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Travers JL, Scales K, Bonner A, Longobardi I, Maki S. Transforming Nursing Home Teams: What We Can Do Now to Build a Stronger Nursing Home Workforce. J Am Med Dir Assoc 2023; 24:1807-1808. [PMID: 38007249 DOI: 10.1016/j.jamda.2023.10.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 10/26/2023] [Indexed: 11/27/2023]
Affiliation(s)
- Jasmine L Travers
- Rory Meyers College of Nursing, New York, NY, USA; Moving Forward Coalition and IHI, Boston, MA, USA
| | - Kezia Scales
- Moving Forward Coalition and IHI, Boston, MA, USA; Research and Evaluation for PHI, New York, NY, USA
| | - Alice Bonner
- Moving Forward Coalition and IHI, Boston, MA, USA; Institute for Healthcare Improvement (IHI), Boston, MA, USA.
| | | | - Sumire Maki
- Moving Forward Coalition and IHI, Boston, MA, USA
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Travers JL, Alexander G, Bergh M, Bonner A, Degenholtz HB, Ersek M, Ferrell B, Grabowski DC, Longobardi I, McMullen T, Mueller C, Rantz M, Saliba D, Sloane P, Stevenson DG. 2022 NASEM Quality of Nursing Home Report: Moving Recommendations to Action. J Am Geriatr Soc 2023; 71:318-321. [PMID: 36795630 DOI: 10.1111/jgs.18274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 01/25/2023] [Indexed: 02/17/2023]
Affiliation(s)
- Jasmine L Travers
- Rory Meyers College of Nursing, New York University, New York, New York, USA
| | | | - Marissa Bergh
- Rory Meyers College of Nursing, New York University, New York, New York, USA
| | - Alice Bonner
- Institute for Healthcare Improvement, Cambridge, Massachusetts, USA.,Moving Forward: Nursing Home Quality Coalition, Washington, District of Columbia, USA
| | - Howard B Degenholtz
- School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Mary Ersek
- Department of Veterans Affairs, Philadelphia, Pennsylvania, USA.,School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | | | | | - Isaac Longobardi
- Moving Forward: Nursing Home Quality Coalition, Washington, District of Columbia, USA
| | - Tara McMullen
- Master of Science in Aging & Health Program, Georgetown University, Washington, District of Columbia, USA
| | - Christine Mueller
- School of Nursing, University of Minnesota, Minneapolis, Minnesota, USA
| | - Marilyn Rantz
- Sinclair School of Nursing, University of Missouri, Columbia, Missouri, USA
| | - Debra Saliba
- Borun Center for Gerontological Research, University of California Los Angeles, Los Angeles, California, USA.,Geriatric Research, Education and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California, USA.,RAND Corporation, Santa Monica, Los Angeles, California, USA
| | - Philip Sloane
- School of Medicine and the Cecil G. Sheps Center for Health Services Research, University of North Carolina, Chapel Hill, North Carolina, USA
| | - David G Stevenson
- Department of Health Policy, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.,Tennessee Valley Veteran's Affairs Geriatric Research Education Clinical Center (GRECC), Nashville, Tennessee, USA
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Acosta-Marin V, Acosta Freites V, Ramirez A, Marin C, Contreras A, Longobardi I, Martinez O, Maldonado V, Acosta M, Perez Fuentes J. Breast cancer in elderly patients in a Venezuelan breast center. How we manage the axilla. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)01396-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Acosta-Marin V, Acosta Freites V, Ramirez A, Marin C, Contreras A, Longobardi I, Martinez O, Maldonado V, Acosta M, Perez Fuentes J. Neoadjuvant treatment for breast cancer patients in a Venezuelan breast center. Pathologic complete response: is it worth it? Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)01517-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Acosta-Marin V, Acosta-Freites V, Contreras A, Ravelo R, Fuenmayor G, Marin C, Ramirez A, Acosta-Marin M, Perez-Fuentes J, Longobardi I, Esteves H. Oncoplastic breast surgery: initial experience at the Centro Clinico de Estereotaxia-CECLINES, Caracas, Venezuela. Ecancermedicalscience 2014; 8:470. [PMID: 25374618 PMCID: PMC4203471 DOI: 10.3332/ecancer.2014.470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Breast-conserving surgery (BCS) may sometimes lead to deformities in the remaining breast. Oncoplastic surgery (OPS) aims to improve our aesthetic results even in the case of major volume resections. The purpose of this study is to provide an objective evaluation of our initial experience with OPS, mainly based on the levels of satisfaction reported by both patients and surgeons. PATIENTS AND METHODS This prospective study was performed at CECLINES in Caracas, Venezuela, between January 2011 and October 2012. It involved 107 consecutive patients in two groups: 52 patients with level II OPS versus 55 patients with 'standard' BCS (SBCS). We evaluated the level of satisfaction and cosmetic outcome at 6 and 12 months post-operation using a score from 1 (bad) to 5 (excellent). The cosmetic score was recorded during the follow-up by the surgeon, by phone calls, and photographs were reviewed by a panel of four observers. RESULTS The participation rate in the cosmetic outcome/level of satisfaction evaluation was 100% at 6 months and 96.2% at 12 months. The average tumour size was 23 mm [standard deviation (SD): 13.5] for the OPS group versus 17.6 mm (SD: 8.3) for the SBCS group (p = 0.017). The average weight for the surgical specimen was 101 g (range: 30-512 g) in the OPS group versus 60.4 g (range: 20-135 g) in the SBCS group (p = 0.004). The OPS techniques most performed were round block 40.3% (21/52), inverted T mammoplasty 26.8% (14/52) and vertical scar mammoplasty 15.3% (8/52). Of all the patients, 51.9% (27/52) had symmetrisation procedures performed distributed according to the period of the study: 77.2% (17/22) in 2011, 56.6% (17/30) in 2012, and 18.1% (6/33) in 2013. The rate of complications was 5.7% (3/52) in the OPS group and 0% for the SBCS group (p < 0.005). The average cosmetic score at 6 months by patients in the OPS group was 4.4; patient satisfaction scores of 4 (good) and 5 (excellent) were 88.4%. In the SBCS group at 6 months, the mean score reported by patients was 4.2, with scores 4-5 being 83.4% (p = 0.644). The cosmetic score by surgeons in the OPS group at 6 months was 4.5; the surgeon satisfaction scores of 4-5 were 94.2%. In the SBCS group, the surgeons' mean score at 6 months was 4.1, with 84.5% of scores being 4 or 5 (p < 0.005). The final cosmetic score by patients in the OPS group at 12 months was 4.5; patient satisfaction scores of 4-5 were 90.4%. In the SBCS group, the final mean score at 12 months by patients was 4.2, with 77.5% of scores being 4 or 5 (p < 0.005). The final cosmetic score by surgeons in the OPS group at 12 months was 4.5; surgeon satisfaction scores of 4-5 were 92.3%. In the SBCS group, the surgeons' final mean score at 12 months was 4.1, with 84.5% of scores being 4 or 5 (p < 0.005). CONCLUSIONS OPS provides good satisfaction rates. An SBCS when an OPS is not indicated mostly results in good satisfaction levels and cosmetic scores. Usually, the results remain stable after 6 months. The use of OPS allows the excision of bigger lesions and surgical specimens. Symmetrisation procedures are not always required. With the appropriate patient selection, the rate of complications is low for both OPS and SBCS.
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Affiliation(s)
- V Acosta-Marin
- Breast Surgery Department, Centro Clinico de Estereotaxia-CECLINES, Caracas, Venezuela
| | - V Acosta-Freites
- Breast Surgery Department, Centro Clinico de Estereotaxia-CECLINES, Caracas, Venezuela
| | - A Contreras
- Breast Surgery Department, Centro Clinico de Estereotaxia-CECLINES, Caracas, Venezuela
| | - R Ravelo
- Breast Surgery Department, Centro Clinico de Estereotaxia-CECLINES, Caracas, Venezuela
| | - G Fuenmayor
- Breast Surgery Department, Centro Clinico de Estereotaxia-CECLINES, Caracas, Venezuela
| | - C Marin
- Breast Pathology Department, Centro Clinico de Estereotaxia-CECLINES, Caracas, Venezuela
| | - A Ramirez
- Breast Pathology Department, Centro Clinico de Estereotaxia-CECLINES, Caracas, Venezuela
| | - M Acosta-Marin
- Breast Pathology Department, Centro Clinico de Estereotaxia-CECLINES, Caracas, Venezuela
| | - J Perez-Fuentes
- Breast Imaging Department, Centro Clinico de Estereotaxia-CECLINES, Caracas, Venezuela
| | - I Longobardi
- Breast Imaging Department, Centro Clinico de Estereotaxia-CECLINES, Caracas, Venezuela
| | - H Esteves
- Breast Nurse Department, Centro Clinico de Estereotaxia-CECLINES, Caracas, Venezuela
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Marin VA, Acosta F V, Ramirez A, Marin C, Contreras A, Ravelo R, Perez J, Longobardi I, Marin MA. 54 Breast Cancer in Young and Elderly Women. Experience in the Estereotaxic Clinic Center (CECLINES), Caracas-Venezuela. Eur J Cancer 2012. [DOI: 10.1016/s0959-8049(12)70122-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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