Association Between the Volume of Inpatient Rehabilitation Therapy and the Risk of All-Cause and Cardiovascular Mortality in Patients With Ischemic Stroke

Objective

To investigate the relationship between the volume of inpatient rehabilitation therapy and mortality among patients with acute ischemic stroke, as well as to assess whether the association varies with respect to stroke severity.

Design

A retrospective study with a cohort of consecutive patients who had acute ischemic stroke between January 1, 2008, and June 30, 2009.

Setting

Referral medical center.

Participants

Adults with acute ischemic stroke (N=1277) who were admitted to a tertiary hospital.

Interventions

Not applicable.

Main Outcome Measure

Stroke-related mortality.

Results

During the median follow-up period of 12.3 months (ranging from January 1, 2008, to December 31, 2009), 163 deaths occurred. Greater volume of rehabilitation therapy was associated with a reduced risk of all-cause and cardiovascular mortality (P for trend <.001 for both). Compared with the first tertile, the third tertile of rehabilitation volume was associated with a 55% lower risk of all-cause mortality (hazard ratio [HR]=.45; 95% confidence interval [CI], .30–.65) and a 50% lower risk of cardiovascular mortality (HR=.50; 95% CI, .31–.82). The association did not vary with respect to stroke severity (P for interaction = .45 and .73 for all-cause and cardiovascular mortality, respectively).

Conclusions

The volume of inpatient rehabilitation therapy and mortality were significantly inversely related in the patients with ischemic stroke. Thus, further programs aimed at promoting greater use of rehabilitation services are warranted.     

Risk of Headache,Temporomandibular Dysfunction,and Local Sensitization in Male Professional Boxers: A Case-Control Study

Objective

To evaluate differences in the incidence of headache, trigeminal nerve mechanosensitivity, and temporomandibular functionality in professional male boxers (exposed to repetitive craniofacial trauma) who were actively training and without severe previous injuries compared with handball players.

Design

Case-control study.

Setting

University-based physical therapy research clinic.

Participants

Eighteen boxers (mean age, 23±4.61y) as the cases group, and 20 handball players as the comparison group (mean age, ±2y, and sex matched), were included. All participants (N=38) completed the assessment protocol.

Interventions

Not applicable.

Main Outcome Measures

Measurements were taken of the headache impact (Headache Impact Test-6) and the pressure pain threshold over the trigeminal nerve sensory branches, the masseter muscle, and the tibialis anterior muscle. The secondary outcome measure included the temporomandibular function (Helkimo Clinic Index).

Results

The boxers showed slight mandibular function impairment, local muscular and neural sensitization, and a higher impact from headaches than did the handball players. The between-group comparison found significant differences in all outcome measures (P<.05), except in the tibialis anterior muscle pressure pain threshold on the dominant (P=.958) and the nondominant (P=.453) sides.

Conclusions

Professional male boxers seem to suffer a greater headache impact and local sensitization of the craniomandibular region than do professional handball players. It cannot be determined whether these findings are short-lasting, as a result of the training activity, or long-lasting.     

Assessing the relationships between nurse work hours/overtime and nurse and patient outcomes: Systematic literature review

Background

The effects of work hours/overtime on nurse and patient outcomes and specific components of work hours (per shift and per week) and overtime on these effects have not been systematically examined.

Purpose

The purpose of this review was to systematically evaluate the effect of nurse overtime and long work hours on nurse and patient outcomes.

Methods

An online search of six electronic bibliographic databases was conducted for research published from 2000 to 2013.

Discussion

Twenty-one nurse outcome measures and 19 patient outcome measures were found in relationships with work hours and overtime. A total of 67 relationships to nurse outcomes and 41 relationships to patient outcomes were examined.

Conclusions

The findings of this review suggested that evidence supporting positive relationships between working long hours and adverse outcomes to the nurses is strong. However, to make a conclusion of the positive relationship between long work hours and adverse patient outcomes, more evidence is needed.     

The Patient-Centered Outcomes Research Institute (PCORI): Information for academic nursing

As part of the Patient Protection and Affordable Care Act of 2010, the U.S. Congress created the Patient-Centered Outcomes Research Institute (PCORI). Its goal is to fund research that will assist patients, caregivers, clinicians, and others in making informed health decisions. Because nurses play a critical role in engaging patients in health care, they are valued participants in setting the institute's agenda and carrying out its programs. In this article, we provide an overview of PCORI and describe how nurses can participate in institute activities and apply for research grants.     

Frontline registered nurse job satisfaction and predictors over three decades: A meta-analysis from 1980 to 2009

Background

Frontline registered nurses' job satisfaction is important because it is tied to retention, organizational commitment, workforce safety, patient safety, and cost savings. The purpose of this study was to comprehensively, quantitatively examine the largest, moderate, and smallest predictors of frontline registered nurse job satisfaction from 1980 to 2009.

Methods

A non−a priori meta-analysis was used to analyze studies that met inclusion.

Results

Sixty-two studies and 27 job satisfaction predictors met inclusion for analysis. The largest effect sizes were found for task requirements (r = .61), empowerment (r = .55), and control (r = .52), and moderate effect sizes were found for 10 predictors. Fail-safe N indicates high reliability. Heterogeneity between studies was present in all of the 27 predictor analyses.

Conclusions

The largest predictors of job satisfaction for the frontline registered nurse may be different than previously thought. Supporting past research, autonomy and stress were found to be moderate predictors of satisfaction. Heterogeneity indicates study differences or moderator influence in studies.     

The National Institute of Nursing Research Graduate Partnerships Program (NINR-GPP): An opportunity for PhD students

The Institutional Graduate Partnerships Program (GPP) offered by the National Institute of Nursing Research (NINR) provides an exceptional opportunity for students who are enrolled in any PhD program in nursing across the nation to complete dissertation research on the premier research campus of the National Institutes of Health, Bethesda, MD. The goal of this doctoral fellowship program, which is up to 3 years in length, is to train promising doctoral students in basic and clinical research. This knowledge and skill set is necessary for the next generation of nurse scientists to ultimately conduct translational research. In this article, the authors describe the program, eligibility requirements, application procedures, and selection criteria for NINR-supported GPP nursing students. Also provided are tips for interested students and outcomes of current and former NINR-supported GPP students (NINR-GPP).