Socio-spatial analysis of Australian residential care facilities: A case study of traditional, medium, and small household models.

While it is imperative to develop building design innovation to adapt to new care models and organisational processes in residential care facilities, there is a lack of research evidence on the interplay between design and resident lived experience, particularly when examined through a building design lens. This study aims to explore the building design factors that contribute to residents' quality of life (QoL), and thus, their ability to find home. The research objectives are to: 1) document and analyse the layout and spatial design of three different typologies (Traditional, Medium, and Small Household models) against key QoL themes and the residents' everyday lived use and sense of feeling at home; and 2) compare the architectural, layout, and lived use of the three typologies through a socio-spatial lens.

Circulating Neoplastic-Immune Hybrid Cells Are Biomarkers of Occult Metastasis and Treatment Response in Pancreatic Cancer.

Background/objectives: Pancreatic ductal adenocarcinoma (PDAC) presents significant diagnostic and prognostic challenges, as current biomarkers frequently fail to accurately stage disease, predict rapid metastatic recurrence (rPDAC), or assess response to neoadjuvant therapy (NAT). We investigated the potential for circulating neoplastic-immune hybrid cells (CHCs) as a non-invasive, multifunctional biomarker for PDAC.

Methods: Peripheral blood specimens were obtained from patients diagnosed with PDAC.

Non-Invasive Ventilatory Support in Preterm Neonates in the Delivery Room and the Neonatal Intensive Care Unit: A Short Narrative Review of What We Know in 2024.

Background: Guidelines recommend non-invasive ventilatory (NIV) support as first-line respiratory support mode in preterm infants as NIV is superior to intubation and mechanical ventilation in preventing death or bronchopulmonary dysplasia. However, with an ever-expanding variety of NIV modes available, there is much debate about which NIV modality should ideally be used, how, and when. The aims of this work were to summarise the evidence on different NIV modalities for both primary and secondary respiratory support: nCPAP, nasal high-flow therapy (nHFT), and nasal intermittent positive airway pressure ventilation (nIPPV), bi-level positive airway pressure (BiPAP), nasal high-frequency oscillatory ventilation (nHFOV), and nasally applied, non-invasive neurally adjusted ventilatory assist (NIV-NAVA) modes, with particular focus on their use in preterm infants.

Development of a New Tool to Combine the Promotion of Patient Mobility With Safe Patient Handling Equipment: The Johns Hopkins Safe Patient Handling Mobility (JH-SPHM) Guide.

Background: Promoting safe patient mobility for providers and patients is a safety priority in the hospital setting. Safe patient handling equipment aids safe mobility but can also deter active movement by the patient if used inappropriately. Nurses need guidance to choose equipment that ensures their safety and that of the patients while promoting active mobility and preventing workplace-related injury.

Detection of neoplastic-immune hybrid cells with metastatic properties in uveal melanoma.

Background: Uveal melanoma is the most common non-cutaneous melanoma and is an intraocular malignancy affecting nearly 7,000 individuals per year worldwide. Of these, approximately 50% will progress to metastatic disease for which there are currently no effective curative therapies. Despite advances in molecular profiling and metastatic stratification of uveal melanoma tumors, little is known regarding their underlying biology of metastasis.

Does nurse use of a standardized flowsheet to document communication with advanced providers provide a mechanism to detect pulse oximetry failures? A retrospective study of electronic health record data.

Background: Pulse oximetry guides clinical decisions, yet does not uniformly identify hypoxemia. We hypothesized that nursing documentation of notifying providers, facilitated by a standardized flowsheet for documenting communication to providers (physicians, nurse practitioners, and physician assistants), may increase when hypoxemia is present, but undetected by the pulse oximeter, in events termed "occult hypoxemia."

Objective: To compare nurse documentation of provider notification in the 4 h preceding cases of occult hypoxemia, normal oxygenation, and evident hypoxemia confirmed by an arterial blood gas reading.

Detection of neoplastic-immune hybrid cells with metastatic properties in uveal melanoma.

Background: Uveal melanoma is the most common non-cutaneous melanoma and is an intraocular malignancy affecting nearly 7,000 individuals per year worldwide. Of these, approximately 50% will progress to metastatic disease for which there are currently no effective therapies. Despite advances in molecular profiling and metastatic stratification of uveal melanoma tumors, little is known regarding their underlying biology of metastasis.

Association of Longitudinal Mobility Levels in the Hospital and Injurious Inpatient Falls.

Falls are one of the most common adverse events in hospitals, and patient mobility is a key risk factor. In hospitals, risk assessment tools are used to identify patient-centered fall risk factors and guide care plans, but these tools have limitations. To address these issues, we examined daily patient mobility levels before injurious falls using the Johns Hopkins Highest Level of Mobility, which quantifies key patient mobility milestones from low-level to community distances of walking.

Development of a 5-FU modified miR-129 mimic as a therapeutic for non-small cell lung cancer.

Lung cancer is the leading cause of cancer-related deaths in the United States with non-small cell lung cancer (NSCLC) accounting for most cases. Despite advances in cancer therapeutics, the 5-year survival rate has remained poor due to several contributing factors, including its resistance to therapeutics. Therefore, there is a pressing need to develop therapeutics that can overcome resistance.

Revealing the tension: The relationship between high fall risk categorization and low patient mobility.

Background: Using an inpatient fall risk assessment tool helps categorize patients into risk groups which can then be targeted with fall prevention strategies. While potentially important in preventing patient injury, fall risk assessment may unintentionally lead to reduced mobility among hospitalized patients. Here we examined the relationship between fall risk assessment and ambulatory status among hospitalized patients.

Lessons From the Northeast COVID-19 Surge: Well-Being of the Health Care Workforce.

The COVID-19 pandemic has had an unprecedented impact on the US health care system which was already experiencing higher levels of personal burnout among health care workers than the average US worker. Well-being efforts to support the workforce have become a critical countermeasure during the pandemic. This work was presented at the Thomas Jefferson University, College of Population Health Seminar Series: Clinical Lessons from the Northeast Surge, COVID-19: Spread the Science, not the Virus, held August 18, 2020.

Creating a Standardized Post-Fall Debrief Tool: A Quality Improvement Project.

Background: Performing post-fall debriefing improves patient outcomes through learning from defects and addresses adherence to fall prevention programs.

Local Problem: While addressing an increase in fall rates, a quality improvement team discovered there was no standardized tool or process for completing post-fall debriefing.

Methods: The team used the Plan-Do-Study-Act (PDSA) process to improve the post-fall debrief tool, with an analysis of pilot using the implementation science RE-AIM framework.

COVID-19-related changes in outpatient CPAP setup pathways for OSA are linked with decreased 30-day CPAP usage.

The COVID-19 pandemic changed continuous positive airway pressure (CPAP) setup pathways. We evaluated patients commenced on CPAP in 2019 (prepandemic) and 2020 (post-first UK wave). Face-to-face (F2F) setup numbers, with CPAP turned on, decreased from 613 patients (98.

Competitive intelligence: A precursor to a learning health system.

Unlike other developed countries, the US healthcare system is largely privatized and highly competitive. This dynamic stifles effective information sharing, while the need for prompt and accurate evidence-based decision making has become crucial. Crises, like the COVID-19 pandemic, elevate the importance of quality decision making and exacerbate issues associated with the lack of a cohesive system to share information.

Innovative Wellness Models to Support Advancement and Retention Among Women Physicians.

Despite improvements in representation of women in academic medicine, the rate of promotion and career advancement remains unequal. Compared with their male colleagues, women report lower rates of personal-organizational value alignment and higher rates of burnout. Particular challenges further exist for Black women, Indigenous women, women of color, and third gender or gender nonbinary faculty.

Psychological and behavioural interventions in bipolar disorder that target sleep and circadian rhythms: A systematic review of randomised controlled trials.

Sleep and circadian disruptions are prominent symptoms of bipolar disorder (BD) and potential targets for adjunctive interventions. The aim of this review was to appraise the effectiveness of psychological and behavioural interventions in BD that target sleep and circadian rhythms, as reported by randomised controlled trials. Nineteen studies met the inclusion/exclusion criteria.

How registered nurses balance limited resources in order to maintain competence: a grounded theory study.

Background: Nurses have limited time outside of work for continuing professional development. Consequently, strategies need to be explored to enable them to better maintain their competence. This article describes recent research investigating if nursing behaviours in the use of mobile technologies could be leveraged to better facilitate mobile learning.

Diagnosis of cystic fibrosis in adulthood and eligibility for novel CFTR modulator therapy.

Background: Cystic fibrosis (CF) is an autosomal recessive condition that primarily manifests as a chronic respiratory disease. CF is usually diagnosed in early childhood or through newborn screening although in a small but important group, diagnosis is not made until adulthood. Highly effective cystic fibrosis transmembrane conductance regulator (CFTR) modulator therapies are now available for most genetic causes of CF highlighting the importance of identifying people with late presentations of CF.

Assessment of Physician Sleep and Wellness, Burnout, and Clinically Significant Medical Errors.

Importance: Sleep-related impairment in physicians is an occupational hazard associated with long and sometimes unpredictable work hours and may contribute to burnout and self-reported clinically significant medical error.

Objective: To assess the associations between sleep-related impairment and occupational wellness indicators in physicians practicing at academic-affiliated medical centers and the association of sleep-related impairment with self-reported clinically significant medical errors, before and after adjusting for burnout.

Design, Setting, And Participants: This cross-sectional study used physician wellness survey data collected from 11 academic-affiliated medical centers between November 2016 and October 2018.

Supporting Well-being Through the Implementation of Education and a Relaxing Retreat Space.

Objective: The objective of this study was to determine whether an innovative program including psychoeducation grounded in positive psychology and awareness of cognitive biases, along with access to a dedicated relaxation environment, would lower burnout for nurses.

Background: Promoting well-being of nurses is an essential goal of healthcare leaders because of the negative effects of burnout out on nurses' health and patient outcomes.

Methods: A prospective cohort analysis was conducted to examine whether exposure to the OASIS (Opportunity to Achieve Staff Inspiration and Strength) education content and using the OASIS rooms were associated with improvements in quality of life or turnover intention among nurses.

Assessing mental health in vulnerable adolescents.

A dramatic shift in adolescent risks and behaviors in recent years threatens adolescents' mental well-being more than ever. This article explores vulnerable adolescent populations, describes the importance of nurses in all categories of assessment for adolescent mental health, and identifies assessment strategies and immediate interventions for successful outcomes.