Barriers and facilitators to home blood pressure monitoring in women with pregnancies complicated by hypertensive disorders: a qualitative study.

Background/objective: Hypertensive disorders of pregnancy (HDP) are a major cause of maternal morbidity and mortality in the US. Improved diagnosis and treatment of HDP may be achieved through home blood pressure monitoring (HBPM). However, there are challenges to effective HBPM during pregnancy.

Championing Civility in the Clinical Learning Environment: Evaluation of a Novel Training Program.

Problem: Incivility in the health care workplace is increasing and negatively impacts everyone in the environment, including health care team members and the patients and families they serve. This study examined the efficacy and impact of Civility Champions (CCs), a novel training program for a multidisciplinary cohort of faculty and graduate medical education (GME) trainees based in principles of trauma-informed care, nonviolent communication, and restorative practices.

Approach: Participants were 39 faculty and GME trainees representing 6 departments in a major academic medical center.

Heatwave resilience of juvenile white sturgeon is associated with epigenetic and transcriptional alterations.

Heatwaves are increasing in frequency and severity, posing a significant threat to organisms globally. In aquatic environments heatwaves are often associated with low environmental oxygen, which is a deadly combination for fish. However, surprisingly little is known about the capacity of fishes to withstand these interacting stressors.

Coupled Scholte modes supported by soft elastic plates in water.

Localized acoustic surface waves supported by a "soft" elastic plate in water are explored. Unlike many materials, such as aluminum, for soft interfaces the Scholte wave, a localized interface wave, has a speed well below that of sound in water, and the energy of the Scholte wave is no longer mainly localized to the water. We note that the Scholte velocity is largely independent of Poisson's ratio in the solid, and rather than the bulk speeds of sound, the ratio between the Young's modulus and the density of the solid may better indicate whether an interface is soft.

The Subtle Cavovarus Foot Deformity: The Nonneurologic Form of Cavus Foot Deformity.

Conditions of ankle instability, peroneal tendon tears, and stress fractures of the lateral metatarsals are commonly encountered in a clinical foot and ankle practice. Evaluation of the supporting foot structure is critical to prevent failure of index procedures. The prominence of the subtle cavus foot is now a recognized entity and must be properly diagnosed and addressed surgically.

Stakeholder-engaged process for refining the design of a clinical trial in home hospice.

Background: Clinical trials in home hospice settings are important to build the evidence base for practice, but balancing the burden and benefit of clinical trial conduct for clinicians, patients, and family caregivers is challenging. A stakeholder-engaged process can help inform and refine key aspects of home hospice clinical trials. The aim of this study was to describe a stakeholder-engaged process to refine, design, and implement aspects of an educational intervention trial in home hospice, including recommendations for refining intervention content and delivery, recruitment and enrollment strategies, and content and frequency of outcome measurement.

Burnout and Association With Resident Performance as Assessed by Pediatric Milestones: An Exploratory Study.

Introduction: Prior work demonstrating that burnout is associated with decreased performance in medical trainees has relied on self-report and/or single-site studies. We explored the relationship between burnout status and Milestones-based scores in pediatric residents nationally.

Methods: In April to June 2016, we confidentially surveyed residents using the Maslach Burnout Inventory.

Burnout in Pediatric Residents: Three Years of National Survey Data.

Background: We aimed to describe the national epidemiology of burnout in pediatric residents.

Methods: We conducted surveys of residents at 34 programs in 2016, 43 programs in 2017, and 49 programs in 2018. Survey items included the Maslach Burnout Inventory, demographics, program characteristics, personal qualities, experiences, and satisfaction with support, work-life balance, and learning environment.

Cultivating Research Skills During Clinical Training to Promote Pediatric-Scientist Development.

Physician-scientists represent a critical component of the biomedical and health research workforce. However, the proportion of physicians who spend a significant amount of effort on scientific research has declined over the past 40 years. This trend has been particularly noticeable in pediatrics despite recent scientific work revealing that early life influences, exposures, and health status play a significant role in lifelong health and disease.

Cutaneous Branch of the Obturator Nerve Extending to the Medial Ankle and Foot: A Report of Two Cadaveric Cases.

The area of skin supplied by the cutaneous branch of the obturator nerve (CBO) is highly variable. Although most introductory anatomy texts describe the CBO as innervating only a portion of the medial thigh, there are numerous reports in the literature of CBOs passing the knee to innervate the proximal, middle, or even distal leg. There are no previous reports of CBOs extending to the ankle and foot.

Do Mindfulness and Self-Compassion Predict Burnout in Pediatric Residents?

Purpose: Burnout symptoms are common among health professionals. Gaps remain in understanding both the stability of burnout and compassion over time and relationships among burnout, self-compassion, stress, and mindfulness in pediatric residents.

Method: The authors conducted a prospective cohort study of residents at 31 U.

Burnout in Pediatric Residents: Comparing Brief Screening Questions to the Maslach Burnout Inventory.

Background: Measuring burnout symptoms is important, but the Maslach Burnout Inventory (MBI) has 22 items. This project compared 3 single-item measures with the MBI and other factors related to burnout.

Methods: Data were analyzed from the 2016 and 2017 Pediatric Resident Burnout-Resilience Study Consortium surveys, which included standard measures of perceived stress, mindfulness, resilience, and self-compassion; the MBI; and the 1- and 2-item screening questions.

Variability of Burnout and Stress Measures in Pediatric Residents: An Exploratory Single-Center Study From the Pediatric Resident Burnout-Resilience Study Consortium.

Residency is a high-risk period for physician burnout. We aimed to determine the short-term stability of factors associated with burnout, application of these data to previous conceptual models, and the relationship of these factors over 3 months. Physician wellness questionnaire results were analyzed at 2 time points 3 months apart.

Milestone-Based Assessments Are Superior to Likert-Type Assessments in Illustrating Trainee Progression.

Background: The Pediatrics Milestone Project uses behavioral anchors, narrative descriptions of observable behaviors, to describe learner progression through the Accreditation Council for Graduate Medical Education competencies. Starting June 2014, pediatrics programs were required to submit milestone reports for their trainees semiannually. Likert-type scale assessment tools were not designed to inform milestone reporting, creating a challenge for Clinical Competency Committees.

Multicenter development, implementation, and patient safety impacts of a simulation-based module to teach handovers to pediatric residents.

Objective: Teaching and evaluation of handovers are important requirements of graduate medical education (GME), but well-defined and effective methods have not been clearly established. Case-based computer simulations provide potential methods to teach, evaluate, and practice handovers.

Methods: Case-based computer simulation modules were developed.

Using an innovative curriculum evaluation tool to inform program improvement: the clinical skills fair.

Background: Program evaluation is important for assessing the effectiveness of the residency curriculum. Limited resources are available, however, and curriculum evaluation processes must be sustainable and well integrated into program improvement efforts.

Intervention: We describe the pediatric Clinical Skills Fair, an innovative method for evaluating the effectiveness of residency curriculum through assessment of trainees in 2 domains: medical knowledge/patient care and procedure.

Distribution of doxorubicin in rats undergoing ultrasonic drug delivery.

Ultrasound (US) increases efficacy of drugs delivered from micelles, but the pharmacokinetics have not been studied previously. In this study, US was used to deliver doxorubicin (Dox) sequestered in micelles in an in vivo rat model with bilateral leg tumors. One of two frequencies with identical mechanical index and intensity was delivered for 15 min to one tumor immediately after systemic injection of micellar Dox.

Role of frequency and mechanical index in ultrasonic-enhanced chemotherapy in rats.

Purpose: The therapeutic effect of ultrasound and micellar-encapsulated doxorubicin was studied in vivo using a tumor-bearing rat model with emphasis on how tumor growth rate is affected by ultrasonic parameters such as frequency and intensity.

Methods: This study employed ultrasound of two different frequencies (20, 476 kHz) and two pulse intensities, but identical mechanical indices and temporal average intensities. Ultrasound was applied weekly for 15 min to one of two bilateral leg tumors (DHD/K12/TRb colorectal epithelial cell line) in the rat model immediately after intravenous injection of micelle-encapsulated doxorubicin.

Risk factors associated with overweight and obesity in college students.

Unlabelled: College obesity is increasing, but to the authors' knowledge, no researchers to date have evaluated risk factors in this population.

Objective: The authors assessed whether abnormal eating perceptions and behaviors were associated with overweight in college students.

Participants And Methods: A sample of undergraduates (N = 4,201) completed an online survey containing demographic questions and the Eating Attitudes Test-26 (EAT-26) questionnaire.