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"Neurochemistry."
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Characteristics of person-centred practice in the stroke patient trajectory: a scoping review
Background
Person-centred practice (PCP) is gaining increasing attention in healthcare practice and research. However, further knowledge is needed to understand PCP in stroke care. The aim of this study was to explore the characteristics of PCP in the stroke patient trajectory.
Methods
The review was conducted using the JBI methodology for scoping reviews. Searches were conducted in MEDLINE, CINAHL, Embase, Cochrane Library, Scopus, PsycINFO, and Web of Science, along with grey literature sources. Two reviewers screened studies for inclusion. Data were extracted using a pilot-tested tool and analysed using content analysis for qualitative data and descriptive statistics for quantitative data.
Results
Ninety-six studies from diverse healthcare contexts and countries were included. The results showed significant variability in the implementation of PCP in the stroke patient trajectory. Key components of PCP that dominate the literature include shared decision-making, holistic care, and information provision. Several categories of facilitators and barriers emerged from the data, including patient participation and interprofessional practice. Recommendations for practice emphasised the need for training healthcare professional in PCP principles and the development of tools to support shared decision-making. Research gaps include PCP gaps, theoretical, methodological, and implementation gaps, as well as tools and digital health gaps.
Conclusions
This scoping review highlights the variability and complexity of implementing PCP in stroke care, emphasising the need for further research and development across the stroke patient trajectory.
Journal Article
Altered Neurochemical Profile after Traumatic Brain Injury: 1 H-MRS Biomarkers of Pathological Mechanisms
Specific neurochemicals measured with proton magnetic resonance spectroscopy ( 1 H-MRS) may serve as biomarkers of pathological mechanism in the brain. We used high field in vivo 1 H-MRS to measure a detailed neurochemical profile after experimental traumatic brain injury (TBI) in rats. We characterized neurochemical changes in the contused cortex and the normal-appearing perilesional hippocampus over a time course from 1 hour to 2 weeks after injury. We found significant changes in 19 out of 20 neurochemicals in the cortex, and 9 out of 20 neurochemicals in the hippocampus. These changes provide evidence of altered cellular metabolic status after TBI, with specific compounds proposed to reflect edema, excitotoxicity, neuronal and glial integrity, mitochondrial status and bioenergetics, oxidative stress, inflammation, and cell membrane disruption. Our results support the utility of 1 H-MRS for monitoring cellular mechanisms of TBI pathology in animal models, and the potential of this approach for preclinical evaluation of novel therapies.
Journal Article