Implementing INTERACT in Veterans Health Administration Community Living Centers: A pragmatic randomized trial.

Background: Hospital transfers from VA Community Living Centers (CLCs) are common. The objective of this study was to evaluate the effect of introducing the Intervention to Reduce Acute Care Transfers (INTERACT) program into VA CLCs.

Methods: Cluster randomized trial involving 16 pair-matched VA CLCs.

Palliative care aspects of wound healing in complex patients: a case report.

The authors have no conflicts of interest to declare.

Evaluation of the Pronouncement of Death Policy Implementation and Outcomes: Implications for Advanced Practice Nursing.

In 2011, the Veterans Health Administration mandated that Veterans Affairs (VA) Medical Centers develop and implement a policy that allowed registered nurses (RNs) and advanced practice registered nurses (APRNs) to pronounce the death of residents who die in Veterans Affairs community living centers, previously known as nursing homes, provided that there is a written do-not-resuscitate order in their medical record. The purpose of this quality improvement project was to determine the extent to which the implementation of the RN/APRN death pronouncement policy affected death pronouncement time for residents who die after 5 PM and before 7:30 AM, on weekends and holidays. This project is significant because the previous physician-only death pronouncement policy was found to cause unnecessary delays in death pronouncement.

Bioaccessibility and speciation of arsenic in country foods from contaminated sites in Canada.

Arsenic in foods obtained through foraging or hunting (country foods) in contaminated areas has not been reported; moreover the chemical form (arsenic speciation) is not known. Bioaccessibility extractions can be used to extract the arsenic from samples, giving information about the arsenic that is available for absorption into humans. Bioaccessibility of arsenic was measured in country foods (berries, other plants, mushrooms and hares) collected from contaminated sites in Canada.

Bioaccessibility of lead and arsenic in traditional Indian medicines.

Arsenic and lead have been found in a number of traditional Ayurvedic medicines, and the practice of Rasa Shastra (combining herbs with metals, minerals and gems), or plant ingredients that contain these elements, may be possible sources. To obtain an estimate of arsenic and lead solubility in the human gastrointestinal tract, bioaccessibility of the two elements was measured in 42 medicines, using a physiologically-based extraction test. The test consisted of a gastric phase at pH 1.