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critical interventions

Jian Du, Gehua Zhen, Huanwen Chen, Shuming Zhang, Liming Qing, Xiuli Yang, Gabsang Lee, Hai-Quan Mao, Xiaofeng Jia
Peripheral nerve injuries often lead to incomplete recovery and contribute to significant disability to approximately 360,000 people in the USA each year. Stem cell therapy holds significant promise for peripheral nerve regeneration, but maintenance of stem cell viability and differentiation potential in vivo are still major obstacles for translation. Using a made-in-house 96-well vertical electrical stimulation (ES) platform, we investigated the effects of different stimulating pulse frequency, duration and field direction on human neural crest stem cell (NCSC) differentiation...
July 20, 2018: Biomaterials
Callum J Donaldson, Ka Hou Lao, Lingfang Zeng
Atherosclerosis, a chronic inflammatory condition that is characterized by the accumulation of lipid-loaded macrophages, occurs preferentially at the arterial branching points where disturbed flow is prominent. The pathogenesis of atherosclerotic lesion formation is a multistage process involving multiple cell types, inflammatory mediators and hemodynamic forces in the vessel wall in response to atherogenic stimuli. Researches from the past decade have uncovered the critical roles of microRNAs (miRNAs) in regulating multiple pathophysiological effects and signaling pathways in endothelial cells (ECs), vascular smooth muscle cells (VSMCs), macrophages and lipid homeostasis, which are key in atherosclerotic lesion formation...
August 8, 2018: Journal of Molecular and Cellular Cardiology
Liron Sinvani, Jessy Warner-Cohen, Andrew Strunk, Travis Halbert, Ruchika Harisingani, Colm Mulvany, Michael Qiu, Andrzej Kozikowski, Vidhi Patel, Tara Liberman, Maria Carney, Renee Pekmezaris, Gisele Wolf-Klein, Corey Karlin-Zysman
OBJECTIVES: To determine whether a multicomponent intervention improves care in hospitalized older adults with cognitive impairment. DESIGN: One-year retrospective chart review with propensity score matching on critical demographic and clinical variables was used to compare individauls with cognitive impairmenet on intervention and nonintervention units. SETTING: Large tertiary medical center. PARTICIPANTS: All hospitalized individuals age 65 and older with cognitive impairment admitted to medicine who required constant or enhanced observation for behavioral and psychological symptoms...
August 11, 2018: Journal of the American Geriatrics Society
Anita K Chisholm, Vicki A Anderson, Natalie A Pride, Stephanie Malarbi, Kathryn N North, Jonathan M Payne
In light of the proliferation of recent research into social function in neurofibromatosis type 1 (NF1), a systematic review and meta-analysis is required to synthesise data and place findings within the context of a theoretical framework. This paper reviews findings from research into social function and autism spectrum disorder (ASD) in children and adults with NF1 and integrates these findings with the Socio-Cognitive Integration Abilities Model (SOCIAL). It also critically appraises links between social outcomes, internal and external factors moderating social functioning, cognitive domains implicated in social functioning, and underlying neural pathology in NF1...
August 11, 2018: Neuropsychology Review
Laura M Schwab-Reese, Vladka Kovar, Sarah Brummett, Carol Runyan
Suicide is a critical public health problem, resulting in more than 40,000 deaths a year in the United States (U.S.) and 800,000 globally. Provision of mental health services is a key component of a comprehensive population-based approach to prevention. State licensing boards in some U.S. states require mental health practitioners to be trained in suicide risk assessment and management, but such requirements are not uniform. Our case study examined mental health practitioner preparedness to engage in suicide prevention and intervention in Colorado, a state with a high suicide rate, using a survey designed to understand training experiences and perceptions of the acceptability of mandated training...
August 10, 2018: Journal of Public Health Policy
Lindsay Atherton Edwards, Henri Justino, Shaine A Morris, Jack Rychik, Chris Feudtner, John D Lantos
A 20-week-old fetus was diagnosed with critical pulmonary valve stenosis. Given the ultrasound findings, the outcome was difficult to predict. The fetal cardiologists discussed the possibility of a pulmonary valvuloplasty (an experimental procedure) with the parents, wherein the fetal right ventricle would be punctured with a long 18G needle, and through it, a wire advanced across the pulmonary valve, allowing for balloon dilation of the valve. The experimental procedure had been performed at a handful of centers...
August 10, 2018: Pediatrics
Jennifer L Sullivan, Marlena H Shin, Ryann L Engle, Enzo Yaksic, Carol VanDeusen Lukas, Michael K Paasche-Orlow, Leigh M Starr, Joseph D Restuccia, Sally K Holmes, Amy K Rosen
BACKGROUND: Improving the process of hospital discharge is a critical priority. Interventions to improve care transitions have been shown to reduce the rate of early unplanned readmissions, and consequently, there is growing interest in improving transitions of care between hospital and home through appropriate interventions. Project Re-Engineered Discharge (RED) has shown promise in strengthening the discharge process. Although studies have analyzed the implementation of RED among private-sector hospitals, little is known about how hospitals in the Veterans Health Administration (VHA) have implemented RED...
August 7, 2018: Joint Commission Journal on Quality and Patient Safety
Asmamaw Malede, Kassahun Alemu, Mulugeta Aemero, Sirak Robele, Helmut Kloos
BACKGROUND: In Ethiopia, malaria has declined in the last decade; only a small number of cases have been reported, primarily from hotspots. The contribution of house proximity to water bodies and the role of migration in malaria transmission has not yet been examined in detail in northwest Ethiopia. Individual and household-level environmental and socio-demographic drivers of malaria heterogeneity were explored contextually in meso-endemic villages around Lake Tana, northwest Ethiopia...
August 10, 2018: Malaria Journal
Gerry F Killeen, Thomas E Reed
BACKGROUND: Portfolio effects were first described as a basis for mitigating against financial risk by diversifying investments. Distributing investment across several different assets can stabilize returns and reduce risks by statistical averaging of individual asset dynamics that often correlate weakly or negatively with each other. The same simple probability theory is equally applicable to complex ecosystems, in which biological and environmental diversity stabilizes ecosystems against natural and human-mediated perturbations...
August 10, 2018: Malaria Journal
Nadiya Sunderji, Allyson Ion, Dan Huynh, Paul Benassi, Abbas Ghavam-Rassoul, Adriana Carvalhal
OBJECTIVE: Integrated or collaborative care is a well-evidenced and widely practiced approach to improve access to high-quality mental health care in primary care and other settings. Psychiatrists require preparation for this emerging type of practice, and such training is now mandatory for Canadian psychiatry residents. However, it is not known how best to mount such training, and in the absence of such knowledge, the quality of training across Canada has suffered. To guide integrated care education nationally, we conducted a systematic review of published and unpublished training programs...
August 2018: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
Nguyen K Tran, Neal D Goldstein, Seth L Welles
Background: Valid measurement of determinants of HIV infection among men who have sex with men (MSM) is critical for intervention planning and resource allocation. However, sexual minority research concerning HIV risk often relies on proxy exposures of sexual behaviors such as sexual orientation and partner gender. Inferring high risk sexual behaviors (i.e., condomless anal intercourse) from these proxies inaccurately captures HIV risk, but few studies have attempted to correct for this bias. Methods: We performed a systematic review of methodological practices for estimating risk of HIV infection among MSM...
August 9, 2018: International Journal of Environmental Research and Public Health
Courtney L Scherr, Sharon Aufox, Amy A Ross, Sanjana Ramesh, Catherine A Wicklund, Maureen Smith
From a public health perspective, the "All of Us" study provides an opportunity to isolate targeted and cost-effective prevention and early-detection strategies. Identifying motivations for participation in large-scale genomic sequencing (LSGS) studies, and motivations and preferences to receive results will help determine effective strategies for "All of Us" study implementation. This paper offers a critical review of the literature regarding LSGS for adult onset hereditary conditions where results could indicate an increased risk to develop disease...
August 8, 2018: Healthcare (Basel, Switzerland)
Joline Goossens, Marjon De Roose, Ann Van Hecke, Régine Goemaes, Sofie Verhaeghe, Dimitri Beeckman
BACKGROUND: Healthcare providers play an important role in providing preconception care to women and men of childbearing age. Yet, the provision of preconception care by healthcare providers remains low. OBJECTIVES: To provide an overview of barriers and facilitators at multiple levels that influence the provision of preconception care by healthcare providers. DESIGN: A mixed-methods systematic review. DATA SOURCES: PubMed, Web of Science, CINAHL, The Cochrane Library, and EMBASE were systematically searched up to April 27, 2017...
June 18, 2018: International Journal of Nursing Studies
Shan Qiao, Xiaoming Li, Yuejiao Zhou, Zhiyong Shen, Bonita Stanton
Individuals' attitudes toward evidence-based practices (EBP) are critical in adopting, implementing and maintaining the EBP in clinical settings. Multiple empirical studies have examined how work context may shape perceptions and attitudes towards EBP. The current study aims to further explore how both work and family contexts, as assessed by three psychosocial indicators (i.e., occupational stress, work-related social support from coworkers, and work-related social support from family), may affect attitudes toward EBP among health care providers in HIV clinics in China...
2018: PloS One
Farhad Rikhtegar Nezami, Lambros S Athanasiou, Junedh M Amrute, Elazer R Edelman
Management of aortic dissections (AD) is still challenging, with no universally-approved guideline among possible surgical, endovascular or medical therapies. Approximately 25% of AD patients suffer post-intervention malperfusion syndrome or hemodynamic instability, with the risk of sudden death if left untreated. Part of the issue is that vascular implants may themselves induce flow disturbances that critically impact vital organs. A multilayer mesh construct might obviate the induced flow disturbances and it is this concept we investigated...
August 10, 2018: American Journal of Physiology. Heart and Circulatory Physiology
Brayden N Kameg, Donna G Nativio
BACKGROUND AND PURPOSE: Primary care providers who encounter children are often the first line of contact for individuals with gender dysphoria, which occurs when sex assigned at birth is incongruent with one's true, expressed sexual identity. Because those with untreated gender dysphoria are at risk of a variety of negative outcomes, including mood symptomatology, suicidality, substance use disorders, and other psychosocial risk factors, it is critical that health care providers are adept in the provision of holistic, patient-centered care...
August 6, 2018: Journal of the American Association of Nurse Practitioners
Jinsoo Min, Youlim Kim, Jung-Kyu Lee, Hannah Lee, Jinwoo Lee, Kyung Su Kim, Young-Jae Cho, You Hwan Jo, Ho Geol Ryu, Kyuseok Kim, Sang-Min Lee, Yeon Joo Lee
Although family satisfaction is an important indicator for quality improvement of intensive care units (ICUs), few studies have translated family satisfaction data into quality improvement in Asia. A prospective multicenter study was conducted to evaluate family satisfaction regarding the care of patients and their family.The family satisfaction in the ICU (FS-ICU) questionnaire was administered from January 2015 to February 2016 at ICUs of 3 tertiary teaching hospitals in South Korea. Family members of adult patients, staying at an ICU for ≥48 hours, were included...
August 2018: Medicine (Baltimore)
Esther G A Karssemeijer, Fleur H de Klijn, Willem J R Bossers, Marcel G M Olde Rikkert, Marieke J G van Heuvelen
BACKGROUND AND PURPOSE: Community-dwelling persons with dementia are inactive most of the day. The purpose of this study was to rank the barriers, motivators, and facilitators that hamper or promote physical activity (PA) participation for persons with dementia. This could provide knowledge that can be used to design effective interventions to promote PA participation for persons with dementia. METHODS: Twenty community-dwelling persons with dementia, mean (SD) age = 79 (5...
August 7, 2018: Journal of Geriatric Physical Therapy
Meredith Campbell Britton, Beth Hodshon, Sarwat I Chaudhry
OBJECTIVES: Care transitions between hospitals and skilled nursing facilities (SNFs) are associated with disruptions in patient care and high risk for adverse events. Communication between hospital-based and SNF-based clinicians is often suboptimal; there have been calls to foster direct, real-time communication between sending and receiving clinicians to enhance patient safety. This article described the implementation of a warm handoff between hospital and SNF physicians and advanced practice providers at the time of hospital discharge...
August 9, 2018: Journal of Patient Safety
Mari Takashima, Jessica Schults, Gabor Mihala, Amanda Corley, Amanda Ullman
OBJECTIVES: To examine the proportion and rate of central venous access device failure and complications across central venous access device types in adult intensive care. DATA SOURCES: A systematic search was undertaken in the electronic databases Cochrane Central Register of Controlled Trials (CENTRAL), Embase, U.S. National Library of Medicine National Institutes of Health (MEDLINE), and Cumulative Index to Nursing and Allied Health (CINAHL) in September 2017...
August 7, 2018: Critical Care Medicine
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