IndraLab

Statements

CALM1 binds Ubiquitin. 76 / 76
| 76
sparser
"The current study compares the salary-related cost of implementing the UB-CAM with and without the skip pattern at the bedside, as administered by the three types of clinicians noted above (see xref )."
35441698
sparser
"Three-hundred ninety-nine clinicians, including 53 physician hospitalists, 236 nurses, and 110 CNAs, participated, and were briefly trained in the UB-CAM prior to participating in the study."
35441698
sparser
"As expected, the average per screen cost of administering the UB-CAM ($1.10 for nurses, $3.61 for physicians) were lower than for the UB-CAM-without skip ($1.66 for nurses, $5.59 for physicians)."
35441698
sparser
"The cost of the simulated CNA-nurse UB-CAM (CNA first step, nurse second step when needed) was slightly lower than the nurse UB-CAM ($0.78 versus $1.10)."
35441698
sparser
"The lowest cost option for implementing the UB-CAM would be the simulated CNA/Nurse protocol, which would cost $42,339 in a 300-bed hospital."
35441698
sparser
"The nurse conducted UB-CAM was slightly more expensive at $63,016, and the hospitalist-conducted UB-CAM was much more expensive at $209,407 in a 300-bed hospital."
35441698
sparser
"The lowest costs per screen were the CNA nurse UB-CAM at 78 cents per screen and nurse UB-CAM at $1.10 per screen."
35441698
sparser
"Understanding screening costs supports our previous work showing the feasibility, accuracy, and efficiency of the UB-CAM and describing barriers and facilitators of screening for delirium. xref , xref "
35441698
sparser
"A third limitation is that the CNA-nurse UB-CAM protocol was not explicitly implemented in our study."
35441698
sparser
"The UB-CAM was generally positively received by all three clinician types."
33474729
sparser
"The UB-2 can effectively rule out delirium in less than 40 seconds, with a 93% sensitivity in persons with and without dementia. xref , xref If the person correctly answers both items in the UB-2, the protocol is complete; if not, the 3D-CAM is administered as step two. xref , xref The 3D-CAM is a validated diagnostic interview for delirium that can be completed in three minutes. xref We refer to this two-step process as the UB-CAM. (See xref , xref , xref )"
33474729
sparser
"Dieser wird u. a. dadurch begegnet, dass ein kurzes Screening einem ausführlicheren Assessment vorgeschaltet wird (z. B. ultra-brief CAM, UB-CAM)."
35029755
sparser
"Our field team examined protocol implementation in real time to understand the conditions and environments under which delirium assessment occurs, and the challenges associated with implementing the UB-CAM into practice."
33474729
sparser
"Assessments like the UB-CAM or the delirium triage screen (DTS) address this limitation by combining a short screening with a focus on inattention, followed by a second assessment that includes collateral history [ xref , xref ]."
35029755
sparser
"The purpose of this study was to explore the barriers and facilitators of implementing the UB-CAM in acute care, to inform its implementation."
33474729
sparser
"Clinicians described a need for delirium screening and appreciated the ease of delivering the UB-CAM two-step process with an App; they reported built-in prompts and direct electronic data entry on the iPad simplified the process."
33474729
sparser
"The systematic nature of the protocol and its perceived sensitivity was also valued, with one hospitalist noting the UB-CAM had picked up delirium where he had missed it."
33474729
sparser
"All clinician types described the ability to integrate the UB-CAM into their role and routine, without adjustments in workflow, assignments or deployment."
33474729
sparser
"A more purposeful approach is to educate patients and families about the brain as a critical organ, and the UB-CAM as a vital sign of brain function. xref , xref This finding corroborates other research that identifies the need for both intellectual and interpersonal skills to attend to the patient’s emotional needs while providing evidence-based care. xref "
33474729
sparser
"The enthusiasm for the UB-CAM’s utility, and its facilitation of systematic assessment , promoted clinician engagement in its use."
33474729
sparser
"Bien qu'ils aient un niveau de preuve plus limité, d'autres outils ayant une durée de passation plus rapide, comme la 4AT, la 3D-CAM et l'UB-CAM, semblent prometteurs, notamment en raison d'excellentes performances diagnostiques."
35652847
sparser
"Among them, the 4AT, the 3D-CAM and the UB-CAM seem particularly promising."
35652847
sparser
"We review a number of delirium screening instruments that have shown promise for use in DSD, including the 4-DSD, combined Six Item Cognitive Impairment Test (6-CIT) and 4 ‘A’s Test (4AT), Confusion Assessment Method (CAM), and the combined UB2 and 3D-CAM (UB-CAM)."
35581117
sparser
"This includes the Six Item Cognitive Impairment Test (6-CIT), 4 ‘A’s Test (4AT), the 4-item delirium superimposed on dementia tool (4-DSD), the Confusion Assessment Method (CAM), the Ultra-brief CAM (UB-CAM), and the Family CAM."
35581117
sparser
"Among them, the 4AT, the 3D-CAM and the UB-CAM seem particularly promising."
35225237
sparser
"Thus, the Ultra-Brief CAM (UB-CAM) may be preferred, which provides an assessment for delirium in approximately one minute or less, using a combination of two instruments that have been well-validated in persons with dementia."
35581117
sparser
"To administer the UB-CAM, first, the Ultra-Brief 2 (UB-2) two-item screen is applied, which uses the combination of “months of the year backwards” and “what is the day of the week?” to screen for delirium with a sensitivity of 93% (95% CI: 81%-99%) and specificity of 64% (95% CI: 56%-70%) ( xref )."
35581117
sparser
"Further, the UB-CAM appears to be positively accepted by hospitalists, nurses, and nursing assistants as a delirium identification protocol, particularly in those with DSD ( xref )."
35581117
sparser
"The UB-CAM does require a verbal patient who can participate in cognitive testing, and may not offer nuanced information about the type and extent of cognitive or functional deficiencies; this makes the UB-CAM poorly adaptable for differing degrees of dementia."
35581117
sparser
"UB-2 is extracted from 3D-CAM ( xref ), but the author does not recommend using UB-2 alone to diagnose delirium but uses the UB-CAM framework."
37251016
sparser
"The UB-2, followed by 3D-CAM with skip pattern, is called the ultra-brief CAM (UB-CAM) ( xref )."
34748377
sparser
"Paper versions of the 3D-CAM, UB-2, and UB-CAM, along with training materials, are available at."
34748377
sparser
"This suggests that delirium screening can be performed efficiently by nurses and CNAs operating within their scope of practice, using for example the nurse two-step protocol with skip (UB-CAM), or the CNA UB-2 followed by nurse 3D-CAM with skip (not explicitly tested in our study)."
34748377
sparser
"The sensitivity of our app-directed protocol was lower than previously reported 3D-CAM or simulated UB-CAM validation results ( xref , xref )."
34748377
sparser
"These strategies include the ultra-brief CAM (UB-CAM) xref or the months of the year backwards test xref , where delirium is associated with the inability to engage and complete the task."
36028563
sparser
"Delirium instruments, including the 4-DSD, UB-CAM, CAM, FAM-CAM, 6-CIT and 4AT, can aid in diagnosis, and each approach has its advantages and limitations."
35581117
sparser
"However, administration takes only 5-10 minutes, and both the CAM and UB-CAM have gained widespread and effective clinical usage worldwide."
35581117
sparser
"Mean administration times were 3 minutes 13 seconds for 3D-CAM, 2 minutes 19 seconds for 3D-CAM with skip, 1 minute 52 seconds for UB-2 + 3D-CAM in positives, and 1 minute 14 seconds for UB-2 + 3D-CAM with skip in positives, which was 1 minute and 59 seconds faster than the 3D-CAM (p<."
32930409
sparser
"The UB-CAM, consisting of the UB-2, followed in positives by the 3D-CAM with skip pattern, is a time-efficient delirium screening protocol that holds promise for increasing systematic screening for delirium in hospitalized older adults."
32930409
sparser
"We built an application (app) and used an iPad to deliver and test the UB-CAM, and previously reported that physician hospitalists, registered nurses, and Certified Nursing Assistants (CNAs) can administer the protocol effectively, with overall accuracy in the high 80%’s xref ."
35441698
sparser
"Physicians and nurses completed the two-step Ultra-brief Confusion Assessment Method (UB-CAM) protocol (with or without a skip pattern), while certified nursing assistants completed only the UB-2 ultra-brief screen."
35441698
sparser
"For the UB-CAM with skip (UB-CAM), costs per protocol were $1.10 for nurses vs. $3.61 for physicians."
35441698
sparser
"The annual salary-related costs of hospital-wide implementation of a nurse-based UB-CAM protocol in a medium sized (300-bed) hospital was $63,015 plus $4,356 for initial and annual training."
35441698
sparser
"Our team developed and field tested the Ultra-brief CAM (UB-CAM) xref , xref – xref , a two-step delirium identification protocol that includes an ultra-brief 2-item screen (UB-2) paired with a validated diagnostic tool (3D-CAM)."
35441698
sparser
"Previous work tested a RedCAP-based UB-CAM app in 527 patients with 399 physicians, nurses, and certified nursing assistants (CNAs) showing it can be successfully completed by all three disciplines in 97% of eligible patients in 80 seconds on average with over 85% accuracy relative to a gold standard."
| PMC
sparser
"To improve accessibility to the clinical setting, our research team now collaborated with a computer scientist to develop and refine an iOS-based UB-CAM app for the iPhone and iPad through iterative “laboratory” testing."
| PMC
sparser
"Next steps include testing effectiveness in a pragmatic trial with clinician users (physicians, nurses, CNAs), integrating the UB-CAM app into the routine hospital care of all older patients."
| PMC
sparser
"This poster describes the development and pilot testing of an iOS-based app that incorporates the Ultra-Brief Confusion Assessment Method (UB-CAM), a two-step, delirium detection protocol that combines the UB-2 (2-item screener) and 3D-CAM."
| PMC
sparser
"Using a stepped-wedge design across three hospitals over 42 months, nurses conduct daily UB-CAM screenings, with new units launching every six months."
| PMC
sparser
"To address the challenge of delirium identification, our team developed, validated, and field tested the Ultra-brief Confusion Assessment Method (UB-CAM), a two-step delirium identification protocol that includes an ultra-brief 2-item screen (UB-2) paired with a validated diagnostic tool (3D-CAM)."
36722177
sparser
"If hospitalized older adults answer both UB-2 questions correctly (day of week and months of the year backwards), the protocol ends and delirium is not present; otherwise, additional questions from the 3D-CAM are administered to determine the presence or absence of the 4 CAM diagnostic features. xref To promote ease of bedside use and integration into clinician workflow, xref we previously developed, tested, and implemented a UB-CAM app using the Application Programming Interface (API) with the Research Electronic Data Capture (REDCap). xref "
36722177
sparser
"To further improve accessibility and sustainability in the clinical setting, our research team collaborated with a computer scientist to develop and refine an iOS-based UB-CAM app for the iPhone and iPad."
36722177
sparser
"Researchers conducted 42 app-directed UB-CAM assessments and 27 (64%) were delirium positive."
36722177
sparser
"UB-CAM integration into EHR, combined with co-designed education and multifaceted implementation strategies, has improved engagement and adherence."
| PMC
sparser
"In conclusion, this study presents estimates of per assessment and annual hospital salary-based costs of implementing the UB-CAM 2-step delirium identification protocol, by physicians, nurses, and CNAs, thereby advancing the implementation and sustainability science of delirium screening."
35441698
sparser
"Structural basis of CALM ANTH domain bound to ubiquitin."
34821552
sparser
"Delirium is underdiagnosed by clinicians, but there are excellent diagnostic tools using history and physical examination that can assist clinicians in making the diagnosis in multiple settings (ie, CAM, CAM-ICU, 3D-CAM, bCAM, 4AT, and UB-CAM)."
35491066
sparser
"This study explores education and implementation strategies for integrating the Ultra-Brief Confusion Assessment Method (UB-CAM) into the electronic health record (EHR) to enhance delirium screening and management."
| PMC
sparser
"A delirium screening protocol consisting of the UB-2, followed in “positives” by the 3D-CAM with skip pattern, or Ultra-Brief CAM (UB-CAM) has high sensitivity and specificity and can be completed in slightly over 1 minute."
32930409
sparser
"Administration of the iOS UB-CAM app took 90 seconds (SD=8 secs) on average."
36722177
sparser
"We provide early evidence that our new iOS-based UB-CAM app demonstrates high efficiency, inter-rater reliability, and acceptability, suggesting that the app will effectively support implementation of the validated UB-CAM two-step protocol."
36722177
sparser
"Next steps include testing effectiveness in a pragmatic trial with clinician users (physicians, nurses, certified nursing assistants), integrating the UB-CAM app into routine hospital care for all older patients, including those with dementia."
36722177
sparser
"The structure of CALM when bound to Ub had extensive overlap with a previously determined crystal structure of CALM alone (PDB:1HFA) ( xref ), indicating that the CALM-ANTH does not undergo large conformational rearrangements upon binding Ub ( xref )."
34821552
sparser
"Recently, the Ultra-Brief Confusion Assessment Method (UB-CAM), designed to help physicians and nurses to recognize delirium, showed high, but imperfect, accuracy compared with Research Reference Standard Delirium Assessments (RRSDAs)."
38014821
sparser
"The aim of this study is to identify factors associated with disagreement between clinicians' app-based UB-CAM assessments and RRSDAs."
38014821
sparser
"Clinicians administered the UB-CAM using an iPad app."
38014821
sparser
"One thousand seven hundred and ninety-five clinician UB-CAM assessments paired with RRSDAs were administered."
38014821
sparser
"The rate of disagreement between clinician UB-CAM assessments and RRSDAs was 12%."
38014821
sparser
"Significant factors associated with disagreement between clinician UB-CAM assessments and RRSDAs (OR [95% CI]) included: presence of dementia (2.7 [1.8-4.1]), patient education high school or less (1.9 [1.3-2.9]), psychomotor retardation (2.5 [1.4-4.2]), and the presence of mild delirium or subsyndromal delirium (5.5 [3.5-8.7])."
38014821
sparser
"The strongest factors associated with disagreement between clinician UB-CAM screens and RRSDAs were the presence of dementia and subsyndromal delirium as risk factors for false positives, and mild delirium and younger age as a risk factor for false negatives."
38014821
sparser
"Mapping the chemical shift perturbations from HSQC experiments with 15 N-Ub bound to the CALM ANTH domain ( xref and xref ) onto the ANTH:Ub crystal structure showed that the residues undergoing the largest changes were located at the interface captured in the crystal structure ( xref )."
34821552
sparser
"The CALM-ANTH:Ub interface showed hydrophobic interactions between Ub (L8, I44, V70) and CALM ANTH (F223, L274); and electrostatic interactions between Ub (R42, K48) and CALM (D224, D276) -To confirm this structure, we performed a series of Paramagnetic Relaxation Enhancement (PRE) experiments ( xref ) that are summarized in xref ."
34821552
sparser
"The UB-CAM provides a brief cognitive assessment and observer rating which can be completed in under one minute to screen for delirium in high risk settings for older adults, such as emergency department, hospital, intensive care unit (ICU), and nursing home. xref "
33720288
sparser
"The largest PRE effects from the HSQC of 15 N-Ub resulting from binding to CALM spin-labeled at residues 209, 268, and 284 were mapped onto the CALM:Ub structure and confirmed that in solution, Ub bound the same region and orientation as observed in the crystal structure."
34821552
sparser
"This study describes the barriers and facilitators related to the implementation of the Ultra-brief Confusion Assessment Method (UB-CAM), a rapid two-step delirium identification protocol (ultra-brief screen, followed by CAM in positives), field tested with hospitalized older adults (70+)."
33474729
sparser
"Field researchers at two sites (an urban academic medical center and a community teaching hospital) collected observational data from 322 clinical staff (50 physician hospitalists, 189 registered nurses, and 83 nursing assistants [NAs]) as they administered the UB-CAM."
33474729