Neuronal HLH-30/TFEB modulates peripheral mitochondrial fragmentation to improve thermoresistance in Caenorhabditis elegans.

Transcription factor EB (TFEB) is a conserved master transcriptional activator of autophagy and lysosomal genes that modulates organismal lifespan regulation and stress resistance. As neurons can coordinate organism-wide processes, we investigated the role of neuronal TFEB in stress resistance and longevity. To this end, the Caenorhabditis elegans TFEB ortholog, hlh-30, was rescued panneuronally in hlh-30 loss of function mutants.

Integrating Palliative Care Into Heart Failure Management.

Background: The World Health Organization defines palliative care as an approach that improves the quality of life of patients and their families through the prevention and relief of suffering by assessment and treatment of physical, psychosocial, and spiritual problems. Any patient with chronic debilitating disease, including heart failure, is a candidate for interdisciplinary palliative care to manage their complex physical and psychosocial needs.

Clinical Relevance: The philosophy of palliative care has evolved to include a vision of holistic care extended to all individuals with serious illness and their families or caregivers that should be integrated throughout the continuum of care, including the acute phase.

Navigating Symptom Management in Heart Failure: The Crucial Role of the Critical Care Nurse.

High-acuity, progressive care, and critical care nurses often provide care for patients with heart failure during an exacerbation of acute disease or at the end of life. Identifying and managing heart failure symptoms is complex and requires early recognition and early intervention. Because symptoms of heart failure are not disease specific, patients may not respond to them appropriately, resulting in treatment delays.

The Three Rs for Preventing Heart Failure Readmission: Review, Reassess, and Reeducate.

Despite improvements in heart failure therapies, hospitalization readmission rates remain high. Nationally, increasing attention has been directed toward reducing readmission rates and thus identifying patients with the highest risk for readmission. This article summarizes the evidence related to decreasing readmission for patients with heart failure within 30 days after discharge, focusing on the acute setting.

Acute Coronary Syndrome Symptom Clusters: Illustration of Results Using Multiple Statistical Methods.

Researchers have employed various methods to identify symptom clusters in cardiovascular conditions, without identifying rationale. Here, we test clustering techniques and outcomes using a data set from patients with acute coronary syndrome. A total of 474 patients who presented to emergency departments in five United States regions were enrolled.

Symptom Cluster Science in Chronic Kidney Disease: A Literature Review.

The purpose of this review was to synthesize evidence on symptom clusters in patients with chronic kidney disease (CKD). The quality of studies was evaluated using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Twelve articles met inclusion criteria.

Organizational Factors Associated With Technical Efficiency of Nursing Care in US Intensive Care Units.

Background: Few studies have evaluated technical efficiency of nursing care, and no such studies have been conducted in intensive care units (ICUs).

Purpose: To explore relative technical efficiency of US ICUs and identify organizational factors associated with efficiency in providing quality of nursing care.

Methods: A total of 404 adult ICUs from the 2014 National Database of Nursing Quality Indicators were included.

Impact of Medicare Advantage penetration and hospital competition on technical efficiency of nursing care in US intensive care units.

This study aimed to evaluate technical efficiency of US intensive care units and determine the effects of environmental factors on technical efficiency in providing quality of nursing care. Data were obtained from the 2014 National Database of Nursing Quality Indicators and the Centers for Medicare and Medicaid Services. Data envelopment analysis was used to estimate technical efficiency for each intensive care unit.

Interdisciplinary Pain Education: Moving From Discipline-Specific to Collaborative Practice.

Background: Pain is a common symptom reported by hospitalized patients with cancer. Cancer pain management requires an interdisciplinary approach for quality patient care. Although the literature suggests that most cancer pain can be managed with available treatments, many patients continue to experience pain even with opioid prescriptions.

Selecting symptom instruments for cardiovascular populations.

The purpose of this review is to provide a guide for researchers and clinicians in selecting an instrument to measure four commonly occurring symptoms (dyspnea, chest pain, palpitations, and fatigue) in cardiac populations (acute coronary syndrome, heart failure, arrhythmia/atrial fibrillation, and angina, or patients undergoing cardiac interventions). An integrative review of the literature was conducted. A total of 102 studies summarizing information on 36 different instruments are reported in this integrative review.

Systematic review of symptom clusters in cardiovascular disease.

Background: Although individual symptoms and symptom trajectories for various cardiovascular conditions have been reported, there is limited research identifying the symptom clusters that may provide a better understanding of patients' experiences with heart disease.

Aims: To summarize the state of the science in symptom cluster research for patients with acute coronary syndrome, myocardial infarction, coronary artery bypass surgery, and heart failure through systematic review and to provide direction for the translation of symptom cluster research into the clinical setting.

Methods: Databases were searched for articles from January 2000 through to May 2015 using MESH terms "symptoms, symptom clusters, acute coronary syndrome (ACS), myocardial infarction (MI), coronary heart disease (CHD), ischemic heart disease (IHD), heart failure (HF), coronary artery bypass surgery (CABS), cluster analyses, and latent classes.

Transitions of care in heart failure: a scientific statement from the American Heart Association.

In patients with heart failure (HF), use of 30-day rehospitalization as a healthcare metric and increased pressure to provide value-based care compel healthcare providers to improve efficiency and to use an integrated care approach. Transition programs are being used to achieve goals. Transition of care in the context of HF management refers to individual interventions and programs with multiple activities that are designed to improve shifts or transitions from one setting to the next, most often from hospital to home.

Nurses' knowledge of inhaler technique in the inpatient hospital setting.

Purpose/objectives: High rates of inhaler misuse in patients with chronic obstructive pulmonary disease and asthma contribute to hospital readmissions and increased healthcare cost. The purpose of this study was to examine inpatient staff nurses' self-perception of their knowledge of proper inhaler technique compared with demonstrated technique and frequency of providing patients with inhaler technique teaching during hospitalization and at discharge.

Design: A prospective, descriptive study.

Fatigue in the presence of coronary heart disease.

Background: Fatigue is a prevalent and disabling symptom associated with many acute and chronic conditions, including acute myocardial infarction and chronic heart failure. Fatigue has not been explored in patients with stable coronary heart disease (CHD).

Objectives: The purpose of this partially mixed sequential dominant status study was to (a) describe fatigue in patients with stable CHD; (b) determine if specific demographic (gender, age, education, income), physiological (hypertension, hyperlipidemia), or psychological (depressive symptoms) variables were correlated with fatigue; and (c) determine if fatigue was associated with health-related quality of life.

Challenges and solutions for using informatics in research.

Computer technology provides innovations for research but not without concomitant challenges. Herein, we present our experiences with technology challenges and solutions across 16 nursing research studies. Issues included intervention integrity, software updates and compatibility, web accessibility and implementation, hardware and equipment, computer literacy of participants, and programming.

Knowledge of heart attack symptoms and risk factors among native Thais: a street-intercept survey method.

This study aimed to determine Thais' knowledge of heart attack symptoms and risk factors and whether that knowledge was related to age, gender or education. Via a street-intercept survey method, a convenience sample of people aged ≥ 35 years (n = 192) was recruited. Mean age was 47 ± 9.

Psychometric properties of three instruments to measure fatigue with myocardial infarction.

The purpose of this study was to evaluate the psychometric properties of three questionnaires to measure fatigue with myocardial infarction. The Fatigue Symptom Inventory Interference Scale, Profile of Moods States Fatigue subscale (POMS-F), and Short Form 36 (SF-36) Vitality Scale were completed during hospitalization (n = 116) and 30 days after hospital admission (n = 49). Moderate to strong correlations were found among each of these fatigue scales and between each fatigue scale and measures of other variables to include vigor, depressed mood, anxiety, and physical functioning.

Classifying subgroups of patients with symptoms of acute coronary syndromes: A cluster analysis.

The purpose of the study was to identify subgroups of patients presenting with acute coronary syndromes based on symptom clusters. Two hundred fifty-six patients completed a symptom assessment in their hospital rooms. Latent class cluster analysis and analysis of variance were used to classify subgroups of patients according to selected clinical characteristics.

Gender differences in fatigue associated with acute myocardial infarction.

Introduction: Fatigue is a symptom of acute myocardial infarction (AMI); however, few studies have characterized the fatigue associated with AMI in men and women.

Methods: The convenience sample included 88 men and 28 women admitted with a diagnosis of AMI at 6 Midwestern facilities. Data were collected upon hospital admission and 30 days after discharge.

Symptoms across the continuum of acute coronary syndromes: differences between women and men.

Background: The urgency and level of care provided for acute coronary syndromes partially depends on the symptoms manifested.

Objectives: To detect differences between women and men in the type, severity, location, and quality of symptoms across the 3 clinical diagnostic categories of acute coronary syndromes (unstable angina, myocardial infarction without ST-segment elevation, and myocardial infarction with ST-segment elevation) while controlling for age, diabetes, functional status, anxiety, and depression.

Methods: A convenience sample of 112 women and 144 men admitted through the emergency department and hospitalized for acute coronary syndromes participated.

Korean immigrants' knowledge of heart attack symptoms and risk factors.

Purpose: This study assessed the knowledge of heart attack symptoms and risk factors in a convenience sample of Korean immigrants.

Method: A total of 116 Korean immigrants in a Midwestern metropolitan area were recruited through Korean churches and markets. Knowledge was assessed using both open-ended questions and a structured questionnaire.

Symptom clusters in acute myocardial infarction: a secondary data analysis.

Background: Early recognition of acute myocardial infarction (AMI) symptoms and reduced time to treatment may reduce morbidity and mortality. People having AMI experience a constellation of symptoms, but the common constellations or clusters of symptoms have yet to be identified.

Objectives: To identify clusters of symptoms that represent AMI.

Chest pain and associated symptoms of acute coronary syndromes.

Coronary heart disease is the primary health risk for all Americans. Acute coronary syndromes (ACS) is the term used to denote any 1 of 3 clinical manifestations of coronary heart disease: unstable angina, non-ST elevation myocardial infarction, and ST-elevation MI. The major challenge to healthcare providers is the rapid and accurate identification of patients with ACS who would benefit from immediate thrombolysis or percutaneous coronary interventions.