The Effect of Telephone Follow-Up on Pain Experienced by Patients After Knee Replacement Surgery

Hospital length of stays are decreasing throughout the U.S. in an effort to contain healthcare costs, but these measures can be detrimental to patients. Those who get knee replacement surgery are finding their length of stay reduced from an average of 3 to 4 days to 24 to 48 hours, which can affect pain control and interfere with rehabilitation and recovery. This affects many people, as more than 632,000 knee replacements occur each year (American Academy of Orthopedic Surgeons, 2008). The purpose of this evidence-based project was to evaluate the effect of telephone follow-up on pain experienced by knee replacement patients the first four weeks post-operatively. Orem’s Self Care Deficit Theory and the Stetler’s Model of evidence utilization were used to guide the project. Patients undergoing knee replacement were randomly assigned to the Intervention group or Usual Care group. The Intervention group received a scheduled telephone call each week for the first 4-weeks postoperatively and a completion call in week five. Those in the Usual Care group received one telephone call following the 4-week postoperative period. Each telephone call included the completion of a standardized questionnaire developed by the project coordinator. Pain coaching was offered to each patient by the project coordinator. Data were collected regarding the assessment of pain, the use of pain medication, and secondary concerns such as constipation, nausea, or edema. An independent-sample t test comparing the mean scores of the Intervention and Usual Care groups found a significant difference between the means (t (23)=-2.578, p \u3c .05), with the Intervention group reporting less pain. Data collected on secondary outcomes indicated constipation accounted for 24% of patient concerns and edema accounting for 5%. Telephone follow-up for post-operative patients is being adopted at the clinical site where the EBP project was completed

Falling Behind: Americans' Access to Medical Care Deteriorates, 2003-2007

Presents survey results on access to medical care for the insured and the uninsured, the healthy and the ill, and for children in wealthy and poor families. Discusses causes of unmet needs such as rising costs and obstacles in the health system and plans

Urosaurus graciosus

Number of Pages: 3Integrative BiologyGeological Science

Polar plots of diamond surface energy

Diamond surface energy sigma_hkl determines crystal habit. We discuss three aspects of a paper by Terentiev (1991). Firstly, we compare Terentiev's algorithm for exact sigma_hkl with the analytic solution for h <= k <= l and h + k < l. Secondly, we show that the general formula given by Terentiev should be interpreted probabilistically in order to be self consistent. Finally, we replicate in principle the simulation results for sigma_hkl in a nickel melt using nothing more than Matlab routines

Effect of Prey Density on Diurnal Activity and Ovarian Development in \u3ci\u3eCalosoma Calidum\u3c/i\u3e (Coleoptera: Carabidae): Implications for Biological Control of the Gypsy Moth, \u3ci\u3eLymantria Dispar (Lepidoptera: Lymantriidae)\u3c/i\u3e in the Midwest

Four feeding treatments were used in the laboratory to study the effects of the availability of prey on diurnal behavior and ovarian development of Calosoma calidum. Activity was closely monitored for six weeks. No significant differences were found between male and female behavior patterns. Diurnal beetle activity was found to be inversely related to prey density; in treatments where prey was available, diurnal activity declined during the course of the experiment. At the end of six weeks, dissections of female beetles showed that ovarian development and fat body quantity were dependent upon the number of prey available for consumption

Progress and opportunities in lesbian, gay, bisexual and transgender health communications

This article describes elements of effective health communication and highlights strategies that may best be adopted or adapted in relation to lesbian, gay, bisexual, and transgender (LGBT) populations. Studies have documented the utility of multidimensional approaches to health communication from the macro level of interventions targeting entire populations to the micro level of communication between health care provider and consumer. Although evidence of health disparities in LGBT communities underscores the importance of population-specific interventions, health promotion campaigns rarely target these populations and health communication activities seldom account for the diversity of LGBT communities. Advances in health communication suggest promising direction for LGBT-specific risk prevention and health promotion strategies on community, group, and provider/consumer levels. Opportunities for future health communication efforts include involving LGBT communities in the development of appropriate health communication campaigns and materials, enhancing media literacy among LGBT individuals, supporting LGBT-focused research and evaluation of health communication activities, and ensuring that health care providers possess the knowledge, skills, and competency to communicate effectively with LGBT consumers

Applying an abstract data structure description approach to parallelizing scientific pointer programs

Even though impressive progress has been made in the area of parallelizing scientific programs with arrays, the application of similar techniques to programs with pointer data structures has remained difficult. Unlike arrays which have a small number of well-defined properties that can be utilized by a parallelizing compiler, pointer data structures are used to implement a wide variety of structures that exhibit a much more diverse set of properties. The complexity and diversity of such properties means that, in general, scientific programs with pointer data structures cannot be effectively analyzed by an optimizing and parallelizing compiler.In order to provide a system in which the compiler can fully utilize the properties of different types of pointer data structures, we have developed a mechanism for the Abstract Description of Data Structures (ADDS). With our approach, the programmer can explicitly describe important properties such as dimensionality of the pointer data structure, independence of dimensions, and direction of traversal. These abstract descriptions of pointer data structures are then used by the compiler to guide analysis, optimization, and parallelization.In this paper we summarize the ADDS approach through the use of numerous examples of data structures used in scientific computations, we illustrate how such declarations are natural and non-tedious to specify, and we show how the ADDS declarations can be used to improve compile-time analysis. In order to demonstrate the viability of our approach, we show how such techniques can be used to parallelize an important class of scientific codes which naturally use recursive pointer data structures. In particular, we use our approach to develop the parallelization of an N-body simulation that is based on a relatively complicated pointer data structure, and we report the speedup results for a Sequent multiprocessor

Roles of Predicted Glycosyltransferases in the Biosynthesis of the Rhizobium etli CE3 O Antigen

The Rhizobium etli CE3 O antigen is a fixed-length heteropolymer. The genetic regions required for its synthesis have been identified, and the nucleotide sequences are known. The structure of the O antigen has been determined, but the roles of specific genes in synthesizing this structure are relatively unclear. Within the known O-antigen genetic clusters of this strain, nine open reading frames (ORFs) were found to contain a conserved glycosyltransferase domain. Each ORF was mutated, and the resulting mutant lipopolysaccharide (LPS) was analyzed. Tricine SDS-PAGE revealed stepwise truncations of the O antigen that were consistent with differences in mutant LPS sugar compositions and reactivity with O-antigen-specific monoclonal antibodies. Based on these results and current theories of O-antigen synthesis, specific roles were deduced for each of the nine glycosyltransferases, and a model for biosynthesis of the R. etli CE3 O antigen was proposed. In this model, O-antigen biosynthesis is initiated with the addition of N-acetyl-quinovosamine-phosphate (QuiNAc-P) to bactoprenol-phosphate by glycosyltransferase WreU. Glycosyltransferases WreG, WreE, WreS, and WreT would each act once to attach mannose, fucose, a second fucose, and 3-O-methyl-6-deoxytalose (3OMe6dTal), respectively. WreH would then catalyze the addition of methyl glucuronate (MeGlcA) to complete the first instance of the O-antigen repeat unit. Four subsequent repeats of this unit composed of fucose, 3OMe6dTal, and MeGlcA would be assembled by a cycle of reactions catalyzed by two additional glycosyltransferases, WreM and WreL, along with WreH. Finally, the O antigen would be capped by attachment of di- or tri-O-methylated fucose as catalyzed by glycosyltransferase WreB

Do Agglomeration Economies Exist in the Hospital Services Industry

Given the importance of knowledge flows and the continued emphasis on face-to-face encounters especially for medical care, close proximity of hospitals may be essential for the efficient delivery of medical care. That is, hospital productivity might be greater where hospitals cluster and allow knowledge to more easily and quickly disperse among personnel in the various organizations. To add to the understanding about agglomeration economies in the hospital services sector, this study analyzes how the clustering of hospitals in the various metropolitan areas of the US affects industry wide productivity. The multiple regression analysis is conducted on a cross-sectional basis for both 1993 and 1999 and by using first differencing of the data between the two years. The observed productivity improvements resulting from the clustering of hospitals provides yet another justification for encouraging a larger number of hospitals in metropolitan areas.