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https://www.readbyqxmd.com/read/29351050/hidden-medical-devices-in-the-school-setting-what-the-school-nurse-needs-to-know-about-the-safe-use-of-baclofen-pumps
#1
Barbara Obst, Megan Roesler
One of the "hidden" medical devices in the school setting is the baclofen pump, which is used for the treatment of spasticity. The goals of spasticity treatment are to decrease muscle tone, deformity, and pain in order to maximize function and ease of care for both child and caregiver. The use of an intrathecal baclofen pump, often for children with cerebral palsy, spinal cord injury, brain injury, or stroke, has been effective in spasticity treatment. It is important for school nurses to be aware of the safety implications associated with this type of device...
January 1, 2018: NASN School Nurse
https://www.readbyqxmd.com/read/29345733/putative-mechanisms-of-cognitive-decline-with-implications-for-clinical-research-and-practice
#2
Tadeu Oliveira, Angela Starkweather, Divya Ramesh, Joseph Fetta, Debra Lynch Kelly, Debra E Lyon, Lana Sargent
Multiple intrinsic and extrinsic mechanisms contribute to vulnerability of cognitive decline and nurses play a significant role in assisting individuals and families to use strategies for healthy cognitive aging. The objective of this narrative review is to provide a synthesis of the intrinsic and extrinsic mechanisms of cognitive decline and conditions that are associated with cognitive decline. Well-established intrinsic mechanisms of cognitive decline include aging, apolipoprotein E (APOE) ε4 carrier status, SORL1 mutations, neuroinflammation, mitochondrial dysfunction, amyloid deposition, and demyelination...
January 18, 2018: Nursing Forum
https://www.readbyqxmd.com/read/29330695/glucosuria-and-all-cause-mortality-among-general-screening-participants
#3
Kunitoshi Iseki, Tsuneo Konta, Koichi Asahi, Kunihiro Yamagata, Shouichi Fujimoto, Kazuhiko Tsuruya, Ichiei Narita, Masato Kasahara, Yugo Shibagaki, Toshiki Moriyama, Masahide Kondo, Chiho Iseki, Tsuyoshi Watanabe
BACKGROUND: Dipstick urine tests are used for general health screening in Japan, but how the test results (e.g., glucosuria) relate to mortality is unknown. METHODS: Subjects participated in a nationwide screening in 2008 in six districts in Japan. We identified those who might have died using the national database of death certificates from 2008 to 2012 (total registered ~ 6 million) and verified candidates with the regional National Health Insurance Agency and public health nurses...
January 12, 2018: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/29321338/improving-access-to-thrombolysis-and-inhospital-management-times-in-ischemic-stroke-a-stepped-wedge-randomized-trial
#4
Julie Haesebaert, Norbert Nighoghossian, Catherine Mercier, Anne Termoz, Sylvie Porthault, Laurent Derex, Pierre-Yves Gueugniaud, Estelle Bravant, Muriel Rabilloud, Anne-Marie Schott
BACKGROUND AND PURPOSE: A suboptimal number of ischemic stroke patients eligible for thrombolysis actually receive it, partly because of extended inhospital delays. We developed a comprehensive program designed for emergency unit staff and evaluated its effectiveness for reducing intrahospital times and improving access to thrombolysis. METHODS: We conducted a randomized stepped-wedge controlled trial in 18 emergency unit. The sequentially implemented training intervention, targeting emergency physicians and nurses, was based on specifically designed videos and interactive simulation workshops on intrahospital management optimization...
January 10, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29321134/efficacy-of-a-chronic-care-based-intervention-on-secondary-stroke-prevention-among-vulnerable-stroke-survivors-a-randomized-controlled-trial
#5
Eric M Cheng, William E Cunningham, Amytis Towfighi, Nerses Sanossian, Robert J Bryg, Thomas L Anderson, Frances Barry, Susan M Douglas, Lillie Hudson, Monica Ayala-Rivera, Jeffrey J Guterman, Sandra Gross-Schulman, Sylvia Beanes, Andrea S Jones, Honghu Liu, Barbara G Vickrey
BACKGROUND: Disparities of care among stroke survivors are well documented. Effective interventions to improve recurrent stroke preventative care in vulnerable populations are lacking. METHODS AND RESULTS: In a randomized controlled trial, we tested the efficacy of components of a chronic care model-based intervention versus usual care among 404 subjects having an ischemic stroke or transient ischemic attack within 90 days of enrollment and receiving care within the Los Angeles public healthcare system...
January 2018: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/29317012/prehospital-identification-of-patients-with-a-final-hospital-diagnosis-of-stroke
#6
Elin Andersson, Linda Bohlin, Johan Herlitz, Annelie J Sundler, Zoltán Fekete, Magnus Andersson Hagiwara
Introduction the early phase of stroke, minutes are critical. Since the majority of patients with stroke are transported by the Emergency Medical Service (EMS), the early handling and decision making by the EMS clinician is important. Problem The study aim was to evaluate the frequency of a documented suspicion of stroke by the EMS nurse, and to investigate differences in the clinical signs of stroke and clinical assessment in the prehospital setting among patients with regard to if there was a documented suspicion of stroke on EMS arrival or not, in patients with a final hospital diagnosis of stroke...
January 10, 2018: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/29315463/a-shorter-system-delay-for-haemorrhagic-stroke-than-ischaemic-stroke-among-patients-who-use-emergency-medical-service
#7
M Andersson Hagiwara, B Wireklint Sundström, P Brink, J Herlitz, P-O Hansson
OBJECTIVES: We compare various aspects in the early chain of care among patients with haemorrhagic stroke and ischaemic stroke. MATERIALS & METHODS: The Emergency Medical Services (EMS) and nine emergency hospitals, each with a stroke unit, were included. All patients hospitalised with a first and a final diagnosis of stroke between 15 December 2010 and 15 April 2011 were included. The primary endpoint was the system delay (from call to the EMS until diagnosis)...
January 8, 2018: Acta Neurologica Scandinavica
https://www.readbyqxmd.com/read/29303838/experiences-related-to-urinary-incontinence-of-stroke-patients-a-qualitative-descriptive-study
#8
Gulcihan Arkan, Ayse Beser, Vesile Ozturk
INTRODUCTION: Poststroke urinary incontinence is a common problem, with a prevalence ranging from 32% to 79%. Urinary incontinence after stroke has negative physiological, psychological, and economic effects, which lead to lifestyle changes for both patients and caregivers. Nurses play an important role in preventing and improving incontinence, understanding the experiences of individuals experiencing incontinence, providing healthcare for them, and implementing behavioral therapy methods...
February 2018: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
https://www.readbyqxmd.com/read/29303837/streamlining-the-process-for-intravenous-tissue-plasminogen-activator
#9
Erin Lawrence, Dawn Merbach, Sherry Thorpe, Rafael H Llinas, Elisabeth B Marsh
BACKGROUND: For ischemic stroke, the chance of improved recovery is directly impacted by length of time from symptom onset to administration of intravenous tissue plasminogen activator (IV tPA). Despite the importance of rapid treatment, stroke centers struggle with achieving consistent door-to-needle times of less than 60 minutes. METHODS: We implemented a change in our response to the acute stroke patient by adding a dedicated stroke nurse and a nursing flow sheet focused on critical benchmarks before treatment...
February 2018: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
https://www.readbyqxmd.com/read/29301522/the-low-indexes-of-metabolism-intervention-trial-limit-design-and-baseline-data-of-a-randomized-controlled-clinical-trial-to-evaluate-how-alerting-primary-care-teams-to-low-metabolic-values-could-affect-the-health-of-patients-aged-75-or-older
#10
Nir Tsabar, Yan Press, Johanna Rotman, Bracha Klein, Yonatan Grossman, Maya Vainshtein-Tal, Sophia Eilat-Tsanani
BACKGROUND: Too-low body mass index (BMI), HbA1c% or cholesterol levels predicts poor survival. This study investigates whether e-mails about these low values, improve health of people older than 75 years. METHODS: LIMIT - an open label randomized trial - compares usual care to the addition of an e-mail which alerts the family physicians and nurses to low metabolic indexes of a specific patient and advises on nutritional and medical changes. PARTICIPANTS: Clalit Health Services (CHS) patients in the Northern and Southern Districts, aged ≥75 years with any of the following inclusion criteria: a...
January 5, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29291599/a-2-year-prospective-follow-up-study-of-temporal-changes-associated-with-post-stroke-cognitive-impairment
#11
HyunSoo Oh, JongSuk Park, WhaSook Seo
AIMS: To explore temporal patterns of change in cognitive impairments during the 2 years following stroke and to identify factors that affect these temporal changes. BACKGROUND: Despite the prognostic importance, temporal changes in post-stroke cognitive impairment have not been systematically investigated. DESIGN: A non-experimental, prospective, longitudinal descriptive study design. METHODS: Fifty-two stroke patients were enrolled...
January 1, 2018: International Journal of Nursing Practice
https://www.readbyqxmd.com/read/29288499/benefit-finding-for-chinese-family-caregivers-of-community-dwelling-stroke-survivors-a-cross-sectional-study
#12
Yongxia Mei, Susan Wilson, Beilei Lin, Yingshuang Li, Zhenxiang Zhang
AIMS AND OBJECTIVES: To identify whether benefit finding is a mediator or moderator in the relationship between caregiver burden and psychological well-being (anxiety and depression) in Chinese family caregivers of community-dwelling stroke survivors. BACKGROUND: Family caregivers not only bear a heavy burden,a high level of anxiety and depression, but also experience benefit finding (positive effects results from stressful events). However, the relationships among benefit finding, caregiver burden and psychological well-being in Chinese family caregivers are not well known...
December 29, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29284341/cerebral-perfusion-monitoring-in-adult-patients-following-cardiac-surgery-an-observational-study
#13
Tammy Slater, Julie Stanik-Hutt, Patricia Davidson
BACKGROUND: Strokes following adult cardiac surgery contribute to burdensome neurocognitive complications, which are often difficult to detect during the perioperative period. Fluctuations in regional cerebral perfusion and co-morbid conditions, such as hypertension, diabetes, prior stroke, symptomatic carotid stenosis, aortic atherosclerotic disease, and peripheral vascular disease are associated with perioperative strokes. Approaches to achieve optimal cerebral perfusion remain elusive and traditional strategies for perioperative monitoring are not always sufficiently sensitive to detect acute changes in cerebral perfusion...
December 28, 2017: Contemporary Nurse
https://www.readbyqxmd.com/read/29276557/safety-and-costs-of-stroke-unit-admission-for-select-acute-intracerebral-hemorrhage-patients
#14
Corey R Fehnel, Kimberly M Glerum, Linda C Wendell, N Stevenson Potter, Brian Silver, Muhib Khan, Ali Saad, Shadi Yaghi, Richard N Jones, Karen Furie, Bradford B Thompson
Background and Purpose: There are limited data to guide intensive care unit (ICU) versus dedicated stroke unit (SU) admission for intracerebral hemorrhage (ICH) patients. We hypothesized select patients can be safely cared for in SU versus ICU at lower costs. Methods: We conducted a retrospective cohort study of consecutive patients with predefined minor ICH (≤20 cm3, supratentorial, no coagulopathy) receiving care in either an ICU or an SU. Multiple linear regression and inverse probability weighting were used to adjust for differences in patient characteristics and nonrandom ICU versus SU assignment...
January 2018: Neurohospitalist
https://www.readbyqxmd.com/read/29273658/qualitative-investigation-of-the-perceptions-and-experiences-of-nursing-and-allied-health-professionals-involved-in-the-implementation-of-an-enriched-environment-in-an-australian-acute-stroke-unit
#15
Ingrid C M Rosbergen, Sandra G Brauer, Sarah Fitzhenry, Rohan S Grimley, Kathryn S Hayward
OBJECTIVE: An enriched environment embedded in an acute stroke unit can increase activity levels of patients who had stroke, with changes sustained 6 months post-implementation. The objective of this study was to understand perceptions and experiences of nursing and allied health professionals involved in implementing an enriched environment in an acute stroke unit. DESIGN: A descriptive qualitative approach. SETTING: An acute stroke unit in a regional Australian hospital...
December 21, 2017: BMJ Open
https://www.readbyqxmd.com/read/29259939/effect-of-high-quality-nursing-on-improvement-of-anxiety-and-depression-of-patients-with-acute-stroke-in-mri-examination
#16
Lin Wu, Li Zhang
Background: We aimed to evaluate the effect of high-quality nursing on improvement of anxiety and depression of patients with acute stroke in magnetic resonance imaging (MRI) examination. Methods: A total of 120 patients diagnosed as acute stroke for the first time were enrolled in Liaocheng People's Hospital from 2016-2017 and randomly divided into control group (n=60) and observation group (n=60). All patients received cerebral MRI examination at 6h and 24h after admission and before discharge...
December 2017: Iranian Journal of Public Health
https://www.readbyqxmd.com/read/29250222/effects-of-computerized-decision-support-systems-on-management-of-atrial-fibrillation-a-scoping-review
#17
Reza Sheibani, Ehsan Nabovati, Mehdi Sheibani, Ameen Abu-Hanna, Alireza Heidari-Bakavoli, Saeid Eslami
Background: Potential role of computerized decision support system on management of atrial fibrillation is not well understood. Objectives: To systematically review studies that evaluate the effects of computerized decision support systems and decision aids on aspects pertaining to atrial fibrillation. Data Sources: We searched Medline, Scopus and Cochrane database. Last date of search was 2016, January 10. Selection criteria: Computerized decision support systems that help manage atrial fibrillation and decision aids that provide useful knowledge for patients with atrial fibrillation and help them to self-care...
June 2017: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/29249776/-diseases-requiring-severe-level-care-certification-for-long-term-care-insurance
#18
Kyoko Takahashi, Eri Tsukishima
Objectives Extending health expectancy is important; however, health and welfare programs in local areas and communities present their own issues. This study aimed to identify main diseases requiring severe-level care certification for long-term care insurance based on information gathered from opinion papers prepared by primary doctors.Methods Data were obtained for 4,089 patients aged ≧65 years who were certified for long-term care insurance for the first time between April 1, 2013, and March 31, 2015...
2017: [Nihon Kōshū Eisei Zasshi] Japanese Journal of Public Health
https://www.readbyqxmd.com/read/29242239/defining-quality-in-cardiovascular-imaging-a-scientific-statement-from-the-american-heart-association
#19
REVIEW
Leslee J Shaw, Ron Blankstein, Jill E Jacobs, Jonathon A Leipsic, Raymond Y Kwong, Viviany R Taqueti, Rob S B Beanlands, Jennifer H Mieres, Scott D Flamm, Thomas C Gerber, John Spertus, Marcelo F Di Carli
The aims of the current statement are to refine the definition of quality in cardiovascular imaging and to propose novel methodological approaches to inform the demonstration of quality in imaging in future clinical trials and registries. We propose defining quality in cardiovascular imaging using an analytical framework put forth by the Institute of Medicine whereby quality was defined as testing being safe, effective, patient-centered, timely, equitable, and efficient. The implications of each of these components of quality health care are as essential for cardiovascular imaging as they are for other areas within health care...
December 2017: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29235430/prevalence-and-risk-factors-for-delirium-diagnosis-in-patients-followed-in-general-practices-in-germany
#20
Jens Bohlken, Karel Kostev
BACKGROUND: The aim of this study is to identify the prevalence and risk factors of documented delirium in general practices in Germany. METHODS: The present study includes 2,194 patients over the age of 65 years with delirium and 2,194 controls without delirium from a sample of 6,180,042 patients from 1,262 general practices. Multivariate logistic regression models were fitted with delirium as a dependent variable and other disorders and drugs as potential predictors...
December 13, 2017: International Psychogeriatrics
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