NCT00056563 and NCT01076452.

No abstract

Parkinson's disease (PD) primarily affects older adults, who manage their symptoms with complex medicine regimens. This mixed-methods study evaluated the usefulness and usability of follow-up telehealth medication counseling with a sample of community-based PD patients. Patients taking three or more medications for Parkinson's disease were randomly assigned to the teaching modalities of videophone or telephone. A self-care standardized medication educational session lasting 20 to 30 minutes was conducted, and patient and nurse usefulness of the intervention was evaluated by responses to a 15-question Likert scale and elicited comments. Patients' satisfaction with the intervention involved patterns of time, education, and technology. Videophone users were more satisfied with the equipment and counseling. Videophones were considered easy access to supportive, expert neuroscience nurses. Overall, videophone counseling sessions were significantly more useful than the telephone sessions (t[34] = 0.896, p = 0.004, 95% confidence interval = 1.90 to 3.12). Nurses found visualization via videophone significantly more useful for medication and self-management interactions.

A team approach is required for the surgical management of the spinal cord-injured patient with a pressure ulcer, beginning preoperatively with patient selection and preparation, continuing through wound debridement and flap closure, and progressing to rehabilitation and patient education. Although possible surgical complications are numerous and the recurrence rate is relatively high, the surgical management of patients with pressure ulcers can be very rewarding. Goals for surgical closure of pressure ulcers include reduction of protein loss through the wound, reduction of rehabilitation costs, prevention of progressive osteomyelitis, and improvement of patient hygiene. The ultimate reward is the restoration of patients to the rehabilitated sitting position so that they can enjoy productive and happy lives.