Sharing Lessons From Successes: Long-term Care Facilities That Weathered the Storm of COVID-19 and Staffing Crises.

Purpose: To identify leadership styles and staffing strategies in Missouri long-term care (LTC) facilities that stood out among their peers as "positive deviants" with regard to COVID-19 infections and staffing shortages.

Methods: Statewide survey of all LTC facilities to identify exemplar facilities with stable staffing and low rates of COVID-19. Interviews with senior leaders were conducted in 10 facilities in the state to understand the strategies employed that led to these "positive outliers.

Differential associations between body mass index and outcome in different age groups in patients with myocardial infarction.

Objective: To investigate the association between age and body mass index (BMI) and mortality in patients with myocardial infarction (MI). Methods We divided 6453 patients into three age groups (<60, 60-75, >75 years) and five BMI categories. Thirty-day and long-term all-cause mortality were assessed.

Fat-Free Mass and Body Fat in Patients with Myocardial Infarction Who Underwent Percutaneous Coronary Intervention.

There are no data on the effects of fat-free mass (FFM) and body fat (BF) on prognosis in patients with myocardial infarction (MI). We investigated the effects of FFM and BF (which were estimated using formulas rather than direct measurements) on 30-day and long-term all-cause mortality in patients with MI who underwent percutaneous coronary intervention. We analyzed data from 6,453 patients with MI.

Virtual external implementation facilitation: successful methods for remotely engaging groups in quality improvement.

Background: Relatively little guidance exists on how to use virtual implementation facilitation to successfully implement evidence-based practices and innovations into clinical programs. Yet virtual methods are increasingly common. They have potentially wider reach, emergent public health situations necessitate their use, and restrictions on resources can make them more attractive.

Enhancing sleep quality for nursing home residents with dementia: a pragmatic randomized controlled trial of an evidence-based frontline huddling program.

Background: Disturbed sleep places older adults at higher risk for frailty, morbidity, and even mortality. Yet, nursing home routines frequently disturb residents' sleep through use of noise, light, or efforts to reduce incontinence. Nursing home residents with Alzheimer's disease and or related dementias-almost two-thirds of long-stay nursing home residents-are likely to be particularly affected by sleep disturbance.

An obesity paradox in patients with myocardial infarction undergoing percutaneous intervention.

Background And Aims: Data concerning the relationship between body mass index (BMI) and outcome in myocardial infarction (MI) patients are inconclusive. Long-term data on the influence of BMI on survival in patients with MI who have undergone percutaneous intervention (PCI) are lacking. We aimed to assess the effect of different categories of BMI on long-term mortality.

Retention of a standard operating procedure under the influence of social stress and refresher training in a simulated process control task.

In a simulated process control task, we investigated the effects of refresher training and acute social stress on performing a standard operating procedure (SOP) containing a production and monitoring task and knowledge recall after a retention interval of two weeks. In a 2 × 2 between-group design (Factor 1: induced social stress, Factor 2: refresher training), 76 engineering students performed an SOP at t1 in week 1 and at t2 in week 3. A MANOVA in week three (t2) indicated a main effect of the refresher training for the SOP execution containing a production and a monitoring task and an impairing effect of stress on the monitoring task.

Leading Through Team Building.

Nursing center academy prepares leaders for new regulatory requirements and performance-based health care.

Does skill retention benefit from retentivity and symbolic rehearsal? - two studies with a simulated process control task.

Two experiments were designed to compare two symbolic rehearsal refresher interventions (imaginary practice, a hidden introspective process) and investigate the role of retentivity in skill retention. Retentivity is investigated as the ability to memorise and reproduce information and associations that were learned a short time ago. Both experiments comprised initial training (week 1), a symbolic rehearsal for the experimental group (week 2) and a retention assessment (week 3).

Counteracting skill decay: four refresher interventions and their effect on skill and knowledge retention in a simulated process control task.

In process automation, skill decay has not been investigated systematically. In two experimental studies, refresher interventions (RIs) were compared to support skill and knowledge retention of a start-up procedure on a simulated process control task. Based on theories of proceduralisation, the 'testing-effect' and mental practice, four different RIs were designed.

Time until incident dementia among Medicare beneficiaries using centrally acting or non-centrally acting ACE inhibitors.

Background: Centrally active (CA) angiotensin-converting enzyme inhibitors (ACEIs) are able to cross the blood–brain barrier. Small observational studies and mouse models suggest that use of CA versus non-CA ACEIs is associated with a reduced incidence of Alzheimer's disease and related dementias (ADRD).

Objective: The aim of this research was to assess the effect of CA versus non-CA ACEI use on incident ADRD.

Exit-site care in Austrian peritoneal dialysis centers -- a nationwide survey.

Background: Catheter-associated infections markedly contribute to treatment failure in peritoneal dialysis (PD) patients. There is much controversy surrounding prophylactic strategies to prevent these infections.

Methods: In this nationwide multicenter study we analyzed strategies to prevent catheter-associated infections as performed in Austrian PD centers in 2006.

Autoimmune disorders: gastrointestinal manifestations and endoscopic findings.

The gastrointestinal tract can be involved in many autoimmune disorders, and women are affected more than men in most of the disease processes discussed. As this article outlines, gastrointestinal manifestations can be either part of the clinical presentation or complications of treatment. Depending on the disease process and the severity of symptoms, gastrointestinal evaluation and treatment can have an important role in the management of these diseases.

Gastric mucosa-associated lymphoid tissue lymphoma.

The connection between Helicobacter pylori and gastric mucosa-associated lymphoid tissue (MALT) lymphoma is well established. H. pylori infection causes an immunological response, leading to chronic gastritis with formation of lymphoid follicles within the stomach.

Calculation of the diameter of the central retinal artery from noninvasive measurements in humans.

Purpose: The aim of the present study was to calculate the diameter of the central retinal artery from results as obtained with non-invasive techniques in healthy young subjects.

Methods: Twenty-four healthy male subjects participated in this study. Total retinal blood flow was calculated from combined bi-directional laser Doppler velocimetry and measurement of retinal venous diameters using the Zeiss retinal vessel analyzer.

Regulation of human retinal blood flow by endothelin-1.

There is evidence from in vitro and animal studies that endothelin is a major regulator of retinal blood flow. We set out to characterize the role of the endothelin-system in the blood flow control of the human retina. Two studies in healthy subjects were performed.

Propranolol and atropine do not alter choroidal blood flow regulation during isometric exercise in healthy humans.

Recent studies indicate that the human choroid has a considerable capacity to keep blood flow constant despite exercise-induced increases in perfusion pressure. The mechanisms underlying this vasoconstrictor response remain unclear. We hypothesized that pharmacological modulation of the autonomic nervous system may alter the choroidal pressure/flow relationship during squatting.