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Status epilepticus, a condition characterized by abnormally prolonged seizures, has the potential to cause irreversible, structural or functional, injury to the brain. Unfavorable consequences of these seizures include mortality, the risk of developing epilepsy, and cognitive impairment. We highlight key findings of clinical and laboratory studies that have provided insights into aspects of cell death, and anatomical and functional alterations triggered by status epilepticus that support the need to intervene before time point 2, the time after which the risk of these long-term consequences increases.
Hemorrhagic strokes have not declined in the United States despite a decline worldwide.
To identify hemorrhagic stroke risk associated with nonsteroidal anti-inflammatory drugs (NSAIDs), other medications associated with increased risk for hemorrhagic stroke, and diabetes, cardiovascular disease, gender, and age.
A post hoc design was used to examine predictors of hemorrhagic stroke for adults of age 65 years and older from the Food and Drug Administration Adverse Events Reporting System database. The initial sample consisted of all cases reported during the third quarter of 2016 and the second quarter of 2018 with an NSAID as the primary suspect for the adverse drug event (ADE). An additional 397 cases with warfarin as the primary suspect were included in the final sample (N = 3,784) to test for bias from including only NSAID as the primary ADE suspect cases. Extracted data included the primary ADE (hemorrhagic stroke or other ADE), age, gender, primary suspect drug (NSAID or warfarin), and presence of a second NSAID, rivaroxaban, warfarin, clopidogrel, antidepressants (selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, and tricyclic antidepressants), inhaled corticosteroids, diabetes, or cardiovascular medications. Logistic regression was used to predict hemorrhagic stroke.
Aspirin and warfarin increased the risk for hemorrhagic stroke by 3.458 and 3.059, respectively. Presence of an additional NSAIDs reduced the risk by 48%.
Hemorrhagic stroke risk specific to older adults may provide helpful estimates for practitioners as they weigh the risk benefit of prescribing aspirin as an antiplatelet therapy for older adults.
Hemorrhagic stroke risk specific to older adults may provide helpful estimates for practitioners as they weigh the risk benefit of prescribing aspirin as an antiplatelet therapy for older adults.Heart failure (HF) is a growing health problem associated with high morbidity and mortality. CHIR-98014 molecular weight Use of evidence-based therapies improves clinical outcomes in patients with HF with reduced ejection fraction (HFrEF). However, in real-world research studies, adults with HFrEF were often medically undermanaged, including failure to use the right medications and failure to up titrate core HF therapies to doses similar to those used in randomized controlled trials. Although guidelines provide best-practice statements about care management, advanced practice providers and clinical nurses often have questions about how to implement guideline-directed therapies in patient care management. With emerging new medications for managing HFrEF, and the possibility of new medications for patients with HF with preserved ejection fraction, complexity of care management will continue to increase. The aims of this review are to provide a summary of the 2017 updates to the national chronic HF management guidelines and use a case-based approach to discuss treatment change considerations associated with optimal guideline-based clinical care.
Telehealth is a solution to combat multiple health care problems such as lack of access, provider shortages, increasing health care expenditures, and a growing number of people living with chronic conditions. Nurse practitioner students are not adequately educated in telehealth and may be unprepared to use it in their future careers.
To evaluate the efficacy of telehealth educational interventions synthesizing current literature.
Using PubMed and Cumulative Index to Nursing and Allied Health Literature databases, a search was conducted in October 2019 for peer-reviewed articles in English using search terms "telemedicine," telehealth," "ehealth," "mhealth," and "mobile health," along with "graduate nursing education" and "nursing education."
A total of 15 articles were included for review. Minimal nurse practitioner student education should include didactic content and student projects because of the ease of implementation. When telehealth didactic education is combined with experiential learning such as simulation and clinical experience, the benefit is greater.
The identified methods for increasing telehealth education should be implemented to prepare nurse practitioner students because telehealth continues to grow and become a vital part of American health care. Telehealth educational resources should be increased, as telehealth is only as useful as providers are prepared to use it.
The identified methods for increasing telehealth education should be implemented to prepare nurse practitioner students because telehealth continues to grow and become a vital part of American health care. Telehealth educational resources should be increased, as telehealth is only as useful as providers are prepared to use it.
In the United States health care system, nurse practitioners (NPs) and physicians work very closely in the delivery of high-quality patient care across lifespans and acuities. In fact, advanced practice nurses work closer with physicians in their day-to-day care delivery than with any other group of professionals. This remains true even in states with independent practice for NPs. Because of the significant relationships between physicians and NPs, assessment of how these professionals resolve conflict is essential.
The purpose of this study was to determine the style of conflict resolution employed by NPs and physicians.
Nurse practitioners (n = 57) and physicians (n = 58) were randomly sampled from the Florida Department of Health-Health Care Practitioner Data Portal (N = 115). Participants completed a demographic questionnaire assessing experience in conflict resolution training and the Rahim Organizational Conflict Inventory-II, Form C, which defined the style of conflict resolution they most used and preferred.
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