An Evidence-Based Initiative to Reduce New Graduate Nurse Turnover: Implementation of a Mentorship Program.

Background: On average, about 17% of new graduate registered nurses (NGN) leave within the first year of employment, leading to high turnover costs. A mentorship program can improve NGN retention and positively impact patient care. A significant opportunity exists for healthcare organizations to protect the investment of NGN.

Association of Social Determinants of Health With Hospital Readmission and Mortality: A Prospective Cohort Study.

Background: The relative contributions of common patient-reported social determinants of health on 30- and 90-day post-discharge outcomes among patients with acute coronary syndromes (ACS) is unclear.

Objective: The aim of this article is to examine the independent associations of social determinants with readmission or death, accounting for medical history.

Methods: Participants included adults who were hospitalized with ACS at an academic medical center.

Days Not at Home: Association of Vulnerability with Healthcare Utilization After Hospitalization for Heart Failure.

Background: Heart failure (HF) hospitalizations are characterized by vulnerability in functioning and frequent post-discharge healthcare utilization in both acute and post-acute settings.

Objective: To determine, in patients hospitalized for decompensated HF, the association of vulnerability with (1) detailed forms of post-discharge healthcare utilization, and (2) days spent away from home after initial hospital discharge.

Design: Secondary analysis of a prospective longitudinal cohort study from a single-center academic institution in the USA.

The Evidence-Based Practice Process Steps 4, 5, and 6: Integration, Evaluation, and Dissemination.

This is the final column in a series of columns that began with the January/February 2021 issue of , describing the evidence-based practice (EBP) project. The series has taken the reader through sparking the spirit of inquiry, asking a compelling question, and searching and critically appraising the literature. This column will briefly describe the final three steps: step 4, the integration of evidence with clinical expertise and patient/family preferences; step 5, the evaluation of outcomes of practice changes based on evidence; and step 6, the dissemination of the outcomes of the EBP change.

Bringing the Global into Medical Sociology: Medicalization, Narrative, and Global Health.

Medical sociologists have much to gain by bringing in global health. In this article, I make the case for expanding our field by furthering sociological perspectives on global health. I reflect on my career, the influence of scholar-activist mentors, and my contributions to the development of scholarship about medicalization, narrative, and global health in medical sociology.

Patient-reported predictors of postdischarge mortality after cardiac hospitalization.

Background: Adults hospitalized for cardiovascular events are at high risk for postdischarge mortality. Screening of psychosocial risk is prioritized by the Joint Commission. We tested whether key patient-reported psychosocial and behavioral measures could predict posthospitalization mortality in a cohort of adults hospitalized for a cardiovascular event.

Vulnerability to functional decline is associated with noncardiovascular cause of 90-day readmission in hospitalized patients with heart failure.

Background: Hospital readmission is common among patients with heart failure. Vulnerability to decline in physical function may increase the risk of noncardiovascular readmission for these patients, but the association between vulnerability and the cause of unplanned readmission is poorly understood, inhibiting the development of effective interventions.

Objectives: We examined the association of vulnerability with the cause of readmission (cardiovascular vs.

Step 3: Critical Appraisal of Evidence-Expert Opinion.

Critically appraising the literature is the third step in the evidence-based practice process. The lowest level of evidence includes expert opinion and related types of literature. This column describes the appraisal of this type of literature using a specific set of questions.

Patient-reported predictors of post-discharge mortality after cardiac hospitalization.

Background: Adults hospitalized for cardiovascular events are at high risk for post-discharge mortality. Hospital-based screening of health-related psychosocial risk factors is now prioritized by the Joint Commission and the National Quality Forum to achieve equitable, high-quality care. We tested our hypothesis that key patient-reported psychosocial and behavioral measures could predict post-hospitalization mortality in a cohort of adults hospitalized for a cardiovascular event.

Association of Depression and Cognitive Dysfunction With Patient-Centered Outcomes After Transcatheter Aortic Valve Replacement.

Background: Depression and cognitive dysfunction (CD) are not routinely screened for in patients before transcatheter aortic valve replacement (TAVR) and their association with postprocedural outcomes is poorly understood. The objectives of this study are to determine the prevalence of depression and CD in patients with aortic stenosis undergoing TAVR and evaluate their association with mortality and quality of life.

Methods: We analyzed a prospective, multicenter TAVR registry that systematically screened patients for preexisting depression and CD with the Patient Health Questionnaire-2 and Mini-Cog, respectively.

Step 3: Critically Appraising Evidence: Quality Improvement Projects.

Critical appraisal of the literature is the third step in the evidence-based practice process. There are 2 types of Level VI evidence, such as single qualitative studies and quality improvement (QI) projects. The process for critical appraisal of a single qualitative study is the same as that for an appraisal of a systematic review or metasynthesis of qualitative studies, as described in a previous evidence-based practice column.

A Randomized Clinical Trial of Transgender Women Switching to B/F/TAF: The (mo)BETTA Trial.

Background: Cardiometabolic disease in transgender women (TW) is affected by gender-affirming hormonal therapies (GAHTs), HIV, and antiretroviral therapy (ART). We evaluated the 48-week safety/tolerability of switching to bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) vs continued ART in TW on GAHT.

Methods: TW on GAHT and suppressive ART were randomized 1:1 to switch to B/F/TAF (Arm A) or continue current ART (Arm B).

Step 3: Critically Appraising Evidence: Systematic Review or Metasynthesis of Qualitative Studies.

Critical appraisal of the evidence is the third step in the evidence-based practice (EBP) process. Many questions in nursing cannot be answered using quantitative methods. We often desire a better understanding of people's lived experiences.

Critically Appraising Evidence, Step 3: Quantitative Evidence-Quasi-Experimental or Nonrandomized Experimental Studies.

Critical appraisal of the evidence is the third step in the evidence-based practice process. This column, the third in a multipart series to describe the critical appraisal process, focuses on critical appraisal of quasi-experimental or nonrandomized experimental studies.

Case Report of Idiopathic Intracranial Hypertension in Pregnancy.

Idiopathic intracranial hypertension (IIH) is a disease of increased intracranial pressure with an unknown cause that is seen most often in women during their childbearing years. Women can be under care for IIH when they become pregnant, or it may occur during pregnancy. In the past, women with IIH who became pregnant were often counseled to terminate their pregnancies, to give birth early, and even to be sterilized to prevent future pregnancies.

Climate drives coupled regime shifts across subtropical estuarine ecosystems.

Ecological regime shifts are expected to increase this century as climate change propagates cascading effects across ecosystems with coupled elements. Here, we demonstrate that the climate-driven salt marsh-to-mangrove transition does not occur in isolation but is linked to lesser-known oyster reef-to-mangrove regime shifts through the provision of mangrove propagules. Using aerial imagery spanning 82 y, we found that 83% of oyster reefs without any initial mangrove cover fully converted to mangrove islands and that mean (± SD) time to conversion was 29.

Sex Differences in Myocardial and Vascular Aging.

It is well known that cardiovascular disease manifests differently in women and men. The underlying causes of these differences during the aging lifespan are less well understood. Sex differences in cardiac and vascular phenotypes are seen in childhood and tend to track along distinct trajectories related to dimorphism in genetic factors as well as response to risk exposures and hormonal changes during the life course.

Step 3, Critically Appraising Evidence: Quantitative Evidence-Systematic Reviews or Meta-Analyses.

Critical appraisal of the evidence is the third step in the evidence-based practice process. This column, the second in a multipart series to describe the critical appraisal process, focuses on critical appraisal of systematic reviews or meta-analyses of randomized controlled trials.

Symposium: Risk, innovation and ignorance production in the field of reproductive biomedicine.

This commentary evaluates the contributions to this special issue through a feminist lens. It reviews the field of ignorance studies and two distinguishable areas in the field: undone science and ignorance/non-knowledge. It points to ways in which the articles in this special issue engage with the social production of ignorance.

Step 3: Critically Appraising Evidence.

Critical appraisal of the evidence is the third step in the evidence-based practice process. This column, the first in a multipart series to describe the critical appraisal process, defines and provides examples of the levels of evidence and tools to begin the appraisal process using a rapid critical appraisal technique.

The Specialist Marine Herbivore Grows Faster on a Less Utilized Algal Diet.

AbstractMany small specialist herbivores utilize their food resources both for nutrition and as a structural refuge or resource. Trophic linkage cannot solely be inferred from physical association of herbivores with a potential food item, because herbivores may temporarily inhabit algae or plants on which they do not feed. , a small sacoglossan sea slug, consumes and sequesters chloroplasts from the siphonaceous, chlorophytic alga ; it also maintains moderate densities on this alga.

Axonal Injury Partially Mediates Associations Between Increased Left Ventricular Mass Index and White Matter Damage.

Background And Purpose: Left ventricular (LV) mass index is a marker of subclinical LV remodeling that relates to white matter damage in aging, but molecular pathways underlying this association are unknown. This study assessed if LV mass index related to cerebrospinal fluid (CSF) biomarkers of microglial activation (sTREM2 [soluble triggering receptor expressed on myeloid cells 2]), axonal injury (NFL [neurofilament light]), neurodegeneration (total-tau), and amyloid-β, and whether these biomarkers partially accounted for associations between increased LV mass index and white matter damage. We hypothesized higher LV mass index would relate to greater CSF biomarker levels, and these pathologies would partially mediate associations with cerebral white matter microstructure.

Phytophthora cactorum causing bleeding canker of Acer x freemanii in southern Idaho.

Since 2018, bleeding cankers have been observed on maple trees in multiple home gardens in southwest Idaho. The cankers ooze a dark sap and and are approximately 10 cm to 35 cm in diameter. Cankers typically occur on the main trunk but are also present on scaffold branches in severe infecrions.

Steps 1 and 2: Asking a Compelling Clinical Question and Searching for the Best Evidence.

A compelling clinical question using the PICOT format sets the stage for a successful search for relevant evidence. This column describes the PICOT format with examples for each component and uses a specific example to demonstrate, through a first-person librarian narrative, how to conduct a literature search for relevant evidence.