A 3-day 'stroke camp' addressed chronic disease self-management elements and perceived stress of survivors of stroke and their caregivers reduced: Survey results from the 14 US camps.

Background: Stroke is a leading cause of disability for persons with stroke (PWS). Difficulty coping with long-term stress for PWS and their caregivers (CG) contributes to their poor health. Variations of chronic-disease self-management programs (CDSMPs) have reduced long-term stress in PWS and CGs.

"If I knew I could get that every hour instead of alcohol, I would take the cannabis": need and feasibility of cannabis substitution implementation in Canadian managed alcohol programs.

Background: While there is robust evidence for strategies to reduce harms of illicit drug use, less attention has been paid to alcohol harm reduction for people experiencing severe alcohol use disorder (AUD), homelessness, and street-based illicit drinking. Managed Alcohol Programs (MAPs) provide safer and regulated sources of alcohol and other supports within a harm reduction framework. To reduce the impacts of heavy long-term alcohol use among MAP participants, cannabis substitution has been identified as a potential therapeutic tool.

Abdominal vessel depiction on virtual triphasic spectral detector CT: initial clinical experience.

Purpose: To evaluate vessel assessment in virtual monoenergetic images (VMI) and virtual-non-contrast images (VNC) derived from venous phase spectral detector computed tomography (SDCT) acquisitions in comparison to arterial phase and true non-contrast (TNC) images.

Methods: Triphasic abdominal SDCT was performed in 25 patients including TNC, arterial and venous phase. VMI and VNC were reconstructed from the venous phase and compared to conventional arterial-phase images (CI), TNC and conventional venous-phase images (CI).

CT artifacts after contrast media injection in chest imaging: evaluation of post-processing algorithms, virtual monoenergetic images and their combination for artifact reduction.

Background: After injection into a brachial vein, high contrast media concentration in axillary and subclavian veins can cause artifacts that impair diagnostic utility. This study assessed artifact reduction by artifact-reduction-algorithms (ARA) and virtual-monoenergetic-images (VMI), as well as their combination (VMI) compared to conventional CT-images (CI).

Methods: Forty-six spectral-detector-CT (SDCT) examinations of patients that received ARA-reconstructions due to perivenous-artifacts were included in this retrospective study.

Diagnostic accuracy of intravascular ultrasound-derived minimal lumen area compared with fractional flow reserve.

Introduction: The use of fractional flow reserve (FFR) as the gold standard for functional assessment of intermediate coronary stenosis has been well documented. Intracoronary imaging techniques such as intravascular ultrasound (IVUS) have been used for additional coronary lesion resolution and some of its anatomic parameters have been studied as having possible correlation with FFR, particularly IVUS minimal lumen area (MLA). We performed a comprehensive review of the available literature in the area.

A multi-center study of fidaxomicin use for Clostridium difficile infection.

Purpose: Fidaxomicin use in real-world clinical practice, especially for severe Clostridium difficile infection (CDI), is mainly based on single-center observational studies. The purpose of this pharmacoepidemiology study was to assess outcomes of patients given fidaxomicin based on episode number and use of concomitant antibiotics.

Methods: Fidaxomicin use over time across included hospitals in the United States was assessed using a large inpatient drug utilization database.

Cellulose-degrading bacteria associated with the invasive woodwasp Sirex noctilio.

Sirex noctilio is an invasive wood-feeding wasp that threatens the world's commercial and natural pine forests. Successful tree colonization by this insect is contingent on the decline of host defenses and the ability to utilize the woody substrate as a source of energy. We explored its potential association with bacterial symbionts that may assist in nutrient acquisition via plant biomass deconstruction using growth assays, culture-dependent and -independent analysis of bacterial frequency of association and whole-genome analysis.

Reciprocal learning and chronic care model implementation in primary care: results from a new scale of learning in primary care.

Background: Efforts to improve the care of patients with chronic disease in primary care settings have been mixed. Application of a complex adaptive systems framework suggests that this may be because implementation efforts often focus on education or decision support of individual providers, and not on the dynamic system as a whole. We believe that learning among clinic group members is a particularly important attribute of a primary care clinic that has not yet been well-studied in the health care literature, but may be related to the ability of primary care practices to improve the care they deliver.

Sustained reduction in antimicrobial use and decrease in methicillin-resistant Staphylococcus aureus and Clostridium difficile infections following implementation of an electronic medical record at a tertiary-care teaching hospital.

Objectives: we evaluated the effect of implementation of an electronic medical record (EMR) on the use of antimicrobial agents and on the rates of infections with Clostridium difficile and methicillin-resistant Staphylococcus aureus (MRSA).

Methods: this was a retrospective, observational study conducted between 1 January 2005 and 31 December 2009. Antimicrobial drug use, rates of nosocomial C.

Host plant phenology affects performance of an invasive weevil, Phyllobius oblongus (Coleoptera: Curculionidae), in a northern hardwood forest.

We investigated how host plant phenology and plant species affected longevity, reproduction, and feeding behavior of an invasive weevil. Phyllobius oblongus L. (Coleoptera: Curculionidae) is common in northern hardwood forests of the Great Lakes Region.

The role of conversation in health care interventions: enabling sensemaking and learning.

Background: Those attempting to implement changes in health care settings often find that intervention efforts do not progress as expected. Unexpected outcomes are often attributed to variation and/or error in implementation processes. We argue that some unanticipated variation in intervention outcomes arises because unexpected conversations emerge during intervention attempts.

Primary care physicians' decisions about discharging patients from their practices.

Objective: There are few data available about factors which influence physicians' decisions to discharge patients from their practices. To study general internists' and family medicine physicians' attitudes and experiences in discharging patients from their practices.

Design: A cross-sectional mailed survey was used.

Surprise, Surprise, Surprise! A complexity science view of the unexpected.

Surprise can emanate from two sources: lack of sufficient information or knowledge and the basic dynamics of complex adaptive systems. The authors expand the traditional view of surprise with a complexity perspective that makes it possible to ask new questions and to consider new ways of understanding the world around us. They discuss creativity and learning as two strategies for capitalizing on the surprises that confront organizations.