Nurse Experiences in an Electronic Health Record Transition: A Mixed Methods Analysis.

Transitions from one EHR to another can be enormously disruptive to care. Nurses are the largest group of EHR users, but nurse experiences with EHR transitions have not been well documented. We sought to understand nurse experiences with an EHR transition at the US Department of Veterans Affairs.

Use of water in dialysis and its impact on the environment.

Purpose Of Review: The climate crisis poses significant challenges across various sectors, including healthcare, where resource consumption often exacerbates environmental issues. This review addresses concerns over current levels of water use for dialysis treatment, a critical procedure for patients with kidney failure. Despite its life-saving importance, the dialysis process consumes large quantities of water, contributing to water scarcity and increased carbon emissions associated with water treatment and distribution.

A Rapid Response Mobile Application Improves First-Year Resident Clinical Performance During Simulated Care Events: A Randomized Controlled Trial.

Background: Rapid response teams (RRTs) are critical to the timely and appropriate management of acutely decompensating patients. In the academic setting, the vital role of RRT leader is often filled by a junior resident physician who may lack the necessary medical knowledge and experience. Cognitive aids help improve guideline adherence and may support resident performance as they transition into leadership roles.

Development of the AMPDECIDE Decision Aid to Facilitate Shared Decision Making in Patients Facing Amputation Secondary to Chronic Limb Threatening Ischemia.

Introduction: We developed a patient decision aid to enhance patient participation in amputation level decision making when there is a choice between a transmetatarsal or transtibial amputation.

Methods: In accordance with International Patient Decision Aid Standards, we developed an amputation level patient decision aid for patients who are being considered for either a transmetatarsal or transtibial amputation, incorporating qualitative literature data, quantitative literature data, qualitative provider and patient interviews, expert panel input and iterative patient feedback.

Results: The rapid qualitative literature review and qualitative interviews identified five domains outcome priority domains important to patients facing amputation secondary to chronic limb threatening ischemia: 1) the ability to walk, 2) healing and risk for reamputation, 3) rehabilitation program intensity, 4) ease of prosthetic use, and 5) limb length after amputation.

"Everything's so Role-Specific": VA Employee Perspectives' on Electronic Health Record (EHR) Transition Implications for Roles and Responsibilities.

Background: Electronic health record (EHR) transitions are increasingly widespread and often highly disruptive. It is imperative we learn from past experiences to anticipate and mitigate such disruptions. Veterans Affairs (VA) is undergoing a large-scale transition from its homegrown EHR (CPRS/Vista) to a commercial EHR (Cerner), creating a unique opportunity of shedding light on large-scale EHR-to-EHR transition challenges.

Impacts of an Electronic Health Record Transition on Veterans Health Administration Health Professions Trainee Experience.

Background: Adoption of electronic health care records (EHRs) has proliferated since 2000. While EHR transitions are widely understood to be disruptive, little attention has been paid to their effect on health professions trainees' (HPTs) ability to learn and conduct work. Veterans Health Administration's (VA) massive transition from its homegrown EHR (CPRS/Vista) to the commercial Oracle Cerner presents an unparalleled-in-scope opportunity to gain insight on trainee work functions and their ability to obtain requisite experience during transitions.

Effect of a Decision Aid on Agreement Between Patient Preferences and Repair Type for Abdominal Aortic Aneurysm: A Randomized Clinical Trial.

Importance: Patients with abdominal aortic aneurysm (AAA) can choose open repair or endovascular repair (EVAR). While EVAR is less invasive, it requires lifelong surveillance and more frequent aneurysm-related reinterventions than open repair. A decision aid may help patients receive their preferred type of AAA repair.

The Interplay of Sexual Arousal and Power-Related Emotions in Men's Alcohol-Involved Sexual Aggression Intentions.

Research has identified power/dominance and sexual arousal as key motivators of men's sexual aggression; however, little research has examined the interplay of these two factors in alcohol-involved sexual aggression. Two alcohol administration experiments investigated the roles of power-related sex motives and power- and sexual arousal-related emotions on men's sexual aggression intentions. In Study 1, participants ( = 96) read a sexual aggression scenario after random assignment to consume either an alcoholic (target peak BrAC = .

The price of mental well-being in later life: the role of financial hardship and debt.

Objective: This study investigated the associations between various financial hardship and debt indicators and mental health status among older adults.

Methods: Using data from the Health and Retirement Study (HRS), we considered the association between different forms of financial hardship and debt of those who were identified as having high levels of depressive symptoms ( = 7678) and anxiety ( = 8079). Financial hardship indicators: difficulty paying bills, food insecurity, and medication need; debt indicators: credit card and medical debt.

Proximal reflux: biochemical mediators, markers, therapeutic targets, and clinical correlations.

Airway reflux is implicated in the pathophysiology of a wide range of adult and pediatric upper and lower airway diseases. However, the diagnosis of proximal reflux-associated disease remains challenging due to evolving clinical criteria and institutional and regional variances in diagnostic practices. Evidence suggests that nonacidic contents of reflux may serve as both pathologic mediators of and biomarkers for reflux in the upper airway.

Association of Allergic Rhinitis With Change in Nasal Congestion in New Continuous Positive Airway Pressure Users.

Importance: Nasal congestion occurring after continuous positive airway pressure (CPAP) treatment initiation impairs CPAP adherence. Allergic rhinitis is associated with worsening nasal congestion in patients who are exposed to nonallergic triggers. Use of CPAP presents potential nonallergic triggers (eg, humidity, temperature, pressure, and airflow).

Long-Term Cognitive Decline After Newly Diagnosed Heart Failure: Longitudinal Analysis in the CHS (Cardiovascular Health Study).

Background: Heart failure (HF) is associated with cognitive impairment. However, we know little about the time course of cognitive change after HF diagnosis, the importance of comorbid atrial fibrillation, or the role of ejection fraction. We sought to determine the associations of incident HF with rates of cognitive decline and whether these differed by atrial fibrillation status or reduced versus preserved ejection fraction.

Trends in cigarette smoking and cessation among Medicare managed care recipients, 2005-2012.

Objectives: To examine recent trends in cigarette smoking among older (65 years and above) adults in the United States.

Methods: We used data from the Medicare Health Outcomes Survey dataset to estimate rates of smoking, quitting, and (re)starting from 2005 to 2012. Medicare Advantage enrollees completed mail surveys at baseline and two years later.

A randomized, double-blind phase I/IIa study of intranasal glutathione in Parkinson's disease.

Background: Depletion of reduced glutathione is associated with PD and glutathione augmentation has been proposed as a disease-modifying strategy. The aim of this study was to determine the safety and tolerability of intranasal reduced glutathione in individuals with PD.

Methods: Thirty individuals with PD were randomized to either placebo (saline), 300 mg/day, or 600 mg/day of intranasal glutathione in three divided daily doses.