Dementia Care Research and Psychosocial Factors.

Background: To promote caregiver health and reduce burden, the Savvy Caregiver Program (SCP), an evidence-based caregiving intervention, was adapted with a Native Hawaiian (NH) community in Hawai'i. The adaptation process occurred prior to pilot testing in two phases: 1) the preliminary adaptation by a community action board (CAB) and mentorship team and 2) pre-pilot testing and expert validation with NH adults. The preliminary adaptation, titled 'Auamo Kuleana O Nā Ma'i Poina ('Auamo Kuleana), aimed to include Hawaiian values, language, proverbs, and culturally relevant examples while maintaining the core components of the program.

The reliability and concurrent validity of goniometric and visual estimation in participants with unilateral shoulder pain.

Introduction: The Constant-Murley Score (CMS) uses universal goniometry (UG), and the Shoulder Functional Reach Score (SFRS) uses visual estimation (VE). The CMS has validity challenges, and the SFRS has been critiqued for using VE. This study sought to determine the reliability and concurrent validity of VE when compared to the UG for shoulder flexion and abduction.

Riding the Waves of Novel Therapies in Hypertrophic Cardiomyopathy.

We discuss a case of a 60-year-old man with hypertrophic cardiomyopathy treated with the novel cardiac myosin inhibitor, mavacamten. Dynamic electrocardiogram patterns of left ventricular hypertrophy and left ventricular strain coincided with the patient starting mavacamten, discontinuing the drug, and then restarting mavacamten, highlighting electrocardiograms as accessible and inexpensive potential tools to monitor drug efficacy. This case also shows the ability of myosin inhibition to positively alter the adverse electrical changes associated with hypertrophic cardiomyopathy.

ACR Appropriateness Criteria® Altered Mental Status, Coma, Delirium, and Psychosis: 2024 Update.

Altered mental status (AMS) and coma are terms used to describe disorders of arousal and content of consciousness. AMS may account for up to 4% to 10% of chief complaints in the emergency department setting and is a common accompanying symptom for other presentations. AMS is not a diagnosis, but rather a term for symptoms of acute or chronic disordered mentation, including confusion, disorientation, lethargy, drowsiness, somnolence, unresponsiveness, agitation, altered behavior, inattention, hallucinations, delusions, and psychosis.

Effectiveness of Implementation of an Enhanced Recovery Program in Bariatric Surgery.

Introduction: While the adoption of ERAS protocols in bariatric surgery has increased, variability exists across centers, reflecting a spectrum of implementation stages. The objective of this study is to understand and increase awareness of the effectiveness of enhanced recovery after surgery (ERAS) protocols in bariatric surgery, given the specific perioperative difficulties and risks for this population. We aimed to study the association between implementation of the ERAS program in bariatric surgery and specific outcomes.

Ten-Year Trends in Venous Thromboembolism Prophylaxis at a High-Volume Arthroplasty Center.

Introduction: Venous thromboembolism (VTE) prophylaxis is the standard of care after total joint arthroplasty. However, there have been changes in the prevalence of certain medication classes used by institutions over time driven by the literature and national clinical practice guidelines. The purpose of this study was to analyze the patterns of VTE medications over the past 10 years at our institution.

Progressive Functional Analysis and Function-Based Intervention Via Telehealth: A Replication and Extension.

The purpose of this study was to evaluate a progressive functional analysis (FA) model and function-based intervention delivered by caregivers with coaching via telehealth. Children diagnosed with autism and at least one caregiver (e.g.

Pediatric Ewing Sarcoma Presentation, Treatment, and Outcomes Across Sociodemographic Groups.

Introduction: In this study, we evaluate the association between sociodemographics and disease presentation, treatment, and survival for children, adolescents, and young adults with Ewing sarcoma.

Methods: Case-level data were downloaded from The Surveillance, Epidemiology, and End Results database. Cases included patients ages 0-24 who were diagnosed with Ewing sarcoma between 2004 and 2020.

An Enhanced Recovery Program for Pediatric, Adolescent, and Young Adult Surgical Oncology Patients Improves Outcomes After Surgery.

Background: Enhanced Recovery after Surgery (ERAS®) is a standardized perioperative approach that utilizes a multidisciplinary team to reduce physiologic stress and improve postoperative recovery. The purpose of our study is to evaluate outcomes in pediatric, adolescent, and young adult (AYA) patients undergoing major oncologic operations before and after the implementation of an enhanced recovery program (ERP).

Methods: All patients ≤23 years old who underwent major oncologic surgery between 1/2017-2/2022 were identified.

Evaluating the impact of a specialized and centralized online medical consultation system for paramedics: pilot study.

Introduction: There are many limitations to utilizing on-duty emergency department (ED) physicians as Base Hospital Physicians for paramedic telephone consultations. We aimed to examine the impact of a specialized and centralized Online Medical Consultation program for paramedic consultations on system-relevant performance.

Methods: This is a before-after study with concurrent control using health record review of audio recordings over a 6-month period before and after implementation of the Online Medical Consultation program.

The Impact of Surgical Margin in Wide Local Excision of Pediatric Melanoma - An Argument for a More Conservative Approach.

Background: Pediatric melanoma is the most common skin cancer in children. Achieving surgical margins recommended by the National Comprehensive Cancer Network (NCCN) for wide local excision (WLE) is challenging in children with less body domain. This study investigated whether surgical margin impacted postoperative clinical outcomes following WLE for melanoma in children and adolescents.

The effect of repeated lipopolysaccharide endotoxin challenge on immune response of breeding ewes and subsequent lamb performance.

Infectious disease caused by exposure to Gram-negative bacterial endotoxin lipopolysaccharide (LPS) is recognized to suppress female fertility. However, the effect of varying low-dose endotoxin exposure during distinct stages of follicle development on immune response, reproductive performance, and lamb performance has yet to be elucidated. Therefore, the objective of this study was to evaluate acute phase response, mRNA abundance of inflammatory markers, reproductive performance and lamb growth characteristics of ewes challenged with subclinical doses of LPS.

Predictors of poor pre-operative patient reported outcome measures in elective foot and ankle surgery: Analysis of 1217 patients.

Aims: Patient reported outcome measures (PROMs) have become the de facto measure of success in orthopaedic publications. It has been established that preoperatively collected patient reported outcomes correlate with post-operative outcome. The aim of our research is to identify which factors predict poor pre-operative scores using the most commonly used PROMs.

Patient reported outcomes measures are infrequently used in clinical studies of heart transplant recipients.

Background: Clinical trials in heart transplantation (HT) recipients have largely focused on objective outcomes such as survival; however, there is a paucity of data regarding the use of patient-reported outcome measures (PROMs) in these studies. We aimed to characterize the use of PROMs in registered clinical studies of HT recipients.

Methods: All clinical studies of adult HT recipients were queried from ClinicalTrials.

Surgical management of rare tumors (Part 1).

With an annual cumulative occurrence of approximately 15,000 in North America, all childhood cancers are rare. Very rare cancers as defined by both the European Cooperative Study Group for Rare Pediatric Cancers and the Children's Oncology Group fall into two principal categories: those so uncommon (fewer than 2 cases/million) that their study is challenging even through cooperative group efforts (e.g.

Principles and Practice in Pediatric Vascular Trauma: Part 1: Scope of Problem, Team Structure, Multidisciplinary Dynamics, and Solutions.

As of 2020, penetrating injuries became the leading cause of death among children and adolescents ages 1-19 in the United States. For the patients who initially survive and receive advanced medical care, vascular injuries are a significant cause of morbidity and additionally trigger notable trauma team angst. Moreover, penetrating injuries can lead to life-threatening hemorrhage and/or limb-threatening ischemia if not addressed promptly.

The development and early success of the South Carolina two-generation community of practice to support family-serving professionals.

Introduction: System-level initiatives are key to promoting health and well-being among young families, yet agencies and organizations who support those families often do not coordinate their delivery of supportive services and resources. We describe the South Carolina (SC) two-generation (2Gen) community of practice (CoP) and its early efforts to foster statewide adoption of "whole family" centered approaches.

Method: This mixed-methods study evaluated the impact of the CoP.