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The objective of this study was to understand veteran perspectives of grief/loss associated with their spinal cord injury (SCI).

Qualitative descriptive design using semistructured interviews with veterans with SCI (n = 15) was performed using interview questions informed by the literature. Analysis was conducted using a deductive/inductive approach.

The 15 participants' mean age was 64 years; six had paraplegia, eight had tetraplegia, one had unknown level of injury, six were ambulatory, and nine were not ambulatory. Selleck (R,S)-3,5-DHPG The grief/loss experience was individual and constant, consisting of seven phases experiencing shock, releasing emotion, withdrawing, focusing on losses, problem solving, realizing strength and motivation, and accepting a new life. Veteran coping strategies used in each phase of the grief experience were also identified, as well as triggers that increased or decreased the grief/loss experience.

A better understanding of veterans' living with SCI grief experience, coping strategies, and triggering events can help healthcare providers support veterans with SCI.

A better understanding of veterans' living with SCI grief experience, coping strategies, and triggering events can help healthcare providers support veterans with SCI.

As attention begins to shift from short-term surgical outcomes to long-term clinical and quality of life outcomes, patients and families are becoming increasingly responsible for outcomes. For this reason, it is essential to effectively include them in the outcome planning, goal setting, and evaluation processes.

There are a number of tools and strategies available to maximize patient engagement. These must be employed in direct patient care and system and policy conversations, for meaningful patient partnerships that can lead to improved outcomes.

As we move from a culture of paternalistic medicine to engaged patient care, there remains a need for a systematic approach to encourage patients and families to play a more active role as partners in improving outcomes. link2 There is a need to be deliberate in setting up infrastructures to ensure successful patient participation. A gap in rigorous research in this area provides an opportunity for patients and researchers to put patient-centered research into practice, to better evaluate effective strategies, and further develop best practices in patient and provider collaboration to improve outcomes.

As we move from a culture of paternalistic medicine to engaged patient care, there remains a need for a systematic approach to encourage patients and families to play a more active role as partners in improving outcomes. There is a need to be deliberate in setting up infrastructures to ensure successful patient participation. A gap in rigorous research in this area provides an opportunity for patients and researchers to put patient-centered research into practice, to better evaluate effective strategies, and further develop best practices in patient and provider collaboration to improve outcomes.

The importance of addressing the proximal causes of atrial fibrillation is recognized, yet frustration with the currently applied preventive measures is high. This review describes the functional medicine model (FMM), which identifies the proximal causes of atrial fibrillation at the level of gene-environment interaction.

The pathological processes leading to atrial fibrillation sustaining disorder have been elucidated in translational studies and are described as 'nodal points.' Examples are inflammation, oxidative stress, autoimmune mechanisms, and visceral adiposity. These same nodal points also cause disorder that results in atrial fibrillation-related complications and the development of atrial fibrillation-associated diseases. These nodal points vary from patient to patient and can be identified by careful evaluation of the patients clinical phenotype.

The application of the FMM identifies the gene--environment interactions that facilitate the patients nodal points and corrects them with emphasis on personalized diet, nutrition, and lifestyle changes.

The application of the FMM identifies the gene--environment interactions that facilitate the patients nodal points and corrects them with emphasis on personalized diet, nutrition, and lifestyle changes.

To review recent evidence evaluating the long-term safety and efficacy outcomes of left atrial appendage occlusion (LAAO), current guideline recommendations for LAAO use, performance of LAAO in comparison with direct oral anticoagulants (DOAC) and recently approved LAAO device.

The last 18 months have been marked with increasing evidence of the utility of LAAO in patients who are not candidates for long-term oral anticoagulation (OAC). Long-term data from two continued access registries to PROTECT-AF and PREVAIL support LAAO as a safe and effective long-term anticoagulation therapy. This new evidence led to class IIb recommendation for LAAO in nonvalvular atrial fibrillation (NVAF) patients not eligible for long-term OAC. PRAGUE-17 randomized controlled trial showed LAAO is noninferior to DOAC lending support to use of this modality in current era. PINNACLE FLX trial showed improved implant success and adequate closure rate which led to the device's Food and Drug Administration approval.

In conclusion, percutaneous LAAO appears to be a promising option for NVAF patients who are not candidates for long-term OAC in the current era. Further evidence guiding optimal patient selection and periprocedural antithrombotic regimen will help identify the patients who would benefit the most from this procedure.

In conclusion, percutaneous LAAO appears to be a promising option for NVAF patients who are not candidates for long-term OAC in the current era. Further evidence guiding optimal patient selection and periprocedural antithrombotic regimen will help identify the patients who would benefit the most from this procedure.

Pulsed field ablation is a nonthermal ablative modality that uses short living, strong electrical field created around catheter to create microscopic pores in cell membranes (electroporation). When adequately dosed/configured it shows a preference for myocardial tissue necrosis. Thus, it holds a promise to become a 'perfect' energy source for cardiac ablation to treat arrhythmias. Herein, we present update on platforms in clinical development.

First in human series using pulsed field ablation for atrial fibrillation ablation have been completed and data published for several platforms. Acute safety outcomes are similar across the platforms with exceptionally low rate of those complications that are typically reported for thermal ablation methods (esophageal injury, pulmonary vein stenosis, phrenic nerve palsy). Promising acute data on pulmonary vein isolation had been corroborated with satisfactory 1-year clinical follow-up for a single platform, whereas reports are pending for the rest. Research efforts are being expanded to a development of focal catheters, and therefore, pulsed field ablation application for ventricular arrhythmias.

As the reports confirming its safety and efficacy build up, there seems to be no way that the promise of pulsed field ablation could end in a blind alley.

As the reports confirming its safety and efficacy build up, there seems to be no way that the promise of pulsed field ablation could end in a blind alley.

For over a decade, vulnerabilities in the healthcare industry have been identified. Medical devices such as cardiovascular implantable electronic devices (CIEDs) are particularly concerning because of direct threats to patient safety and protected health information (PHI). Although these vulnerabilities have been identified and changes have been made, there is significant room for improvement. We identify changes and improvements to be made in the industry, by providers, and by patients.

Cybersecurity threats in cardiac implantable devices are legitimate concerns for patient safety and PHI. Changes to cybersecurity in these devices have been made, but are far from sufficient.

The number of CIEDs implanted worldwide are expected to increase over the next decade. As computer technology advances, cybersecurity threats will only continue to evolve and become more complex. The healthcare industry should seriously consider improvements to protect patients and providers.

The number of CIEDs implanted worldwide are expected to increase over the next decade. As computer technology advances, cybersecurity threats will only continue to evolve and become more complex. The healthcare industry should seriously consider improvements to protect patients and providers.PRéCIS Ocular surface disease (OSD) in glaucoma is an area for improvement in the management of patients with glaucoma. This study explores the knowledge of glaucoma subspecialists toward OSD in glaucoma, then provides a suggested treatment algorithm.

To assess the attitudes, knowledge, and level of comfort of Canadian glaucoma specialists with respect to the assessment and management of OSD among patients with glaucoma.

Ophthalmologist members of the Canadian Glaucoma Society with fellowship training in glaucoma were contacted to participate in this cross-sectional survey study. Responses were recorded to statements regarding attitudes toward OSD in glaucoma, and assessment and management modalities. These were recorded primarily in the form of a Likert scale rated 1 to 7 from "strongly disagree" to "strongly agree." Descriptive statistics were generated, and mean and SD for responses on Likert scales.

Thirty-six responses were included. link3 All respondents agreed that comprehensive management of OSD could aucoma-related outcomes, only a small percentage felt it was presently adequately managed. Increasing knowledge related to the assessment and management of OSD in glaucoma may in the future improve patient care.

Approximately 1 in 9 Florida residents over the age of 65 years (438,642 people) live more than an hour away from a glaucoma specialist, which represents a significant barrier to care.

To describe access to glaucoma care for Florida's elderly population using travel time to American Glaucoma Society (AGS) member offices.

For this cross-sectional service coverage analysis, a list of AGS member locations was extracted from the AGS website, and addresses were geocoded using ArcGIS Online. Driving time regions were created using the service area tool in ArcGIS Pro 2.4 and overlaid with 2010 United States Census and 2016 American Community Survey data for all Florida residents age 65 or older.

Fifty-eight AGS member providers with 65 locations were identified and geocoded. There were 3,797,625 individuals aged over 65 years in Florida, of which 1,153,320 (30.4%) lived within 15 minutes of driving time from an AGS provider's office, 2,586,825 (68.1%) within 30 minutes, 3,358,983 (88.4%) within 60 minutes, and 3,491,815 (91.9%) within 120 minutes. The areas with the lowest access include rural areas near Lake Okeechobee and the Florida Panhandle. The population living beyond a 60-minute drive was more likely to be White, non-Hispanic and older, but less likely to be living below the federal poverty level or receiving public assistance than the population living within a 60-minute drive.

There is a significant travel burden for the elderly community of Florida to reach AGS providers. Additional studies could help identify other social barriers to accessing glaucoma providers in Florida and beyond in an effort to improve patient compliance and, ultimately, vision outcomes.

There is a significant travel burden for the elderly community of Florida to reach AGS providers. Additional studies could help identify other social barriers to accessing glaucoma providers in Florida and beyond in an effort to improve patient compliance and, ultimately, vision outcomes.