Perceptions of Nurses Who Are Second Victims in a Hospital Setting.

BACKGROUND: Second victims (SVs) are health care workers traumatized by unanticipated, adverse patient events. These experiences can have personal and professional effects on SVs. Research indicates that SVs experience inadequate support following adverse events. PURPOSE: To determine the prevalence of nurses who identified as SVs and their awareness and use of supportive resources. METHODS: A convenience sample of nurses was surveyed, and SV responses were compared with those who did not identify as a SV. Responses were analyzed using nonparametric methods. RESULTS: One hundred fifty-nine (44.3%) of 359 participants identified as SVs. There was a significant relationship between work tenure and SVs (P = .009). A relationship was found between SVs and awareness and use of support resources, with debriefing being the preferred method after an event. CONCLUSIONS: Adverse events trigger emotional trauma in SVs who require administrative awareness, support, and follow-up to minimize psychological trauma in the clinical nurse.

Specific functional asymmetries of the human visual cortex revealed by functional near-infrared spectroscopy.

Based on multiple invasive reports and neuroimaging studies, it is well established that the cytoarchitecture of the visual cortex is related to its functional organization, namely, its retinotopy. The present study aimed to further investigate retinotopic mapping as well as specific vertical and horizontal functional asymmetries within the human visual cortex using functional near-infrared spectroscopy (fNIRS). Black and white wedge checkerboard stimuli were randomly presented to the four visual field (VF) quadrants of eight healthy adults in order to quantify and compare the localization and the amplitude of hemodynamic cortical responses to each VF quadrant. Results showed the expected activation in the contralateral hemisphere, with respect to the side of the stimulated quadrant. We also measured significantly stronger activations in the upper visual cortex when low hemifield stimuli were presented compared to activations in the lower visual cortex when upper hemifield stimuli were shown, especially when the stimulation was presented in the right visual field. These findings confirm the vertical asymmetry of the visual cortex previously reported by neuroimaging and behavioral studies. More importantly, the present work confirms the reliability of the fNIRS technique for functional mapping of the human brain.

Non-invasive pre-surgical investigation of a 10 year-old epileptic boy using simultaneous EEG-NIRS.

Near-infrared spectroscopy (NIRS) is a novel imaging technique of potential value in the pre-surgical investigation of patients with refractory epilepsy. We recorded simultaneously electrophysiology (EEG; Compumedics, USA) and near-infrared spectroscopy (NIRS; ISS, USA) to examine the localization of the ictal onset zone and assess language lateralization in a young epileptic boy (L.H., 10 years) as part of his pre-surgical evaluation. L.H. underwent a prolonged EEG-NIRS recording while electro-clinical and electrical seizures were recorded. Results were compared to those obtained with other pre-surgical techniques (SPECT, FDG-PET, EEG-fMRI and EEG-MEG) and showed good concordance for ictal onset zone localization. A second NIRS session without EEG was carried out in order to investigate language lateralization. For this purpose, the patient performed a categorical verbal-fluency task during NIRS recordings. Results showed left-hemisphere dominance for language function in this young boy. This case report illustrates that multi-channel EEG-NIRS has the potential to contribute favourably to pre-surgical investigation in young patients.

A noninvasive, presurgical expressive and receptive language investigation in a 9-year-old epileptic boy using near-infrared spectroscopy.

The intracarotid amobarbital test (IAT) is used for presurgical evaluation of language lateralization. However, this procedure has many limitations, especially in children. As an alternative to IAT, in the case described here, near-infrared spectroscopy (NIRS) was used to investigate expressive and receptive language lateralization as part of the presurgical evaluation of a 9-year-old Yiddish-speaking boy with a probable left temporal epileptic focus. This child could not tolerate IAT or functional MRI. He underwent two NIRS recording sessions while performing expressive and receptive language tasks. Results indicated predominantly left-sided expressive language in Broca's area with ipsilateral cortical recruitment of more posterior regions. Receptive language showed a bilateral cerebral pattern, perhaps as an expression of cerebral plasticity or compensation in this young patient. This case report illustrates that NIRS may contribute to presurgical investigation and could become a noninvasive alternative to IAT and functional MRI in determining speech lateralization in children.

Functional cerebral reorganization for auditory spatial processing and auditory substitution of vision in early blind subjects.

Early blind (EB) individuals can recognize bidimensional shapes using a prosthesis substituting vision with audition (PSVA) and activate right dorsal extrastriate visual cortex during the execution of this task. The present study used repetitive transcranial magnetic stimulation (rTMS) to further examine the functional role of this structure in the successful use of the PSVA. Moreover, we investigated which auditory parameter used in the prosthesis (pitch, intensity, or spatial location) might contribute to this occipital activation. Results revealed that rTMS applied to right dorsal extrastriate cortex in EB subjects interferes with both the PSVA use and the auditory spatial location task but not with pitch and intensity discriminations. By contrast, rTMS targeting the same cortical areas in sighted subjects did not affect performance on any auditory tasks. Early visual deprivation thus leads to functional cerebral cross-modal reorganization in the processing of auditory information and auditory-to-visual sensory substitution. The findings also point to the specific involvement of the dorsal visual stream for auditory spatial processing in blind subjects. Moreover, this suggests that sensory substitution prostheses can be developed using these additional neural resources to perform tasks that partially compensate for the loss of vision.