Acute effects and recovery after sport-related concussion: a neurocognitive and quantitative brain electrical activity study.

Objective: To investigate the clinical utility and sensitivity of a portable, automatic, frontal quantitative electroencephalographic (QEEG) acquisition device currently in development in detecting abnormal brain electrical activity after sport-related concussion.

Design: This was a prospective, non-randomized study of 396 high school and college football players, including cohorts of 28 athletes with concussion and 28 matched controls. All subjects underwent preseason baseline testing on measures of postconcussive symptoms, postural stability, and cognitive functioning, as well as QEEG.

Exploring parish nurses' perspectives of parish nurse training.

Background: Little research has explored parish nurses' perceptions of their preparation for their new role transition. This article studied role preparation from the perspective of practicing parish nurses.

Methods: A qualitative descriptive design used in-person interviews and open-ended questions.

An integrated review of recovery after mild traumatic brain injury (MTBI): implications for clinical management.

The diagnosis and treatment of mild traumatic brain injury (MTBI)have historically been hampered by an incomplete base of scientific evidence to guide clinicians. One question has been most elusive to clinicians and researchers alike: What is the true natural history of MTBI? Fortunately, the science of MTBI has advanced more in the last decade than in the previous 50 years, and now reaches a maturity point at which the science can drive an evidence-based approach to clinical management. In particular, technological advances in functional neuroimaging have created a powerful bridge between the clinical and basic science of MTBI in humans.

Effects of a symptom-free waiting period on clinical outcome and risk of reinjury after sport-related concussion.

Objective: This study is the first to investigate the influence of a symptom-free waiting period (SFWP) on clinical outcome and risk of repeat injury after sport-related concussion.

Methods: This was a prospective, nonrandomized study of 16 624 player seasons from 1999 to 2004, including a cohort of 635 concussed high school and college athletes grouped on the basis of an SFWP or no SFWP observed after their concussion. Clinical outcome in symptoms, cognitive functioning, and postural stability 45 and 90 days postinjury was compared with preinjury baseline.

Effects of gender, alcohol, smoking, and dairy consumption on bone mass in Wisconsin adolescents.

Introduction: Failure to attain peak bone mass during adolescence may be an important contributor to the development of osteoporosis.

Methods: This prospective, descriptive study evaluated the relationship between osteoporosis risk factors and attainment of bone mass in 239 Wisconsin high school students. Students completed an annual risk assessment questionnaire that included questions about dairy intake, alcohol use, and smoking.

Percutaneous tibial nerve stimulation for treatment of overactive bladder and urinary retention in an elderly population.

Percutaneous tibial nerve stimulation (PTNS) is a treatment option for patients who present with urinary urgency, frequency, urge incontinence, or urinary retention. When behavior modification and/or pharmacotherapy did not adequately relieve symptoms, this treatment was found to decrease incidence of overactive bladder or retention symptoms in the authors' patient population.

MVPlex assay for direct detection of methicillin-resistant Staphylococcus aureus in naris and other swab specimens.

We evaluated the MVPlex assay (Geneco Biomedical Products), which uses target-enriched multiplex PCR amplification followed by liquid array identification, for the detection of methicillin-resistant Staphylococcus aureus (MRSA) from 307 dual-swab specimens. By using a combination of culture (Trypticase soy agar-5% sheep blood agar and Columbia CNA agar-5% sheep blood) and an FDA-approved MRSA PCR assay as the "gold standard," the MVPlex MRSA assay and culture were found to have sensitivities of 97.8% and 84.

Official position of the military TBI task force on the role of neuropsychology and rehabilitation psychology in the evaluation, management, and research of military veterans with traumatic brain injury.

This Position Statement is a summary of the literature and learning regarding current issues raised by the occurrence, treatment, and study of traumatic brain injury in military service members and veterans. The Report has been approved by the American Academy of Clinical Neuropsychology (AACN), Divisions 40 (Neuropsychology) and 22 (Rehabilitation Psychology) of the American Psychological Association (APA), and the National Academy of Neuropsychology (NAN), with the goal of providing information of relevance on an important public policy matter within their respective areas of expertise. The Report is not intended to establish guidelines or standards for the professional practice of psychology, nor has it been adopted as official policy by the American Psychological Association or any other division or subunit of APA.

Recurrent concussion and risk of depression in retired professional football players.

Purpose: The purpose of our study was to investigate the association between prior head injury and the likelihood of being diagnosed with clinical depression among retired professional football players with prior head injury exposure.

Methods: A general health questionnaire, including information about prior injuries, the SF-36 (Short Form 36), and other markers for depression, was completed by 2552 retired professional football players with an average age of 53.8 (+/-13.

Evaluation of the Cepheid herpes simplex virus typing real-time PCR assay using dermal and genital specimens.

The Cepheid herpes simplex virus (HSV) (Cepheid, Sunnyvale, CA) typing multiplex real-time polymerase chain reaction (PCR) assay was evaluated for its ability to detect HSV in dermal and genital specimens stored in M5 media. Swab specimens (n = 114) for HSV testing were placed in M5 media and split between our laboratory and a highly experienced reference laboratory. Aliquots for testing with the Cepheid assay were processed using a simple boil-and-go procedure and then run in a SmartCycler II (Cepheid).

Standardizing the care of detox patients to achieve quality outcomes.

Providing appropriate treatment for detoxification patients is both challenging and difficult because alcohol abuse and dependence are largely underestimated in the acute hospital setting. Alcohol withdrawal syndrome is treated not only by addictionologists on chemical dependency units, but also by primary care physicians in acute inpatient settings. The need for consistent inpatient treatment through the use of identified protocols can help provide safe and effective care.

Standard regression-based methods for measuring recovery after sport-related concussion.

Clinical decision making about an athlete's return to competition after concussion is hampered by a lack of systematic methods to measure recovery. We applied standard regression-based methods to statistically measure individual rates of impairment at several time points after concussion in college football players. Postconcussive symptoms, cognitive functioning, and balance were assessed in 94 players with concussion (based on American Academy of Neurology Criteria) and 56 noninjured controls during preseason baseline testing, and immediately, 3 hr, and 1, 2, 3, 5, and 7 days postinjury.

Unreported concussion in high school football players: implications for prevention.

Objective: To investigate the frequency of unreported concussion and estimate more accurately the overall rate of concussion in high school football players.

Design: Retrospective, confidential survey completed by all subjects at the end of the football season.

Setting And Participants: A total of 1,532 varsity football players from 20 high schools in the Milwaukee, Wisconsin, area were surveyed.

Acute effects and recovery time following concussion in collegiate football players: the NCAA Concussion Study.

Context: Lack of empirical data on recovery time following sport-related concussion hampers clinical decision making about return to play after injury.

Objective: To prospectively measure immediate effects and natural recovery course relating to symptoms, cognitive functioning, and postural stability following sport-related concussion.

Design, Setting, And Participants: Prospective cohort study of 1631 football players from 15 US colleges.

Standardized Mental Status Testing on the Sideline After Sport-Related Concussion.

OBJECTIVE: The effects of concussion on mental status are often difficult to assess on routine clinical examination. I investigated the efficacy of standardized mental status testing on the sport sideline to detect abnormalities that result from concussion and provide an objective measure of postinjury cognitive recovery. DESIGN AND SETTING: All subjects underwent a standardized preseason baseline mental status evaluation.

Self-hypnosis: alternative anesthesia for childbirth.

The purpose of this article is to inform nurses about the use of self-hypnosis in childbirth. Hypnosis is a focused form of concentration. Self-hypnosis is one form of hypnosis in which a certified practitioner or therapist teaches an individual to induce his or her own state of altered consciousness.

The Geriatric Resource Nurse Model: a culture change.

The introduction of the Geriatric Resource Nurse (GRN) Model and the Nurses Improving Care for Healthsystem Elders (NICHE) program has changed the culture at Waukesha Memorial Hospital. The number one key to successfully implementing them has been the overwhelming administrative and staff support. The following article contains an outline of the initial steps taken to implement the GRN model and a NICHE program, the way both became fully integrated into the culture of care, and evidence of positive patient and staff outcomes.

The pineal gland.

The pineal gland is located posterior to the midbrain and is the site of melatonin production. Research on pineal gland function in neonates is very limited. This article will discuss pineal gland development and the possible relationship between melatonin production and sudden infant death syndrome.

Immediate neurocognitive effects of concussion.

Objective: To prospectively measure the immediate neurocognitive effects and early course of recovery from concussion and to examine the effects of loss of consciousness (LOC) and posttraumatic amnesia (PTA) on the severity of neurocognitive impairment immediately after concussion.

Methods: A sports-related concussion research model was used to allow prospective immediate evaluation of concussion. A total of 2385 high school and college football players were studied.

Standardized mental status assessment of sports concussion.

Neurocognitive status is often considered the domain of neurologic functioning most sensitive to change following concussion, but the effects are often subtle and difficult to detect on routine clinical examination. Recent efforts have focused on the development of brief, standardized methods of mental status assessment for use by sports medicine clinicians to quantify the acute neurocognitive effects of concussion and objectively track postinjury recovery. Research has demonstrated the reliability, validity, and sensitivity of these measures in detecting concussion in athletes and providing empirical data for consideration in the context of other examination findings, neuropsychologic test data, and neuroimaging results.

Understanding equianalgesic dosing.

Over the past several years, improving pain management has become a major initiative. Nurses play a vital role in this effort. To be most effective in this pain relief role, nurses need to develop a clearer understanding of the opioid analgesics and how to use them.