Notes

N6-methyladenosine encourages induction regarding ADAR1-mediated A-to-I RNA editing for you to curb aberrant antiviral inborn defense answers.
their caregivers to be comparable with in-person care. find more Positive satisfaction scores also serve to reinforce the need for healthcare providers to seek ways to actively engage with patients and their caregivers through elements of communicative skills such as active listening, building patient rapport, encouraging patient autonomy, and providing an adequate amount of time for interaction and questions. Telehealth for concussion care is increasing in implementation across health systems, and demand is likely to grow in light of the current COVID-19 pandemic and advances in telehealth delivery.
To describe dosing practices for amantadine hydrochloride and related adverse effects among children and young adults with traumatic brain injury (TBI) admitted to pediatric inpatient rehabilitation units.

Eight pediatric acute inpatient rehabilitation units located throughout the United States comprising the Pediatric Brain Injury Consortium.

Two-hundred thirty-four children and young adults aged 2 months to 21 years with TBI.

Retrospective data revie.

Demographic variables associated with the use of amantadine, amantadine dose, and reported adverse effects.

Forty-nine patients (21%) aged 0.9 to 20 years received amantadine during inpatient rehabilitation. Forty-five percent of patients admitted to inpatient rehabilitation with a disorder of consciousness (DoC) were treated with amantadine, while 14% of children admitted with higher levels of functioning received amantadine. Children with DoC who were not treated with amantadine were younger than those with DoC who received amantadine (median 3.0oC. Dosing varied widely, with weight-based dosing for younger/smaller children at both lower and higher doses than what had been previously reported. Prospective studies are needed to characterize the safety and tolerability of higher amantadine doses and optimize amantadine dosing parameters for children with TBI.
To compare healthcare and productivity costs between patients with mild traumatic brain injury (mTBI) who received verbal discharge instructions only and patients who received an additional flyer with or without video instructions.

Emergency departments (EDs) of 6 hospitals in the Netherlands.

In total, 1155 adult patients with mTBI (384 with verbal instructions; 771 with additional flyer with or without video instructions) were included.

Cost study with comparison between usual care and intervention.

Medical and productivity costs up to 3 months after presentation at the ED were compared between mTBI patients with usual care and mTBI patients who received the intervention.

Mean medical costs per mTBI patient were slightly higher for the verbal instructions-only cohort (€337 vs €315), whereas mean productivity costs were significantly higher for the flyer/video cohort (€1625 vs €899). Higher productivity costs were associated with higher working age, injury severity, and postconcussion symptoms.

This study showed that the implementation of flyer (and video) discharge instructions for patients with mTBI who present at the ED increased reports of postconcussion symptoms and reduced medical costs, whereas productivity costs were found to be higher for the working population in the first 3 months after the sustained head injury.
This study showed that the implementation of flyer (and video) discharge instructions for patients with mTBI who present at the ED increased reports of postconcussion symptoms and reduced medical costs, whereas productivity costs were found to be higher for the working population in the first 3 months after the sustained head injury.
To identify factors associated with treatment response to cognitive behavioral therapy for sleep disturbance and fatigue (CBT-SF) after acquired brain injury (ABI).

Community dwelling.

Thirty participants with a traumatic brain injury or stroke randomized to receive CBT-SF in a parent randomized controlled trial.

Participants took part in a parallel-groups, parent randomized controlled trial with blinded outcome assessment, comparing an 8-week CBT-SF program with an attentionally equivalent health education control. They were assessed at baseline, post-treatment, 2 months post-treatment, and 4 months post-treatment. The study was completed either face-to-face or via telehealth (videoconferencing). Following this trial, a secondary analysis of variables associated with treatment response to CBT-SF was conducted, including demographic variables; injury-related variables; neuropsychological characteristics; pretreatment sleep disturbance, fatigue, depression, anxiety and pain; and mode of treatment deliv CBT-SF in individuals with ABI.
To identify disruption due to dizziness symptoms following deployment-related traumatic brain injury (TBI) and factors associated with receiving diagnoses for these symptoms.

Administrative medical record data from the Department of Veterans Affairs (VA).

Post-9/11 veterans with at least 3 years of VA care who reported at least occasional disruption due to dizziness symptoms on the comprehensive TBI evaluation.

A cross-sectional, retrospective, observational study.

International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes of dizziness, vestibular dysfunction, and other postconcussive conditions; neurobehavioral Symptom Inventory.

Increased access to or utilization of specialty care at the VA was significant predictors of dizziness and/or vestibular dysfunction diagnoses in the fully adjusted model. Veterans who identified as Black non-Hispanic and those with substance use disorder diagnoses or care were substantially less likely to receive dizziness and vestibl facilities or experts for veterans who report disruptive dizziness following deployment-related TBI. There is a clear need for an evidence-based pathway to address disruptive symptoms of dizziness, given the substantial variation in audiovestibular tests utilized by US providers by region and clinical specialty. Further, the dearth of diagnoses among Black veterans and those in more rural areas underscores the potential for enhanced cultural competency among providers, telemedicine, and patient education to bridge existing gaps in the care of dizziness.
A significant minority of adolescents will have persistent postconcussion symptoms after an injury, potentially having a negative impact on family functioning. However, the reasons for a family's negative impact are not clearly understood. The objective of this study was to determine whether preinjury/demographic factors, injury characteristics, and/or worse postinjury symptoms are associated with higher levels of family stress in youth with refractory postconcussion symptoms.

Pediatric refractory concussion clinic in a tertiary care center.

A total of 121 adolescents (13-18 years old) who were 1 to 12 months postconcussion.

Primary outcome was the mean stress rating on the Family Burden of Injury Interview (FBII), a 27-item questionnaire rating the impact on a family as a result of an injury. Preinjury/demographic and injury details were collected. Youth and their parents also completed measures of postconcussion symptoms, depression, anxiety, and behavioral problems.

Participants had a mean age ofmpact. The severity of reported family burden in those with slow recovery from concussion was significantly associated with parents' perception of their child's cognitive symptoms and peer problems. These results could provide support for family-based interventions in this population.
Families of youth with refractory postconcussion symptoms can experience a negative impact. The severity of reported family burden in those with slow recovery from concussion was significantly associated with parents' perception of their child's cognitive symptoms and peer problems. These results could provide support for family-based interventions in this population.
To investigate differences between older men and women in Taiwan in personal and situational risk factors for sustaining a traumatic brain injury (TBI) versus soft-tissue injury (STI) due to a fall.

Matched case-control study.

Cases were defined as patients with a primary diagnosis of TBI due to a fall and were identified from those 60 years or older who visited the emergency department (ED) of 3 university-affiliated hospitals in 2015. Matched by the same hospital ED, gender, and time of falling, 3 controls who had no TBI and who had sustained only soft-tissue injury (STI) due to falling were selected for comparison with each case. Personal factors and situational exposures were compared between the control and case groups. In total, 96 cases and 288 controls in men and 72 cases and 216 controls in women participated in this study.

Personal factors (sociodemographic and lifestyle factors, medical characteristics, and functional abilities) and situational exposures (location, activities before the falies and differences in personal and situational risk factors for fall-related TBIs versus STIs between older men and women, and gender differences should be considered when developing intervention strategies.
The COVID-19 pandemic has been exceptionally disruptive to healthcare delivery, exposing the strengths and weaknesses of our healthcare system. Though systems will continue to improvise in the short term to provide essential patient care, thoughtful consideration should be given to a long-term approach to improve healthcare delivery. Policy makers, legislators, and healthcare system leaders have the opportunity to reflect on lessons learned during this time and update outdated and detrimental restrictions affecting healthcare providers who have been vital to the pandemic response. This article focuses on lessons learned about the use of physician assistants and NPs, who have been readily deployed during this time.
The COVID-19 pandemic has been exceptionally disruptive to healthcare delivery, exposing the strengths and weaknesses of our healthcare system. Though systems will continue to improvise in the short term to provide essential patient care, thoughtful consideration should be given to a long-term approach to improve healthcare delivery. Policy makers, legislators, and healthcare system leaders have the opportunity to reflect on lessons learned during this time and update outdated and detrimental restrictions affecting healthcare providers who have been vital to the pandemic response. This article focuses on lessons learned about the use of physician assistants and NPs, who have been readily deployed during this time.
To evaluate an enhanced physical health clinic led by physician associates (PAs) for patients with severe mental illness.

A guidance and data collection tool was developed to support and document the outcomes of the PA-led enhanced physical health clinic.

The clinic led to diagnoses of diabetes, hyperlipidemia, and hematologic abnormalities. One patient was started on metformin, two patients started a prediabetes program with their general practitioner, one patient started simvastatin, one patient switched from cigarettes to e-cigarettes, and one patient switched from olanzapine to aripiprazole because of metabolic adverse reactions. Three patients intended to contact the National Health Service for cancer screening for which they were eligible but they had not taken up.

PAs can be integrated into a community mental health multidisciplinary team and support the physical health of people with severe mental illness. Mental health trusts should consider roles for PAs in their workforce planning.
PAs can be integrated into a community mental health multidisciplinary team and support the physical health of people with severe mental illness.
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