An Innovative Preventive and Rehabilitative Model for Acute Care: The Independence Model.

Purpose: The Independence Model (TIM) is a new rehabilitative model of care implemented in an acute care hospital to address patients' functional decline and a high vacancy rate for rehabilitation therapists.

Methods: TIM was developed by a team with expertise in evidence, scope of practice and roles, population care needs, and current state related to rehabilitation. TIM utilizes rehabilitation assistants, supervised by physical therapists, occupational therapists or speech-language pathologists, to assist patients in functional areas such as ambulation, activities of daily living (ADLs), cognition and communication.

Pilot and quantitative evaluation of the TARGET acne toolkit by UK pharmacy professionals working in general practice.

Background: Acne vulgaris (acne) is a common skin condition sometimes needing topical or oral antibiotic treatment. Pharmacists and pharmacy technicians (together known as pharmacy professionals) working in general practice are well placed to ensure their appropriate use.

Objectives: The objectives of this study are to pilot an evidence-based intervention ('How to…' tool) to review treatments in the management of acne and evaluate the capability, opportunity, motivation and behaviour (COM-B) of pharmacy professionals working in general practice before and after the use of this tool.

Perceived current and future roles of UK-based community pharmacy professionals in the long-term management of acne.

Introduction: Acne is a common skin condition treated in community pharmacy but moderate to severe cases may need referral to general practice for treatment that may include topical or oral antimicrobial treatments. Pharmacy teams working in the community are well-placed to manage acne treatments in line with NICE guidance.

Objectives: To explore the perceived current and future roles of community pharmacy (CP) teams alongside needs to achieve potential future roles.

Closing the Osteoporotic-Fracture Care Gap for Frail Older Persons.

Aim To implement standardised fracture risk assessment in the frail older person. Methods Frail older patients underwent opportunistic screening for fracture risk. Roadblocks to standardised assessment were identified.

Culture, politics and being more equal than others in COVID-19: some psychological anthropology perspectives.

The COVID-19 pandemic changed how we view the world, human behaviour, and societal structures and institutions. The emerging subdiscipline of psychological anthropology is well placed to provide a perspective on the way individuals and communities are affected by and respond to the pandemic, as well as the fallout from government responses and prevention strategies. Moreover, this viewpoint enables insights into the workings of societal structures and agents of power in the context of a health crisis that is worsened by poverty, inequality, and structural violence.

Depressive symptoms in first year students at a rural South African University.

Background: The rate of depressive illness in university students is currently regarded as being higher than the general population prevalence. While some students are insightful into the mental health issues they are facing and are voicing their concerns regarding the need for intervention services, many others are not wholly aware of the significance of their emotional states within the broader context of mental health problems.

Methods: A sample of 483 undergraduate first-year Psychology students at a rural-based university in the KwaZulu-Natal province of South Africa was administered the University Student Depression Inventory (USDI).

Prevalence and determinants of self referrals to a District-Regional Hospital in KwaZulu Natal, South Africa: a cross sectional study.

Introduction: Self-referrals to inappropriate levels of care result in an increased patient waiting time, overburdening of higher levels of care, reduced primary healthcare utilisation rate and increasing healthcare costs. Furthermore, self-referral places an additional encumbrance on various levels of care as allocation of resources and infrastructure cannot be accurately planned, based on the facility catchment population. The aim of this study was to determine the prevalence and determinants of patient self-referral at the out-patient department of Stanger Hospital, KwaZulu-Natal between January and June 2017.

Confusion and altered behaviour? Cause.

We describe the case of a 65-year-old man who presented with confusion and change in behaviour, and describe the investigative steps that were taken before a diagnosis was made. This patient was eventually diagnosed with leptomeningeal carcinomatosis secondary to a previously undiagnosed oesophageal carcinoma.

Fracture liaison service in a non-regional orthopaedic clinic--a cost-effective service.

Fracture liaison services (FLS) aim to provide cost-effective targeting of secondary fracture prevention. It is proposed that a dedicated FLS be available in any hospital to which a patient presents with a fracture. An existing orthopaedic clinic nurse was retrained to deliver a FLS.

How do patients in a rural setting respond to receiving a copy of their general practitioners letter?

The practice of sending copies of General Practitioners (GPs) letters to patients is not new. As a team in Geriatric and general internal medicine in a rural secondary referral hospital, we asked patients for feedback on how they felt about copies of their GPs letters being sent to them. 126 (96%) of patients were not frightened by the letter.

Preliminary work on the development of a novel detection method for osteoporosis.

Osteoporosis affects both the organic and mineral phases of bone resulting in a decrease in resistance to fracture. Dual x-ray absorptiometry (DEXA) scans are used for diagnosing osteoporosis, which is conventionally characterised by a decrease in mineral density. Unfortunately, some patients who suffer osteoporotic fractures have normal bone density, because both the organic and the mineral phase are affected.

The use of fingernails as a means of assessing bone health: a pilot study.

Background: Anecdotally, patients volunteer reports of increasing hardness of their fingernails within months of starting diverse treatments for osteoporosis. The properties of both nail and bone may be linked in a comparable, measurable way.

Methods: We examined the fingernails of two groups of patients, with (n = 9) and without (n = 13) osteoporosis at either the hip or lumbosacral spine.

Use of serial Mini-Mental State Examinations to diagnose and monitor delirium in elderly hospital patients.

Objectives: To determine the responsiveness of serial Mini-Mental State Examinations (MMSEs) for the diagnosis and monitoring of delirium in elderly hospital patients.

Design: Prospective study.

Setting: University teaching hospital.

Orthostatic tolerance in older patients with vitamin B12 deficiency before and after vitamin B12 replacement.

Orthostatic hypotension (OH) and vitamin B12 deficiency are common disorders in older people. Several case series have reported an association between vitamin B12 deficiency and OH. The effect of vitamin B12 replacement on this dysfunction has not been studied.

Interleukin-1 gene polymorphism disease activity and bone mineral metabolism in rheumatoid arthritis.

Objective: To determine whether interleukin-1 alpha and 1 beta gene polymorphism is associated with rheumatoid arthritis disease activity and bone mineral metabolism, and whether there is any relationship between IL-1 beta and rheumatoid arthritis (RA) motif gene.

Methods: IL-1 gene polymorphisms were analyzed in 65 RA patients who met American College of Radiology (ACR) criteria and 60 controls. From genomic DNA, 2 polymorphisms in each gene for IL1 alpha-889 and IL-1 beta + 3953 were typed by PCR-RFLP and HLA-DRB1 allele typing was also undertaken by PCR-SSOP.

Telling the truth about cancer: views of elderly patients and their relatives.

The aim of this study was to compare the attitudes of elderly patients and their relatives towards telling the truth about cancer. 120 patients were asked if they would wish to be told about bad news, such as cancer, which might emerge during the admission. Matched relatives were asked if such information should be disclosed to the patient.

Diffuse stromal Leydig cell hyperplasia: a unique cause of postmenopausal hyperandrogenism and virilization.

A 60-year-old woman presented with diffuse scalp alopecia, hirsutism, and clitorimegaly, and the mean serum testosterone levels were greater than 200 ng/dL. Findings on computed tomography of both adrenal glands were normal. After bilateral oophorectomy, a unique histological picture consisting of diffuse stromal Leydig cell hyperplasia was found.

Radicicol inhibits tyrosine phosphorylation of the mitotic Src substrate Sam68 and retards subsequent exit from mitosis of Src-transformed cells.

Sam68 (Src-associated in mitosis 68 kDa) is a protein that associates with and is tyrosine phosphorylated by Src in a mitosis-specific manner, thereby raising the possibility of a role for Src in the regulation of the cell cycle. This study examines the effects of radicicol, a Src tyrosine kinase inhibitor, upon both the phosphorylation of Sam68 and mitotic progression in Src-transformed mouse fibroblasts. Radicicol reversibly inhibits the mitosis-specific tyrosine phosphorylation of Sam68 in vivo, as determined by antiphosphotyrosine immunoblotting.

In vivo and in vitro serine/threonine phosphorylations of epidermal growth factor receptor upon entry into the cell cycle.

Protein phosphorylation and dephosphorylation is one of the main mechanisms of cell cycle regulation. This study examines the modulation of epidermal growth factor receptor phosphorylation as cells emerge from quiescence and enter the S phase of the cell cycle. The epidermal growth factor receptor is phosphorylated primarily on serine and threonine, but not on tyrosine residues, in an S phase-dependent fashion, as determined by phosphoamino acid analysis and anti-phosphotyrosine immunoblotting.

Delirium in newly admitted elderly patients: a prospective study.

The prevalence, associated conditions and outcome of delirium were studied in a consecutive series of 184 patients admitted with acute illness to a department of health care of the elderly. Forty of these elderly subjects (22 per cent) met Diagnostic and Statistical Manual version 3 (revised) criteria for delirium. Screening for delirious patients using the abbreviated mental test on admission gave a high sensitivity (92 per cent).

The abbreviated mental test: its use and validity.

The validity of the Abbreviated Mental Test was demonstrated by comparison with final clinical diagnoses in a consecutive sample of 168 patients admitted with acute illness to a department of health care of the elderly. Fifty-eight (34%) had abnormal cognition. The best cut-off point was 8, with less than 8 suggesting abnormal cognitive function.

Complete Release of Axillary Buds from Apical Dominance in Intact, Light-Grown Seedlings of Pisum sativum L. following a Single Application of Cytokinin.

Single applications of either 6-benzyladenine or zeatin to inhibited axillary buds of intact, light-grown seedlings of Pisum sativum L. cv Black-eyed Susan, resulted in the formation of rapidly elongating, leafy shoots. Similar treatment with kinetin or isopentenyladenine caused only limited but outgrowth which stopped 6 days after application.