Securement of Tracheostomy Collar After Free Flap Surgery for Patients With Head And Neck Cancer.

Background: For patients with head and neck cancer who have undergone microvascular free flap surgery, securing a tracheostomy collar onto the neck using the traditional method (ie, with tracheostomy ties) is contraindicated because the ties may compress the newly vascularized tissue. However, no clear guidance exists for the use of other methods in these patients. Current techniques often use safety pins, which can cause injury to staff members.

Development and Testing of the Relational and Structural Components of Innovativeness Across Academia and Practice for Healthcare Progress Scale.

Objective: Using data from 5 academic-practice sites across the United States, researchers developed and validated a scale to measure conditions that enable healthcare innovations.

Background: Academic-practice partnerships are a catalyst for innovation and healthcare development. However, limited theoretically grounded evidence exists to provide strategic direction for healthcare innovation across practice and academia.

Quantifying emergency department nursing workload at the task level using NASA-TLX: An exploratory descriptive study.

Background: Emergency departments (ED) nurses experience high mental workloads because of unpredictable work environments; however, research evaluating ED nursing workload using a tool incorporating nurses' perception is lacking. Quantify ED nursing subjective workload and explore the impact of work experience on perceived workload.

Methods: Thirty-two ED nurses at a tertiary academic hospital in the Republic of Korea were surveyed to assess their subjective workload for ED procedures using the National Aeronautics and Space Administration Task Load Index (NASA-TLX).

Impact of Telemedicine on Access to Care for Rural Transgender and Gender-Diverse Youth.

Objective: To explore the impact of telemedicine on access to gender-affirming care for rural transgender and gender diverse youth.

Study Design: A retrospective analysis of data drawn from the electronic medical records of a clinic that provides approximately 10 000 adolescent and young adult visits per year and serves patients seeking gender health care. The no-show rate was examined as a proxy for access to care due to anticipated challenges with recruiting a representative sample of a historically marginalized population.

The Impact of Nurse-Physician Relationships on Emergency Nurses' Moral Distress.

Introduction: Moral distress affects registered nurses' job dissatisfaction, and may ultimately be associated with higher rates of turnover. Nurse-physician relationships have been shown to affect moral distress in the intensive care unit setting, but no research has evaluated this impact on emergency nurses. The purpose of this study was to investigate the impact of nurse-physician relationships on the moral distress of emergency nurses.

Back to basics: Practical strategies to reduce sensory overstimulation in the emergency department identified by adults and caregivers of children with autism spectrum disorder.

Introduction: Sensory overstimulation of autistic patients of all ages during an ED visit can ultimately lead to care escalation, but few studies have evaluated patient perspectives on improving the ED sensory experience across the age continuum. The purpose of this study was to explore patient-centered perspectives on reducing adult and pediatric autistic patients' sensory stimulation during an ED visit.

Methods: We used a qualitative descriptive design to explore how autistic patients experience sensory disruption and recommendations to improve care.

Cancer-Related Distress: Symptom Clusters in Rural Head and Neck Cancer Survivors.

Background: Rural post-treatment head and neck cancer (HNC) survivors experience high rates of cancer-related distress and may experience unique symptom clusters. Oncology nurses can benefit from a better understanding of the symptom clusters that HNC survivors experience.

Objectives: The purpose of this secondary data analysis was to identify symptom clusters of cancer-related distress in rural HNC survivors.

Rural Cancer Survivors' Perceptions of a Nurse-Led Telehealth Intervention to Manage Cancer-Related Distress.

Objectives: To understand rural survivors' experiences of participating in a nurse-led telehealth visit designed to address cancer-related distress.

Sample & Setting: 25 rural-dwelling, post-treatment adult survivors of head and neck cancer recruited from a cancer center clinic affiliated with an academic health system serving a rural catchment area in the southeastern United States.

Methods & Variables: A descriptive multimethod approach using semistructured qualitative interviews and the Telemedicine Satisfaction and Usefulness Questionnaire.

Climate and human mortality in Virginia, 2005-2020.

Using an extensive database of every resident death in Virginia from 2005 to 2020, climate-mortality relationships are examined for 12 climatically homogeneous regions within the Commonwealth. Each region is represented by a first-order weather station from which archived temperature and humidity data are used to generate a variety of biometeorologically relevant indices. Using these indices and other variables (such as air quality and heat and cold waves), daily mortality and climate relationships are modeled for each region over a 21-day lag period utilizing generalized additive models and distributed lag non-linear models.

Exploration of shared decision making in oncology within the United States: a scoping review.

Purpose: Shared decision making (SDM) among the oncology population is highly important due to complex screening and treatment decisions. SDM among patients with cancer, caregivers, and clinicians has gained more attention and importance, yet few articles have systematically examined SDM, specifically in the adult oncology population. This review aims to explore SDM within the oncology literature and help identify major gaps and concerns, with the goal to provide guidance in the development of clear SDM definitions and interventions.

Extending health care access via telemedicine in public libraries.

Background: Despite the potential for telemedicine in public libraries to expand health care access to those living a long distance from care and in broadband poor areas, there are few libraries that collaborate with providers to extend access.

Purpose: To explore licensed health care providers' perspectives on telemedicine in public libraries as a method of improving equitable access to care for populations lacking the ability to connect to telemedicine from home.

Methods: We used a two-phase explanatory sequential mixed methods design with a quantitative strand followed by a qualitative strand.

A framework to guide research and practice response to emerging infectious diseases: Genomic-to-global considerations.

Newly emerging infectious diseases (EIDs), like the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus, are becoming increasingly common. Due to geographic, political, social, behavioral, and genomic differences, some populations are more vulnerable to infectious disease spread than others. The purpose of this article is to present a framework for research and practice response to emergent infectious diseases that addresses multiple transdisciplinary actions to limit exposure or mitigate adverse outcomes for individuals and communities.

A Telemedicine-Delivered Nursing Intervention for Cancer-Related Distress in Rural Survivors.

Objectives: To evaluate preliminary efficacy, fidelity, and integrity of data collection of a nurse-led, telemedicine-delivered video visit intervention aimed at improving management of rural survivors' cancer-related distress symptoms.

Sample & Setting: 21 rural survivors participated in a nurse-led telemedicine intervention delivered six weeks after the end of active cancer treatment.

Methods & Variables: Participants' symptom management was measured with the Short Form Survivor Unmet Needs Survey, a four-factor, 30-item instrument that measures the unmet needs of adult survivors.

Self-reliance, Social Norms, and Self-stigma as Barriers to Psychosocial Help-Seeking Among Rural Cancer Survivors With Cancer-Related Distress: Qualitative Interview Study.

Background: Even when technology allows rural cancer survivors to connect with supportive care providers from a distance, uptake of psychosocial referrals is low. Fewer than one-third of participants in a telemedicine intervention for identifying rural survivors with high distress and connecting them with care accepted psychosocial referral.

Objective: The purpose of this research was to examine the reasons for which rural cancer survivors did not accept a psychosocial referral.

Spatial analysis of colorectal cancer outcomes and socioeconomic factors in Virginia.

Background: Colorectal cancer (CRC) disparities vary by country and population group, but often have spatial features. This study of the United States state of Virginia assessed CRC outcomes, and identified demographic, socioeconomic and healthcare access contributors to CRC disparities.

Methods: County- and city-level cross-sectional data for 2011-2015 CRC incidence, mortality, and mortality-incidence ratio (MIR) were analyzed for geographically determined clusters (hotspots and cold spots) and their correlates.

Improving equitable access to care via telemedicine in rural public libraries.

Objective: Rural public libraries have been proposed as ideal locations from which individuals can access a telemedicine visit, but limited adoption of this practice suggests significant barriers remain. The purpose of this study was to determine rural public librarians' perspectives on the benefits and barriers to offering patrons the ability to use their public library for a telemedicine video visit, and to suggest strategies for moving this practice forward.

Design: Qualitative content analysis.

Delirium Education in Hospice Care: A Quality Improvement Project.

Diagnosing delirium in hospice patients is challenging owing to the multifactorial causes and symptoms of delirium that can mimic natural end-of-life processes. When delirium goes unrecognized in hospice patients, preventable causes can be left untreated, leading to sequelae that are misaligned with the principles of hospice care. We conducted an evidence-based quality improvement project on a 10-bed inpatient hospice unit aimed at increasing nursing staff knowledge about assessing delirium, with a focus on preventable causes.

Use of trajectory models to track air pollution from source to exposure: A methodological approach for identifying communities at risk.

Objective: Ongoing environmental changes increasingly require public health nurses to understand how environmental factors impact the health of populations. One approach to researching these impacts is incorporating environmental research methods to determine associations between harmful exposures and health. We use the Salton Sea in Southern California as a demonstration of how environmental exposure can be examined using air parcel trajectory analysis.

Rural Disparities in Early Childhood Well Child Visit Attendance.

Purpose: Children should attend well child visits (WCVs) during early childhood so that developmental disorders may be identified as early as possible, so treatment can begin. The aim of this research was to determine if rurality impacts access to WCV during early childhood, and if altering rurality measurement methods impacts outcomes.

Design And Methods: We utilized a longitudinal correlational design with early childhood data gathered from the Virginia All Payer Claims Database, which contains claims data from Medicaid and the majority of Virginia commercial insurance payers (n = 6349).

The Disappearing Lake: A Historical Analysis of Drought and the Salton Sea in the Context of the GeoHealth Framework.

The Imperial Valley region of Southeastern California has become one of the most productive agricultural regions in the state and has the highest rates of childhood asthma in California. Lack of precipitation in the Imperial Valley has caused the water level of the Salton Sea to recede to a record low since its formation in the early 1900s. Previous studies of wind and dust deposition conducted in other regions have shown how reduced precipitation, ground heating, and the diminishing water level in an arid climate pose a risk of exposing previously sequestered toxic chemicals to open air, adversely affecting lung health.

Evaluation of rural public libraries to address telemedicine inequities.

Access to home-based telemedicine is inequitably distributed in the United States due to the limited reach of fixed broadband in rural areas. Public libraries typically offer patrons free access to broadband. Libraries, particularly those in rural regions, need to be evaluated as sites for patients to connect to a health care provider over a video visit.

Evaluation of 12-Week Shelf Life of Patient-Ready Endoscopes.

Current research suggests that for certain types of gastrointestinal endoscopes, longer shelf life (the interval of storage after which endoscopes should be reprocessed before their reuse) may not increase the likelihood of endoscope contamination. Scope contamination may, in fact, be related primarily to either inadequate disinfection processes or inadvertent contamination during storage, not to duration of storage. The purpose of this study evaluated the presence of bacteria and fungus following liquid chemical sterilization in colonoscopes and gastroscopes, after 12 weeks of shelf life during which time personal protective equipment was used during endoscope storage cabinet access.

Towards translational health policy: Findings from a state evaluation of programs targeting children with special health care needs.

Purpose: Current evidence-based research suggests that early evaluation, comprehensive care plans, and appropriate referrals for childhood and adolescent behavioral and development needs is critical for successful family-centered outcomes. The overall purpose of this study was to conduct an assessment of a state public health program that offers diagnostic evaluation and coordination for children with behavioral and developmental disorders in the state of Virginia (Child Development Center programs, or CDC). A secondary purpose was to provide translational policy and advocacy targets based on key findings.