Perceptions of and Experiences in a Clinical Externship Program During the COVID-19 Pandemic.

The clinical externship program for nursing students was developed and implemented during the COVID-19 pandemic at a multi-site healthcare organization. The program aimed to address the critical shortage of health human resources by hiring qualifying undergraduate nursing and diploma program practical nursing students as unregulated care providers to meet staffing needs. The program incorporated a structured orientation, providing a mix of e-learning modules, in-person learning and shifts with an assigned preceptor.

Incongruence between Cardiorespiratory Fitness and Subjective Reports of Physical Activity in Multiple Sclerosis: A Focus on Sex Differences.

Purpose: The link between moderate- to vigorous-intensity physical activity (MVPA) and cardiorespiratory fitness in individuals with multiple sclerosis (MS) remains unclear. This study examined the relationship between self-reported MVPA and objectively assessed cardiorespiratory fitness, emphasizing sex differences.

Methods: 107 adults with MS (77 females), aged (mean ± standard deviation) 47.

Psychological Distress and Unmanaged Negative Emotions: Examining Resilience Among Nurses Working on COVID-19 Designated Inpatient Units.

Anecdotal evidence suggests nurses are engaging in resilience-based strategies to mitigate increased levels of psychological distress and unmanaged negative emotions they have been experiencing. Nurses' levels of resilience during the coronavirus disease 2019 (COVID-19) pandemic have not been clearly articulated, specifically in relation to psychological distress and negative emotions. The purpose of the current mixed-methods non-experimental descriptive study was to examine nurses' resilience during the pandemic.

"Goodbye … Through a Glass Door": Emotional Experiences of Working in COVID-19 Acute Care Hospital Environments.

Background: The severity of the COVID-19 health crisis has placed acute care nurses in dire work environments in which they have had to deal with uncertainty, loss, and death on a constant basis. It is necessary to gain a better understanding of nurses' experiences to develop interventions supportive of their emotional well-being.

Purpose: The purpose of this study is to explore how nurses are emotionally affected working in COVID-19 acute care hospital environments.

Influence of Test Environment, Age, Sex, and Sport on Baseline Computerized Neurocognitive Test Performance.

Background: Baseline computerized testing is a common component of concussion assessments, and the testing environment has been suggested to influence test performance and validity.

Purpose: To compare concussion baseline computerized neurocognitive test performance and validity among adolescent athletes based on testing environment (group, individual), age group (10-12, 13-15, 16-18 years), sex (male, female), and sport type (collision/combat, contact, noncontact).

Study Design: Cohort study; Level of evidence, 3.

TAAR1 levels and sub-cellular distribution are cell line but not breast cancer subtype specific.

Trace amine-associated receptors are G protein-coupled receptors of which TAAR1 is the most well-studied. Recently, Vattai et al. (J Cancer Res Clin Oncol 143:1637-1647 https://doi.

The Acceptability and Feasibility of Implementing an Online Educational Intervention With Nurses in a Provincial Prison Context.

Background: Correctional nursing requires a strong knowledge base with access to continuing education (CE) to maintain and enhance competencies. Nurses working in provincial prisons have reported many challenges in accessing CE, with online learning being identified as a potential solution. Limited research was found, however, which examined the correctional context in the development and delivery of online learning for nurses.

Using Local Data to Improve Care and Collaborative Practice: Insights From a Qualitative Study.

A qualitative study was undertaken to explore the experiences and perceptions of project leaders, clinicians, managers, and mentors associated with the implementation of a strategy aimed at enhancing clinicians' ability to use data to guide quality improvement projects. Our study findings elucidated the value and benefits including (1) using data to understand local context and move forward and (2) improving care and engaging in collaborative professional practice.

Contextualizing learning to improve care using collaborative communities of practices.

Background: The use of interorganizational, collaborative approaches to build capacity in quality improvement (QI) in health care is showing promise as a useful model for scaling up and accelerating the implementation of interventions that bridge the "know-do" gap to improve clinical care and provider outcomes. Fundamental to a collaborative approach is interorganizational learning whereby organizations acquire, share, and combine knowledge with other organizations and have the opportunity to learn from their respective successes and challenges in improvement areas. This learning approach aims to create the conditions for collaborative, reflective, and innovative experiential systems that enable collective discussions regarding daily practice issues and finding solutions for improvement.

Enabling Role of Manager in Engaging Clinicians and Staff in Quality Improvement: Being Present and Flexible.

Managers are uniquely placed to facilitate quality improvement (QI), yet little empirical evidence exists about their influence in engaging clinicians in QI. To address this gap, a qualitative study was undertaken and revealed 2 themes: balancing being present with letting frontline staff lead their QI projects, and leveraging flexibility in scheduling with protected time. Efforts are needed to enable managers to engage clinicians and staff in local QI efforts.

Alcohol Septal Ablation for Hypertrophic Obstructive Cardiomyopathy: Safe and Apparently Efficacious But Does Reporting of Aggregate Outcomes Hide Less-Favorable Results, Experienced by a Substantial Proportion of Patients?

Aims: To describe individual and aggregate outcomes for patients undergoing alcohol septal ablation (ASA) for hypertrophic obstructive cardiomyopathy (HOCM).

Methods: Retrospective case series reviewing all patients undergoing ASA at a United Kingdom tertiary referral center from 2000-2012. Aggregate and individual outcomes are described in terms of symptomatic and hemodynamic response.

Selective endothelin A receptor antagonism with sitaxentan reduces neointimal lesion size in a mouse model of intraluminal injury.

Background And Purpose: Endothelin (ET) receptor antagonism reduces neointimal lesion formation in animal models. This investigation addressed the hypothesis that the selective ETA receptor antagonist sitaxentan would be more effective than mixed ETA / B receptor antagonism at inhibiting neointimal proliferation in a mouse model of intraluminal injury.

Experimental Approach: Antagonism of ETA receptors by sitaxentan (1-100 nM) was assessed in femoral arteries isolated from adult, male C57Bl6 mice using isometric wire myography.

The safety at home study: an evidence base for policy and practice change.

This paper explores the policies and practices that are needed to improve the safety of home care in light of the most recent evidence about home care safety in Canada. Four areas for policy and practice change are addressed: 1) the promotion of effective communication processes in home care through cross-sector collaboration, case management and technology innovations; 2) screening for safety risk factors; 3) standardizing care processes, packaging and equipment; and 4) supporting family/caregivers and strengthening clients' ability to engage in therapeutic self-care. Evidence-based strategies for change are presented within the context of the evidence about home care safety issues.

The impact of social deprivation on coronary revascularisation treatment outcomes within the National Health Service in England and Wales.

Background: There is strong evidence to suggest that social deprivation is linked to health inequalities. In the UK, concerns have been raised regarding disparities in the outcomes of acute cardiac services within the National Health Service (NHS). This study explored whether differences exist in (a) elective hospital presentation time (b) indicators of severity and disease burden and (c) treatment outcomes (hospital stay and mortality) on the basis of the index of multiple deprivation (IMD) status.

The effect of patient sex on survival in patients undergoing isolated coronary artery bypass surgery receiving a radial artery.

Objectives: To determine whether patient sex makes a difference to in-hospital mortality and survival in patients undergoing isolated coronary artery bypass graft surgery (CABG) receiving a radial artery graft.

Methods: Analysis of consecutive patients on a validated prospective cardiac surgery database was performed for patients undergoing isolated CABG. Uni- and multivariate analyses were performed for in-hospital mortality and long-term survival.

Should obese patients undergo on- or off-pump coronary artery bypass grafting?

Objectives: To determine if on- or off-pump coronary artery bypass grafting (CABG) makes a difference to in-hospital mortality and long-term survival in obese patients.

Methods: Analysis of consecutive patients on a validated prospective cardiac surgery database was performed for patients undergoing isolated CABG. Obesity was defined as a body mass index (BMI) >30 kg/m(2).

Pneumonectomy: risk factor or innocent bystander?

Background: Pneumonectomy is associated with a higher operative mortality rate and worse 5-year survival after resection for non-small-cell lung cancer, compared to lobectomy. We investigated whether pneumonectomy is an independent risk factor for hospital mortality and poor long-term survival, after risk factor adjustment.

Methods: We analyzed a prospectively validated thoracic surgery database.

Virchow's triad and intestinal ischemia post cardiac surgery.

Background: Intestinal ischemia is associated with a very high mortality rate. We combined the principles of Virchow's triad to produce preoperative and postoperative models for the development of intestinal ischemia.

Methods: A single institutional study was undertaken involving 18,325 consecutive patients from April 1997 to March 2012.

Wedge resection verses lobectomy for stage 1 non-small-cell lung cancer.

Background: Lobectomy remains the gold standard with regard to potentially curative resection of non-small-cell lung carcinoma. We aimed to investigate whether there is a survival difference in stage 1 non-small-cell lung cancer patients who undergo lobectomy compared to a wedge resection.

Methods: We retrospectively analyzed a prospective database of 1283 patients who had potentially curative resection for stage 1 non-small-cell lung cancer.

The European Heart Rhythm Association symptom classification for atrial fibrillation: validation and improvement through a simple modification.

Aims: To validate the European Heart Rhythm Association (EHRA) symptom classification in atrial fibrillation (AF) and test whether its discriminative ability could be improved by a simple modification.

Methods And Results: We compared the EHRA classification with three quality of life (QoL) measures: the AF-specific Atrial Fibrillation Effect on QualiTy-of-life (AFEQT) questionnaire; two components of the EQ-5D instrument, a health-related utility which can be used to calculate cost-effectiveness, and the visual analogue scale (VAS) which demonstrates patients' own assessment of health status. We then proposed a simple modification [modified EHRA (mEHRA)] to improve discrimination at the point where major treatment decisions are made.

Identification of serious and reportable events in home care: a Delphi survey to develop consensus.

Objective: To assess which client events should be considered reportable and preventable in home care (HC) settings in the opinion of HC safety experts.

Background: Patient safety in acute care settings has been well documented; however, there are limited data about this issue in HC. While many organizations collect information about 'incidents', there are no standards for reporting and it is challenging to compare incident rates among organizations.

Long-term survival of non-smokers undergoing coronary artery bypass surgery.

Objectives: We sought to investigate long-term survival of non-smokers undergoing coronary artery bypass surgery (CABG).

Methods: A prospective database of consecutive patients was retrospectively analysed and cross correlated with the UK strategic tracking service to evaluate survival after primary CABG. Univariate, multivariate and a propensity analyses were performed.

Statins and long-term survival after isolated valve surgery: the importance of valve type, position and procedure.

Objectives: To investigate whether valve position, type and procedure are important factors in determining the beneficial effects of statin therapy with regard to long-term survival in patients undergoing isolated single valve surgery.

Methods: A prospective single-institution cardiac surgery database was analysed. Univariate, multivariate stepwise linear, logistic and Cox regression analysis and propensity matching were performed to identify if statins were associated with increased survival post-valve surgery.

Preoperative red cell distribution width in patients undergoing pulmonary resections for non-small-cell lung cancer.

Objectives: Red cell distribution width (RDW) has been identified as an independent risk factor with regard to prognosis in patients with cardiac disease. We sought to investigate the association of RDW in patients undergoing lung resections for non-small-cell lung cancer with respect to in-hospital morbidity, mortality and long-term survival.

Methods: Analysis of consecutive patients on a validated prospective thoracic surgery database was performed for those undergoing potentially curative resections at a single institution.

The impact of positive circumferential margin on survival following oesophagectomy using the new 7th TNM classification.

Objectives: Previous studies looking at the influence of positive circumferential margin (CRM) on survival after oesophagectomy are conflicting. This may be due to the fact that older versions of the TNM classification were used, which do not predict survival as accurately as the new 7th edition. We examine whether CRM involvement has an impact on survival when the 7th TNM classification is used.