An Educational Module Explaining The Effect of Cryotherapy on Post-Operative Opioid Consumption Following Orthopedic Surgery: A Quality Improvement Project

Background: The opioid crisis has stemmed from the undertreatment of pain. This inadequacy has led to increased use of opioids and a rapid rise in opioid-related fatalities. Opioids are used extensively in the perioperative period because of their beneficial pain-relieving and conscious-altering properties. Patients are often sent home with prescriptions for these habit-forming medications, leading to tolerance, addiction, and potential overdoses. This is especially true for very painful procedures, such as orthopedics. As a result, healthcare providers are at the forefront of making a change in the trajectory of the opioid crisis. One method is to find safe and effective non-opioid modalities to control postoperative pain. One such modality is the use of cryotherapy. Methods: A comprehensive search was conducted using Google Scholar and PubMed databases to find research articles within the last 6 years on the effects of cryotherapy on postoperative opioid consumption following orthopedic surgery. Results: Five research articles were selected for review. The articles investigated the effect of cryotherapy on postoperative opioid consumption in orthopedic surgery patients. It was shown that cryotherapy reduces postoperative opioid consumption following orthopedic surgery

An Educational Module on Minority Maternal Mortality and Complications in Obstetric Care

Background Certified Registered Nurse Anesthetists may be impacted by the growing minority maternal mortality and complications of obstetric care. Healthcare providers will be held accountable for the adverse health outcomes of minority obstetric patients by completing the Multidimensional Cultural Humility Scale and Cultural Humility Scale educational tools which shed light on racial biases. The U.S is ranked 46th in maternal mortality, reflecting a rate that has doubled since 1990, and includes an exponential increase in the African American (AA) population. The significance of the problem is seen in the comparison of mortality ratios between white women, black women, and women of other races during childbirth. Promoting cultural humility by instituting educational tools is the proposed solution to combat the disproportionate rate of AA maternal mortality. Methods Utilizing CINAHL and MEDLINE the keywords “Cultural humility” “African American”, and “maternal mortality” were searched yielding 133 results. Applying inclusion criteria resulted in 3 articles included in this study. An educational module and pre- and posttest test questionnaire were prepared and disseminated to anesthesia providers based on the selected evidence with the intent to answer the question: In minority obstetric patients, how effective are cultural humility educational tools in improving healthcare providers accountability and awareness for racial inequalities in obstetric healthcare? Results The baseline knowledge was 49% on the pretest and 73% on the posttest, reflecting a 24% knowledge increase. Limitations were a small sample size and time constraints to administer the pre and post survey. Implementation of both scales may bridge the gap between cultural humility and AA maternal mortality by increasing awareness of providers to diverse patients

Exploring the utility of a \u27PRAXIS\u27 evaluation framework in capturing transformation: a tool for all seasons?

An evaluation approach, developed for the purpose of capturing greater understanding of transformational change in healthcare contexts, is presented. PRAXIS evaluation is an innovative framework that aims to capture the dynamic subtleties of individual, team and organisational transformation within the complexity of contemporary healthcare contexts. The PRAXIS evaluation framework offers a collaborative process for evaluating healthcare practice change and takes into consideration the influences of workplace culture. An ultimate intention is to further inform new knowledge creation and its subsequent transfer into critically informed, considered, practical action; i.e. praxis. The intention is to provide examples of using the PRAXIS evaluation framework for planning, implementing and delivering an evaluation project that pays attention to capturing and exploring, in depth and in detail, both process and outcome evaluation data alongside inter- relational issues that are often hidden or ignored. The PRAXIS evaluation framework aims to expose, critically consider and utilise, multiple issues in a systematic approach that captures the relational dynamism of the environment alongside participants\u27 own influential contribution to healthcare transformation

Understanding axial progenitor biology in vivo and in vitro

The generation of the components that make up the embryonic body axis, such as the spinal cord and vertebral column, takes place in an anterior-to-posterior (head-to-tail) direction. This process is driven by the coordinated production of various cell types from a pool of posteriorly-located axial progenitors. Here, we review the key features of this process and the biology of axial progenitors, including neuromesodermal progenitors, the common precursors of the spinal cord and trunk musculature. We discuss recent developments in the in vitro production of axial progenitors and their potential implications in disease modelling and regenerative medicine

Understanding the practice of \u27Specialling\u27 older people with cognitive impairment in hospital by using Concept Analysis

Population ageing is a success story of our time. Unfortunately healthcare, especially in hospitals has been slow to adapt to the changing needs of the community

In My Shoes Can wearing an age-suit increase person-centred practices for the hospitalised older adult?

Abstract presented at the 11th International Association of Gerontology and Geriatrics Asia/Oceania Regional Congress, 23-27 October 2019, Taipei, Taiwa

Hyperpolarized 13C Spectroscopic Evaluation of Oxidative Stress in a Rodent Model of Steatohepatitis.

Nonalcoholic fatty liver disease (NAFLD) has become highly prevalent, now considered the most common liver disease in the western world. Approximately one-third of patients with NASH develop non-alchoholic steatohepatitis (NASH), histologically defined by lobular and portal inflammation, and accompanied by marked oxidative stress. Patients with NASH are at increased risk for cirrhosis and hepatocellular carcinoma, and diagnosis currently requires invasive biopsy. In animal models of NASH, particularly the methionine-choline deficient (MCD) model, profound changes are seen in redox enzymes and key intracellular antioxidants. To study antioxidant status in NASH non-invasively, we applied the redox probe hyperpolarized [1-13C] dehydroascorbic acid (HP DHA), which is reduced to Vitamin C (VitC) rapidly in the normal liver. In MCD mice, we observed a significant decrease in HP DHA to VitC conversion that accompanied hepatic fat deposition. When these animals were subsequently placed on a normal diet, resonance ratios reverted to those seen in control mice. These findings suggest that HP DHA, a potentially clinically translatable imaging agent, holds special promise in imaging NASH and other metabolic syndromes, to monitor disease progression and response to targeted therapies

Childhood IQ and marriage by mid-life: the Scottish Mental Survey 1932 and the Midspan Studies

The study examined the influence of IQ at age 11 years on marital status by mid-adulthood. The combined databases of the Scottish Mental Survey 1932 and the Midspan studies provided data from 883 subjects. With regard to IQ at age 11, there was an interaction between sex and marital status by mid-adulthood (p = 0.0001). Women who had ever-married achieved mean lower childhood IQ scores than women who had never-married (p < 0.001). Conversely, there was a trend for men who had ever-married to achieve higher childhood IQ scores than men who had never-married (p = 0.07). In men, the odds ratio of ever marrying was 1.35 (95% CI 0.98–1.86&#59; p = 0.07) for each standard deviation increase in childhood IQ. Among women, the odds ratio of ever marrying by mid-life was 0.42 (95% CI 0.27–0.64; p = 0.0001) for each standard deviation increase in childhood IQ. Mid-life social class had a similar association with marriage, with women in more professional jobs and men in more manual jobs being less likely to have ever-married by mid-life. Adjustment for the effects of mid-life social class and height on the association between childhood IQ and later marriage, and vice versa, attenuated the effects somewhat, but suggested that IQ, height and social class acted partly independently