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991.
992.
An In‐House Prevocational Training Program for Newly Discharged Psychiatric Inpatients: Exploring Its Employment Outcomes and the Predictive Factors 下载免费PDF全文
Wen‐Fang Chuang Eric Hwang Hui‐Ling Lee Shang‐Liang Wu 《Occupational therapy international》2015,22(2):94-103
Individuals with severe mental disorders continue to experience low employment rates. Occupational therapists play an important role in helping these individuals develop the skills and obtain the supports necessary for productive living. This retrospective cohort study aimed to explore employment outcomes and identify factors predictive of the outcomes of an in‐house prevocational training program designed for newly discharged psychiatric inpatients. Data retrieved from the files of 58 participants including demographics, diagnostic history, physical fitness, functional assessment results, the use of vocational counselling service and employment status were analyzed. The overall employment rates among the participants were high (67.2–79.3%) within the 6 months following the prevocational training program. No significant differences were found in the employment rates across the 1, 3 and 6‐month time periods post‐training. Vocational counselling service post‐training and hand function were two factors predictive of participants' employment outcomes. Occupational therapists should attend to the clients' need for continuous vocational support and carefully identify the personal, functional and environmental factors contributing to successful employment. Caution in interpreting the results is warranted because of the lack of control and randomization in this retrospective study. Additional longitudinal cohort or experimental studies would add further certainty to the current findings. Copyright © 2015 John Wiley & Sons, Ltd. 相似文献
993.
Iftikhar J. Kullo Janet Olson Xiao Fan Merin Jose Maya Safarova Carmen Radecki Breitkopf Erin Winkler David C. Kochan Sara Snipes Joel E. Pacyna Meaghan Carney Christopher G. Chute Jyoti Gupta Sheethal Jose Eric Venner Mullai Murugan Yunyun Jiang Magdi Zordok Stephen N. Thibodeau 《Mayo Clinic proceedings. Mayo Clinic》2018,93(11):1600-1610
Objectives
To identify clinically actionable genetic variants from targeted sequencing of 68 disease-related genes, estimate their penetrance, and assess the impact of disclosing results to participants and providers.Patients and Methods
The Return of Actionable Variants Empirical (RAVE) Study investigates outcomes following the return of pathogenic/likely pathogenic (P/LP) variants in 68 disease-related genes. The study was initiated in December 2016 and is ongoing. Targeted sequencing was performed in 2533 individuals with hyperlipidemia or colon polyps. The electronic health records (EHRs) of participants carrying P/LP variants in 36 cardiovascular disease (CVD) genes were manually reviewed to ascertain the presence of relevant traits. Clinical outcomes, health care utilization, family communication, and ethical and psychosocial implications of disclosure of genomic results are being assessed by surveys, telephone interviews, and EHR review.Results
Of 29,208 variants in the 68 genes, 1915 were rare (frequency <1%) and putatively functional, and 102 of these (60 in 36 CVD genes) were labeled P/LP based on the American College of Medical Genetics and Genomics framework. Manual review of the EHRs of participants (n=73 with P/LP variants in CVD genes) revealed that 33 had the expected trait(s); however, only 6 of 45 participants with non–familial hypercholesterolemia (FH) P/LP variants had the expected traits.Conclusion
Expected traits were present in 13% of participants with P/LP variants in non-FH CVD genes, suggesting low penetrance; this estimate may change with additional testing performed as part of the clinical evaluation. Ongoing analyses of the RAVE Study will inform best practices for genomic medicine. 相似文献994.
995.
The epidemiology of bacterial culture–positive and septic transfusion reactions at a large tertiary academic center: 2009 to 2016 下载免费PDF全文
996.
The “hidden” concealed left‐sided accessory pathway: An uncommon cause of SVT in young people 下载免费PDF全文
997.
Anesthesia for subcutaneous implantable cardioverter‐defibrillator implantation: Perspectives from the clinical experience of a U.S. panel of physicians 下载免费PDF全文
Michael K. Essandoh MD George E. Mark MD Johan D. Aasbo DO Charles A Joyner MD Saumya Sharma MD Beningo F Decena MD Eric D Bolin MD Raul Weiss MD Martin C Burke DO Timothy R. McClernon PhD Emile G. Daoud MD Michael R. Gold MD PhD 《Pacing and clinical electrophysiology : PACE》2018,41(7):807-816
1 Background and objective
Worldwide adoption of the subcutaneous implantable cardioverter‐defibrillator (S‐ICD) for preventing sudden cardiac death continues to increase, as longer‐term evidence demonstrating the safety and efficacy of the S‐ICD expands. As a relatively new technology, comprehensive anesthesia guidance for the management of patients undergoing S‐ICD placement is lacking. This article presents advantages and disadvantages of different periprocedural sedation and anesthesia options for S‐ICD implants including general anesthesia, monitored anesthesia care, regional anesthesia, and nonanesthesia personnel administered sedation and analgesia.2 Methods
Guidance, for approaches to anesthesia care during S‐ICD implantation, is presented based upon literature review and consensus of a panel of high‐volume S‐ICD implanters, a regional anesthesiologist, and a cardiothoracic anesthesiologist with significant S‐ICD experience. The panel developed suggested actions for perioperative sedation, anesthesia, surgical practices, and a decision algorithm for S‐ICD implantation.3 Conclusions
While S‐ICD implantation currently requires higher sedation than transvenous ICD systems, the panel consensus is that general anesthesia is not required or is obligatory for the majority of patients for the experienced S‐ICD implanter. The focus of the implanting physician and the anesthesia services should be to maximize patient comfort and take into consideration patient‐specific comorbidities, with a low threshold to consult the anesthesiology team. 相似文献998.
Purpose
Morphine ARER is a novel oral, abuse-deterrent, extended-release (ER) formulation of morphine sulfate with physical and chemical properties that deter misuse and abuse by nonoral routes of administration. Here we evaluate the relative bioavailability of morphine ARER and extended-release morphine.Methods
This single-dose, 2-treatment, 2-period, 2-sequence, randomized crossover study in healthy adult subjects compared the relative bioavailability of morphine ARER 100 mg to that of ER morphine 100 mg in the fasted condition. At 12 and 1.5 hours before dosing and 12 hours after dosing, all subjects received a 50-mg oral naltrexone tablet to minimize opioid-related side effects. Pharmacokinetic parameters including the AUC0–t, AUC0–∞, and Cmax of morphine and its metabolite morphine-6-glucuronide (M6G) were determined at various times up to 48 hours postdose. The bioequivalence of morphine ARER and ER morphine was determined using an ANOVA of the least-squares mean values of morphine and M6G bioavailability.Findings
Forty-nine subjects completed the study. Both morphine ARER and ER morphine exhibited peak plasma morphine and M6G concentrations of ~30 ng/mL and ~200 ng/mL, respectively, at 3 hours postdose. The 90% CIs of the ln-transformed values of morphine AUC0–t, AUC0–∞, and Cmax were within the 80% to 125% range for bioequivalence. M6G values also indicated bioequivalence of morphine ARER and ER morphine. The most common adverse events were nausea and somnolence.Implications
These data show that, in these subjects, morphine ARER was bioequivalent to ER morphine, a treatment for pain with well-established efficacy and safety profiles. 相似文献999.
Janet Prvu Bettger Vu Q.C. Nguyen J. George Thomas Tami Guerrier Qing Yang Mark A. Hirsch Terrence Pugh Gabrielle Harris Mary Ann Eller Carol Pereira Deanna Hamm Eric A. Rinehardt Matthew Shall Janet P. Niemeier 《Archives of physical medicine and rehabilitation》2018,99(6):1226-1231
Attention to health care quality and safety has increased dramatically. The internal focus of an organization is not without influence from external policy and research findings. Compared with other specialties, efforts to align and advance rehabilitation research, practice, and policy using electronic health record data are in the early stages. This special communication defines quality, applies the dimensions of quality to rehabilitation, and illustrates the feasibility and utility of electronic health record data for research on rehabilitation care quality and outcomes. Using data generated at the point of care provides the greatest opportunity for improving the quality of health care, producing generalizable evidence to inform policy and practice, and ultimately benefiting the health of the populations served. 相似文献
1000.