Alien Registration- Given, Patrick A. (Presque Isle, Aroostook County)

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Fall Prevention in Hospitals: An Integrative Review

Purpose: This article summarize research and draws overall conclusions from the body of literature on fall prevention interventions to provide nurse administrators with a basis for developing evidence-based fall prevention programs in the hospital setting. Method: Data were obtained from published studies. Thirteen articles were retrieved that focused on fall interventions in the hospital setting. An analysis was performed based on levels of evidence using an integrative review process. Results: Multifactoral fall prevention intervention programs that included fall risk assessments, door/bed/patient fall risk alerts, environmental and equipment modifications, staff and patient safety education, medication management targeted to specific types, and additional assistance with transfer and toileting demonstrated reduction in both falls and fall injuries in hospitalized patients. Conclusion: Hospitals need to reduce falls by using multifactoral fall prevention programs using evidence-based interventions to reduce falls and injuries

Policy Implications of Oral Agents

OBJECTIVE: With the increasing use of oral antineoplastic agents in cancer management, patients and family members need to understand of how to obtain, safely handle, and store the medication, how and when the medications should be taken, and when to report toxic side effects to accomplish efficacious treatment. DATA SOURCES: Research based articles and conference presentations. CONCLUSION: Cancer centers to modify policies, protocols, or practices to assure safe and proper administration of oral antineoplastic agents. IMPLICATIONS FOR NURSING PRACTICE: Clinicians need to monitor and facilitate administration of oral antineoplastic agents, and ultimately improve clinical outcomes

Effects of depressive symptomatology on cancer‐related symptoms during oral oncolytic treatment

ObjectiveThis manuscript assesses association between depressive symptoms and symptoms from cancer and its treatment during the first 12 weeks of a new oral oncolytic treatment.MethodsThis secondary analysis used data from a recently completed trial of an intervention to improve adherence to oral oncolytic treatment and manage symptoms. Following the initiation of the new oral oncolytic medication, 272 patients were interviewed at intake and weeks 4, 8, and 12 to assess depressive symptoms, and symptoms from cancer and its treatment. Depressive symptoms were measured using the Center for Epidemiologic Studies‐Depression (CES‐D20). The summed index of 18 cancer‐related and treatment‐related symptoms as well as the number of symptoms above threshold at intake, weeks 4, 8, and 12 were related to intake and time‐varying CES‐D20 using linear mixed effects models.ResultsDepressive symptomatology was a significant predictor of cancer‐related and treatment‐related symptoms at all‐time points, but the strength of this relationship was greatest at the time of oral oncolytic agent initiation and at week 4. The strength of this relationship was the same for both summed symptom severity index and the number of symptoms above threshold, and using either intake or time‐varying CES‐D20.ConclusionIntroducing strategies to treat and manage symptoms of depression along with other symptoms might have added benefits among patients who start a new oral oncolytic treatment and report modest to higher levels of depressive symptoms. Assessments for the impact of strategies to lower depressive symptoms can be taken within the first 4 weeks.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/147865/1/pon4916.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/147865/2/pon4916_am.pd

Partial discharge detection and location for HVDC polymeric cables

This poster is concerned with use of partial discharge monitoring to provide information about the condition of the insulation of electrical cables used for HVDC transmission systems. Electrical cables are among the most fundamental components of any electrical grid, from large subsea international interconnectors, to the ‘last mile’ providing consumers with their electrical supply. The size, cost and current carrying capability are the main considerations when designing and selecting a cable, and in this regard the insulation of these cables is as fundamental as the conductor. Partial discharge (PD) measurement is becoming increasingly vital in monitoring the condition of cable insulation, providing valuable information about the health of the insulation, and predicting when insulation is likely to fail. The majority of this PD monitoring is performed on cable operating under AC conditions, however, with the increasing use of high voltage DC links, for subsea, or long land-based connections provides motivation for the increased use of PD monitoring on cables operating under HVDC. However, despite the increased intensity of research into PD in HVDC cables, there are significant knowledge gaps, preventing the practical application of PD monitoring techniques to HVDC cables. This poster describes the initial stages of a project to partially address these gaps in knowledge, by seeking to obtain results from PD measurements on cables of different insulation types under both AC and DC conditions. From this, recommendations on the use of PD monitoring for HVDC cables, with emphasis on insulation type, are will be provided, as well as recommendations for future research at both an academic and industrial level. The poster will detail the results of the initial literature review, as well as the design for the planned experimentation, and test rig

A Pilot Study of an Automated Voice Response System and Nursing Intervention to Monitor Adherence to Oral Chemotherapy Agents

This study was designed to develop and test a system to monitor adherence with non-hormonal oral chemotherapeutic agents using an automated voice response (AVR) system plus nursing intervention. Participants received the Symptom Management Toolkit then participated in an interview for symptom severity, satisfaction, and beliefs about oral agents. Patients received weekly AVR calls, which assessed adherence to oral agents and severity of 15 symptoms. Patients who reported adherence of \u3c 100% of prescribed oral agents or symptoms of 4 or greater (0-10 scale) for three consecutive weeks, were called by a nurse for assistance with symptom management and adherence to oral chemotherapy medications. Following the 8 weekly AVR calls, patients participated in a follow up interview and medical record review. Subjects were 30 oncology patients who were ambulatory and treated at two cancer centers in Midwest USA. The results indicate 23.3% non adherence rate to oral chemotherapy medications due to symptoms and forgetting to take the medication. An association between symptom management and adherence was found. Symptom severity and beliefs about medications were not significantly different between adherent and non adherent patients. This pilot study demonstrated the ability to accrue patients for a longitudinal trial and informed intervention design, while providing guidance for future interventions and research studies. This study was designed to develop and test a system to monitor adherence with nonhormonal oral chemotherapeutic agents using an automated voice response (AVR) system plus nursing intervention. Participants were patients diagnosed with solid tumor cancers, primarily breast, colon, and lung cancers, who received the Symptom Management Toolkit and participated in an interview for symptom severity, satisfaction, and beliefs about oral agents. Patients received weekly AVR calls, which assessed adherence to oral agents and severity of 15 symptoms. Patients who reported adherence of below 100% of the prescribed oral agents or symptoms of 4 or greater (0 Y 10 scale) for 3 consecutive weeks were called by a nurse for assistance with symptom management and adherence to oral chemotherapy medications. After the 8 weekly AVR calls, patients participated in a follow-up interview and medical record review. Participants were 30 oncology patients who were ambulatory and treated at 2 cancer centers in Midwest United States. The results indicate 23.3% nonadherence rate to oral chemotherapy medications due to symptoms and forgetting to take the medication. An association between symptom management and adherence was found. Symptom severity and beliefs about medications were not significantly different between adherent and nonadherent patients. This pilot study demonstrated the ability to accrue patients for a longitudinal trial and informed intervention design while providing guidance for future interventions and research studies

The Challenges of Oral Agents as Antineoplastic Treatments

OBJECTIVE: Given the increasing use of oral antineoplastic agents in cancer management, patient adherence is critical to successful treatment outcomes. This article reviews the scope of the problem and issues of adherence to oral antineoplastic agents. DATA SOURCES: Research based and other articles, newsletters, and conference presentations. CONCLUSION: Suboptimal adherence to oral antineoplastic agents is a significant clinical problem that may result in disease or treatment complications, adjustment in treatment regimen, disease progression, and premature death. IMPLICATIONS FOR NURSING PRACTICE: Healthcare providers need to monitor and facilitate adherence by identifying barriers and implementing strategies to assure adherence, and therefore, improve clinical outcomes

On the Rapid Estimation of Permeability for Porous Media Using Brownian Motion Paths

We describe two efficient methods of estimating the fluid permeability of standard models of porous media by using the statistics of continuous Brownian motion paths that initiate outside a sample and terminate on contacting the porous sample. The first method associates the "penetration depth" with a specific property of the Brownian paths, then uses the standard relation between penetration depth and permeability to calculate the latter. The second method uses Brownian paths to calculate an effective capacitance for the sample, then relates the capacitance, via angle-averaging theorems to the translational hydrodynamic friction of the sample. Finally, a result of Felderhof is used to relate the latter quantity to the permeability of the sample. We find that the penetration depth method is highly accurate in predicting permeability of porous material

An Intervention to Improve Adherence and Management of Symptoms for Patients Prescribed Oral Chemotherapy Agents: An Exploratory Study

Background: The use of oral chemotherapy agents to treat cancer has increased. Patients are responsible for adhering to complex dosing regimens, while monitoring and managing symptoms from side effects of the chemotherapy at home. Objective: This study examined an intervention to manage symptoms and promote adherence to oral chemotherapy agents. Intervention and Methods: A 3 group exploratory pilot study determined how an Automated Voice Response (AVR) system alone (N=40), or the AVR with strategies to manage symptoms and adherence (N=40), or the AVR with strategies to manage adherence (N=39) reduced symptom severity and improved adherence. Participants received a Symptom Management Toolkit, completed a baseline interview, and were randomized to receive 8 weekly AVR calls. The AVR directed patients to the toolkit for high symptoms and nurse calls occurred for management of severe symptoms or non-adherence. An exit interview occurred at 10 weeks. Results: Mean age was 59.6, with 70% female and 76% Caucasian. Overall, 42% of patients were non-adherent, with missed doses increasing with regimen complexity. Symptom severity declined over time in all groups. No difference was found in adherence rates among intervention groups. Higher adherence rates were related with lower levels of symptom severity across groups. Conclusions: Adherence is a significant clinical problem, which can affect efficacy of the cancer treatment. The AVR intervention alone was just as effective as the AVR plus the nurse intervention at promoting adherence and managing symptoms from side effects. Implications for Practice: Nurses need to focus on patient education by assuring patient understanding of oral agent regimen, and the need to adhere to the oral agent for efficacious cancer treatment. Nurses can promote the use of medication reminders and self- management of symptoms from side effects, to support adherence to the oral agent