Conducting a SWOT Analysis and Assessing Clinic Roles to Improve Integrated Healthcare

Currently, those with a mental illness are less likely to receive primary care services and are more likely to die sooner than those without a mental illness. Combating this health disparity, integrated healthcare is a holistic approach that treats both mental and physical health. The cooperation and partnership of multiple health disciplines is a whole-person method that improves a patient’s overall wellbeing. Community Alliance is an organization in Omaha, Nebraska that offers integrated health care services through its clinic to community members. With multiple areas of care, roles and responsibilities can become easily obscured creating confusion and mistakes in the clinic. To alleviate these obstacles and improve their integrated healthcare services, I took field notes and conducted interviews to understand the roles and responsibilities of the Community Alliance clinic staff. Clearly defined roles and responsibilities can support fewer mistakes and a smoother transition between care services can improve employee satisfaction and a patient’s overall experience, safety, and health outcomes. To further understand and assess the clinic’s operations, an evaluation of strengths, weaknesses, opportunities, and threats was conducted to provide insight into possible changes that would enhance efficiency and execution of care. From these insights, future structural and policy changes can be supported to improve integrated healthcare and patient health

Agents in Network Management

The ubiquity and complexity of modern networks require automated management and control. With increases in scale, automated solutions based on simple data access models such as SNMP will give way to more distributed and algorithmic techniques. This article outlines present and near-term solutions based on the ideas of active networks and mobile agents, which permit sophisticated programmable control and management of ultra large scale networks

Exploring Parent/Caregiver Perspectives of Self-Determination and Its Impact on Mental Health in Adolescents with and without Disabilities

Introduction. Parents and caregivers play key roles in supporting the development of self-determination and mental health needs in adolescents with and without disabilities. This study explored parent/caregiver perceptions of the relationships among mental health and self-determination constructs for youth with disabilities, across gender and disability status. Method. Parents/caregivers of adolescents with and without disabilities completed rating scales regarding adolescents’ self-determination status (Self Determination Inventory) and mental health symptoms (Behavior Assessment System for Children, 3rd Edition). Bayesian analyses examined the relationships among self-determination and mental health status. Results. Results are mixed, indicating moderate to robust relationships for self-determination as a moderator for the relationship between disability status and adaptive skills and behavioral symptoms, but mixed results for self-determination as a moderator of those demographic variables on internalizing and externalizing symptoms. Conclusion. While sample size is limited, results suggest that there are potential relationships among these variables that warrant further exploration

Nutritional risk amongst community-living Maori and non-Maori older people in Hawke’s Bay

Karen Anne Hicks - ORCID 0000-0002-7274-9745 https://orcid.org/0000-0002-7274-9745INTRODUCTION: Maintaining good nutrition is vital for healthy ageing. Poor nutrition increases the risk of hospitalisation, disability and mortality. Research shows clinical malnutrition is preceded by a state of nutritional risk and screening can identify older people at risk of poor nutrition or who currently have impaired nutritional status. AIM: To assess the population prevalence of nutritional risk amongst community-living Maori and non-Maori older people in Hawke’s Bay. METHODS: A postal survey of 1268 people aged 65 years or older on the electoral roll for Hawke’s Bay was conducted. Nutritional risk was measured using the SCREEN II questionnaire. RESULTS: Responses from 473 people were received (43.8% male, 49.9% female, 6.3% unspecified) with an estimated average age of 74 years. Nutritional risk was present amongst 56.5% of older people with 23.7% at risk and 32.8% at high risk. Maori were 5.2 times more likely to be at nutritional risk than non-Maori. Older people living alone were 3.5 times more likely to be at nutritional risk than those living with others. The most frequent risk factors were low milk-product intake, perception of own weight being more or less than it should be, and low meat and alternatives intake. Skipping meals and low fruit and vegetable intake were additional frequent risk factors for Maori. DISCUSSION: Both living situation and ethnicity are associated with nutritional risk. Further investigation is needed to confirm these findings and to determine issues specific for older Maori, including barriers to good nutrition and opportunities for nutritional improvement.https://doi.org/10.1071/HC122994pubpub

Rights and representation support justice across aquatic food systems

Injustices are prevalent in food systems, where the accumulation of vast wealth is possible for a few, yet one in ten people remain hungry. Here, for 194 countries we combine aquatic food production, distribution and consumption data with corresponding national policy documents and, drawing on theories of social justice, explore whether barriers to participation explain unequal distributions of benefits. Using Bayesian models, we find economic and political barriers are associated with lower wealth-based benefits; countries produce and consume less when wealth, formal education and voice and accountability are lacking. In contrast, social barriers are associated with lower welfare-based benefits; aquatic foods are less affordable where gender inequality is greater

Maternal Prenatal Cortisol Programs the Infant Hypothalamic–Pituitary–Adrenal Axis

One of the key proposed agents of fetal programming is exposure to maternal glucocorticoids. Experimental animal studies provide evidence that prenatal exposure to elevated maternal glucocorticoids has consequences for hypothalamic–pituitary–adrenal (HPA) axis functioning in the offspring. There are very few direct tests of maternal glucocorticoids, such as cortisol, during human pregnancy and associations with infant cortisol reactivity. The current study examined the link between maternal prenatal cortisol trajectories and infant cortisol reactivity to the pain of inoculation in a sample of 152 mother-infant (47.4% girls) pairs. The results from the current study provide insight into fetal programming of the infant HPA axis, demonstrating that elevated prenatal maternal cortisol is associated with a larger infant cortisol response to challenge at both 6 and 12 months of age

People with Aphasia: Knowledge of Restorative and Supported Reading Techniques

Restorative and supported reading interventions are available for people with aphasia (PWA). However, the extent to which this population accesses these resources is undocumented. Therefore, the purpose of this study was to explore the reading practices of PWA and discover how PWA developed strategies to navigate written material. The researchers used a phenomenological qualitative approach. They conducted 16 in-depth semi-structured interviews with PWA and their caregivers. These interviews revealed the types of reading materials accessed by PWA, reading strategies employed, barriers to reading, issues regarding reading comprehension and the use of reading therapy delivery models

A customizable microfluidic platform for medium-throughput modeling of neuromuscular circuits

Neuromuscular circuits (NMCs) are vital for voluntary movement, and effective models of NMCs are needed to understand the pathogenesis of, as well as to identify effective treatments for, multiple diseases, including Duchenne's muscular dystrophy and amyotrophic lateral sclerosis. Microfluidics are ideal for recapitulating the central and peripheral compartments of NMCs, but myotubes often detach before functional NMCs are formed. In addition, microfluidic systems are often limited to a single experimental unit, which significantly limits their application in disease modeling and drug discovery. Here, we developed a microfluidic platform (MFP) containing over 100 experimental units, making it suitable for medium-throughput applications. To overcome detachment, we incorporated a reactive polymer surface allowing customization of the environment to culture different cell types. Using this approach, we identified conditions that enable long-term co-culture of human motor neurons and myotubes differentiated from human induced pluripotent stem cells inside our MFP. Optogenetics demonstrated the formation of functional NMCs. Furthermore, we developed a novel application of the rabies tracing assay to efficiently identify NMCs in our MFP. Therefore, our MFP enables large-scale generation and quantification of functional NMCs for disease modeling and pharmacological drug targeting. © 2019 The Author

Aripiprazole lauroxil, a novel injectable long-acting antipsychotic treatment for adults with schizophrenia: A comprehensive review

Purpose of Review. This is a comprehensive review of the literature regarding the use of Aripiprazole lauroxil for schizophrenia. This review presents the background, evidence, and indications for using aripiprazole lauroxil to treat schizophrenia in the context of current theories on the development of schizophrenia. Recent Findings. Schizophrenia is a chronic mental health disorder that currently affects approximately 3.3 million people in the United States. Its symptoms, which must be present for more than six months, are comprised of disorganized behavior and speech, a diminished capacity to comprehend reality, hearing voices unheard by others, seeing things unseen by others, delusions, decreased social commitment, and decreased motivation. The majority of these symptoms can be managed with antipsychotic medication. Aripiprazole lauroxil is a long-acting intramuscular injection that works as a combination of partial agonist activity at D2 and 5-HT1A receptors combined with antagonist activity at 5-HT2A receptors. It can be dosed as a 4-, 6-, or 8-week injection, depending on oral dosage. Aripiprazole lauroxil was FDA approved in October of 2015. Summary. Schizophrenia is a severe psychiatric disorder if left untreated. There are multiple medications to help treat schizophrenia. One antipsychotic agent, aripiprazole lauroxil, offers long duration injections that optimize and improve compliance. Known side effects include weight gain, akathisia, neuroleptic malignant syndrome, tardive dyskinesia, and orthostatic hypotension. Aripiprazole lauroxil is an FDA-approved drug that can be administered monthly, every six weeks, or every two months and has been shown to be both safe and effective