National assessment on the frequency of pain medication prescribed for intrauterine device insertion procedures within the Veterans Affairs Health Care System.

Background: The intrauterine device (IUD) is a highly effective form of long-acting reversible contraception, widely recognized for its convenience and efficacy. Despite its benefits, many patients report moderate to severe pain during and after their IUD insertion procedure. Furthermore, reports suggest significant variability in pain control medications, including no adequate pain medication.

Implementation of EMS Clinician Feedback Tool Encourages Patient Feedback Requests and Professional Development: A Mixed-Methods Study.

Objectives: Emergency medical services (EMS) clinicians express dissatisfaction with the quality and quantity of clinical feedback received from hospitals, which is exacerbated by the absence of standardized feedback processes. A reported lack of regular feedback impedes their ability to learn and improve care. We evaluated a newly implemented feedback tool's utilization and perceived impact on EMS clinicians and our health system.

Predicting Nephrotoxic Acute Kidney Injury in Hospitalized Adults: A Machine Learning Algorithm.

Rationale And Objective: Acute kidney injury (AKI) is a common complication among hospitalized adults, but AKI prediction and prevention among adults has proved challenging. We used machine learning to update the nephrotoxic injury negated by just-in time action (NINJA), a pediatric program that predicts nephrotoxic AKI, to improve accuracy among adults.

Study Design: A retrospective cohort study.

Determining the Severity of Benign Urologic Health States in Men Using Utilities Measures.

Objective: To assess a population-level perceived health status of common reconstructive urologic conditions using health utilities.

Methods: Health utilities are generic quality-of-life measures that can help describe overall health status and can quantitatively compare different disease states and the perceived benefits of various interventions. An a priori determined, representative sample of adult men were recruited by Qualtrics to review standardized scenarios describing typical patients with reconstructive urologic conditions, surgeries to treat conditions, and control conditions (eg, blindness, osteoarthritis).

Leveraging public health cancer surveillance capacity to develop and support a rural cancer network.

Introduction: As the rural-urban cancer mortality gap widens, centering care around the needs of rural patients presents an opportunity to advance equity. One barrier to delivering patient-centered care at rural hospitals stems from limited analytic capacity to leverage data and monitor patient outcomes. This case study describes the experience of a public health cancer surveillance system aiming to fill this gap within the context of a rural cancer network.

The approach of Norm Balance in predicting pharmacists' intention to collaborate with physicians to improve medication therapy.

Objective: Norm Balance is an approach under the Theory of Planned Behavior (TPB) where subjective norm is weighted by the relative importance of others and self-identity is weighted by the relative importance of self. The relative importance was measured previously by a trade-off measure. In this study, we developed separate measures for the relative importance.

Do human resource systems indeed have "system" effects? The dual internal fit model of a high-performance work system.

The configurational or "internal fit" perspective proposes that human resource (HR) systems are most effective when individual practices are configured such that they fit together and are mutually reinforcing. The Ability-Motivation-Opportunity (AMO) model has emerged as a predominant way to select and configure HR practices based on whether they attempt to enhance employee ability, motivation, or opportunities. Despite the widespread use of the configurational perspective and AMO model in building a high-performance work system (HPWS), researchers have not clearly articulated how HR practices across the AMO domains should be configured to maximize internal fit across the system.

Perceived Food-Related Responsibilities Among Adults Aged 60 Years and Older.

Food citizenship states individuals, organizations, and governments have responsibilities for their actions and policies around food. We conducted twenty semi-structured interviews with older adults as an exploratory study about perceived food-related responsibilities. The government and agribusiness were seen as responsible for food safety and how healthy foods are.

Incidence and risk of post-COVID-19 thromboembolic disease and the impact of aspirin prescription; nationwide observational cohort at the US Department of Veteran Affairs.

Introduction: COVID-19 triggers prothrombotic and proinflammatory changes, with thrombotic disease prevalent in up to 30% SARS-CoV-2 infected patients. Early work suggests that aspirin could prevent COVID-19 related thromboembolic disorders in some studies but not others. This study leverages data from the largest integrated healthcare system in the United States to better understand this association.

An evaluation of thermal tolerance in six tardigrade species in an active and dry state.

Tardigrades are known for their ability to survive extreme conditions. Reports indicate that tardigrade thermal tolerance is enhanced in the desiccated state; however, these reports have almost always used a single tardigrade species and drying/heating methods vary between studies. Using six different species of tardigrades we confirm that desiccation enhances thermal tolerance in tardigrades.

Ultrasonication-Boosted Resorcinol-Formaldehyde Resin Nanoparticle Bromine Fixation and Corresponding Upgraded Aquatic Applications.

Bromine (Br) and related species removal from water systems are rather complicated due to the complicated chemistry instability, and materials with high Br removal rate and efficiency, along with stimuli/apparatus suitable for highly corrosive environments, are necessary. Ultrasonication as a non-destructive process is especially suitable in scenarios where conventional stir apparatus is not applicable, such as highly corrosive environments. Considering the validity nature of Br and combining the advantages of ultrasonic with a highly stable Br fixation method through aromatic polymer nanoparticles, we demonstrate highly efficient acoustic-aided Br removal in aqueous solutions with two times capacity compared to the non-treated sample.

Making the grade? A meta-analysis of academic performance as a predictor of work performance and turnover.

Many organizations assess job applicants' academic performance (AP) when making selection decisions. However, researchers and practitioners recently have suggested that AP is not as relevant to work behavior as it used to be due to factors such as grade inflation and increased differences between academic and work contexts. The present meta-analysis examines whether, and under what conditions, AP is a useful predictor of work behavior.

Natural Language Processing Accurately Differentiates Cancer Symptom Information in Electronic Health Record Narratives.

Purpose: Identifying cancer symptoms in electronic health record (EHR) narratives is feasible with natural language processing (NLP). However, more efficient NLP systems are needed to detect various symptoms and distinguish observed symptoms from negated symptoms and medication-related side effects. We evaluated the accuracy of NLP in (1) detecting 14 symptom groups (ie, pain, fatigue, swelling, depressed mood, anxiety, nausea/vomiting, pruritus, headache, shortness of breath, constipation, numbness/tingling, decreased appetite, impaired memory, disturbed sleep) and (2) distinguishing observed symptoms in EHR narratives among patients with cancer.

The identity conflict process: Appraisal theory as an integrative framework for understanding identity conflict at work.

Identity conflict-the experience of perceiving incompatibilities between aspects of one's identity content that call into question the individual's ability to meet the identity standard of at least one of these identities-can significantly impact individuals' work experiences. As individuals navigate experiences of identity conflict at work, managers and organizations also grapple with how to support employees' multiple identities while mitigating the primarily negative outcomes of identity conflict. However, the scholarship on work-relevant identity conflict faces several challenges, including disciplinary fragmentation, conceptual imprecision, and diverse but deficient theoretical perspectives, which together have limited our ability to accumulate knowledge about this experience and to develop useful management tools.

Home health utilization in the Veterans Health Administration: Are there rural and urban differences?

Purpose: Growing numbers of older adults need home health care, yhese services may be more difficult to access for rural Veterans, who represent one-third of Veterans Health Administration (VA) enrollees. Our objective was to examine whether home health use differs within VA based on rurality.

Methods: We examined national VA administrative data for 2019-2021 (January 1, 2019 to December 31, 2021) among Veterans ages ≥65 years.

Perceptions of Responsibilities by Primary Care Staff in a Patient-Centered Medical Home.

Objective: To examine the extent to which Veterans Health Administration (VHA) Patient-Aligned Care Team (PACT) members have a shared understanding/ agreement upon and enact responsibilities within the team.

Background: The PACT model focuses on team-based care management. However, lack of a shared understanding of team-based care management roles and responsibilities makes system-wide implementation a challenge.

WORKING AT THE TOP OF THEIR CAPABILITIES: HOW TEAMWORK SUPPORT ATTENUATES LEADER ROLE CONFLICT.

Objective: To understand whether team member support reduces team leader stress.

Method: In Phase 1, we used hierarchical linear modeling with survey data and administrative records from 45 Veterans Health Administration teams (73 providers and 228 associated members) to investigate how teamwork support mitigates leader stress. In Phase 2, we adopted a parallel/simultaneous mixed methods design, utilizing open- and closed-ended responses from 267 additional Veterans Health Administration providers.

Rural comprehensive cancer care: Qualitative analysis of current challenges and opportunities.

Purpose: While limited resources can make high-quality, comprehensive, coordinated cancer care provision challenging in rural settings, rural cancer patients often rely on local hospitals for care. To develop resources and strategies to support high-quality local cancer care, it is critical to understand the current experiences of rural cancer care physicians, including perceived strengths and challenges of providing cancer care in rural areas.  METHODS: Semi-structured interviews were conducted with 13 cancer providers associated with all 12 non-metropolitan/rural Iowa hospitals that diagnose or treat >100 cancer patients annually.

Development and Testing of the Relational and Structural Components of Innovativeness Across Academia and Practice for Healthcare Progress Scale.

Objective: Using data from 5 academic-practice sites across the United States, researchers developed and validated a scale to measure conditions that enable healthcare innovations.

Background: Academic-practice partnerships are a catalyst for innovation and healthcare development. However, limited theoretically grounded evidence exists to provide strategic direction for healthcare innovation across practice and academia.

Participation in Advance Care Planning Among Medically At-Risk Rural Veterans: Protocol for a Personalized Engagement Model.

Background: Many of the challenges in advanced care planning (ACP) conversations are linked to the waxing and waning progress of serious illnesses. Conversations with patients about future medical care decisions by a surrogate decision maker have historically been left until late in the patient's disease trajectory. These conversations often happen at a time when the patient is already very ill.

Determinants of Patient Aligned Care Team (PACT) members' burnout and its relationship with patient-centered care.

Burnout is a prevalent issue among healthcare providers affecting up to 54% of physicians and 35% of nurses. Patient Aligned Care Teams (PACT) is a team-based primary care delivery model designed to assure the delivery of high-quality care while improving clinicians' well-being. Limited studies evaluated the relationship between work environment variables and PACT members' burnout and the relationship between PACT members' burnout and patient-centered care.

Prediction of Cancer Symptom Trajectory Using Longitudinal Electronic Health Record Data and Long Short-Term Memory Neural Network.

Purpose: Ability to predict symptom severity and progression across treatment trajectories would allow clinicians to provide timely intervention and treatment planning. However, such predictions are difficult because of sparse and inconsistent assessment, and simplistic measures such as the last observed symptom severity are often used. The purpose of this study is to develop a model for predicting future cancer symptom experiences on the basis of past symptom experiences.

Rural Emergency Medical Services Clinicians' Perceptions and Preferences in Receiving Clinical Feedback From Hospitals: A Qualitative Needs Assessment.

Objective: Emergency medical services (EMS) clinicians experience dissatisfaction with the quality and quantity of clinical feedback from hospitals. Satisfaction is further diminished by the lack of a standardized systems approach. The purpose of this study was to identify rural clinicians' perceptions and preferences regarding clinical feedback received from hospitals, the delivery mechanisms, and its impact on their relationships with health care organizations.

Comparison of Time to Intubation of a Double-Lumen Endobronchial Tube Utilizing C-MAC® Versus GlideScope® Versus Macintosh Blade: A Randomized Crossover Manikin Study.

Background: Macintosh blade direct laryngoscopy is widely used for endotracheal intubation. It may, however, provide an incomplete view of the glottis in patients with challenging airway anatomy. Consequently, various video laryngoscopes have been developed to enhance the visualization of the glottis and facilitate intubation.