scholarly journals Effectiveness of Interprofessional Consultation-Based Interventions for Delirium: A Scoping Review

2021 ◽  
pp. 073346482110180
Author(s):  
Caitlin Monaghan ◽  
Grace Martin ◽  
Jason Kerr ◽  
Mary-Lynn Peters ◽  
Judith Versloot
Keyword(s):  
Pharmacological Interventions ◽  
Ovid Medline ◽  
Novel Approach ◽  
Geriatric Consultation ◽  
Core Components ◽  
Barriers To Implementation ◽  
Facilitators And Barriers ◽  
Multicomponent Interventions ◽  
Team Interventions ◽  
Insight Into

Background: Interprofessional geriatric consultation teams and multicomponent interventions are established models for delirium care. They are combined in interprofessional consultative delirium team interventions; however, insight into this novel approach is lacking. Objective: To describe the effectiveness and core components of consultation-based interventions for delirium. Method: Ovid MEDLINE, EMBASE, PsycINFO, CINAHL, and ProQuest. Data on core intervention components, outcomes, facilitators, and barriers were extracted. Results: 10 studies were included. Core intervention components were systematic delirium screening, ongoing consultation, implementation of non-pharmacologic and pharmacological interventions, and staff education. Of the included studies, 1/6 found a significant reduction in delirium incidence, 1/2 a reduction in delirium duration, and 2/3 found a reduction in falls. Facilitators and barriers to implementation were discussed. Conclusion: There was consistency in team structure and core components, however intervention operationalization and effectiveness varied widely. There is some evidence that this model is effective for reducing delirium and its sequelae.

Facilitators and Barriers to Implementation of School-Based Telehealth Asthma Care: Program Champion Perspectives

2021 ◽  
Author(s):  
Emily E Johnson ◽  
Claire MacGeorge ◽  
Kathryn L. King ◽  
Annie L. Andrews ◽  
Ronald J Teufel ◽  
...  
Keyword(s):  
Care Program ◽  
Asthma Care ◽  
School Based ◽  
Barriers To Implementation ◽  
Facilitators And Barriers

Anodic stripping voltammetry of anti-Vi antibody functionalized CdTe quantum dots for the specific monitoring of Salmonella enterica serovar Typhi

RSC Advances ◽  
2015 ◽  
Vol 5 (107) ◽  
pp. 88234-88240 ◽  
Author(s):  
Satish K. Pandey ◽  
Praveen Rishi ◽  
C. Raman Suri ◽  
Aaydha C. Vinayaka
Keyword(s):  
Quantum Dots ◽  
Capsular Polysaccharide ◽  
Anodic Stripping Voltammetry ◽  
Stripping Voltammetry ◽  
Cdte Quantum Dots ◽  
Salmonella Enterica Serovar Typhi ◽  
Novel Approach ◽  
Anodic Stripping ◽  
Vi Capsular Polysaccharide ◽  
Insight Into

CdTe QD based stripping voltammetry for Vi capsular polysaccharide detection. The technique has provided an insight into the competence of CdTe QD and GNP immuno-conjugates. This is a novel approach to characterize the efficiency of immuno-conjugates of QDs and GNPs.

Preservation for diverse users: digital preservation and the “Designated Community” at the Ontario Jewish Archives

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Nathan Moles
Keyword(s):  
Digital Preservation ◽  
Reference Points ◽  
Digital Information ◽  
User Group ◽  
Content Type ◽  
Open Archival Information System ◽  
Novel Approach ◽  
Core Components ◽  
Unique Approach

PurposeConventional approaches to digital preservation posit that archives should define a Designated Community, or future user group, for whom they preserve digital information. Archivists can then use their knowledge of these users as a reference to help them deliver digital information that is intelligible and usable. However, this approach is challenging for archives with mandates to serve wide and diverse audiences; these archives risk undermining their efforts by focusing on the interests of a narrow user group.Design/methodology/approachA unique approach to this challenge was developed in the context of a project to build a digital preservation program at the Ontario Jewish Archives (OJA). It draws from previous research on this topic and is based on a combination of practical and theoretical considerations.FindingsThe approach described here replaces the reference of a Designated Community with three core components: a re-articulation of the Open Archival Information System (OAIS) mandatory responsibilities; the identification of three distinct tiers of access for digital records; and the implementation of an access portal that allows digital records to be accessed and rendered online. Together with supplemental shifts in reference points, they provide an alternative to the concept of a Designated Community in the determination of preservation requirements, the identification of significant properties, the creation of Representation Information and in the evaluation of success.Originality/valueThis article contributes a novel approach to the ongoing conversation about the Designated Community in digital preservation, its application and its limitations in an archival context.

Envelope wages as a new normal? An insight into a pool of prospective quasi-formal workers in the European Union (EU)

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Josip Franic ◽  
Stanislaw Cichocki
Keyword(s):  
European Union ◽  
Pension System ◽  
Older Individuals ◽  
The European Union ◽  
Content Type ◽  
Random Intercept ◽  
Novel Approach ◽  
Wage Earners ◽  
Insight Into

PurposeIn spite of millions of quasi-formal workers in the European Union (EU), there is still limited understanding of what motivates workers to participate in these detrimental employment schemes, and why certain groups of workers exhibit higher inclination towards it. This article takes a novel approach by putting prospective envelope wage earners in the centre of this analysis.Design/methodology/approachData from the 2019 Special Eurobarometer on undeclared work are used, and two-level random intercept cumulative logit modelling is applied.FindingsOne in seven fully declared EU workers would have nothing against receiving one part of their wages off-the-books. Manual workers and individuals whose job assumes travelling are the most willing to accept such kind of remuneration, and the same applies to workers with low tax morale and those who perceive the risk of being detected and persecuted as very small. On the other hand, women, older individuals, married persons and employees from large enterprises express the smallest inclination towards envelope wages. The environment in which an individual operates also plays a non-negligible role as the quality of the pension system and the strength of social contract were also identified as significant determinants of workers' readiness to accept envelope wages.Originality/valueThis article fills in the gap in the literature by analysing what workers think about wage under-reporting and what factors drive their willingness to accept envelope wages.

Successes and Challenges of Implementing a Lung Cancer Screening Program in Federally Qualified Health Centers: A Qualitative Analysis Using the Consolidated Framework for Implementation Research

2020 ◽  
Author(s):  
Caitlin G. Allen ◽  
Megan M. Cotter ◽  
Robert A. Smith ◽  
Lesley Watson
Keyword(s):  
Lung Cancer ◽  
Cancer Screening ◽  
Screening Program ◽  
Lung Cancer Screening ◽  
Pilot Project ◽  
Health Centers ◽  
Implementation Barriers ◽  
Successful Program ◽  
Barriers To Implementation ◽  
Facilitators And Barriers

Abstract Background: The American Cancer Society (ACS) partnered with two federally qualified health centers (FQHCs) and American College of Radiology designated lung cancer screening facilities on a two-year pilot project to implement lung cancer screening. The project aimed to develop a referral program and care coordination practices to move patients through the screening continuum and identify critical facilitators and barriers to implementation. Methods: Evaluators conducted key informant interviews (N=46) with navigators, clinical staff, administrators from both sites, and ACS staff during annual site visits in 2017 and 2018 to capture data on implementation barriers and facilitators. Three evaluators conducted a thematic analysis using the Consolidated Framework for Implementation Research (CFIR) and assessed factors associated with effective implementation and improved screening outcomes.Results: One study site established a sustainable lung screening program, while the other encountered numerous implementation barriers which they failed to overcome. CFIR constructs highlighted critical barriers and factors associated with success and improved outcomes. Intervention Characteristics: Time spent with patients and disruption to normal workflows were challenges to implementation at both sites. Outer Setting: Both sites struggled with building patient trust and worked to gain trust by providing clear, consistent information about the screening process. One site was located in a state with Medicaid expansion that reimbursed screening but the other was not. Inner Setting: Engaged, supportive leaders who provided clear, consistent communication about implementation helped improve staff capacity, which was critical to building a successful program. Individual Characteristics: Knowledgeable, confident champions and intervention leaders were able to train, guide, and motivate staff throughout the intervention, whereas the absence of supportive leadership failed to produce staff champions and intervention leaders. Process: A slow, stepwise approach to implementation at one site allowed project champions to pilot-test the referral and reimbursement processes and resolve issues before scaling-up.Discussion: This pilot project provides insight into critical resources and steps for successful program implementation in underserved FQHC settings. Future efforts could build upon these findings by considering self-assessment and monitoring tools that incorporate CFIR constructs to help identify and address possible facilitators and barriers to implementation of LDCT.

scholarly journals Dysregulated Pyrimidine Biosynthesis Contributes to 5-FU Resistance in SCLC Patient-Derived Organoids but Response to a Novel Polymeric Fluoropyrimidine, CF10

Cancers ◽  
2020 ◽  
Vol 12 (4) ◽  
pp. 788 ◽  
Author(s):  
William H. Gmeiner ◽  
Lance D. Miller ◽  
Jeff W. Chou ◽  
Anthony Dominijanni ◽  
Lysette Mutkus ◽  
...  
Keyword(s):  
Drug Target ◽  
Pyrimidine Biosynthesis ◽  
Cancer Drug ◽  
Rna Seq ◽  
Novel Approach ◽  
Anti Cancer ◽  
New Treatments ◽  
Insight Into ◽  
Sclc Patient ◽  
Identify Gene Expression

Chemo-immunotherapy is central to the treatment of small cell lung cancer (SCLC). Despite modest progress made with the addition of immunotherapy, current cytotoxic regimens display minimal survival benefit and new treatments are needed. Thymidylate synthase (TS) is a well-validated anti-cancer drug target, but conventional TS inhibitors display limited clinical efficacy in refractory or recurrent SCLC. We performed RNA-Seq analysis to identify gene expression changes in SCLC biopsy samples to provide mechanistic insight into the potential utility of targeting pyrimidine biosynthesis to treat SCLC. We identified systematic dysregulation of pyrimidine biosynthesis, including elevated TYMS expression that likely contributes to the lack of efficacy for current TS inhibitors in SCLC. We also identified E2F1-3 upregulation in SCLC as a potential driver of TYMS expression that may contribute to tumor aggressiveness. To test if TS inhibition could be a viable strategy for SCLC treatment, we developed patient-derived organoids (PDOs) from human SCLC biopsy samples and used these to evaluate both conventional fluoropyrimidine drugs (e.g., 5-fluorouracil), platinum-based drugs, and CF10, a novel fluoropyrimidine polymer with enhanced TS inhibition activity. PDOs were relatively resistant to 5-FU and while moderately sensitive to the front-line agent cisplatin, were relatively more sensitive to CF10. Our studies demonstrate dysregulated pyrimidine biosynthesis contributes to drug resistance in SCLC and indicate that a novel approach to target these pathways may improve outcomes.

scholarly journals Facilitators and Barriers to Implementation of a Peer Support Intervention for Patients with Chronic Pain: A Qualitative Study

Pain Medicine ◽  
2018 ◽  
Vol 20 (7) ◽  
pp. 1311-1320
Author(s):  
Sarah A Shue ◽  
Alan B McGuire ◽  
Marianne S Matthias
Keyword(s):  
Chronic Pain ◽  
Peer Support ◽  
Medical Center ◽  
Successful Implementation ◽  
Clinical Settings ◽  
Support Intervention ◽  
Barriers To Implementation ◽  
Facilitators And Barriers ◽  
Peer Coach ◽  
Peer Support Intervention

Abstract Objective Pain self-management information and support, delivered by peers, are a potentially useful approach to help patients who are struggling to manage their chronic pain. Before implementation into clinical settings, it is important to understand factors that may influence the success of implementation. The purpose of this study was to explore facilitators and barriers to implementation of peer support for chronic pain. Design Semistructured interviews were conducted with clinicians who provide care to patients with chronic pain, regarding their perceptions of the proposed peer support intervention. Setting A single US Veterans Affairs Medical Center. Subjects Using maximum variation sampling, 15 providers were interviewed (11 women, four men). Clinicians’ disciplines included primary care, physical therapy, nursing, clinical psychology, social work, and pharmacy. Results Findings indicated that clinicians 1) had an overall positive perception of the intervention; 2) had specific intervention outcomes they wanted for patients; 3) anticipated that the intervention could positively influence their role; 4) anticipated barriers to intervention participation and maintenance; and 5) had concerns regarding peer coach selection. Findings are discussed in the context of the Consolidated Framework for Implementation Research. Conclusions Understanding clinician perceptions of a peer support intervention is critical for successful implementation. The feedback collected in this study will facilitate implementation of the intervention on a broader scale, allowing more patients to benefit.

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