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Background This project investigates a music intervention to deprescribe antipsychotics in rural Veterans with dementia.  Methods The Veterans Health Administration Home-Based Primary Care Program is care provided in the home by an interdisciplinary team with the goals of decreasing hospitalizations and falls, providing education to patients and caregivers, and improving quality of life. Eighteen Home Based Primary Care Veterans with dementia and active antipsychotic prescriptions were identified with the goal to deprescribe antipsychotics in 50% of them using a music intervention. Individualized playlists and assessments for Veteran quality of life and caregiver burden were evaluated. Phone visits tracked music utilization and captured the voice of the customer. Results Antipsychotic dose reduction occurred in five of eight Veterans, totaling eight dose reductions and one discontinuation. Veteran quality of life improved; however, caregiver burden increased initially. The caregiver burden did improve when an outlier was removed. The voice of the customer favored music intervention. Conclusions A personalized music intervention is a feasible approach for reducing antipsychotic use in rural Veterans, improving quality of life, and potentially reducing caregiver burden.

Responses to pain are variable. Research suggests that within the central nervous system, modulatory systems operate that regulate pain. Massage may stimulate activity in non-nociceptive afferent fibers and lead to decreased pain perception by modifying nociceptive fiber input to spinal cord neurons. The purpose of this study was to examine responses of surgical patients experiencing acute surgical pain to determine if simple massage of feet decreases the patient's perception of pain intensity or pain affect. Simple massage involved light to medium touch and is similar to that used by nurses to provide back rubs. Prior to initiation of the massage, the investigator obtained patient responses on two pain scales, a 0–10 numeric descriptor of pain severity and a 0–5 verbal descriptor rating scale of pain distress. The massage intervention was initiated for five minutes to each foot for a total of 10 minutes. A convenience sample of 32 volunteers, age 18 or greater, who spoke English and had a total joint replacement surgery during the hospital stay agreed to participate in the study. The majority was female and Caucasian. Foot massage significantly decreased pain severity and pain affect. No significance was found among subject responses when compared by demographics or surgery characteristics. This study holds promise that simple massage to the feet may provide a cost effective, easily administered, non-pharmacological intervention for nurses and others to use in decreasing a patient's pain perception.

Kids walk to [Barsby] to catch the bus to attend Cedar, then after school catch the bus from Cedar, get dropped off at Barsby and walk home.

A place for privacy and retreat, rest and renewal, the bedroom is, for many a haven unlike any other. People who know the value of quiet time make no apologies for spending half the day there. And they furnish their bedrooms to create islands of solitude and comfort.

The sleeping rooms of three noted men.

Older diabetic patients with chronic renal failure are generally unable to meet the standard stringent eligibility criteria established for renal transplant candidates. The nurse must understand the complex physiological processes that occur when the older diabetic patient is being dialyzed.

The aim of our study was to explore reasons for starting and then stopping electronic cigarette (e-cigarette) use. Among a national sample of 3878 U.S. adults who reported ever trying e-cigarettes, the most common reasons for trying were curiosity (53%); because a friend or family member used, gave, or offered e-cigarettes (34%); and quitting or reducing smoking (30%). Nearly two-thirds (65%) of people who started using e-cigarettes later stopped using them. Discontinuation was more common among those whose main reason for trying was not goal-oriented (e.g., curiosity) than goal-oriented (e.g., quitting smoking) (81% vs. 45%, p < 0.001). The most common reasons for stopping e-cigarette use were that respondents were just experimenting (49%), using e-cigarettes did not feel like smoking cigarettes (15%), and users did not like the taste (14%). Our results suggest there are two categories of e-cigarette users: those who try for goal-oriented reasons and typically continue using and those who try for non-goal-oriented reasons and then typically stop using. Research should distinguish e-cigarette experimenters from motivated users whose decisions to discontinue relate to the utility or experience of use. Depending on whether e-cigarettes prove to be effective smoking cessation tools or whether they deter cessation, public health programs may need distinct strategies to reach and influence different types of users.

We sought to understand smokers’ perceived likelihood of health problems from using cigarettes and four non-cigarette tobacco products (NCTPs: e-cigarettes, snus, dissolvable tobacco, and smokeless tobacco). A US national sample of 6,607 adult smokers completed an online survey in March 2013. Participants viewed e-cigarette use as less likely to cause lung cancer, oral cancer, or heart disease compared to smoking regular cigarettes (all p  < .001). This finding was robust for all demographic groups. Participants viewed using NCTPs other than e-cigarettes as more likely to cause oral cancer than smoking cigarettes but less likely to cause lung cancer. The dramatic increase in e-cigarette use may be due in part to the belief that they are less risky to use than cigarettes, unlike the other NCTPs. Future research should examine trajectories in perceived likelihood of harm from e-cigarette use and whether they affect regular and electronic cigarette use.