Preventing Exertional Heat Stroke in Football: Time for a Paradigm Shift.

Context: Among American sports, football has the highest incidence of exertional heat stroke (EHS), despite decades of prevention strategies. Based on recent reports, 100% of high school and college EHS football fatalities occur during conditioning sessions. Linemen are the at-risk population, constituting 97% of football EHS deaths.

Association between Self-reported Sleep Quality and Single-task Gait in Young Adults: A Study Using Machine Learning.

 The objective of the present study was to find biomechanical correlates of single-task gait and self-reported sleep quality in a healthy, young population by replicating a recently published study.  Young adults (  = 123) were recruited and were asked to complete the Pittsburgh Sleep Quality Inventory to assess sleep quality. Gait variables (  = 53) were recorded using a wearable inertial measurement sensor system on an indoor track.

Towards practice change: a qualitative study examining the impact of a Child Psychiatric Access Program (Project TEACH) on Primary Care Provider practices in New York State during pandemic times.

Background: This study aims to explore the perceived impact of Project TEACH (Training and Education for the Advancement of Children's Health), a New York State Office of Mental Health funded Child Psychiatric Access Program (CPAP), on pediatric Primary Care Providers (PCPs) and their practice. Practice change over time was assessed in the context of rising mental health needs and in the context of COVID19 pandemic.

Methods: Focus groups utilizing a semi-structured format were conducted with pediatric PCPs who have been high utilizers of Project TEACH over the past 5-10 years and PCPs in similar regions who have been low or non-utilizers of the program.

A Mixed Methods Investigation on the Relationship Between Perceived Self-Regard, Self-Efficacy, and Commitment to Serve Among Military Medical Students.

Introduction: Routinely faced with potentially traumatizing situations, resilience is critical for military physicians. However, related studies are limited in scope. The current study distinctively combines hyper-realistic immersion training for military medical students with emotional intelligence and hardiness measures.

Association between Self-Reported Prior Night's Sleep and Single-Task Gait in Healthy, Young Adults: A Study Using Machine Learning.

Failure to obtain the recommended 7−9 h of sleep has been associated with injuries in youth and adults. However, most research on the influence of prior night’s sleep and gait has been conducted on older adults and clinical populations. Therefore, the objective of this study was to identify individuals who experience partial sleep deprivation and/or sleep extension the prior night using single task gait.

Identifying Individuals Who Currently Report Feelings of Anxiety Using Walking Gait and Quiet Balance: An Exploratory Study Using Machine Learning.

Literature suggests that anxiety affects gait and balance among young adults. However, previous studies using machine learning (ML) have only used gait to identify individuals who report feeling anxious. Therefore, the purpose of this study was to identify individuals who report feeling anxious at that time using a combination of gait and quiet balance ML.

Clinical Outcomes Before and After Complete Everolimus-Eluting Bioresorbable Scaffold Resorption: Five-Year Follow-Up From the ABSORB III Trial.

Background: The Absorb everolimus-eluting bioresorbable vascular scaffold (BVS) provides early drug delivery and mechanical support similar to those of metallic drug-eluting stents, followed by complete resorption in ≈3 years with recovery of vascular structure and function. The ABSORB III trial demonstrated noninferior rates of target lesion failure (cardiac death, target vessel myocardial infarction, or ischemia-driven target lesion revascularization) at 1 year with BVS compared with cobalt chromium everolimus-eluting stents. Between 1 and 3 years and cumulative to 3 years, adverse event rates (particularly target vessel myocardial infarction and scaffold thrombosis) were increased after BVS.

The Patient Experience and Safety.

Patient harm continues to be a leading cause of morbidity and mortality in the United States. Among high-risk industries, the health care system has a significantly lower safety profile than that of others. There are many driving forces behind this, including significant resistance within the medical community in the late 1960s to consumer demand of patient-centered and family-centered care.

Acquired Hemophilia A: A Case Report.

Hemophilia A, also known as factor VIII deficiency, is a rare disorder caused by an insufficient level of factor VIII, an essential clotting protein. Hemophilia A can be inherited or acquired. Inherited hemophilia A is caused by a mutation to the gene on the X chromosome, which is commonly passed down from parents to children.

Acute renal failure in a patient with PR3-ANCA and monoclonal immunoglobulin deposition disease: Case report.

Rationale: Acute renal failure developing over a short period of time with evidence of glomerular disease by urine sediment microscopy characterizes the clinical syndrome of rapidly progressive glomerulonephritis (RPGN), of which the most common causes are ANCA-associated glomerulonephritis (GN), immune-complex mediated GN and anti-GBM disease.

Patient Concerns: This was a middle-aged gentleman who presented with acute renal failure and a positive PR3-ANCA.

Diagnosis: Renal biopsy showed an unusual combination of PR3-ANCA GN with focal crescents, monoclonal immunoglobulin deposition disease (MIDD) and mesangial IgA deposition on renal biopsy.

Opioid Prescribing Patterns After Micrographic Surgery: A Follow-up Retrospective Chart Review.

Background: The abuse of opioids has reached epidemic proportions in the United States, and leftover medications are a primary source for nonmedical pain relievers. A past study at the University of Utah showed that micrographic surgeons were likely overprescribing opioids, with 35% of patients receiving a postoperative prescription.

Objective: To examine the current opioid prescribing habits of the micrographic surgeons at the University of Utah compared with those in 2010.

Trichobezoar requiring surgical intervention.

A trichobezoar is a collection of hair that forms a mass in the gastrointestinal tract and can cause obstructive symptoms when it fails to pass through the intestine. This article reviews the epidemiology, pathogenesis, clinical manifestations, diagnosis, and surgical management of trichobezoar. Managing the psychiatric aspect of this condition is key to preventing recurrence and the need for another surgery.

Takotsubo Cardiomyopathy-Induced Cardiac Free Wall Rupture: A Case Report and Review of Literature.

Takotsubo cardiomyopathy (TCM) is an acquired form of cardiomyopathy that is commonly seen among post-menopausal women. It is characterized by left ventricular apical ballooning, electrocardiographic changes and mild elevation of cardiac enzymes in the absence of significant coronary artery stenosis. TCM usually has benign course.

Upfront Radiotherapy with Concurrent and Adjuvant Vismodegib Is Effective and Well-Tolerated in a Patient with Advanced, Multifocal Basal Cell Carcinoma.

We present a case report of a male with multifocal and extensive basal cell carcinoma. Due to extremely large size and deep tumor infiltration, he was not a surgical candidate. Combined modality treatment of fractionated radiation with concurrent vismodegib was chosen.

3-Year Clinical Outcomes With Everolimus-Eluting Bioresorbable Coronary Scaffolds: The ABSORB III Trial.

Background: The Absorb everolimus-eluting poly-L-lactic acid-based bioresorbable vascular scaffold (BVS) provides early drug delivery and mechanical support functions similar to metallic drug-eluting stents (DES), followed by complete bioresorption in approximately 3 years with recovery of vascular structure and function. The ABSORB III trial demonstrated noninferior rates of target lesion failure (cardiac death, target vessel myocardial infarction [TVMI], or ischemia-driven target lesion revascularization) at 1 year in 2,008 patients with coronary artery disease randomized to BVS versus cobalt-chromium everolimus-eluting stents (EES).

Objectives: This study sought to assess clinical outcomes through 3 years following BVS implantation.

Severe polyarthralgia, high-grade fever, diffuse maculopapular rash on trunk and extremities · Dx?

The patient was nauseous, and had been experiencing headaches, generalized weakness, and fatigue. Her physical exam revealed a maculopapular rash on her trunk and upper extremities. She had tenderness and pain, as well as decreased range of motion in her ankles, knees, and wrists.

Clinical Presentation and Bacteriology of Eyebrow Infections: The Massachusetts Eye and Ear Infirmary Experience (2008-2015).

Purpose: This study retrospectively reviews preseptal cellulitis and abscesses involving the eyebrow to elucidate the bacteriology and potential causative factors.

Methods: A retrospective chart review was conducted to identify patients who had been diagnosed with preseptal cellulitis or abscess involving the eyebrow at the Massachusetts Eye and Ear Infirmary between 2008 and 2015. Demographic, clinical, and microbiological data were collected.

The Impact of an Integrated Electronic Health Record Adoption on Nursing Care Quality.

Objectives: The purpose of this study was to measure the impact of an integrated electronic health record (EHR) innovation adoption on the quality of nursing care delivered, including hospital-acquired falls, hospital-acquired pressure ulcers, ventilator-associated pneumonia (VAP), central line-associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTIs), and costs measured in nursing hours. The impact on quality, cost, and nurse satisfaction measured in turnover rates before, during, and after implementation of EHR tools was also investigated.

Background: Little is known about the adoption patterns of computerized documentation by nursing and the effects on the practice environment.

Daily Informal Multidisciplinary Intensive Care Unit Operational Debriefing Provides Effective Support for Intensive Care Unit Nurses.

Background: Although most organizations have comprehensive formal stress management programs, an approach that is most likely to be helpful is the one that is curtailed specifically to the needs of a particular nursing unit. With that aim in mind, a process of daily intensive care unit (ICU) multidisciplinary operational debriefings was developed. These operational debriefings use the same concepts as traditional debriefing, yet are offered on a daily basis, rather than being reserved only for major stressful events.

Clinical training in the rural setting: using photovoice to understand student experiences.

Introduction: Attracting and retaining healthcare providers in rural locations in the USA has been an issue for more than two decades. In response to this need, many health sciences education institutions in the USA have developed special programs to encourage students to become healthcare providers in rural locations. One approach is the use of community-based education experiences through rural track programs.

Treatment Modalities and Antimicrobial Stewardship Initiatives in the Management of Intra-Abdominal Infections.

Antimicrobial stewardship programs (ASPs) focus on improving the utilization of broad spectrum antibiotics to decrease the incidence of multidrug-resistant Gram positive and Gram negative pathogens. Hospital admission for both medical and surgical intra-abdominal infections (IAIs) commonly results in the empiric use of broad spectrum antibiotics such as fluoroquinolones, beta-lactam beta-lactamase inhibitors, and carbapenems that can select for resistant organisms. This review will discuss the management of uncomplicated and complicated IAIs as well as highlight stewardship initiatives focusing on the proper use of broad spectrum antibiotics.

A cross-hospital exploration of nurses' experiences with horizontal violence.

Aim: To explore nurses' experiences of horizontal violence (HV) in three diverse non-affiliated organisations within a single city in the USA.

Background: Horizontal violence, also called workplace bullying or lateral violence, is a long-standing nursing issue.

Method: Content analysis was used to analyse open-format textual responses from 126 registered nurses.

Evaluating Schwartz Center Rounds in an urban hospital center.

Purpose: Schwartz Center Rounds (SCRs) bring multidisciplinary caregivers together to discuss authentic patient cases from the social and emotional perspective. The monthly sessions provide a forum to share personal thoughts and feelings. The purpose of this paper is to learn why people attend SCR, understand what is gained from the experience, and identify key elements to use in measuring the program's effectiveness.

The Symptoms of Trauma Scale (SOTS): An Initial Psychometric Study.

The Symptoms of Trauma Scale (SOTS) is a 12-item, interview-based, clinician-rated measure that assesses the severity of a range of trauma-related symptoms. This pilot study evaluated its use and psychometric properties in an outpatient setting that provides treatment to survivors of chronic interpersonal trauma. Thirty participants completed self-report measures of posttraumatic stress symptoms, depression, dissociation, self-esteem, and affect dysregulation; the participants also participated separately in a semistructured interview based on the SOTS conducted by 2 trained interviewers.