Teaching Vulnerability in Research: A Study of Approaches Utilized by a Sample of Research Ethics Training Programs.

This article reports the outcomes of qualitative research on the teaching of "vulnerability in research" undertaken with principal investigators of international bioethics training programs funded by the Fogarty International Center of the National Institutes of Health (NIH) of the United States. To properly contextualize this research, we begin with an overview of the various ways in which vulnerability has been conceptualized both by writers and by ethical guidance from low-, middle-, and high-income countries. We conclude with some preliminary suggestions for best practice and recommendations for further research.

Bilateral Contralaterally Controlled Functional Electrical Stimulation Reveals New Insights Into the Interhemispheric Competition Model in Chronic Stroke.

Upper-limb chronic stroke hemiplegia was once thought to persist because of disproportionate amounts of inhibition imposed from the contralesional on the ipsilesional hemisphere. Thus, one rehabilitation strategy involves discouraging engagement of the contralesional hemisphere by only engaging the impaired upper limb with intensive unilateral activities. However, this premise has recently been debated and has been shown to be task specific and/or apply only to a subset of the stroke population.

Non-Hispanic Black Adolescents' Self-Reported Health Behaviors Associated With Childhood Obesity in an Urban Clinic.

Background: The prevalence of children with overweight or obese weight status in the United States is ~30%. Limited data exist on urban adolescents' self-reported health behaviors and their perceptions to healthy living.

Objectives: To examine adolescents' self-reported health behaviors and perceived barriers and their associations with weight status.

Correlation between the distance from the pubic symphysis to the sacrum with pelvic incidence.

Introduction: The distance between the pubic symphysis and sacrococcygeal joint has been noted as an important parameter in evaluating pelvic tilt in an anteroposterior (AP) radiograph. Similarly, pelvic incidence measures the sagittal balance of the pelvis and is influenced by pelvic rotation. The relationship between these 2 parameters is unknown and could affect interpretation of pelvic AP radiographs.

Surgical Versus Medical Team Assignment and Secondary Palliative Care Services for Patients Dying in a Cardiac Hospital.

Background:: Secondary palliative care (SPC) provides several benefits for patients with cardiovascular disease, but historically, it has been underutilized in this population. Prior research suggests a low rate of SPC consultation by surgical teams in general, but little is known about how surgical teams utilize SPC in the setting of severe cardiovascular disease.

Aim:: To determine if surgical team assignment affects the probability of SPC for inpatients dying of cardiovascular disease.

Attendance at Well-Child Visits After Reach Out and Read.

Attendance at well-child visits (WCVs) is a sine qua non of preventive care. We hypothesized that Reach Out and Read (ROR) would be associated with better WCV attendance. Parents of children 76 to 72 months at 8 clinics who did not yet have ROR reported how many WCVs their child had attended in the previous year; separate samples at the same clinics were interviewed 16 months after the ROR program was instituted.

Correlates of Cognitive Load in Surrogate Decision Makers of the Critically III.

Surrogate decision makers (SDMs) of the critically ill experience intense emotions and transient states of decision fatigue. These factors may increase the cognitive load experienced by electronic decision aids. This cross-sectional study explored the associations of emotion regulation (expressive suppression and cognitive reappraisal) and decision fatigue with cognitive load (intrinsic and extraneous) among a sample of 97 SDMs of the critically ill.

Evaluation of Treatment and Other Factors That Lead to Drug Court Success, Substance Use Reduction, and Mental Health Symptomatology Reduction Over Time.

Adults presenting with substance use and mental health disorders in the criminal justice system is well documented. While studies have examined drug courts and medication-assisted treatment (MAT), few have examined social and behavioral health indicators, and even fewer have multiple study periods. This study employed a comprehensive approach to studying the MAT contribution to drug court success; reduce substance use, mental health symptoms, and risky behaviors; and the role that violence or trauma plays in mental health symptomatology.

Hypertension Self-Management Perspectives From African American Older Adults.

African Americans are disproportionately impacted by hypertension, suffering earlier onset and greater severity of the disease, and premature cardiovascular mortality, than the general population. Managing hypertension is an unending concern for African American older adults. A better understanding of the self-management preferences of this vulnerable population will lead to the enhanced design of culturally acceptable interventions.

Greater Cortical Thickness Is Associated With Enhanced Sensory Function After Arm Rehabilitation in Chronic Stroke.

Objective: Somatosensory function is critical to normal motor control. After stroke, dysfunction of the sensory systems prevents normal motor function and degrades quality of life. Structural neuroplasticity underpinnings of sensory recovery after stroke are not fully understood.

Literacy Promotion Strategies Within Reach Out and Read: An Exploratory Study.

Literacy promotion (LP) is an essential component of primary care. This study explored different LP strategies in 2 cohorts of children aged 6 months to 6 years coming for routine care. In cohort 1 (N = 24), LP consisted mainly of advice.

Neuroendocrine Neoplasia in Extranodal Marginal Zone Lymphoma of Mucosa-Associated Lymphoid Tissue (MALT Lymphoma) of the Lung: A Case Report and Immunohistochemistry Analysis of Eight Pulmonary MALT Lymphomas.

Carcinoid tumorlets are peribronchiolar proliferations of neuroendocrine cells often associated with lung scars. Extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) is a non-Hodgkin's lymphoma that frequently involves the gastrointestinal tract but less commonly is described in the lung. Simultaneous occurrence of neuroendocrine neoplasms and MALT lymphoma is extraordinarily rare and has predominately been reported in the gastrointestinal tract.

Implementing a Produce Prescription Program for Hypertensive Patients in Safety Net Clinics.

Introduction: Although community-clinical linkages can improve chronic disease management, little is known regarding strategies for program implementation. We describe implementation of a unique produce prescription program for patients with hypertension (PRxHTN) involving 3 safety net clinics and 20 farmers' markets (FMs).

Strategy: Safety net clinics were invited to participate, and provider-leads received assistance in (1) developing a process flow to screen for food insecurity among hypertensive adults for program referral, (2) integrating the program into their electronic health record for scheduling, and (3) counseling patients on PRxHTN/FM use.

The Influence of Multimorbidity on Leading Causes of Death in Older Adults With Cognitive Impairment.

The aim of this study is to evaluate the relationship of leading causes of death with gradients of cognitive impairment and multimorbidity. This is a population-based study using data from the linked 1992-2010 Health and Retirement Study and National Death Index ( = 9,691). Multimorbidity is defined as a combination of chronic conditions, functional limitations, and geriatric syndromes.

Associations among comorbid anxiety, psychiatric symptomatology, and diabetic control in a population with serious mental illness and diabetes: Findings from an interventional randomized controlled trial.

Objective Serious mental illness and type II diabetes mellitus have a high comorbidity, and both have a higher prevalence of anxiety disorders compared to the general population. Targeted Training in Illness Management is a group-based self-management training approach which targets serious mental illness and type II diabetes mellitus concurrently. This analysis examines data from a randomized controlled trial of Targeted Training in Illness Management intervention to examine the impact of comorbid anxiety on baseline psychiatric symptomatology and diabetic control, and on longitudinal treatment outcomes.

Creation of Data Repositories to Advance Nursing Science.

Data repositories are a strategy in line with precision medicine and big data initiatives, and are an efficient way to maximize data utility and form collaborative research relationships. Nurse researchers are uniquely positioned to make a valuable contribution using this strategy. The purpose of this article is to present a review of the benefits and challenges associated with developing data repositories, and to describe the process we used to develop and maintain a data repository in HIV research.

Factors Affecting Perceptions of Disability and Self-Rated Health Among Older Adult, Long-Term Cancer Survivors.

Objective: This article examines the relative importance of cancer-related and noncancer illness factors as they predict the health quality of life among older adult, long-term cancer survivors. Specifically, it examines the effects that continuing cancer symptoms and comorbidities have on functional difficulties and how they in turn affect perceptions of disability and self-rated health.

Method: Data from an National Cancer Institute (NCI)-funded, tumor registry-based 10-year study of 321 older adult (age 60+), long-term (5+years post diagnosis) survivors of breast colorectal and prostate cancer are examined using regression analyses.

Outpatient Palliative Cardiology Service Embedded Within a Heart Failure Clinic: Experiences With an Emerging Model of Care.

Background: The role of palliative care consultation in the outpatient treatment of patients with symptomatic heart failure (HF) is poorly studied. In August 2015, we created an outpatient palliative care service embedded within the HF clinic at Cleveland Clinic main campus.

Aim: To characterize patients cared for by our novel outpatient palliative cardiology service, including their degree of HF, symptoms, comorbidities, topics addressed in clinic, palliative treatments prescribed, advanced directives status, and mortality.

Evaluation of the Decisional Fatigue Scale Among Surrogate Decision Makers of the Critically Ill.

Intense emotional distress and impaired information processing have been implicated in reducing a surrogate decision maker's ability to formulate informed health care decisions for a critically ill patient. The heightened intensity of negative emotions, mental effort, and impaired judgment is consistent with the manifestation of decision fatigue. The aim of this article is to describe the validity and reliability of the Decision Fatigue Scale (DFS) among surrogate decision makers of the critically ill.

Maternal Perspectives of Well Siblings' Adjustment to Family Life With a Technology-Dependent Child.

Technology-dependent (TD) children require complex care and are dependent on medical technology. Approximately 75% of families, in the United States, who are caring for a TD child, also care for a well child. Well siblings are likely to be affected by the experience of living with a TD sibling as the process of family normalization is described as a family affair.