Nurses' attitudes of a web patient portal prior to its implementation in home health care nursing

ObjectivesEffective communication is essential in home health care nursing in order to meet the needs of both the patients and the caregivers. Given the key role of nursing staff inpatient training through the patient portal; nursing staffs' attitudes toward the use of this technology thus need to be further evaluated. The present study evaluated Iranian nurses' attitudes before the web-based patient portal implementation in home health care nursing.MethodsThis study was conducted on 600 nursing staff working in health care organizations affiliated to Semnan University of Medical Sciences in Iran. A questionnaire was used to evaluate the nurses’ attitudes.ResultsThe study subjects' attitudes scores were 3.06±0.71 on "patient education", 3.02±0.78 on "health care plan" and 2.95±0.82 on the cost of nursing services, based on the 5-point Likert scale (1-5: completely disagree to completely agree). There was a statistically significant relationship between nurses' attitudes and computer skill (B=0.07, SE=0.03, P=0.021) and nurses' acceptance of IT (B=0.085, SE=0.039, P=0.030), and sex (B=0.176, SE=0.058, P=0.003).ConclusionThe nurses agreed that the use of this self-management tool can ease patient education, easily implement a health care plan for patients and reduce the cost of nursing services. The nurses also agreed that changes are required at the minor and major levels of in-home health care institutions to support the implementation and meaningful use of this portal for home health care nursing.Public interest (lay) summaryHome health care is one of the alternative solutions to continue hospital care that is performed by nursing staff. The nursing staff in-home care should effectually cooperate to render secure and high-quality patient care. The web-based patient portals have confirmed effectiveness to improve patient gratification, engagement, and health outcomes, improve the quality and efficacy of the healthcare settings, decrease emergency unit appointments and ease patient-centered care. Nurses agree the implementation of the patient portal in home health care nursing depends on organizational and individual preparation in healthcare organizations and this technology should be also adopted by the nursing staff to meaningful use of the patient portal to attain significant improvements in home health care nursing.     

Laboratory methods and biomarkers in the evaluation of bisphosphonate effects on body tissues: a literature review

Bisphosphonates are extensively used to treat bone metabolism disorders; meanwhile, these drugs have important side effects such as jaw osteonecrosis and femoral fracture. Therefore, studies have been conducted aimed at better understanding their mechanism of action and determining a course of action to avoid these side effects. We present here a literature review focusing on the laboratory methods available for investigating bisphosphonate effects on body tissues. There are many different methods available for this purpose, but the appropriate application of these methods and knowledge of their limitations are crucial for understanding the effects of bisphosphonates.     

Unusual presentation of giant thymolipoma]

Thymolipoma is a rare thymic tumor; His frequency is estimated at 2 at 9% of all thymic tumors. His diagnosis usually easy, can be difficult with an unusual radio clinic pattern, but actually get benefice from progress in radiologic investigations especially MRI. We reported a case of a 36-year old woman, admitted for a left pleuro-pneumopathy investigation. Evolution, after antibiotic treatment and pleural effusion draining, was well. However, patient developed systolic aortic murmur and a chest-X-ray cardiomegaly supposing cardiologic dysfunction. But the normality of cardiac sonography, the ascension of diaphragma and non-specific thoracic sonographic pattern, guided to thoracic MRI. This exploration demonstrated a giant thymolipoma, which was confirmed by the histologic examination of a resected mass.     

Human resources and health work: challenges for a research agenda

This article discusses several key concepts for human resources policy in health in the context of Latin America's regional integration efforts. The article focuses on different concepts of integration to emphasize the analytical distinction between regional and conceptual integration. It also presents labor and human resources concepts before discussing, in the final analysis, the challenges that a common research agenda faces in the context of current health sector reforms in Latin America. The conclusion emphasizes the need to develop a technology and research system capable of supporting the agenda for exchange between MERCOSUR member countries.     

Neural stem/progenitor cell‐laden microfibers promote transplant survival in a mouse transected spinal cord injury model

Previous studies have demonstrated that transplantation of neural stem/progenitor cells (NS/PCs) into the lesioned spinal cord can promote functional recovery following incomplete spinal cord injury (SCI) in animal models. However, this strategy is insufficient following complete SCI because of the gap at the lesion epicenter. To obtain functional recovery in a mouse model of complete SCI, this study uses a novel collagen‐based microfiber as a scaffold for engrafted NS/PCs. We hypothesized that the NS/PC–microfiber combination would facilitate lesion closure as well as transplant survival in the transected spinal cord. NS/PCs were seeded inside the novel microfibers, where they maintained their capacity to differentiate and proliferate. After transplantation, the stumps of the transected spinal cord were successfully bridged by the NS/PC‐laden microfibers. Moreover, the transplanted cells migrated into the host spinal cord and differentiated into three neural lineages (astrocytes, neurons, and oligodendrocytes). However, the NS/PC‐laden scaffold could not achieve a neural connection between the rostral end of the injury and the intact caudal area of the spinal cord, nor could it achieve recovery of motor function. To obtain optimal functional recovery, a microfiber design with a modified composition may be useful. Furthermore, combinatorial therapy with rehabilitation and/or medications should also be considered for practical success of biomaterial/cell transplantation‐based approaches to regenerative medicine. © 2015 Wiley Periodicals, Inc.     

Inhibition of platelet activation prevents the P‐selectin and integrin‐dependent accumulation of cancer cell microparticles and reduces tumor growth and metastasis in vivo

Venous thromboembolism constitutes one of the main causes of death during the progression of a cancer. We previously demonstrated that tissue factor (TF)‐bearing cancer cell‐derived microparticles accumulate at the site of injury in mice developing a pancreatic cancer. The presence of these microparticles at the site of thrombosis correlates with the size of the platelet‐rich thrombus. The objective of this study was to determine the involvement of TF expressed by cancer cell‐derived microparticles on thrombosis associated with cancer. We observed that pancreatic cancer cell derived microparticles expressed TF, its inhibitor tissue factor pathway inhibitor (TFPI) as well as the integrins αvβ1 and αvβ3. In mice bearing a tumor under‐expressing TF, a significant decrease in circulating TF activity associated with an increase bleeding time and a 100‐fold diminished fibrin generation and platelet accumulation at the site of injury were observed. This was mainly due to the interaction of circulating cancer cell‐derived microparticles expressing TFPI with activated platelets and fibrinogen. In an ectopic model of cancer, treatment of mice with Clopidogrel, an anti‐platelet drug, decreased the size of the tumors and restored hemostasis by preventing the accumulation of cancer cell‐derived microparticles at the site of thrombosis. In a syngeneic orthotopic model of pancreatic cancer Clopidogrel also significantly inhibited the development of metastases. Together, these results indicate that an anti‐platelet strategy may efficiently treat thrombosis associated with cancer and reduce the progression of pancreatic cancer in mice.