This document analyzes and synthesizes research on treatment options for multiple sclerosis (MS). It summarizes three studies that examined switching treatments for relapsing-remitting MS. One study found switching from Natalizumab (NAT) to Fingolimod (FTY) increased relapse rates. Two other studies found switching to NAT from other treatments reduced relapse rates. The document concludes some secondary treatments may help prevent MS symptoms while more research is needed on others. Nurses should apply research by recommending NAT as a secondary treatment and individualizing patient education and care.
2006 presentation at The European Health Psychology Conference in Bath: Can We Bury the Idea That Psychotherapy Extends the survival of Cancer Patients?
2006 presentation at The European Health Psychology Conference in Bath: Can We Bury the Idea That Psychotherapy Extends the survival of Cancer Patients?
Presentation performed for highlighting VERIFY: Galvus-met trials superiority in managing newly diagnosed DMT2 patients with preserving B cell function, evidence.
Presentation performed for highlighting VERIFY: Galvus-met trials superiority in managing newly diagnosed DMT2 patients with preserving B cell function, evidence.
Impacto da Internet e das bibliotecas digitais na pesquisa científica : o cas...Elisabeth Dudziak
DUDZIAK, E. A. ; VILLELA, M. C. O. ; BARBIN, S.E. . Impacto da Internet e das bibliotecas digitais na pesquisa científica : o caso da Engenharia Elétrica na Escola Politécnica da USP. In: Simpósio Internacional de Bibliotecas Digitais, 3., 2005, São Paulo. SIDB : trabalhos. São Paulo : CRUESP / ISTEC, 2005.
Breve introdução a TDD, expondo uma aplicação simples - visível somente via controle de versão - escrita em PHP, exercitando os ciclos propostos pela metologia.
Gravação da apresentação: http://youtu.be/M5f32O-Afq0
Repositório do projeto: http://github.com/augustohp/gravata
Running Head QUANTITATIVE RESEARCH SUMMARY1QUANTITATIVE RESE.docxtodd581
Running Head: QUANTITATIVE RESEARCH SUMMARY 1
QUANTITATIVE RESEARCH SUMMARY 10
QUANTITATIVE RESEARCH SUMMARY
Student’s Name: Letzy Reyes
Institution: Grand Cayon University
Date: 06/10/2018
Nursing Practice Problem
P-(Problem) – elderly patients aged above 50 years admitted in hospital and having shown blood pressure disease signs. Patients not included in the research were pregnant women.
I-(Intervention) – the patients who are subject in this research will be subjected to therapeutic routine concerning hypertension. The blood pressure of all the patients was tested after administering hypertension medicine to the subjects. The resultant changes were recorded every day to determine the reaction and thus the group will make a conclusion.
C-(Comparison) – institutionalized quality methods will be regulated for hypertension and subjected to the group. The comparison between the groups will be done towards the end of the month in the group.
O-(Outcome) - there will be good relation between the hypertension medication and blood pressure.
T-(Time) – for the next one month the blood pressure will be monitored closely.
The nursing practice portion should be in paragraph form.
PICOT Statement
Elderly patients under hypertension medication together with pharmacological interventions can be maintained in hospitals to improve their blood pressure and with understanding the background and culture of the patients will be of great help in dealing with hypertension. Comment by Doreen Farley: Letzy, I know that this is not the PICOT question that we decided on. What happened to the PICOT?
In patients with hypertension, does the use of meditation along with pharmacological interventions compared to medications alone improve blood pressure? This was the PICOT from out last discussion on 6-1-18
This paper is supposed to be double space only. I am not sure why there is so much space in between concepts.
Introduction
Background of the study
The purpose of the study was to evaluate analyze how patients using hypertension medication along with pharmacological interventions compared to medications alone improve blood pressure. The bottom line of the study was to evaluate how different opinions on hypertension and the treatment of the disease and how such opinions differ from one place to another especially due to the difference in culture or ethnicity of these groups. In addition, the study will be evaluated on what the proposed interventions would do to improve the adherence to these groups. Comment by Doreen Farley: The study evaluated…
The proposed interventions from the research on the two articles will be of importance to the nursing field. There is the need for the nurses to connect, care and convey treatment for various groups of patients in our diverse community. These include taking treatment to patients from different ethnic and racial groups. When it comes to hypertension, nurses have been faced with challenges .
OPIOID IN ALZHEIMER’S DISEASE 1ARTICLE CRITIQUE 9Opi.docxvannagoforth
OPIOID IN ALZHEIMER’S DISEASE
1
ARTICLE CRITIQUE
9
Opioid use and the presence of Alzheimer's disease and related dementias among elderly Medicare beneficiaries diagnosed with chronic pain conditions
Chan Shen, Xiaohui Zhao, Nilanjana Dwibedi, R. Constance Wiener, Patricia A. Findley & Usha Sambamoorthi
Odanayza Casanola Chavez
Article title: Opioid use and the presence of Alzheimer's disease and related dementias among elderly Medicare beneficiaries diagnosed with chronic pain conditions
Authors: Chan Shen, Xiaohui Zhao, Nilanjana Dwibedi, R. Constance Wiener, Patricia A. Findley & Usha Sambamoorthi
Introduction
Summary: The study by Shen et al. (2018) represents a retrospective-cross-sectional study which aimed at determining the relationship between ADRD (Alzheimer's disease and related dementias) and opioids prescription among elderly patients as compared to their counterparts without ADRD. Through the use of Medicare beneficiaries from 2006 to 2013, the study was able to determine the fact that opioids prescription among elderly patients with ADRD is comparatively lower than their non-ADRD counterparts hence leading to possibly unmet pain management needs for elderly patients with ADRD. This trend is largely caused by the unfounded notion that opioids use have negative effects among ADRD patients in as far as worsening ADRD symptoms is concerned.
Problem: The fundamental problem that informed this study has been clearly stated. Arguably, the problem is quite practical owing to the fact that pain is a major cause of low quality of life among elderly persons. There have been a lot of fears associated with opioids use among elderly patients with ADRD due to the assumptions that opioids may exacerbate ADRD symptoms. Although opioids have been evidently associated with major pain relief capabilities- their use among ADRD patients experiencing pain is minimal. Therefore, the authors hypothesize that there is great risk of going with unmet pain management needs among elderly persons with ADRD as compared to their counterparts without ADRD.
While the research questions have not been explicitly highlighted, it is apparent that as can be extrapolated from the research aims- the primary research questions that the study pursued to answer relates to whether opioids use in elderly patients is in any way linked to increased risk of ADRD and whether elderly patients with ADRD are more likely to endure sub-optimal pain management due to limited prescription of opioids. The researchers utilized a sample of n= 19,347 participants who were Medicare beneficiaries between 2006 and 2013. Among these participants, 7.7% of them had ADRD and the rest were ADRD-free. By analyzing opioids prescription for this period, the study found out that participants with ADRD received less opioids prescriptions as compare to their non-ADRD counterparts therefore confirming that community-dwelling elderly patients with ADRD are more likely to experience unmet pain ma ...
OPIOID IN ALZHEIMER’S DISEASE 1ARTICLE CRITIQUE 9Opi.docxamit657720
OPIOID IN ALZHEIMER’S DISEASE
1
ARTICLE CRITIQUE
9
Opioid use and the presence of Alzheimer's disease and related dementias among elderly Medicare beneficiaries diagnosed with chronic pain conditions
Chan Shen, Xiaohui Zhao, Nilanjana Dwibedi, R. Constance Wiener, Patricia A. Findley & Usha Sambamoorthi
Odanayza Casanola Chavez
Article title: Opioid use and the presence of Alzheimer's disease and related dementias among elderly Medicare beneficiaries diagnosed with chronic pain conditions
Authors: Chan Shen, Xiaohui Zhao, Nilanjana Dwibedi, R. Constance Wiener, Patricia A. Findley & Usha Sambamoorthi
Introduction
Summary: The study by Shen et al. (2018) represents a retrospective-cross-sectional study which aimed at determining the relationship between ADRD (Alzheimer's disease and related dementias) and opioids prescription among elderly patients as compared to their counterparts without ADRD. Through the use of Medicare beneficiaries from 2006 to 2013, the study was able to determine the fact that opioids prescription among elderly patients with ADRD is comparatively lower than their non-ADRD counterparts hence leading to possibly unmet pain management needs for elderly patients with ADRD. This trend is largely caused by the unfounded notion that opioids use have negative effects among ADRD patients in as far as worsening ADRD symptoms is concerned.
Problem: The fundamental problem that informed this study has been clearly stated. Arguably, the problem is quite practical owing to the fact that pain is a major cause of low quality of life among elderly persons. There have been a lot of fears associated with opioids use among elderly patients with ADRD due to the assumptions that opioids may exacerbate ADRD symptoms. Although opioids have been evidently associated with major pain relief capabilities- their use among ADRD patients experiencing pain is minimal. Therefore, the authors hypothesize that there is great risk of going with unmet pain management needs among elderly persons with ADRD as compared to their counterparts without ADRD.
While the research questions have not been explicitly highlighted, it is apparent that as can be extrapolated from the research aims- the primary research questions that the study pursued to answer relates to whether opioids use in elderly patients is in any way linked to increased risk of ADRD and whether elderly patients with ADRD are more likely to endure sub-optimal pain management due to limited prescription of opioids. The researchers utilized a sample of n= 19,347 participants who were Medicare beneficiaries between 2006 and 2013. Among these participants, 7.7% of them had ADRD and the rest were ADRD-free. By analyzing opioids prescription for this period, the study found out that participants with ADRD received less opioids prescriptions as compare to their non-ADRD counterparts therefore confirming that community-dwelling elderly patients with ADRD are more likely to experience unmet pain ma.
Understanding the nutrition care needs of patients newly diagn.docxgibbonshay
Understanding the nutrition care needs of patients newly diagnosed
with type 2 diabetes: a need for open communication
and patient-focussed consultations
Lauren BallA,C, Ruth DavmorA, Michael LeverittB, Ben DesbrowA, Carolyn EhrlichA
and Wendy ChaboyerA
AMenzies Health Institute Queensland, Griffith University, Gold Coast 4222, Qld, Australia.
BSchool of Human Movement and Nutrition Sciences, The University of Queensland,
Brisbane 4072, Qld, Australia.
CCorresponding author. Email: [email protected]
Abstract. Patients who are newly diagnosed with type 2 diabetes mellitus (T2DM) commonly attempt to modify their
dietary intake after receiving nutrition care from primary health professionals. Yet, adherence to dietary recommendations
is rarely sustained and factors influencing adherence are poorly understood. This study exploredT2DMpatients’ experiences
of dietary change and their views on how primary health professionals can best support long-term maintenance of dietary
change.Apurposive sample of 10 individuals recently diagnosedwithT2DMparticipated in three individual semi-structured
qualitative telephone interviews: at baseline, then at 3 and 6 months after recruitment. Interview questions were modified
from the initial interview inorder to investigate emergingfindings.A two-step data analysis process occurred throughcontent
analysis of individual interviews andmeta-synthesis of findings over time. Participants initiallymadewide-ranging attempts
to improve dietary behaviours, butmost experienced negative emotions from the restraint required tomaintain a healthy diet.
Participants felt confused by the conflicting advice received from health professionals and other sources such as friends,
family, internet and diabetes organisations. Participants frequently reported feeling rushed and not heard in consultations,
resulting in limited ongoing engagement with primary healthcare services. These findings suggest that there is opportunity
for primary health professionals to enhance the dietary support provided to patients by: acknowledging the challenges of
sustained improvements in dietary intake; open communication; and investing in patient relationships through more
patient-focussed consultations.
Additional keywords: chronic disease, general practice, primary care, nutrition therapy, nutritional management.
Received 28 April 2015, accepted 18 August 2015, published online 5 October 2015
Introduction
Type 2 diabetes mellitus (T2DM) is a lifestyle-related chronic
disease and leading cause of morbidity andmortality in Australia
(Australian Institute of Health andWelfare 2007). Over 5%of the
Australian population has been diagnosed with T2DM, and an
additional 0.9% is predicted to be diagnosed annually (Australian
Bureau of Statistics (ABS) 2012). T2DM is typically diagnosed
and managed in the primary healthcare setting, and patients with
T2DM receive health care from a variety of primary health
professionals (Diabetes Australia 2012). Impor ...
Running head CRITIQUE QUANTITATIVE, QUALITATIVE, OR MIXED METHODS.docxtodd271
Running head: CRITIQUE QUANTITATIVE, QUALITATIVE, OR MIXED METHODS DESIGN
5
CRITIQUE OF QUANTITATIVE, QUALITATIVE, OR MIXED METHODS DESIGN
Critiquing Quantitative, Qualitative, or Mixed Methods Studies
Adenike George
Walden University
NURS 6052: Essentials of Evidence-Based Practice
April 11, 2019
Critique of Quantitative, Qualitative, or Mixed Method Design
Both quantitative and qualitative methods play a pivotal role in nursing research. Qualitative research helps nurses and other healthcare workers to understand the experiences of the patients on health and illness. Quantitative data allows researchers to use an accurate approach in data collection and analysis. When using quantitative techniques, data can be analyzed using either descriptive statistics or inferential statistics which allows the researchers to derive important facts like demographics, preference trends, and differences between the groups. The paper comprehensively critiques quantitative and quantitative techniques of research. Furthermore, the author will also give reasons as to why qualitative methods should be regarded as scientific.
The overall value of quantitative and Qualitative Research
Quantitative studies allow the researchers to present data in terms of numbers. Since data is in numeric form, researchers can apply statistical techniques in analyzing it. These include descriptive statistics like mean, mode, median, standard deviation and inferential statistics such as ANOVA, t-tests, correlation and regression analysis. Statistical analysis allows us to derive important facts from data such as preference trends, demographics, and differences between groups. For instance, by conducting a mixed methods study to determine the feeding experiences of infants among teen mothers in North Carolina, Tucker and colleagues were able to compare breastfeeding trends among various population groups. The multiple groups compared were likely to initiate breastfeeding as follows: Hispanic teens 89%, Black American teens 41%, and White teens 52% (Tucker et al., 2011).
The high strength of quantitative analysis lies in providing data that is descriptive. The descriptive statistics helps us to capture a snapshot of the population. When analyzed appropriate, the descriptive data enables us to make general conclusions concerning the population. For instance, through detailed data analysis, Tucker and co-researchers were able to observe that there were a large number of adolescents who ceased breastfeeding within the first month drawing the need for nurses to conduct individualized follow-ups the early days after hospital discharge. These follow-ups would significantly assist in addressing the conventional technical problems and offer support in managing back to school transition (Tucker et al., 2011).
Qualitative research allows researchers to determine the client’s perspective on healthcare. It enables researchers to observe certain behaviors and experiences amo.
Qualitative evaluation of successful homeopathic treatment of individuals wit...home
Homeopathy, an over 200-year-old major
system of care within complementary and alternative
medicine, is used worldwide. While homeopathy has
stimulated much debate over the nature of its medicines
(remedies), relatively little research has focused on its
therapeutic process as experienced by patients in clinical
practice. The goal of this qualitative study was to use
descriptive phenomenology to assess patients’ experiences
of the homeotherapeutic process. We interviewed 36
homeopathic patients with a history of at least one chronic
disease who, in the provider’s global clinical impression,
had exhibited a treatment-related sustained, outstanding or
extremely successful outcome in their condition for at
least 1-year follow-up. Two essential structures describing
the lived experiences of homeopathic treatment emerged
from the data. One of the structures characterizes what it
is like to be ‘‘successfully healed’’ as a transformative
process of coming home to self. The second structure
describes the experience of receiving care by a homeopath
as an intensive process of self-exploration and self-discovery
that was facilitated by a trusted partner in care.
The data are consistent with contemporary concepts
within nonlinear complex systems science. The current
findings offer insights into the homeopathic patient’s
experience of treatment and provide a fuller clinical picture
to guide future qualitative and quantitative research in
homeopathy.
Preprint review article letter to all pharmacist 2016 pharmaceutical care la...
Research paper 2
1. Running head: MULTIPLE SCLEROSIS 1
Multiple Sclerosis
Breanna Hernandez
California Baptist University
Author’s Note
This paper is presented to Professor Jetton in partial fulfillment for the requirements of
Research and Writing, NUR 375A, on February 26nd, 2015
2. MULTIPLE SCLEROSIS 2
Multiple Sclerosis
According to Brunetti and Hunter, over 20 years have passed since the first disease-
modifying therapies (DMTs) were approved in the treatment of Multiple Sclerosis (MS). There
is an importance for clinicians to stay up to date and familiar on new updates of treatment
options to be most effective in treating patients with diagnosed MS (Brunneti & Hunter, 2014).
There are several treatment options for MS and every patient has their individualized plan of
care, but two main treatments include the Natalizumab therapy (NAT) and Fingolimod therapy
(FTY) (Hoepner et al., 2014). Because no cure currently exists, these treatment options aim to
reduce the frequency of exacerbations and also reduce the progression of the disease to increase
the quality of life (Brunneti & Hunter, 2014). This paper will analyze the research of Hoepner et
al. (2014), synthesize the same research with Putzki et al. (2009) and Lanzillo et al. (2013), and
show how the research can be applied in practice.
Research Article Analysis
Research was done by Hoepner, et al. (2014) to determine the risk factors for the
recurrence of relapses after switching from Natalizumab (NAT) therapy to Fingolimod (FTY)
therapy in relapsing-remitting multiple sclerosis (RRMS). The purpose of the research was to
identify the clinical risk factors that could help identify responses to FTY after NAT was
discontinued (Hoepner et al. , 2014). The research was also done to find out the effectiveness of
FTY and the parameters that might show higher relapse risk (Hoepner et al. , 2014).
The sample size for this retrospective observational study conducted by Hoepner et al.
had 33 patients with a diagnosis of RRMS chosen from electronic databases. Other inclusion
factors listed are having at least 12 months of NAT therapy, switching from NAT to FTY within
24 weeks, and following up for at least a period of 12 months thereafter (Hoepner et al. , 2014).
3. MULTIPLE SCLEROSIS 3
Six patients were excluded because they had switched from NAT to FTY after 24 weeks or had
followed up less than 12 months after switching to FTY (Hoepner et al. , 2014).
A few different methods were used in this research to measure variables. The methods
used to identify predictors in response to FTY was univariate logistic regression analysis and the
Expanded Disability Status scale (EDSS) (Hoepner et al. , 2014). When analyzing the variable
for a significant difference in patients with or without relapse during FTY the Mann-Whitney-
Exact Test was used (Hoepner et al., 2014).
This study found that an increase of disease activity occurred after discontinuing NAT
and it didn’t matter whether they switched during the 24 week period. After the discontinuation
of NAT, 61% (20) relapsed but only 48% (16) relapsed during FTY treatment. Of that 16, 63%
had relapsed during NAT and 87.5% relapsed during the switching period (Hoepner et al., 2014).
The only significant value that was found to predict the occurrence of relapse activity during
FTY was the last EDSS done during the switching period from NAT to FTY (Hoepner et al.,
2014). Other significant data pointed to an increase of annual relapse rate (ARR) in the first year
after switching from NAT to FTY (Hoepner et al., 2014).
Hoepner et al.’s research explains that the size of the population in the study was not big
enough to make the decision to switch to FTY or other alternate therapies. Further studies
should be done to improve the individual risk-benefit assessment. Also, the retrospective design,
and lack of MRI data in the electronic data bases was a concern in choosing to implement the use
of FTY after discontinuing NAT (Hoepner et al. , 2014). What the research of Hoepner et al.
does indicated is that patients with a low EDSS seem to be safe and switching from NAT to FTY
is effective.
4. MULTIPLE SCLEROSIS 4
Synthesis
Research done by Hoepner et al. (2014) showed that switching from Natalizumab (NAB)
to Fingolimod (FTY) was ineffective in reducing the amount of disease activity in Multiple
Sclerosis (MS). Additional studies by Lanzillo et al. (2013) and Putzki et al. (2009) both showed
that switching to NAT from another disease modifying therapy (DMT) is effective in reducing
relapse in MS. Studies done by Hoepner et al. and Putzki et al. were conducted in Germany
while the study done by Lanzillo et al. was conducted in Italy.
Sample
The research done by Hoepner et al. had 33 patients and Putzki et al. had 31 but Lanzillo et al.
was also very similar in that it had 50 patients. All research had in common that the population
sizes were very small. The inclusion criteria for all three studies included, patients previously
using a DMT and those with relapsing remitting multiple sclerosis (RRMS). The difference in
inclusion criterion was that in Hoepner et al. patients were on NAB prior to switching to FTY.
Other research done by Lanzillo et al. and Putzki et al. had patients previously on another DMT
prior to the switch to NAB for 12 months.
Methodology
Hoepner et al. research as well as Lanzillo et al. were retrospective studies, while the research
done by Putzki et al. was a prospective observational study. Hoepner et al. and Lanzillo both
assessed annual relapse rate (ARR) and Expanded Disability Status scale scores (EDSS) but
Lanzillo also assessed the reduction if contrast enhancing lesions (CELs). Hoepner et al.,
Lanzillo et al., and Putzki all got patients from MS center database centers from universities.
Findings
5. MULTIPLE SCLEROSIS 5
Hoepner et al. concluded that more research needs to be done to use FTY as second line therapy
effectively but significant data showed that those with a low grade disbitlty had a smaller relapse
rate after switching from NAT to FTY. Putzki et al had significant data that showed mean EDDS
scores at basline decreased. Lanzillo et al. showed that the ARR at all time points was significant
because it did not drastically change over time. Putzki et al. and Lanzillo et al. both came to the
conclusion that NAT is effective as treatment in reducing disease symptoms of MS for at least 12
months after the use of another DMT or the failed use of a DMT.
Application to Practice
When patients are deciding on the treatment of multiple sclerosis they should be
completely informed to accurately make the best choice for their situation. The effectiveness,
risks, and side effects of the best treatments should be explained thoroughly. To best educate a
patient on treatment options, the patient’s needs, goals, preferences and concerns should all be
met during teaching rounds (Weinberger, Johnson & Ness, 2014). According to Weinberger,
Johnson & Ness (2014) it is also important to include families in teaching so that if needed a
family can make a decisions to together. The concerns and questions of all family members
present should also be addressed to provide a more effective teaching approach (Weinberger,
Johnson & Ness, 2014).
Nurses and other health care personal should be implementing individualized care with
patients while helping them make informed decisions (Suhonen et al., 2014). According to
Suhonen et al. it is important to find ways to understand people in their life situations, what they
prefer, and the amount of effort they will put into their care or the level of desire they wish to put
into their. Understanding these concepts for each individual patient can help direct health
personal into what to teach and how to teach it with different patients. Different treatment
6. MULTIPLE SCLEROSIS 6
therapies of multiple sclerosis (MS) can be emphasized or even more thoroughly looked at if the
health care provider is informed of the patient’s life. Nurses can help with implementing a
certain therapy over another by learning as much about the patient as possible to choose the best
option for them to provide the highest level of patient care (Suhonen et al., 2014).
When the health provider knows the patient individualizing the care is made easier.
Teaching the patient then becomes more organized because treatment can be taught in a way that
helps the patient fully understand its effects (Suhonen et al., 2014). If switching from Fingolimod
(FTY) to Natalizumab (NAT) to reduce relapse in MS is a likely option for a patient, an
informed decision can be made by the medical/nursing staff, the patient, and family/friends. The
health provider, whether a doctor or nurse practitioner can apply the research of Lanzillo et al.
(2013) and Putzki et al. (2009) by prescribing NAT as a second line therapy for MS (Buckley et
al. 2012).
Conclusion
Studies by Hoepner et al. (2014), Putzki et al.. (2009) and Lanzillo et al. (2013)
demonstrate that some secondary disease modifying treatments (DMT’s) in Multiple Sclerosis
(MS) can be beneficial in the prevention of relapse and other symptoms, while others are still not
adequately researched to be certain of their effect. Research done by Hoepner et al. indicated that
Fingolimod (FTY) as a secondary treatment after the discontinued use of Natalizumab (NAT)
needs to be studied more over greater populations to prove its effectiveness. Other research
performed by Lanzillo et al. and Putzki et al., did show that switching to NAT from another
DMT, rather than FTY was much more effective in reducing symptoms associated with relapse.
Subject size was very small among all studies and shows that it may not be generalized to all
population groups rather only those specifically with the same inclusion criteria. These findings
7. MULTIPLE SCLEROSIS 7
can however, be used in practice by having nurse practioners prescribe NAT as a secondary line
therapy because it is effective in reducing relapse in patients with MS. Also, individualized care
and patient teaching can be implemented when making decisions on treatmeant options and plans
of care. Finding other ways to implement the research of Hoepner et al., Putzki et al., and
Lanzillo et al. into practice raises the potential for improving the quality of life of those
individuals with MS greatly.
8. MULTIPLE SCLEROSIS 8
References
Brunetti, L., & Hunter, S. F. (2014). Implications for multiple sclerosis in the era of the
affordable care act: An evolving treatment paradigm. American Journal of Managed
Care, 20(1), 228-241.
Buckley, T., Cashin, A., Stuart, M., Browne, G., & Dunn, S. V. (2013). Nurse practitioner
prescribing practices: the most frequently prescribed medications. Journal of Clinical
Nursing, 22(13/14), 2053-2063.
Hoepner, R., Havla, J., Eienbröker, C., Tackenberg, B., Hellwig, K., Meinl, I., & ... Kleiter, I.
(2014). Predictors for multiple sclerosis relapses after switching from natalizumab to
fingolimod. Multiple Sclerosis Journal, 20(13), 1714-1720.
Lanzillo, R., Bonavita, S., Quarantelli, M., Vacca, G., Lus, G., Amato, L., & ... Brescia Morra,
V. (2013). Natalizumab is effective in multiple sclerosis patients switching from other
disease modifying therapies in clinical practice. Neurological Sciences, 34(4), 521-528.
Putzki, N., Kollia, K., Woods, S., Igwe, E., Diener, H. C., & Limmroth, V. (2009). Natalizumab
is effective as second line therapy in the treatment of relapsing remitting multiple
sclerosis. European Journal of Neurology, 16(3), 424-426.
Suhonen, R., Stolt, M., Gustafsson, M., Katajisto, J., & Charalambous, A. (2014). The
associations among the ethical climate, the professional practice environment and
individualized care in care settings for older people. Journal of Advanced Nursing, 70(6),
1356-1368.
Weinberger, S. E., Johnson, B. H., & Ness, D. L. (2014). Patient- and family-centered medical
education: The next revolution in medical education?. Annals of Internal
Medicine, 161(1), 73-75.