Transitional Care Coordination in New York City Jails: Facilitating Linkages to Care for People with HIV Returning Home from Rikers Island

New York City (NYC) jails are the epicenter of an epidemic that overwhelmingly affects Black and Hispanic men and offer a significant opportunity for public health intervention. The NYC Department of Health and Mental Hygiene instituted population based approaches to identify the HIV-infected, initiate discharge planning at jail admission, and facilitate post-release linkages to primary care. Using a caring and supportive ‘warm transitions’ approach, transitional care services are integral to continuity of care. Since 2010, over three-quarters of known HIV-infected inmates admitted to jails received discharge plans; 74 % of those released were linked to primary care. The EnhanceLink initiative’s new Health Liaison, a lynchpin role, facilitated 250 court-led placements in medical alternatives to incarceration. Transitional care coordination programs are critical to facilitate continuity of care for people with chronic health conditions including the HIV-infected returning home from jail and for the public health of the communities to which they return.     

Bath Salts Ingestion: Diagnosis and Treatment of Substance-Induced Disorders

A new synthetic drug of abuse is appearing in the United States known as bath salts. This street drug is used for its stimulant properties, which come from its primary chemical cathinone, methylenedioxypyrovalerone. Bath salts are highly addictive, associated with substance-induced disorders, and can have serious long-term consequences, including extreme paranoia, agitation, and psychosis. This article explains the psychopharmacology, comprehensive assessments, differential diagnoses, and nurse practitioners’ role in acute treatment of patients under the influence of bath salts and includes a case study.     

Further evidence of construct validity of standardized patient‐based performance examinations

The purpose of this study was to gather additional evidence pertinent to the construct validity of standardized patient‐based clinical performance examinations. Specifically, the study determined whether students who indicated they had previously read about, seen, or worked up a case on the examination performed differently on that case from those students who had not. Overall, it was found that students with previous reading or direct experiences with cases on the test tended to have higher case mean scores on those cases than those who had not. These results demonstrated that scores on standardized patient‐based performance examinations are sensitive to the examinees’ various learning experiences.     

Performance Development Plans for the Radiation Therapist: A Literature Review

IntroductionAt many radiotherapy departments around the world, radiation therapists (RTs) undergo performance appraisals annually. Performance appraisals can be confronting and involve complex issues such as feedback, delivering constructive criticism, and positive reinforcement. The focus of this research article was to identify some strengths and weaknesses of general performance appraisal processes and to determine how this process can be streamlined using positive psychology and strength-based development to form a performance management strategy for RTs.MethodsDatabase searches were conducted through ScienceDirect and PubMed for journal articles via the Queensland University of Technology Library website. General article searches were conducted through the online search engine Google. Books were accessed through the University of Southern Queensland Library and Google Scholar. Exclusion criteria included only viewing journal articles with full-text available. Key words searched included positive psychology, strength-based development, performance appraisals, 360° appraisals, and performance management.Results/DiscussionThe total number of journal articles accessed was 61. Because of exclusion criteria, there were 33 articles deemed appropriate to be used. Ultimately, 13 journal articles were referenced among the other sources accessed. Findings included that 360° appraisals generally have a conflicted user base. Findings also included discovering that positive psychology and strength-based development have numerous positive benefits. It was also well documented that performance appraisals should be used as part of an overall performance management strategy for staff. It was also noted that there are many commercially available solutions for performance appraisals.ConclusionsThe literature review identified that 360° appraisals could be integrated into a performance management structure in radiation therapy departments worldwide. Performance management can further be enhanced with the inclusion of positive psychology and strength-based development, which can create a meaningful process that benefits the individual, the team, and the organization. The choice of a new performance management structure is a challenging process but should be pivotal in developing more effective RTs.     

Thyroid Hormone in the Treatment of Post-transplant Acute Tubular Necrosis (ATN)

Delayed graft function (DGF) in cadaver kidney transplants is a common problem and is often due to acute tubular necrosis (ATN). DGF in transplants may have a deleterious effect on long-term graft survival. Since thyroid hormone has been shown to hasten recovery from ATN in experimental models, we designed a trial to determine if a defined course of triiodothyronine (T3) would improve the short- or long-term outcome of patients with DGF in cadaveric transplants. A prospective, randomized, placebo controlled, double blind trial of T3 was carried out in patients with DGF in cadaveric renal transplants. End-points were percentage requiring dialysis, percentage recovering function, time to recovery and length of hospital stay. Long-term outcomes were percentage grafts functioning at 1 year and mean serum creatinine at 1 year. Forty-four patients were randomized to receive either T3 or placebo. Three patients were dropped from each group when early biopsies disclosed that DGF was due to rejection. The groups were well matched by age, cold ischemia time of the graft, and percentage reactivity to a random panel of antigens. Baseline thyroid function studies, including T3, reverse T3 (rT3), and thyroid stimulating hormone (TSH) levels, were similar between the two groups and typical of 'euthyroid-sick syndrome'. T3 had no effect on percentage requiring dialysis, time to recovery, percentage recovering function, or length of stay. At 1 year follow-up, graft function was similar in both groups and significantly lower than that seen in patients with good initial function. Thyroid hormone, given early in the course of DGF in cadaver kidney recipients, had no effect on the course of DGF. Long-term graft function is impaired in patients who experience post-transplant DGF compared to those who have good initial function.