Cerebral microdialysis: research technique or clinical tool

Cerebral microdialysis is a well-established laboratory tool that is increasingly used as a bedside monitor to provide on-line analysis of brain tissue biochemistry during neuro-intensive care. This review describes the principles of cerebral microdialysis and the rationale for its use in the clinical setting, including discussion of the most commonly used microdialysis biomarkers of acute brain injury. Potential clinical applications are reviewed and future research applications identified. Microdialysis has the potential to become an established part of mainstream multimodality monitoring during the management of acute brain injury but at present should be considered a research tool for use in specialist centres

Disturbances of sodium in critically ill adult neurologic patients: A clinical review

Disorders of sodium and water balance are common in critically ill adult neurologic patients. Normal aspects of sodium and water regulation are reviewed. The etiology of possible causes of sodium disturbance is discussed in both the general inpatient and the neurologic populations. Areas of importance are highlighted with regard to the differential diagnosis of sodium disturbance in neurologic patients, and management strategies are discussed. Specific discussions of the etiology, diagnosis, and management of cerebral salt wasting syndrome, the syndrome of inappropriate antidiuretic hormone secretion, and central diabetes insipidus are presented, as well as the problems of overtreatment. The importance of diagnosis at an early stage of these diseases is stressed, with a recommendation for conservative management of milder cases. Copyright © 2005 by Lippincott Williams & Wilkins

Applying human rights to children’s participation in research

Profound and multiple learning disabilities (PMLD) is a term used in the UK education system to refer to children with congenital neurological impairments that are said to result in global developmental delay. Traditionally, children with PMLD have been educated in special schools, and research informed by experimental psychology has aimed to develop intervention strategies and assessment tools to push children with PMLD through the so-called preverbal stages of development. There has been growing criticism of the dominance of psychological lenses in the PMLD field to the extent that they construct children’s identities in terms of cognitive and behavioural traits (or lack of). Furthermore, the postpositivist forms of experimental research have been challenged for overlooking the lived experiences of children with PMLD. To address the situation, this chapter aims to develop and examine a phenomenological framework that can guide researchers’ reflection about the lived social experiences of children with PMLD. The chapter explores literature on the experiences of embodiment and relationality, and investigates how a description of the lived experience of intersubjectivity can provide a framework for making sense of, and legitimising those tacit, pre-reflective intuitions about the sociality of children with PMLD. The chapter draws from the work of Maurice Merleau-Ponty (1908-1961) and his proponents to develop this framework, which is “tested” through application to participatory fieldwork research data that the author is currently engaged in. The chapter concludes with a discussion on the strengths and limitations of this approac