Contextualizing the Well-being of Asexual Youth: Evidence of Differences in Family, Health, and School Outcomes.

Despite increasing efforts to better understand sexual and gender minority youth (SGMY), asexual youth remain understudied. This study examines differences in health, family support, and school safety among asexual youth (n = 938) from a national study of SGMY (N = 17,112) ages 13-17. Compared to non-asexual youth, asexual youth were more likely to identify as transgender and report a disability, and less likely to identify as Black or Hispanic/Latino.

Measuring Sensitivity and Precision of Real-Time Location Systems (RTLS): Definition, Protocol and Demonstration for Clinical Relevance.

The ability of a Real Time Location System (RTLS) to provide correct information in a clinical environment is an important consideration in evaluating the effectiveness of the technology. While past efforts describe how well the technology performed in a lab environment, the performance of such technology has not been specifically defined or evaluated in a practice setting involving workflow and movement. Clinical environments pose complexity owing to various layouts and various movements.

Attitudes and Behavior of Health Care Workers Before, During, and After Implementation of Real-Time Location System Technology.

Objective: To assess how staff attitudes before, during, and after implementation of a real-time location system (RTLS) that uses radio-frequency identification tags on staff and patient identification badges and on equipment affected staff's intention to use and actual use of an RTLS.

Participants And Methods: A series of 3 online surveys were sent to staff at an emergency department with plans to implement an RTLS between June 1, 2015, and November 29, 2016. Each survey corresponded with a different phase of implementation: preimplementation, midimplementation, and postimplementation.

Preliminary Investigation of Civilian Clinician Perspectives & Just-in-Time Guidance for Tourniquet Use to "Stop the Bleed".

Objective: The American College of Surgeons (ACS) encourages clinicians to provide training to laypeople on tourniquet application. It is unclear whether clinicians are confident in their abilities and equipped with adequate knowledge, skills, and resources. This study aimed to determine surgical trainee knowledge and attitudes regarding tourniquet application and compare the effectiveness of instructions.

A pilot study of non-routine events in gynecological surgery: Type, impact, and effect.

Objective: Quantifying non-routine events (NREs) assists with identify underlying sociotechnical factors that could lead to adverse events. NREs are considered any event that is unusual or atypical during surgical procedures. This study aimed to use prospective observations to characterize the occurrence of non-routine events in gynecological surgeries.

Interruptions Experienced by Emergency Nurses: Implications for Subjective and Objective Measures of Workload.

Introduction: This study aimed to describe interruptions experienced by emergency nurses and establish convergence validity of 1 objective workload measure by linking interruption characteristics to objective and subjective measures of workload.

Methods: Interruptions were captured in real time across 8- or 12-hour shifts using a previously validated Workflow Interruptions Tool (WIT). Data collected on each interruption included type, priority, and location where the interruption occurred.

Physician, Interrupted: Workflow Interruptions and Patient Care in the Emergency Department.

Background: It is unclear how workflow interruptions impact emergency physicians at the point of care.

Objectives: Our study aimed to evaluate interruption characteristics experienced by academic emergency physicians.

Methods: This prospective, observational study collected interruptions during attending physician shifts.

Lean health care.

Principles of Lean management are being adopted more widely in health care as a way of improving quality and safety while controlling costs. The authors, who are chief executive officers of rural North Carolina hospitals, explain how their organizations are using Lean principles to improve quality and safety of health care delivery.

Successful treatment of preadolescents with small cell carcinoma of the ovary hypercalcemic type.

Background: Small cell carcinoma of the ovary hypercalcemic type (SCCOHT) is a rare tumor with a peak incidence in young adulthood that historically has carried a poor prognosis.

Observations: We present 2 advanced stage cases of SCCOHT in preadolescents successfully treated with a combination of cisplatin-based chemotherapy and surgical resection. The more recent patient also underwent consolidative high-dose chemotherapy with stem cell rescue and external beam radiotherapy.

Effects of atrial fibrillation and atrial flutter on the signal-averaged electrocardiogram.

In conclusion, atrial flutter can create significant errors in the automated time-domain analysis of the SAECG that are only apparent when the study is repeated in sinus rhythm, thus lowering the predictive accuracy of the technique in patients with atrial flutter. Atrial fibrillation rarely creates problems with time-domain analysis of the SAECG. These findings suggest that, unless the performance of a specific signal-averaging device has been evaluated in patients with atrial flutter and found to have acceptable error rates, patients with atrial flutter should not have SAECGs performed for postinfarction risk assessment.

P wave morphology during atrial pacing along the atrioventricular ring. ECG localization of the site of origin of retrograde atrial activation.

P wave morphology during atrial pacing along the atrioventricular (AV) ring was evaluated to develop electrocardiographic (ECG) criteria for identifying the site of origin of the atrial activation wave during reentrant supraventricular tachycardia. Because P wave morphology changes as the pattern of atrial activation changes, the P wave should show characteristic morphologies during reentrant supraventricular tachycardia with use of either accessory AV pathways or the AV node for retrograde atrial activation. In 14 patients, 12-lead ECGs were recorded during bipolar atrial pacing at sites in the coronary sinus vein (along the mitral annulus) and along the atrial endocardium of the tricuspid annulus.

Late occurrence of incessant atrial tachycardia following the maze procedure.

We report a patient with incessant atrial tachycardia and AV nodal reentrant tachycardia tachycardia and AV nodal reentrant tachycardia beginning almost 18 months following a successful maze procedure. Both tachycardias were cured by radiofrequency ablation. We speculate that the right atrial tachycardia may have been related to the maze procedure.

Can amiodarone pulmonary toxicity be predicted in patients undergoing implantable cardioverter defibrillator implantation?

Implantable cardioverter defibrillator (ICD) implantation is rapidly becoming accepted as primary therapy for malignant ventricular arrhythmias. Many patients undergoing ICD implantation are on concomitant antiarrhythmic drugs to decrease shock frequency, slow tachycardia rate, and suppress supraventricular arrhythmias. Amiodarone is a potent antiarrhythmic agent that is also frequently used in the treatment of patients with refractory ventricular arrhythmias.

Individual external exposures from Nevada Test Site fallout for Utah leukemia cases and controls.

External gamma-ray exposures from fallout originating at the Nevada Test Site (NTS) have been assigned to 6,507 individual subjects (1,177 leukemia cases and 5,330 control subjects) who died as Utah residents between 1952 and 1981. Leukemia cases were identified, confirmed, and classified by cell type from the Utah Cancer Registry, Utah State vital records, and medical records. Residential histories were obtained from the Deceased Membership File (DMF) of the Church of Jesus Christ of Latter-day Saints (LDS), supplemented by information from the LDS Church Census Records that were taken in 1950, 1955, and 1960-62.

Development of a method to estimate thyroid dose from fallout radioiodine in a cohort study.

A cohort of 4831 persons aged 11-18 y in 1965 was identified among students in the schools of Washington County, UT; Lincoln County, NV; and Graham County, AZ. These children who had potentially been exposed to radioiodine from atomic weapons test fallout from the Nevada Test Site during 1951-1962 were selected for participation in a study of thyroid disease. The entire cohort was first examined during 1965-1968 for thyroid abnormalities.

The acute non-hospital: a California model.

Crisis residential programs were established by the California legislature in 1978 to provide an alternative to hospitalization for treatment of voluntary acute psychiatric patients. The five crisis residential programs in San Diego County, California, provide high-quality mental health care that is community-based and considerably less expensive than traditional in-hospital programs. Currently, the majority of public-sector, voluntary adult patients in San Diego County receives acute psychiatric inpatient services in these programs.

Mechanicla properties and mineral content of avascular and revascularizing cortical bone.

The mechanical properties of avascular and revascularizing bone and their mineral content were studied in thirty adult dogs. The strength and mineral content of avascular bone decreased in the early phase of avascular necrosis, and with revascularization the bone-mineral content increased but the mechanical strength decreased further. In the normal bone the mechanical strength increased with an increase in mineral content.