects through all services for children and families including general practice. The current UK GP contract is certainly not child and family friendly and it is unlikely that current NHS changes will improve matters. ⋯ Those specific to general practice are on pages 60-63 of Working Together to Safeguard Children 2012.5GP colleagues in Cornwall show appreciation of the importance of safeguarding, but many feel there is too much guidance and insufficient resources. The majority of the practices value the RCGP/NSPCC Toolkit for Safeguarding Adults and Young People, that being written for GPs by GPs helps practices establish policies and procedures on safeguarding which work.6 I commend the RCGP for grasping the safeguarding nettle, collaborating with the NSPCC to produce this toolkit, and including safeguarding as one of the ten priorities of the RCGP Child Health Strategy for 2012-15.7 Can the BJGP help the College bring this strategy forward? Up to 25% of our patients are children. They are the future of the UK.