Introduction: Comprehensive, high-value patient-centered care incorporates many facets of the health care system that are beyond the realm of traditional medical knowledge and/or clinical skills.
Methods: We describe a novel, learning program integrating systems-based practice curricula into competency-based interprofessional continuing education curriculum for health care professionals. The program incorporated experiential, team-based learning through the development of quality improvement projects. Presurveys and postsurveys assessed participant knowledge and skills. Mixed-level modeling analysis was used to examine the differences across all participants and each cohort.
Results: Across all individuals in all cohorts, postsurvey scores significantly improved (pretest score 2.65) (P ≤ .001). Controlling for cohort year, postsurvey scores increased between cohorts 1 and 2 (B = 0.52; P = .01) and between cohorts 2 and 3 (B = 0.24; P = .15), although increased were nonsignificant. Cohort participants also participated in health systems improvement projects and leveraged improved patient outcomes.
Discussion: This project signifies a unique approach to delivering systems-based curricula to interprofessional learners in the health care system. Participants became more engaged in systems change, influenced network-level QI initiatives and improvement projects, and positively influenced patient-centered outcomes. Health systems can model this program by partnering with academic organizations to scale and disseminate best practices.
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http://dx.doi.org/10.1097/CEH.0000000000000330 | DOI Listing |
Background: The autophagy lysosomal pathway (ALP) and the ubiquitin-proteasome system (UPS) are key proteostasis mechanisms in cells, which are dysfunctional in AD and linked to protein aggregation and neuronal death. Autophagy is over activated in Alzheimer's disease brain whereas UPS is severely impaired. Activating autophagy has received most attention, however recent evidence suggests that UPS can clear aggregate proteins and a potential therapeutic target for AD and protein misfolding diseases.
View Article and Find Full Text PDFBackground: In Alzheimer's Disease trials, the Mini-Mental State Examination (MMSE) and Clinical Dementia Rating (CDR) are commonly utilized as inclusionary criteria at screening. These measures, however, do not always reaffirm inclusionary status at baseline. Score changes between screening and baseline visits may imply potential score inflation at screening leading to inappropriate participant enrollment.
View Article and Find Full Text PDFAlzheimers Dement
December 2024
Karolinska Institute, Stockholm, Södermanland and Uppland, Sweden.
Background: Novel anti-amyloid therapies (AAT) for Alzheimer's Disease (AD) have recently been approved in the United States, Japan and China, and are under regulatory review in Europe. Questions remain regarding the long-term effectiveness and value of these drugs when used in routine clinical practice. Data from follow-up studies will be important to inform their optimal use, including criteria for treatment initiation, monitoring strategies, stopping rules, pricing and reimbursement considerations.
View Article and Find Full Text PDFAlzheimers Dement
December 2024
Center for Health + Technology, University of Rochester Medical Center, Rochester, NY, USA.
Background: In preparation for therapeutic trails involving patients with Alzheimer's disease (AD) and mild cognitive impairment (MCI), there is a need for valid, disease-specific caregiver-reported outcome (CRO) measures capable of tracking symptomatic burden in response to therapy over time. CROs are useful tools in clinical trials for individuals with AD, MCI, and dementia who are unable to self-report. In addition, CROs are accepted by the United States Food and Drug Administration to support regulatory claims.
View Article and Find Full Text PDFAlzheimers Dement
December 2024
University of Southern California, Los Angeles, CA, USA.
Background: Blood pressure (BP) management is an accessible therapeutic target for dementia prevention. BP variability (BPV) is a newer aspect of BP control recently associated with cognitive decline, dementia and Alzheimer's disease (AD), independent of traditionally targeted mean BP levels. Most of this work has relied on largely non-Hispanic White study samples in observational cohorts.
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