Carilion Clinic

About: Carilion Clinic is a healthcare organization based out in Roanoke, Virginia, United States. It is known for research contribution in the topics: Medicine & Population. The organization has 457 authors who have published 427 publications receiving 5002 citations. The organization is also known as: Carilion Health System.

Sundown syndrome in persons with dementia: an update.

Abstract: "Sundowning" in demented individuals, as distinct clinical phenomena, is still open to debate in terms of clear definition, etiology, operationalized parameters, validity of clinical construct, and interventions. In general, sundown syndrome is characterized by the emergence or increment of neuropsychiatric symptoms such as agitation, confusion, anxiety, and aggressiveness in late afternoon, in the evening, or at night. Sundowning is highly prevalent among individuals with dementia. It is thought to be associated with impaired circadian rhythmicity, environmental and social factors, and impaired cognition. Neurophysiologically, it appears to be mediated by degeneration of the suprachiasmatic nucleus of the hypothalamus and decreased production of melatonin. A variety of treatment options have been found to be helpful to ameliorate the neuropsychiatric symptoms associated with this phenomenon: bright light therapy, melatonin, acetylcholinesterase inhibitors, N-methyl-d-aspartate receptor antagonists, antipsychotics, and behavioral modifications. To decrease the morbidity from this specific condition, improve patient's well being, lessen caregiver burden, and delay institutionalization, further attention needs to be given to development of clinically operational definition of sundown syndrome and investigations on etiology, risk factors, and effective treatment options.

Assessing teamwork attitudes in healthcare: development of the TeamSTEPPS teamwork attitudes questionnaire

Abstract: Introduction The report, To Err is Human, indicated that a large number of deaths are caused by medical error. A central tenet of this report was that patient safety was not only a function of sophisticated healthcare technology and treatments, but also the degree to which healthcare professionals could perform effectively as teams. Research suggests that teamwork comprises four core skills: Leadership, Situation Monitoring, Mutual Support and Communication. In healthcare, team training programmes, such as TeamSTEPPS®, are designed to improve participant knowledge of, attitudes towards, and skills in these core areas. If such training programmes are effective, changes in knowledge, attitudes and skills should be observed. The purpose of this study was to develop and validate the TeamSTEPPS Teamwork Attitudes Questionnaire (T-TAQ), a measure designed to assess attitudes towards the core components of teamwork in healthcare. Method A pilot test version of the survey was developed and administered to 495 respondents from various healthcare organisations. Results Classical item statistics were used to select the final T-TAQ items. Based on this analysis, 30 of the original 110 items were selected for inclusion in the final instrument. Scale reliabilities exceed 0.7, and scales were found to be moderately correlated. Discussion The T-TAQ provides a useful, reliable and valid tool for assessing individual attitudes related to the role of teamwork in the delivery of healthcare. Issues related to its use and interpretation are discussed.