Need to Intervene: An Exploratory Study of Nurses' Experiences With Patienthood.

Much has been written about the patient experience, but there is little information about experiences of providers as patients. Since lay patients and providers have differing perspectives and expectations, it is important to identify those elements shared by those in each group and those that diverge. This study identified experiences of nurses as being a patient or a family caregiver of a patient as well as identified assessments of the healthcare system by nurses.

Erratum: Relative Efficacy of a Nutritional Intervention on Cognitive Performance Across the Adult Lifespan and During Early Cognitive Decline.

[This corrects the article DOI: 10.3233/ADR-190124.].

Relative Efficacy of a Nutritional Intervention on Cognitive Performance Across the Adult Lifespan and During Early Cognitive Decline.

A nutritional supplement has maintained or improved cognitive performance for healthy adults and individuals with mild cognitive impairment (MCI). Performance varied between 93 healthy adults aged 18-73 years versus 43 aged 75-85 years and among individuals with MCI. Healthy adult performance was stratified by age and for MCI as "intact" or "impaired" (Dementia Rating Scale guidelines).

Cognitive Improvement in Healthy Older Adults Can Parallel That of Younger Adults Following Lifestyle Modification: Support for Cognitive Reserve During Aging.

Executive function was assayed following a nutritional supplementation in healthy adults using the Trail Making Test. Comparison with published normative scores demonstrated that cohorts from 35-74 years of age displayed similar relative improvement compared to their own baseline performance. These findings support early, pro-active lifestyle modifications to maintain cognitive performance during aging and further demonstrate the persistence of cognitive reserve in healthy older adults.

Apparent Cognitive Decline as Revealed by an Executive Function Test within a Cohort of Elderly Individuals Self-Reporting Normal Cognitive Performance.

Alzheimer's disease (AD) can be preceded by subtle memory decline that can last a decade or more before progressing to what would be diagnosed as the mild cognitive impairment stage. During this early stage of decline, individuals and even their caregivers can fail to perceive any serious difficulty or need to consult a physician. Herein, we present evidence in support of these concerns, and demonstrate how this can interfere not only with clinical trials of AD but also those involving cognitive performance of elderly individuals without intentional reference to AD.

Characteristics of Reviews Published in Nursing Literature: A Methodological Review.

Integrative and systematic reviews present synthesized research. Scholars have called for increased rigor and reporting in reviews. The purpose of this methodological review was to describe the characteristics of nurse-led reviews.

A Medicare Current Beneficiary Survey-Based Investigation of Alternative Primary Care Models in Nursing Homes: Cost and Utilization Differences.

The current study used the Medicare Current Beneficiary Survey-Based (MCBS) Cost and Use files for 2006-2008 to investigate whether health care costs and service utilization of nursing home residents varied with nurse practitioner (NP) and physician assistant (PA) involvement, compared to the use of medical doctors (MDs) only. The sample included Medicare beneficiaries 65 and older residing in a nursing home for the entire study year (433 annual observations). A generalized estimating equations procedure was used to assess whether health care cost and utilization measures varied by cohort.

Maintenance of Cognitive Performance and Mood for Individuals with Alzheimer's Disease Following Consumption of a Nutraceutical Formulation: A One-Year, Open-Label Study.

Nutritional interventions have shown varied efficacy on cognitive performance during Alzheimer's disease (AD). Twenty-four individuals diagnosed with AD received a nutraceutical formulation (NF: folate, alpha-tocopherol, B12, S-adenosyl methioinine, N-acetyl cysteine, acetyl-L-carnitine) under open-label conditions (ClinicalTrials.gov NCT01320527).

A Nutritional Formulation for Cognitive Performance in Mild Cognitive Impairment: A Placebo-Controlled Trial with an Open-Label Extension.

Thirty-four individuals with mild cognitive impairment were randomized for 6 months to a nutraceutical formulation (NF: folate, alpha-tocopherol, B12, S-adenosyl methioinine, N-acetyl cysteine, acetyl-L-carnitine) or indistinguishable placebo, followed by a 6-month open-label extension in which all individuals received NF. The NF cohort improved in the Dementia Rating Scale (DRS; effect size >0.7) and maintained baseline performance in CLOX-1.

Cognitive testing for dementia is adversely affected by administration in a foreign location.

Background: It is colloquially considered that cognitive tests can be adversely affected by administration in a foreign location. However, a definitive demonstration of this is lacking in the literature. To determine whether or not this is the case, we compared the results of cognitive testing in a familiar versus foreign environment by single test administrator of individuals diagnosed with Alzheimer's disease randomized to placebo in a multi-site clinical study.

A Medicare current beneficiary survey-based investigation of alternative primary care models in nursing homes: functional ability and health status outcomes.

This study assessed how the health status and functioning of Medicare beneficiaries residing in nursing homes varies systematically with nurse practitioners (NPs) and physician assistants (PAs) providing primary care services. A secondary analysis was conducted using data from the 2006, 2007, and 2008 Medicare Current Beneficiary Surveys. The study sample included 433 participant-year observations within one of three cohorts: (a) medical doctor (MD)-only, those who received primary care services exclusively from a physician; (b) MD-dominant, those who received some primary care services from an NP or PA, but those visits accounted for less than one half of total primary care visits; and (c) NP/PA-dominant, those who received more than one half of their primary care visits from an NP or PA.

Nutritional supplementation for Alzheimer's disease?

Purpose Of Review: Evidence for the benefit of nutrition in Alzheimer's disease continues to accumulate. Many studies with individual vitamins or supplements show marginal, if any, benefit. However, new findings with combinatorial formulations demonstrate improvement in cognitive performance and behavioral difficulties that accompany Alzheimer's disease.

A Phase II Randomized Clinical Trial of a Nutritional Formulation for Cognition and Mood in Alzheimer's Disease.

Background: Increasing evidence points toward the efficacy of nutritional modifications in delaying cognitive decline and mood/behavioral difficulties in Alzheimer's disease (AD). Nutritional supplementation with individual agents has shown varied results suggesting the need for combinatorial intervention.

Objective: We set out to determine whether nutritional intervention could positively impact cognitive performance and behavioral difficulties for individuals diagnosed with AD.

Developing a dedicated education unit in long-term care: a pilot project.

Within long-term care, the transitional care setting provides post-acute and short-stay rehabilitation to older adults, easing the transition between the acute care hospital and home or long-term care. The current nursing shortage makes it difficult for these facilities to attract and retain qualified nursing staff. In order to meet the rehabilitation needs for this patient population while at the same time addressing the challenge in nursing education of limited clinical placements and severe nurse faculty shortages, an academic-practice partnership was developed to establish a Dedicated Education Unit (DEU).

The percutaneous endoscopic gastrostomy tube: a nurse's guide to PEG tubes.

Nurses are primarily responsible for the care and maintenance of percutaneous endoscopic gastrostomy (PEG) tubes and yet their care is not often included in nursing skills textbooks. Best practice recommendations to care for a person with a PEG tube are described.

Neurocognitive diagnostic challenges and the DSM-5: perspectives from the front lines of clinical practice.

The proposed changes to the DSM-IV-TR are an attempt to advance a common language to be used by clinicians and researchers in psychiatry in the United States. Any improvement brought about by these changes may be jeopardized unless the ICD-10, which is used by non-psychiatric clinicians and researchers worldwide, and the DSM resolve the differences in the definitions and diagnostic criteria of most disorders. Unless there is congruence between the two manuals, debate is therefore likely to continue in the literature as to which provider is best suited to direct the care for the person with dementia: primary care providers, psychiatric providers, or neurologists.

Positive argument for debate in J Neural Transmission: Alzheimer's disease: are we intervening too late? Yes, by years if not decades.

The ongoing debate as to whether we are or are not early enough in treatment for Alzheimer's disease presents distinct vantage points. Points expressed range from stressing the need for early preventive measures to highlighting the failure of "alternative" therapies, and concluding that we are unfortunately doing all that we can at present. Herein, we stress the worth of nutritional intervention, and review why such studies are often inherently compromised.

Lack of Correlation of WAIS Digit Span with Clox 1 and the Dementia Rating Scale in MCI.

Individuals with MCI declined in performance over 6 months in the Clock-drawing (Clox 1) and the WAIS Digit Span tests, but not in the Dementia Rating Scale (DRS). Individual performance on Clox 1 and Digit Span did not correlate after 6 months. Performance on the Digit Span Test also did not correlate with the DRS, but performance on Clox 1 correlated with the DRS.

Nutrition and dementia: are we asking the right questions?

Alzheimer's disease (AD) has no cure or nullifying pharmacological interventions. Nutritional supplementation represents a systemic approach that in some studies has provided benefit and has augmented pharmacological approaches. However, additional studies report no benefit of supplementation.

A comparison of hospice in the United States and the United Kingdom: implications for policy and practice.

The modern hospice movement in the United States was modeled on the specialized care for dying individuals that was championed by Dame Cicely Saunders, a social worker, nurse, and physician, in London in the 1960s. A collaboration between Saunders and Florence Wald, then at Yale University, led to the establishment of the first hospice in the United States in 1974. Despite similar foundations, the provision of hospice care differs in the United States and the United Kingdom with regard to financing and access.

Apple juice improved behavioral but not cognitive symptoms in moderate-to-late stage Alzheimer's disease in an open-label pilot study.

Preclinical studies demonstrate that apple juice exerts multiple beneficial effects including reduction of central nervous system oxidative damage, suppression of Alzheimer's disease (AD) hallmarks, improved cognitive performance, and organized synaptic signaling. Herein, we initiated an open-label clinical trial in which 21 institutionalized individuals with moderate-to-severe AD consumed 2 4-oz glasses of apple juice daily for 1 month. Participants demonstrated no change in the Dementia Rating Scale, and institutional caregivers reported no change in Alzheimer's Disease Cooperative Study (ADCS)-Activities of Daily Living (ADL) in this brief study.