Notes

The expense of the Epistemic Action: Examining Scalar Implicatures fully as well as Partially Info Contexts.
Patient understanding of plan of care is associated with positive outcomes in ambulatory settings. In hospital medicine settings, patient-physician agreement on plan of care (concordance) has been limited and difficult to improve. This study examined the impact of adding a hospitalist to interdisciplinary rounds (IDR) on physician-patient-nurse concordance and the relationship between concordance and outcomes.

IDR were conducted by core teams made up of unit-based nurses, a case manager, and a pharmacist. Over time, with cohorting, hospitalists were included in IDR (hospitalist IDR) for some patients assigned to unit-based hospitalists. In developing hospitalist IDR, the researchers emphasized using an IDR checklist, including a patient communication plan. Patient-nurse-physician interviews were used to assess concordance in the domains of diagnosis, tests and procedures, and expected discharge date. Using two-hospitalist review, agreement was rated as none, partial, or complete, and a total concordance score was calculated for each patient in both IDR groups. Multivariate analysis was used to examine the relationship between concordance, IDR type, patient factors, and utilization outcomes.

For 658 patients, the mean concordance score was 11.71 out of a possible 18. There was no difference in concordance between hospitalist and core IDR groups (11.68 vs. 11.84, p = 0.7). Higher total concordance score was associated with lower lengths of stay (p < 0.001) and readmission rates (p = 0.001). Total concordance had a negative association with patient age (p = 0.04).

Concordance did not change with IDR type. Higher concordance appears to be related to positive utilization outcomes. Future studies are needed to evaluate potential interventions to improve concordance.
Concordance did not change with IDR type. Higher concordance appears to be related to positive utilization outcomes. Future studies are needed to evaluate potential interventions to improve concordance.
A nurse-triggered sepsis alert called "Code Sepsis" was implemented for early recognition and management of sepsis. The researchers analyzed its impact on antimicrobial use and identified factors associated with infection as source of Code Sepsis.

The medical records of hospitalized patients with Code Sepsis between January 1 and June 30, 2018, were reviewed. Patients were classified as "Infection" when probable or definitive infection was identified or "No Infection" when a probable or definitive noninfectious source was identified. Patients were categorized as "Escalation" with addition or change to broader-spectrum antimicrobials or "No Escalation" with no change or change to narrower-spectrum antimicrobials. Escalation was classified as "Indicated" with appropriate escalation or "Not Indicated" with inappropriate escalation. Logistic regression model was used to identify factors associated with Infection as Code Sepsis trigger.

Code Sepsis was activated in 529 patients, with Escalation in 246 (46.5%es to optimize resource utilization and improve patient outcomes.
Considering the prevalence of mental health problems in older adults, this study aims to investigate the effect of inhalation aromatherapy using lavender and chamomile essential oils on depression, anxiety, and stress of community-dwelling older people.

A three-armed, parallel, randomized, and controlled trial design was used in this study. 183 participants were enrolled and randomly assigned to three groups (n=61) the lavender, chamomile, and control groups. The participants in the experimental groups inhaled three drops of 1.5% lavender and chamomile essential oils for 30 nights. The participants in the control group inhaled only distilled water in a similar fashion. Data were collected using the Depression, Anxiety, and Stress-Scale (DASS) at baseline, immediately after the intervention, and one month after the intervention. Chi-square, Fisher's exact, one-way ANOVA, and repeated measures ANOVA were used for data analysis.

Statistically significant improvement occurred in depression, anxiety, and stress levels immediately and one month after the intervention in lavender and chamomile groups compared to the control group (p<0.01).

Inhalation aromatherapy with both lavender and chamomile essential oils helped decrease depression, anxiety, and stress levels in community-dwelling older adults.
Inhalation aromatherapy with both lavender and chamomile essential oils helped decrease depression, anxiety, and stress levels in community-dwelling older adults.
Healthcare provision for the multimorbid elderly is complex. Care and Case Managers (CCMs) can help to coordinate and structure outpatient care for these patient groups. This approach will be realized in the project RubiN ("Continuous Care in Regional Networks"), which is funded by the Federal Joint Committee. The aim of the present qualitative study was to explore the motivation to work as a CCM.

As part of the qualitative study framework, semi-structured interviews with CCMs were conducted as part of a joint kick-off event. The interviews were focused on the reasons and motivation for participating in the RubiN project. The transcribed interviews were analyzed using qualitative content analysis.

Eight of 20 CCMs agreed to take part in the interviews. One of the main motivations for taking part in RubiN was to shift away from working conditions that were perceived as stressful and towards an activity that was experienced as appreciative. The CCMs felt that their professional expertise was recognized by other service providers, and that appreciation of their role increased through their active involvement in the care of geriatric patients.

Care and Case Management as a practical application with extensive coordination services for geriatric patients may contribute to an increase in appreciation and recognition through establishing a separate area of responsibility and scope as well as working in an interdisciplinary team.
Care and Case Management as a practical application with extensive coordination services for geriatric patients may contribute to an increase in appreciation and recognition through establishing a separate area of responsibility and scope as well as working in an interdisciplinary team.
The progress of a discipline depends on the knowledge widely shared, an aim fulfilled by publications. But which are the factors influencing publication? We examine predictors of a subsequent publication for abstracts submitted to the annual scientific conference of the German Society of Orthodontics (DGKFO).

For all 288 abstracts presented in 2014 and 2015 we recorded presentation format, number and gender of authors, study design and university affiliation. Subsequent publication as a peer-reviewed full-text article was researched over a period of more than three years.

A total of 88 abstracts (30.6%) were published in full-text after a mean time span of 1.2±1.6 years after the respective conference. In multivariate logistic regression, secondary studies (OR 9.27 [1.51-57.04]; p=0.016), a higher number of authors (OR 1.21 [1.02-1.43]; p=0.030), a higher percentage of female authors (OR 1.01 [1.00-1.03]; p=0.036) but male gender of the first author (OR 2.10 [1.11-3.98]; p=0.023) resulted in a higher probability of getting published as a journal paper.

Our investigation shows that secondary studies, a higher number of authors, a higher percentage of women among the authors and male first authors are predictive factors of publication. After more than three years, only about one third of the abstracts presented at the DGKFO annual scientific conference have been published as a full-text journal article, meaning that a huge part of knowledge remains unshared.
Our investigation shows that secondary studies, a higher number of authors, a higher percentage of women among the authors and male first authors are predictive factors of publication. After more than three years, only about one third of the abstracts presented at the DGKFO annual scientific conference have been published as a full-text journal article, meaning that a huge part of knowledge remains unshared.
The lesbian, gay, bisexual, trans, queer, two-spirit, pansexual, intersex, asexual, plus (LGBTQ2SPIA+) population faces unique cancer health risks and barriers to competent healthcare. This study aimed to identify current knowledge, attitudes, and practice behaviours amongst radiation therapists regarding the LGBTQ2SPIA+community to ultimately improve care given to this population.

A 22-item online survey was sent out to Canadian radiation therapy department managers and forwarded to radiation therapists. The survey collected demographics and addressed knowledge, attitudes, and practice behaviours regarding the LGBTQ2SPIA+population. Results were analyzed using descriptive statistics, inferential statistics and thematic analysis.

214 radiation therapists completed the survey. find more Over 70% were unfamiliar with all terms associated with "LGBTQ2SPIA+". 91.6% believed that being conscious of the LGBTQ2SPIA+community is important to their role as a therapist; however, 34.5% reported "rarely" or "never" adapting nd aid in providing inclusive patient care.
Overall, this study was unable to provide national generalizability, however the results suggest that amongst the respondents there are knowledge gaps and inconsistencies in practice when caring for LGBTQ2SPIA+ cancer patients. Given the limited literature available, and the results from this study, more education and research is warranted to bridge knowledge gaps and aid in providing inclusive patient care.Donor-derived cell-free DNA refers to the cell-free DNA derived from apoptosis or necrosis of allograft tissue, circulating in the body fluids of patients after organ transplantation, and carries health information on the donor tissue. In the past two years, donor-derived cell-free DNA has rapidly become a research hotspot in the field of graft rejection detection after organ transplant. Recent published data have increased our understanding of donor-derived cell-free DNA in the field of kidney transplantation, especially in association with acute rejection. Donor-derived cell-free DNA is predicted to become the next-generation biomarker for the non-invasive detection of allograft rejection. This article reviews the research, involving donor-derived cell-free DNA in ischemia-reperfusion injury, delayed graft function, acute rejection (antibody mediated rejection and T-cell mediated rejection), and BK virus nephropathy. We further discuss the limitations of current research models and suggest directions for future study.Since its initial description in 1996 by Yii and Niranjan, the internal pudendal perforator flap (also known as the Singapore flap, the gluteal fold flap, and the lotus petal flap) has become a workhorse in perineal soft tissue reconstruction. In 2001, Hashimoto described the presence of three to five perforators in the perineal anogenital triangle. The ischial tuberosity has thus become a useful anatomic landmark for the safe boundary of medial dissection during flap elevation, in order to avoid damaging the perforator vessels. The objective of the present study was to evaluate the perforators' positions within the anogenital triangle by using color Doppler ultrasound. In a study of 15 subjects in the lithotomy position, we identified a total of 24 perforator vessels with a diameter greater than 5 mm. We noted the vessels' positions using orthonormal measurements, according to the distance from the midline and the distance on a straight line between the two ischial tuberosities (i.e. consistent bony anatomic landmarks that are independent of the patient's height and body mass index).
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