在每一代和连续几代人身上应用大脑护理捆绑包。

IF 2.9 3区 医学 Q1 PEDIATRICS
Seminars in Fetal & Neonatal Medicine Pub Date : 2024-11-01 Epub Date: 2024-11-07 DOI:10.1016/j.siny.2024.101558
Mark S Scher, Susan Ludington, Valerie Smith, Stina Klemming, Betsy Pilon
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引用次数: 0

摘要

世界范围内的多重危机继续对世界卫生组织提出的 2030 年可持续发展目标构成挑战。持续性的脑护理捆绑服务有助于通过维持一代又一代人的脑健康来实现这些目标。健康的社会驱动因素必须将跨学科护理纳入公平的干预选择中。将孕产妇和儿科评估结合起来,更有效地应对各种驱动因素,以解决每个生命周期的发病率和死亡率问题。护理捆绑包括至少三种以证据为基础的干预措施,在临床实践中共同实施,以达到预期效果。在根据不断变化的临床条件选择护理包时,利益相关者之间的协同作用将优先考虑沟通、责任、合规性和信任。产前跨学科模式在婴儿出生后继续开展以婴儿和家庭为中心的发育护理实践,直至出院,以补充必要的肌肤接触。胎儿-新生儿神经病学培训鼓励参与这种脑健康护理模式,以便更有效地选择神经诊断和神经保护方案。共同临床决策可评估从受孕到出生后 1000 天内的干预措施。在神经可塑性的第一个关键/敏感时期,至少有 80% 的大脑连接已经完成。健康和疾病的发展起源概念为神经病学亚专科医生在选择大脑健康策略时提供了一个生命过程的视角。生殖和妊娠期疾病及逆境造成的有毒压力相互作用可能会损害胚胎、胎儿和新生儿的大脑发育。在整个成熟和衰老过程中持续暴露于有毒物质会使结果风险恶化,尤其是在青春期和生殖衰老期。代内和跨代使用护理捆绑将指导神经监测和神经保护的选择,从而加强预防性神经病学战略。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Brain care bundles applied over each and successive generations.

Worldwide polycrises continue to challenge the World Health Organization's proposed 2030 sustainable development goals. Continuity of brain care bundles helps attain these goals by sustaining brain health over successive generations. Factors representing social drivers of health must incorporate transdisciplinary care into equitable intervention choices. Drivers are more effectively addressed by combining maternal and pediatric assessments to address morbidity and mortality across each lifespan. Care bundles comprise at least three evidenced-based interventions collectively implemented during a clinical experience to achieve a desired outcome. Synergy among stakeholders prioritize communication, responsibility, compliance and trust when choosing bundles in response to changing clinical conditions. A prenatal transdisciplinary model continues after birth with infant and family-centered developmental care practices through discharge to supplement essential skin-to-skin contact. Fetal-neonatal neurology training encourages participation in this model of brain health care to more effectively choose neurodiagnostic and neuroprotective options. Shared clinical decisions evaluate interventions from conception through the first 1000 days. At least eighty percent of brain connectivity will have been completed during this first critical/sensitive period of neuroplasticity. The developmental origins of health and disease concept offers neurology subspecialists a life-course perspective when choosing brain health strategies. Toxic stressor interplay from reproductive and pregnancy diseases and adversities potentially impairs embryonic, fetal and neonatal brain development. Continued exposures throughout maturation and aging worsen outcome risks, particularly during adolescence and reproductive senescence. Intragenerational and transgenerational use of care bundles will guide neuromonitoring and neuroprotection choices that strengthen preventive neurology strategies.

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来源期刊
CiteScore
6.40
自引率
3.30%
发文量
49
审稿时长
6-12 weeks
期刊介绍: Seminars in Fetal & Neonatal Medicine (formerly Seminars in Neonatology) is a bi-monthly journal which publishes topic-based issues, including current ''Hot Topics'' on the latest advances in fetal and neonatal medicine. The Journal is of interest to obstetricians and maternal-fetal medicine specialists. The Journal commissions review-based content covering current clinical opinion on the care and treatment of the pregnant patient and the neonate and draws on the necessary specialist knowledge, including that of the pediatric pulmonologist, the pediatric infectious disease specialist, the surgeon, as well as the general pediatrician and obstetrician. Each topic-based issue is edited by an authority in their field and contains 8-10 articles. Seminars in Fetal & Neonatal Medicine provides: • Coverage of major developments in neonatal care; • Value to practising neonatologists, consultant and trainee pediatricians, obstetricians, midwives and fetal medicine specialists wishing to extend their knowledge in this field; • Up-to-date information in an attractive and relevant format.
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