ABSTRACT
BACKGROUND: A community-based non-profit hospice provider implemented "TeleCaring" as a quality improvement intervention to identify and take action on patient or caregiver needs or concerns, such as uncontrolled symptoms or prescription problems. MEASURES: We assessed the rate of acceptance of the intervention, intensity of the intervention, escalations of calls from Specialists to Nurses, and the effect of the intervention on utilization of clinical services, clinical miles traveled, and family satisfaction with care. INTERVENTION: TeleCaring consisted of daily proactive phone calls to patients and caregivers by Specialists and Nurses. OUTCOMES: Eighty-eight percent of new home hospice patients accepted TeleCaring when offered. A total of 5.3% of calls by Specialists were escalated to Nurses. TeleCaring participants had lower utilization of clinical services compared with non-participants. Family satisfaction increased and clinical miles decreased across the organization after the implementation of TeleCaring. CONCLUSIONS/LESSONS LEARNED: TeleCaring is a viable method to proactively identify home hospice patient or caregiver needs and adjust clinical services accordingly.
Subject(s)
Home Care Services , Hospice Care/methods , Telemedicine/methods , Telephone , Caregivers/psychology , Communication , Family/psychology , Home Care Services/statistics & numerical data , Hospice Care/psychology , Hospice Care/statistics & numerical data , Humans , Nurses , Patient Acceptance of Health Care/statistics & numerical data , Specialization , Telemedicine/statistics & numerical data , Time FactorsABSTRACT
Small interfering RNAs (siRNAs) and microRNAs (miRNAs) are effector molecules of RNA interference (RNAi), a highly conserved RNA-based gene suppression mechanism in plants, mammals and other eukaryotes. Endogenous RNAi-based gene suppression has been harnessed naturally and through conventional breeding to achieve desired plant phenotypes. The present study demonstrates that endogenous small RNAs, such as siRNAs and miRNAs, are abundant in soybean seeds, corn kernels, and rice grain, plant tissues that are traditionally used for food and feed. Numerous endogenous plant small RNAs were found to have perfect complementarity to human genes as well as those of other mammals. The abundance of endogenous small RNA molecules in grain from safely consumed food and feed crops such as soybean, corn, and rice and the homology of a number of these dietary small RNAs to human and animal genomes and transcriptomes establishes a history of safe consumption for dietary small RNAs.
