Identifying Risk Factors Associated With Postoperative Infection Following Elective Lower-Extremity Total Joint Arthroplasty.

This article addresses the importance of identifying risk factors associated with postoperative infection following elective lower-extremity total joint arthroplasty. Specifically, this review discusses risk factors recognized by the American Academy of Orthopaedic Surgeons that should be carefully considered and assessed by the orthopaedic team in collaboration with the primary care provider before proceeding with surgery.

The Impact of Point-of-Care Hemoglobin A1c Testing on Population Health-Based Onsite Testing Adherence: A Primary-Care Quality Improvement Study.

Background: The hemoglobin A1c (HbA1c) is a gold-standard test to diagnose and monitor diabetes mellitus and has been incorporated into population health performance metrics for quality care. However, patients and practices remain challenged in completing timely HbA1c tests. Point-of-care testing (POCT) for HbA1c provides a quick, easy, reliable method for monitoring diabetes in the primary care office setting.

Validity of the Spot Vision Screener in detecting vision disorders in children 6 months to 36 months of age.

Purpose: To evaluate the Spot Vision Screener in detecting targeted vision disorders compared to cycloplegic retinoscopy in children <3 years of age.

Methods: Children, ages 6 months to 36 months underwent vision screening using the Spot Vision Screener. Results were compared to results of comprehensive eye examinations.

Opioid Prescribing by Nurse Practitioners in Medicare Part D: Impact of State Scope of Practice Legislation.

Many state legislatures restrict nurse practitioner (NP) scope of practice as a way of addressing patient safety concerns. The purpose of this study was to investigate the influence of state NP scope of practice laws on the prescription of oxycodone and hydrocodone containing medications by NP and MD/DO/PA prescribers to Medicare Part D beneficiaries. Using the Medicare Part D public use file, we analyzed oxycodone and hydrocodone containing prescriptions per Medicare Part D beneficiary by prescriber type, NP state scope of practice, and geographic variables.

Use of Simulation to Integrate Cultural Humility Into Advanced Health Assessment for Nurse Practitioner Students.

Background: Increasing cultural humility among nursing students requires the application of knowledge and skills. The integration of an Objective Structured Clinical Examination (OSCE) offered nurse practitioner students practice in simulation.

Method: This learning activity included pre- and postassessments of knowledge regarding cultural issues and level of student satisfaction.

Changing Resident Physician Studying Behaviors: A Randomized, Comparative Effectiveness Trial of Goal Setting Versus Use of WOOP.

Background: Following through on one's goals to study is essential for effective, self-regulated learning. This can be difficult for residents because of clinical demands and limited personal time. WOOP (Wish, Outcome, Obstacle, Plan) is a self-regulation strategy, also known as .

Primary Care-Based Health Coaching Intervention for Weight Loss in Overweight/Obese Adults: A 2-Year Experience.

Obesity is a major contributor to medical comorbidity and places a large economic burden on health care. This study examined the effectiveness of primary care-integrated health coaching for weight loss in overweight/obese patients. This observational clinical study with a retrospective comparison analysis was performed at an urban academic primary care practice.

Health hackathons: theatre or substance? A survey assessment of outcomes from healthcare-focused hackathons in three countries.

Background: Healthcare-focused hackathons are 48-hour platforms intended to accelerate novel medical technology. However, debate exists about how much they contribute to medical technology innovation. The Consortium for Affordable Medical Technologies (CAMTech) has developed a three-pronged model to maximise their effectiveness.

Preliminary Predictors of Initial Attendance, Symptom Burden, and Motor Subtype in a US Functional Neurological Disorders Clinic Population.

Background And Objective: Although many patients present with functional neurological symptoms (FNS), few US clinics offer specialized FNS care, and data on clinic attendees remain limited. We determined predictors of initial attendance, symptom burden, and FNS subtype in the first patients referred to our Functional Neurological Disorders Clinic for suspected FNS.

Methods: We reviewed the charts of 62 consecutive patients (46 women, 16 men).

Promoting interprofessionalism: initial evaluation of a master of science in health professions education degree program.

This survey study assessed former students' perceptions on the efficacy of how well a newly implemented master's in health professions education degree program achieved its academic aims. These academic aims were operationalized by an author-developed scale to assess the following domains: a) developing interprofessional skills and identity; b) acquiring new academic skills; and c) providing a student-centered environment. The respondents represented a broad range of health care providers, including physicians, nurses, and occupational and physical therapists.

Identification and Treatment of New Inflammatory Triggers for Complex Regional Pain Syndrome: Small Intestinal Bacterial Overgrowth and Obstructive Sleep Apnea.

Complex regional pain syndrome (CRPS) is evoked by conditions that may be associated with local and/or systemic inflammation. We present a case of long-standing CRPS in a patient with Ehlers-Danlos syndrome in which prolonged remission was attained by directing therapy toward concomitant small intestinal bacterial overgrowth, obstructive sleep apnea, and potential increased microglia activity. We theorize that cytokine production produced by small intestinal bacterial overgrowth and obstructive sleep apnea may act as stimuli for ongoing CRPS symptoms.

Impact of Intensive Summer Reading Intervention for Children With Reading Disabilities and Difficulties in Early Elementary School.

Efficacy of an intensive reading intervention implemented during the nonacademic summer was evaluated in children with reading disabilities or difficulties (RD). Students (ages 6-9) were randomly assigned to receive Lindamood-Bell's Seeing Stars program ( n = 23) as an intervention or to a waiting-list control group ( n = 24). Analysis of pre- and posttesting revealed significant interactions in favor of the intervention group for untimed word and pseudoword reading, timed pseudoword reading, oral reading fluency, and symbol imagery.

Patient-reported outcomes in multiple sclerosis: Relationships among existing scales and the development of a brief measure.

Several patient-reported outcome (PRO) measures are commonly used in multiple sclerosis (MS) research, but the relationship among items across measures is uncertain. We proposed to evaluate the associations between items from a standard battery of PRO measures used in MS research and to develop a brief, reliable and valid instrument measure by combining these items into a single measure. Subjects (N = 537) enrolled in CLIMB complete a PRO battery that includes the Center for Epidemiologic Studies Depression Scale, Medical Outcomes Study Modified Social Support Survey, Modified Fatigue Impact Scale and Multiple Sclerosis Quality of Life-54.

Effect of Lidocaine on Swallowing During FEES in Patients With Dysphagia.

Purpose: The aims of this study were to assess the effects of 0.2 mL of 4% atomized lidocaine on swallowing and tolerability during Fiberoptic Endoscopic Evaluation of Swallowing (FEES).

Methods: A single blinded study was conducted with 17 dysphagic patients, who received 4 standardized boluses in 2 sequential FEES exams under 2 conditions: non-anesthetized (decongestant only) and anesthetized (lidocaine 4%+decongestant).

Reliance on auditory feedback in children with childhood apraxia of speech.

Unlabelled: Children with childhood apraxia of speech (CAS) have been hypothesized to continuously monitor their speech through auditory feedback to minimize speech errors. We used an auditory masking paradigm to determine the effect of attenuating auditory feedback on speech in 30 children: 9 with CAS, 10 with speech delay, and 11 with typical development. The masking only affected the speech of children with CAS as measured by voice onset time and vowel space area.

Preliminary evidence of a blunted anti-inflammatory response to exhaustive exercise in fibromyalgia.

Exercise intolerance, as evidenced by a worsening of pain, fatigue, and stiffness after novel exertion, is a key feature of fibromyalgia (FM). In this pilot study, we investigate whether; insufficient muscle repair processes and impaired anti-inflammatory mechanisms result in an exaggerated pro-inflammatory cytokine response to exhaustive exercise, and consequently a worsening of muscle pain, stiffness and fatigue in the days post-exercise. We measured changes in muscle pain and tenderness, fatigue, stiffness, and serum levels of neuroendocrine and inflammatory cytokine markers in 20 women with FM and 16 healthy controls (HCs) before and after exhaustive treadmill exercise.

CALM Pregnancy: results of a pilot study of mindfulness-based cognitive therapy for perinatal anxiety.

Many women experience anxiety during pregnancy with potential negative effects on maternal, birth, and child outcomes. Because of potential risks of fetal exposure to psychotropic medications, efficacious non-pharmacologic approaches are urgently needed. However, no published studies of psychotherapeutic treatments for anxiety in pregnancy exist.

The Mobility Scale for Acute Stroke predicts discharge destination after acute hospitalization.

Objective: To evaluate the predictive validity of the Mobility Scale for Acute Stroke (MSAS) in determining discharge destination (home or not home) after an acute stroke.

Design: Cohort study.

Subjects: Two-hundred and twenty-three patients with acute ischemic or intraparenchymal hemorrhagic, unilateral stroke

Methods: The MSAS was administered as part of the initial physical therapy examination.

The development of skill and knowledge during a sport education season of track and field athletics.

Purpose: The purpose of this study was to examine the relative effectiveness of 2 forms of physical education instruction on students' skill and technical performance, as well as content knowledge in 3 track and field events.

Method: Students from 6 classes in 3 Portuguese schools completed 900-min units conducted under the auspices of sport education or a more traditional teacher-directed format. Classes were randomly assigned to these conditions within each school.

Child mental health and service needs in Iraq: beliefs and attitudes of primary school teachers.

Objective: To survey Iraqi primary school teachers' beliefs and attitudes about mental health and behavioural problems of children.

Methods: From 10 primary schools in Baghdad, 148 teachers were surveyed using a closed-response questionnaire to assess beliefs and attitudes regarding students' mental health and behavioural problems, needs, resources and limitations to teaching.

Results: Disruptive behaviours were rated as main problems by the largest proportions of teachers.

Community-based newborn resuscitation among frontline providers in a low-resource country.

Objective: To evaluate a birth asphyxia management program among community midwives in a low-resource rural setting.

Methods: Concise training with provision of positive-pressure ventilation devices was implemented in Indonesia in 2005. The effectiveness of the intervention among community-based midwives between October 2007 and September 2008 was evaluated.