Nurse practitioner and physician associate mentorship: Improving retention and employment experiences.

Background: Clinician turnover is costly for health care organizations.

Local Problem: A retention strategy for newly hired nurse practitioners (NPs) and physician associates (PAs) was needed at our organization.

Methods: A quality improvement project was conducted to determine whether a mentorship program could improve retention and employment experiences of newly hired NPs and PAs.

Bilateral rTMS Shows No Advantage in Depression nor in Comorbid Depression and Anxiety: A Naturalistic Study.

The objective was to determine if adding low-frequency right-sided rTMS treatment to the standard high-frequency left-sided treatment (LUL), referred to as sequential bilateral treatment (SBT), confers additional benefit for depression or anxiety outcomes. A retrospective chart review from January 2015 through December 2018 yielded 275 patients, all of whom were treated with a figure-8 coil for a major depressive episode. Their protocol was either LUL or SBL.

A water-soluble alternative to simethicone for gastrointestinal endoscopy: Results of a clinical trial.

During endoscopy, simethicone defoaming agents are commonly used to improve visualization, but they leave residues and impact drying. This clinical trial involved patients undergoing colonoscopy procedures with substantial bubbles that impeded mucosal wall visibility. As an alternative to simethicone, investigators evaluated a water-soluble, ginger-based gastrointestinal supplement (GI-Ease) that did not contain sugars, thickeners, or binding agents.

Creating a Comprehensive Pandemic Response to Decrease Hospitalist Burnout During COVID-19: Intervention vs Control Results in 2 Comparable Hospitals (HOSP-CPR).

Background: Physician burnout increased during the COVID-19 pandemic.

Objective: To evaluate the effectiveness of a multimodal workplace intervention designed to reduce hospitalist burnout.

Design: Participants and setting: Our intervention group was composed of internal medicine hospitalists at Providence Portland Medical Center (64 providers including 58 physicians and 6 nurse practitioners).

Comparison of robotic versus laparoscopic right colectomy node retrieval in the obese population.

Data are scarce comparing robotic and laparoscopic colectomy node retrieval based on body mass index or age. With differences in anastomosis, mobilization, and ligation between these approaches, obese and/or elderly patients undergoing robotic surgery may have differences in node yield compared to laparoscopy. A retrospective review was conducted between four institutions from February 1, 2019 through August 1, 2021, during which 144 right colectomies were performed.

Impact of a multidisciplinary sepsis huddle in the emergency department.

Background: Sepsis is a leading cause of death in hospitals requiring prompt recognition and treatment. The sepsis bundle is the cornerstone of sepsis treatment. Studies have evaluated the impact of a sepsis huddle on sepsis bundle compliance but not in sepsis identification.

Who was at risk for COVID-19 late in the US pandemic? Insights from a population health machine learning model.

Notable discrepancies in vulnerability to COVID-19 infection have been identified between specific population groups and regions in the USA. The purpose of this study was to estimate the likelihood of COVID-19 infection using a machine-learning algorithm that can be updated continuously based on health care data. Patient records were extracted for all COVID-19 nasal swab PCR tests performed within the Providence St.

PCM1-JAK2 Fusion Tyrosine Kinase Gene-Related Neoplasia: A Systematic Review of the Clinical Literature.

Background: This review summarizes the case studies of PCM1-JAK2 fusion tyrosine kinase gene-related neoplasia. Recommended treatment includes JAK2 inhibitors and hematologic stem cell transplantation (HSCT), although the small number of patients has limited study of their efficacy. Herein, we present all available cases in the current searchable literature with their demographics, diagnoses, treatments, and outcomes.

Could bipolar depressed patients respond better to rTMS than unipolar depressed patients? A naturalistic, observational study.

Previous studies of rTMS for bipolar depressed (BD) patients have yielded mixed results. In this retrospective, naturalistic, observational study, we reviewed charts of 317 patients undergoing rTMS treatment between 1/2015-2/2018, yielding 283 unipolar depressed (UD) and 34 BD patients. All were treated with a figure-of-8 coil, with either high-frequency (HF) left-sided, sequential bilateral (HF left-sided and low-frequency right-sided), or mixed protocols (switched from unilateral to bilateral mid-course).

Eye-controlled, power wheelchair performs well for ALS patients.

Background: Our pilot study tested the feasibility and performance of an eye-controlled power wheelchair for amyotrophic lateral sclerosis (ALS) patients.

Methods: In this prospective pilot study, participants drove the wheelchair three times around an indoor course. We assessed the time to complete the course; starting and stopping on command; turning 90, 135, and 180 degrees; time to backup; and obstacle negotiation.

Predictors of Art and PrEP Adherence and Medication-Taking Practices and Preferences to Inform Development of a Wrist-Worn Adherence System.

We examined adherence, medication-taking practices, and preferences to inform development of a wrist-worn adherence system. Two convenience samples of persons taking antiretroviral therapy and HIV pre-exposure prophylaxis completed a survey. Additional online questions asked about willingness to use a wrist-worn device and reminder and feedback preferences.

Does Maternal Buprenorphine Dose Affect Severity or Incidence of Neonatal Abstinence Syndrome?

Objectives: To measure the incidence, onset, duration, and severity of neonatal abstinence syndrome (NAS) in infants born to mothers receiving buprenorphine and to assess the association between buprenorphine dose and NAS outcomes.

Methods: We reviewed charts of all mother-infant pairs maintained on buprenorphine who delivered in our hospital from January 1, 2000 to April 1, 2016.

Results: In 89 infants, NAS incidence requiring morphine was 43.

Dementia Services Mini-Screen: a simple method to identify patients and caregivers in need of enhanced dementia care services.

Objective: Improving dementia care in health systems requires estimates of need in the population served. We explored whether dementia-specific service needs and gaps for patients and caregivers could be predicted by simple information readily captured in routine care settings.

Method: Primary family caregivers (n = 215) rated their own current stress, challenging patient behaviors, and prior-year needs and gaps in 16 medical and psychosocial services.

Comorbidity in aging and dementia: scales differ, and the difference matters.

Background: Accurate assessment of the effect of dementia on healthcare utilization and costs requires separation of the effects of comorbid conditions, often poorly accounted for in existing claims-based studies.

Objective: To determine whether two different types of comorbidity and risk adjustment scales, the Chronic Disease Score (CDS) and the Cumulative Illness Rating Scale for Geriatrics (CIRS-G), perform similarly in older persons with and without dementia.

Methods: All subjects in the community-outreach diagnostic program of the University of Washington Alzheimer's Disease Research Center Satellite were included (N = 619).

Screening for undiagnosed cognitive impairment in homebound older adults.

Objective: To screen for undetected cognitive impairment in homebound elders receiving home health care services.

Design: A cross-sectional study of adults 60 years of age and older receiving visiting nurse services. A pharmacist administered the Mini-Cog, a rapid screening test for cognitive impairment, during the enrollment home visit.

Depressed mood mediates decline in cognitive processing speed in caregivers.

Purpose: Very few studies have examined cognitive decline in caregivers versus noncaregivers, and only 1 study has examined mediators of such decline. We evaluated the relationship between caregiver status and decline on the digit symbol test (DST; a measure of processing speed, attention, cognitive-motor translation, and visual scanning) and whether this relationship was mediated by depressed mood.

Design And Methods: Caregivers for spouses with Alzheimer's disease (n = 122) were compared with demographically similar noncaregiver spouses (n = 117) at study entry (Time 1 = T1), T2 (1 year later), and T3 (2 years after T1).

The Mini-Cog: a rapid dementia screening tool suitable for pharmacists' use.

Objective: To familiarize the consultant pharmacist with the use of the Mini-Cog as a rapid screening tool for the assessment of dementia and outline currently available evidence regarding the validity of this screening tool within the community.

Data Sources: MEDLINE (1990-December 2006) and Web of Science (1995-December 2006) were searched for original research and review articles published in English.

Study Selection And Data Extraction: Relevant literature regarding use of the Mini-Cog.

Time that tells: critical clock-drawing errors for dementia screening.

Background: Clock-drawing tests are popular components of dementia screens but no single scoring system has been universally accepted. We sought to identify an optimal subset of clock errors for dementia screening and compare them with three other systems representative of the existing wide variations in approach (Shulman, Mendez, Wolf-Klein), as well as with the CDT system used in the Mini-Cog, which combines clock drawing with delayed recall.

Methods: The clock drawings of an ethnolinguistically and educationally diverse sample (N = 536) were analyzed for the association of 24 different errors with the presence and severity of dementia defined by independent research criteria.

Cognitive impairment, chronic disease burden, and functional disability: a population study of older Italians.

Objective: To evaluate associations of cognitive impairment and disease burden with disability in an elderly population.

Methods: The Mini-Cog was used as a cognitive screen in a population-based survey of health and functional status of 2,192 randomly selected older adults (age 65+ years) in 11 regions of Italy. Associations of cognitive and disease measures with functional outcomes were calculated using hierarchical logistic regressions including age, Mini-Cog score, disease burden, age, education, and geographic region.

Improving identification of cognitive impairment in primary care.

Objectives: To compare the relative level and predictors of accuracy of a brief cognitive screen, the Mini-Cog, with spontaneous detection of cognitive impairment by subjects' primary care physicians.

Participants: A heterogeneous community sample (n=371) of predominantly ethnic minority elderly assessed by standardized research protocol, 231 of whom met criteria for dementia or mild cognitive impairment (MCI).

Results: The Mini-Cog detected cognitively impaired subjects much more effectively than did subject's own physicians (p<0.

IPA survey of brief cognitive screening instruments.

Background And Objectives: Cognitive screening is a "first step" in detecting dementia and other neuropsychiatric syndromes and hence represents an important public health and clinical initiative. A plethora of cognitive screening instruments has been advocated in recent years, but the extent to which these instruments are used or their effectiveness is not well known. An International Psychogeriatric Association (IPA) survey was designed to determine which cognitive screening instruments were used most frequently by clinicians with special expertise in the neuropsychiatric aspects of old age and also to determine the ones considered most useful by these specialists.

Simplifying detection of cognitive impairment: comparison of the Mini-Cog and Mini-Mental State Examination in a multiethnic sample.

Objectives: To compare detection of cognitive impairment using the Mini-Cog and Mini-Mental State Examination (MMSE) and to identify sociodemographic variables that influence detection in an ethnoculturally diverse sample.

Design: Cross-sectional.

Setting: A registry of the University of Washington Alzheimer's Disease Research Center Satellite.

Is caregiving hazardous to one's physical health? A meta-analysis.

Caring for a family member with dementia is generally regarded as a chronically stressful process, with potentially negative physical health consequences. However, no quantitative analysis has been conducted on this literature. The authors combined the results of 23 studies to compare the physical health of caregivers with demographically similar noncaregivers.