Notes

Automated Blend of Operators inside a Genetic Protocol to Solve the Traveling Salesman Dilemma.
Three key predictors of food insecurity and CRN in older adults were identified low income, health insurance gaps, and higher out-of-pocket prescription costs. Most studies reported that subjects with higher food insecurity and CRN were more likely to be young-old (ages 60 to 84), have lower income, and have relatively more chronic conditions. Conclusion Overall, the findings indicate that older adults who have multiple chronic conditions and only receive Medicare are at increased risk for food insecurity and CRN. Finding ways for health care providers and organizations to help manage these risks is critical to improving health outcomes and reducing use of health care services. Nurses can be pivotal in taking the lead to develop appropriate interventions and programs for patients, and to advocate better government-funded health care and policy reform in order to improve outcomes in this vulnerable population.Editor's note The mission of Cochrane Nursing is to provide an international evidence base for nurses involved in delivering, leading, or researching nursing care. Cochrane Corner provides summaries of recent systematic reviews from the Cochrane Library. For more information, see https//nursing.cochrane.org.Shortages of vital PPE during the COVID-19 pandemic.A new book makes the case for 'a culture shift of epic proportions.'New research finds no harm to infant-mother attachment.Nearly a decade of conflict leaves health and housing systems in shambles.Concerns for physical and mental health.Twenty-five years after the Beijing Declaration, progress is marginal.A striking plea for education in recognizing mental illness.The COVID-19 pandemic is a watershed moment for nurses.Constipation seems like a ubiquitous condition, something people of all ages experience and many complain about. It is often associated with infrequent bowel movements; however, in reality, constipation has a wide array of symptoms including hard stools, feeling of incomplete evacuation, abdominal discomfort, bloating, distension, excessive straining, sensation of anorectal blockage, or need for manual maneuvers during defecation. Determining the cause of the constipation is essential to ensure the appropriate treatment approach. The patient evaluation consists of collecting subjective and objective information. Constipation has many different treatment options, with many treatments available as over-the-counter products as well as prescription medications. For most types of constipation, nonpharmacological and dietary changes are typically recommended as first-line treatment. SM04690 Prescription medications are available with indications for specific types of constipation. Both nonpharmacological and pharmacological interventions have a key role, and follow-up is important to ensure treatment is appropriate and adequate.As the silver tsunami hits the world, older patients with hip fractures are expected to increase to 6.3 million by the year 2050, of which the majority will occur in Asia. The estimated global cost of hip fractures in the year 2050 is estimated to reach U.S. $130 billion. Hence, in addition to implementation of prevention strategies, it is important to develop an optimal model of care for older patients with hip fracture to minimize the huge medical and socioeconomic burden, especially in rapidly aging nations. This review summarizes the complications of hip fractures, importance of comprehensive geriatric assessment, and multidisciplinary rehabilitation, as well as predictors of rehabilitation outcome in older patients with hip fracture.Background Traditional care of patients with geriatric hip fracture has been fragmented with patients admitted under various specialty services and to different units within a hospital. This produces inconsistent care and leads to varying outcomes that can be associated with increased length of stay, delays in time from admission to surgery, and higher readmission rates. Purpose The purpose of this article is to describe the process taken to establish a successful geriatric hip fracture program (GFP) and the initial results observed in a single institution after its implementation. Methods All patients 60 years or older, with an osteoporotic hip fracture sustained from a low energy mechanism (defined as a fall from 3-ft height or less), were included in our program. Fracture patterns include femoral neck, intertrochanteric, pertrochanteric, and subtrochanteric femur fractures including displaced, nondisplaced, and periprosthetic fractures. Preprogram data included all patients admitted from January 1, 2012, tcrease in time from admission to surgery, length of stay, and blood transfusion requirements.The successful implementation of a geriatric fracture program is dependent on engaging a multidisciplinary team. The goal of these programs is to address the unique needs of patients with geriatric fracture by providing the support necessary for return to their prefracture level of activities of daily living. Identifying the key stakeholders and clarifying their role in pre- and postoperative patient support are vital to the development of such an initiative. The purpose of this article is to discuss the steps to plan and implement a geriatric fracture program in a hospital and lessons learned from our experience initiating such a program.Fragility fractures among the older adult population are common, costly, and one of the top acute care facility diagnoses for this age group. Approximately 150,000 older adults in the United States are admitted to a hospital for treatment of a fragility hip fracture annually, with an estimated cost of more than $10 billion to the healthcare system. On admission to the hospital, patient treatment may be delayed, fragmented, or inadequate, adversely impacting length of stay and short- and long-term patient outcomes. Development of a geriatric fracture program implementing standardized, evidence-based guidelines can streamline clinical pathways and care processes and has been demonstrated to be a cost-effective method to improve patient outcomes.Background We evaluated the clinical management and risk factors for Trichomonas vaginalis-positive adolescents in upstate South Carolina. Methods An EPIC electronic medical record report was generated to identify any physician-ordered T. vaginalis test from February 2016 to December 2017 for patients aged 12-18 years within the Prisma Health Upstate system. Utilizing a case-control study design of patients with a documented T. vaginalis diagnostic result, we reviewed records of patients with physician-ordered T. vaginalis tests for demographics, clinical disease course, sexually transmitted infection test results, treatment order and dosage, infection risk factors, comorbidities, pregnancy term, and neonatal birth outcomes. Results Of 789 male and female adolescents with physician-ordered T. vaginalis tests, 44% had a documented result. Of those with a document test result, 13% were T. vaginalis positive. Cases (n=45) and randomly selected negative controls (n=45) were all female. Cases were more likely to be African American, symptomatic, and present with vaginal discharge, pain, and vulvar itch.
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