A Literature Review of the Team Approach in the Cardiac Rehabilitation Process

Teamwork is a term that is now commonplace in the provision of health services for all people. Variations of this team are widely used, such as multidisciplinary teams and inter-disciplinary teams. A health care team is a group of persons, each possessing particular expertise, who have a common purpose and goal. Teams including professionals, such as nurses, doctors, physical therapists, social workers, and other staff, depending on needs and local resources, are now commonplace in hospital and community services. The purpose of this independent study is to review the literature regarding collaborative team approaches to cardiac rehabilitation. Included in this review is: (a) a history of team processes in cardiac rehabilitation, (b) the function of a cardiac rehabilitation team, (c) definition of team members\u27 roles and responsibilities, and (d) a review of the effectiveness of the team process. Essentially, the cardiac team concept of health care delivery evolved as a compromise between the benefits of specialization and the need for continuity and comprehensiveness of care. The future direction in cardiac rehabilitation lies in the improvement of inter-disciplinary teams and an understanding of the concept of team work

Children With Special Needs Oral Health Quality of Life Survey

Purpose: The purpose of this study was to asses the oral health quality of life of children with special health care needs. This study examined the effects of oral health conditions on general well-being and family life of these children. A secondary aim of the study was to investigate correlations between specific health care conditions, gender, and age of these children and their global ratings of oral health and well-being.Methods: This study was a cross-sectional design with subjects who are members of the Virginia Care Connection for Children program, based at Virginia Commonwealth University. The oral health quality of life was measured using a shortened version of the Parental Caregiver Perceptions Questionnaire (P-CPQ). The questionnaire includes measures of global ratings of oral health and well-being as well as effects of oral health on domains of oral symptoms, functional limitations, emotional well-being, and family well-being/parental distress. The parents/caregivers were asked to report on these domains as they related to their child\u27s oral health within the past 3 months. Additional survey items included questions regarding demographic factors of the child (age, sex, special health care conditions) and parent (i.e. mother, father, or other). Results: The survey was sent out to 429 individuals and 137 usable surveys were returned for a response rate of 32%. Special health care conditions of the children were categorized and reported as follows: 1) Neurodevelopmental/Genetic/Neuro-muscular disorders, N=69 (59.13%); 2) Respiratory disorders, N=12 (10.43%); 3) Cardiac disorders, N=5 (4.35%); 4) Craniofacial disorders, N=12 (10.43%); 5) Metabolic disorders, N=15 (13.04%); 6) Psychological disorders, N=3 (2.61%). In general, caregivers reported the children to have a fair to good oral health quality of life in each domain. It was determined that two of the domains, functional limitations and emotional well-being, were not correlated with the child\u27s oral health or well-being. However, the oral symptoms and family well-being/parental distress domains did have a positive correlation (p = 0.0340 and p = 0.0420, respectively). Conclusions: In a population of children with special health care needs it appears that oral symptoms and family well-being outweighed functional limitations and emotional well-being

Community building

This thesis is focused on neighborhood revitalization through building. Case studies and applicable theory are used to generate a building design on an actual site in Omaha, Nebraska. The design focuses on the unavailability of fresh foods and transportation in inner city neighborhoods and an architectural solution is offered to address these issues

Intuition Before Integers: Integrating Building Technology Into the Design Studio

The studio methodology, used almost universally to teach architectural design in the US, embraces speculative investigation and hands-on learning, offering unparalleled opportunities for integrated thinking and open-ended inquiry. Building technology courses, in contrast, tend to be taught in more constrained, and more passive modes - lecture classes, sometimes accompanied by a laboratory or including a project or two. As instructors of both design studios and building technology courses, we have found it difficult to generate the level of engagement and enthusiasm, or achieve the depth of inquiry, in the technology classroom that is common in the design studio. Moreover, we find that students fail to apply their developing technical knowledge to inform their studio design work. With a goal of greater comprehension and application as a guide, we developed an immersive making-based exercise in the design studio with an overt focus on building technology, elevating technical concerns to primary design drivers. In this case, the development of a tectonic daylighting building skin was selected as an opportunity to incorporate building construction, structures, and performance, while exploring the potential of the envelope as moderator of the exterior environment and shaper of experience. The work was organized as a series of iterative feedback loops: make – learn – test - analyze – refine – make… This began with intuitive making – developing a series of material investigations in response to an initial prompt. Making was immediately followed by learning - the introduction of a specific building technology concepts and considerations. The previously-generated products then served as a subject for testing and analysis, applying the newly-learned technical concepts and tools. The feedback from testing and analysis directed refinement of the design. This pattern was repeated, with episodic technical workshops positioned throughout the project, presenting additional topics such as material selection, tectonics, and structures, for integration into the evolving design. This gradual exposure to new concepts and concerns incrementally built technical awareness and knowledge, spurring continued analysis and development. Additional design and performance criteria, aligned with the new technical topics, added complexity at a measured pace, allowing students to focus on a single concern at a time, without becoming overwhelmed. By engaging with physical making and testing, and scaffolding technical concepts, students begin to perceive the opportunities to develop designs informed by a multitude of intentions – truly integrated design

Commodity AND Delight: A Case for a Qualitative Basis for Environmental Technology Instruction

Throughout history, human beings have lived in environments of sensory richness and variation. Outside of modern buildings and urbanized landscapes, the thermal, luminous, and acoustic environments of the natural world shift and change seasonally, diurnally, and from moment to moment. Established research points to links between the kind of multisensory environmental variation experienced in the natural world, and positive impacts to human physiological and psychological wellbeing. Unfortunately, modern design standards and comfort guidelines, and the built environments designed to meet them, permit only a very narrow acceptable range of variation in sound, light and temperature levels. This rigid control of the interior environment is believed to ensure human comfort, but leaves no room for human delight, resulting in environments of sensory monotony. A more productive approach to teaching environmental technology requires a paradigm shift - away from the perception that consideration of environmental control strategies and technologies hamper design, and toward the recognition that embracing these concerns results in higher quality designed environment that surpasses comfort and constancy to better serve building occupants by creating sustainable multisensory spaces. The authors teach in both building technology courses and design studios, and aspire for students to understand the lessons and the concerns of their respective technology courses as integral to the matter of architectural design. Transcending a set of technical and functional obligations, students must learn to appreciate the potential of environmental factors to inform and enrich the experience of designed space. It can be difficult, however, to generate the level of engagement and enthusiasm, or to achieve the depth of inquiry in the technology course that is common in the design studio. Moreover, students often fail to utilize and apply developing technical knowledge to inform studio design work. This paper proposes a pedagogical process of teaching environmental technology courses with emphasis on both quantitative and qualitative concerns. This process will be illustrated and assessed through a series of case studies. These laboratory exercises were undertaken in building technology courses at multiple levels in undergraduate architectural curriculum

Fertility Intentions and Outcomes in Indonesia: Evolutionary Perspectives on Sexual Conflict

Differential fertility preferences for men and women may provide insights into human sexual conflict. We explore whether pairbonded couples have different preferences for future offspring, which socioecological factors are associated with these preferences, and who achieves their desired fertility over time. We utilise the Indonesia Family Life Survey (IFLS), a longitudinal survey which collected data from 1993 to 2015, to compare desired future fertility for 9655 couples and follow couples who had divergent preferences. The majority of couples (64.8%) want the same number of future offspring. In 20.7% of couples, husbands want more future offspring than their wives, while the reverse occurs in 14.5% of couples. Living in villages with the husband\u27s or the wife\u27s parent(s) is associated with having divergent preferences for future offspring, where there is a higher likelihood that women prefer more offspring than their husbands. When examining fertility outcomes, women, particularly those who marry at older ages, are more likely to achieve their desired preference. Contrary to previous research, we do not find that living near one\u27s natal kin or having increased autonomy increases an individual\u27s likelihood of achieving desired fertility outcomes

What does the evidence tell us about treating very-high-risk patients to an LDL <70 mg/dL?

No studies directly compare low-density lipoprotein (LDL) levels <70 mg/dL to levels of 71 to 100 mg/dL in very-high-risk patients. However, no evidence suggests a "floor" for LDL cholesterol levels beyond which further reductions of heart disease risk can't be achieved (strength of recommendation [SOR]: A, systematic reviews of randomized controlled trials [RCTs]). The target LDL cholesterol of <70 mg/dL is based on data extrapolated from RCTs (SOR: B)

The oncoprotein H-RasV12 increases mitochondrial metabolism

This is an Open Access article distributed under the terms of the Creative Commons Attribution Licens

Macrocytosis and TKI Efficacy in Chronic Myeloid Leukemia

Introduction: Orally administered tyrosine kinase inhibitors (TKIs) are the cornerstone of treatment for patients with chronic phase chronic myeloid leukemia (CML). Currently, there is a paucity of validated predictive biomarkers to predict response to these medications. The identification and validation of a predictive biomarker of TKI response could conceivably aid clinicians in drug and dose selection. We aimed to evaluate treatment-emergent macrocytosis and clinical outcomes in CML patients taking TKIs. Methods: This was a single-institution retrospective study that included patients (n=110) if they were > 18 years old with chronic phase CML and who were treated with imatinib, dasatinib, nilotinib, bosutinib or ponatinib between January 1, 2010 to April 15, 2018. Patients were excluded if they lacked baseline and on-treatment mean corpuscular volume (MCV) measurements or baseline and on-treatment BCR-ABL1 transcript measurements. The primary endpoint was incidence of complete hematologic response (CHR) at 30 days after TKI initiation. Secondary endpoints included time to CHR, early molecular response (EMR) and major molecular response (MMR) as well as EMR at 90 days and MMR at 365 days. Results: The overall incidence of TKI-induced macrocytosis was low (n=7 or 6.4%) in the study population. Patients with treatment-emergent macrocytosis achieved CHR at median 26 days compared to 32 days in MCV 100 fL achieved CHR at 30 days, 87.5% vs 39% in patients with MCV <100 fL (OR=10.9, 95% CI [1.76-125.2] P=0.02). Significant associations between treatment-emergent macrocytosis and EMR or MMR were not observed. Conclusions: Patients with treatment-emergent macrocytosis achieved CHR more rapidly compared to patients who did not. No difference was observed between treatment-emergent macrocytosis and EMR or MMR. Validation with a larger population of CML patients is needed to confirm the association between CHR at 30 days and MCV >100 fL based on the low incidence of macrocytosis in the study cohort.Doctor of Pharmac

Orthodontic Marketing Through Social Media Networks: The Patient and Practitioners\u27 Perspective

Objective: The aim of this study was to (1) assess the orthodontic patient and practitioner use and preferences of social media, and (2) to investigate the potential benefit of social media in marketing and communication strategies in orthodontic practices. Material and Methods: A survey was distributed to all participants, which included orthodontists from the American Association of Orthodontists (AAO) and patients/parents from the VCU Orthodontic Clinic and Private Practices throughout the United States. The participants were asked to answer questions related to their use of social media as well as their perceptions of usage of social media in the orthodontic practice. Results: 76% of orthodontists, 71% of the VCU Practice participants and 89% of the Private Practice participants used social media, with the highest preference for Facebook among all of the participants. Orthodontist’s posed information more often in the morning and afternoon (40% and 56%, respectively) and patients used social media mainly in the evening (76%). The most commonly used marketing strategies in the orthodontic practice were social media and a practice website (76% and 59%, respectively). Social media and practice websites were positively related to new patient starts (P=0.0376, P=0.0035, respectively). Newspapers were negatively related to new patient starts (P=0.0003). Conclusions: Social media use was more common in females and younger adults and facebook was the most commonly used social media site among all of the participants. Orthodontists posted information on social media websites mainly in the morning and afternoon, while patients spend more time on social media sites in the evening. Newspaper advertisements were negatively related to new patient starts. Facebook and Twitter were positively related to new patient starts when used as a marketing and communication tool in the orthodontic practice