JAAPA : official journal of the American Academy of Physician Assistants
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Clinicians must be prepared to identify tobacco use among patients and implement behavioral interventions to help patients quit. By understanding behavioral interventions and pharmacologic options, clinicians can design an optimal quit plan for each patient. This article reviews foundations of tobacco cessation, pharmacotherapy updates, and the emergence of e-cigarettes as desirable cessation tools for patients.
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Hypokalemia can cause reactions from mild muscular cramping to life-threatening paralysis and cardiac dysrhythmias. This article describes a patient whose unusual, recurrent muscular symptoms and electrolyte abnormalities were eventually identified as Gitelman syndrome, a rare genetic disorder resulting in severe refractory hypokalemia.
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The development of postoperative confusion in older patients is increasingly being recognized as clinically significant because it is becoming more common as the population ages. Postoperative delirium and postoperative cognitive dysfunction differ in time course of development. ⋯ Postoperative delirium and postoperative cognitive dysfunction appear to increase a patient's risk for developing dementia. Routine preoperative screening may help to identify patients with preexisting cognitive impairment who are at greatest risk for developing postoperative delirium or postoperative cognitive dysfunction.
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The world of healthcare is changing, and patient needs are changing with it. Traditional doctor-driven models of workforce planning are no longer sustainable in the United Kingdom (UK) healthcare economy, and newer models are needed. ⋯ This report describes the development of the PA profession in the UK from 2002, with projections through 2020, and includes governance, training, and the path to regulation. With rising demands on the healthcare workforce, the PA profession is predicted to positively influence clinical workforce challenges across the UK healthcare economy.
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To determine the effectiveness of effleurage hand massage performed by trained volunteers on reducing anxiety and pain in patients receiving treatment at a chemotherapy center in Fort Wayne, Ind., as measured by heart rate, respiratory rate, BP, visual analogue scale for anxiety (VAS-A), and visual analogue scale for pain (VAS-P). ⋯ In patients receiving chemotherapy, effleurage hand massages performed by trained volunteers effectively reduced anxiety and pain similar to previously reported results with massages administered by massage therapists. These findings could have important future implications, allowing for training of family members and caregivers in the technique of effleurage massage.