ABSTRACT
This JAMA Patient Page describes the types of flat head syndrome and its prevention and treatment.
Subject(s)
Craniosynostoses , Humans , Infant , Infant, Newborn , Craniosynostoses/diagnosis , Craniosynostoses/prevention & control , Craniosynostoses/therapy , Head/abnormalities , Head Protective Devices , SyndromeABSTRACT
OBJECTIVES: The purpose of this document is to establish practical recommendations on neurogenic bladder (NB) management based on scientific evidence and medical and nursing perspective in Spinal Cord Injury (SCI) Units as a first multidisciplinary consensual approach in Spain. METHODS: This paper reports results from the first modified Delphi consensus building exercise on this procedure. A committee of recognised opinion-leaders in rehabilitation and urology with special interest in NB was constituted. A working group formed by rehabilitation doctors, urologists and nursing staff of SCI and Neurorehabilitation Units of a number of Spanish hospitals and specialised centres associated with the panel of NB experts have prepared this document. RESULTS: This review provided an overview of the main aspects described by the different clinical guidelines already available and highlighted the need to focus on recommendations in special priority situations in which there was no consensus. In view of the considerable impact this condition has on quality of life, patients should be offered help to better understand the disorder and they should be taught how to use the treatment techniques to obtain satisfactory results and promote their autonomy. CONCLUSIONS: This article presents a version of guidelines for patients with NB. The guidelines define the clinical profile of patients to provide the best evidence- based care and also an overview of the current drug and surgical treatments of NB.
OBJETIVO: El objetivo de este documento es establecer recomendaciones prácticas sobre el manejo de la vejiga neurógena (VN) en función de la evidencia científica y las perspectivas médicas y de enfermería en Unidades de Lesionados Medulares (ULM) como un primer enfoque de consenso multidisciplinar en España.MÉTODOS: En este artículo se presentan los resultados del primer ejercicio de consenso basado en metodología Delphi modificada sobre este procedimiento. Se constituyó un comité del que formaron parte reconocidos expertos en rehabilitación y urología, especializados en el manejo de VN. Este documento ha sido elaborado por un grupo de trabajo formado por médicos especialistas en rehabilitación, urólogos y personal de enfermería de ULM y unidades de Neurorrehabilitación de varios hospitales y centros especializados españoles asociados con el panel de expertos sobre VN. RESULTADOS: Esta revisión ofrece un resumen de los principales aspectos descritos en diversas guías clínicas ya disponibles y destaca la necesidad de centrarse en recomendaciones sobre situaciones especialmente prioritarias sobre las que actualmente no existe consenso. En vista del considerable impacto de esta enfermedad sobre la calidad de vida, los pacientes deben recibir ayuda para que comprendan mejor su enfermedad y también deben recibir formación sobre el uso de técnicas de tratamiento para conseguir resultados satisfactorios y fomentar su autonomía. CONCLUSIONES: En este artículo se presenta una versión de la guía para el manejo de pacientes con VN. Las guías definen el perfil clínico de los pacientes para ofrecer la mejor asistencia basada en la evidencia y también un resumen de los tratamientos farmacológicos y quirúrgicos actuales para la VN.
Subject(s)
Urinary Bladder, Neurogenic , Consensus , Humans , Quality of Life , Spain , Urinary Bladder, Neurogenic/diagnosis , Urinary Bladder, Neurogenic/therapyABSTRACT
Although skin cancer is less common in Hispanics, they are at higher risk for presenting with more advanced stage skin cancer. We performed semi-structured interviews with Hispanic women that found high concern for photoaging from sun exposure. Based on these results, we developed two short Spanish-language films. The first emphasized photoaging benefits of sun protection, while the second focused on its benefits for skin cancer prevention. Our hypothesis was that the reduction of photoaging would be a more persuasive argument than skin cancer prevention for the adoption of sunscreen use by Hispanic women. Study participants were recruited from beauty salons located in predominantly Hispanic neighborhoods. Each of the two Spanish-language films was approximately 3 min long. A pre-intervention questionnaire assessed subjects' general knowledge and sunscreen habits, and a second questionnaire administered after viewing both films assessed for improvements in risk perception and inquired about which film was more persuasive. Eighty Hispanics participated ranging in age from 19 to 75. The pre-education survey found that 54 out of 80 believed that fair-skin Hispanics (FS) were at risk for skin cancer, and 44 out of 80 believed that dark-skin Hispanics (DS) were at risk. These numbers increased to 72 (FS) and 69 (DS) after the intervention (p value: <0.0002 FS, <0.0001 DS). Hispanics overwhelmingly selected the video emphasizing the benefits of sun protection for skin cancer prevention as the more persuasive film (74 out of 80). A Spanish-language video has the potential to make an impact in healthy sun-protective behaviors, and information on how to properly apply sunscreen should be included in educational messages.
