Coaching and Communication Training for HPV Vaccination: A Cluster Randomized Trial.

Background And Objectives: US health departments routinely conduct in-person quality improvement (QI) coaching to strengthen primary care clinics' vaccine delivery systems, but this intervention achieves only small, inconsistent improvements in human papillomavirus (HPV) vaccination. Thus, we sought to evaluate the effectiveness of combining QI coaching with remote provider communication training to improve impact.

Methods: With health departments in 3 states, we conducted a pragmatic 4-arm cluster randomized clinical trial with 267 primary care clinics (76% pediatrics).

Acute Traumatic Spinal Cord Injury: Implementation of a Multidisciplinary Care Pathway.

Background: Management of acute traumatic spinal cord injuries is complex, and patients are at risk for severe complications while inpatient. Performance review revealed opportunities for improvement in the care of patients with acute traumatic spinal cord injury at our institution.

Objective: To compare mortality, failure-to-rescue, and health care utilization of patients with acute traumatic spinal cord injury after implementation of a revised multidisciplinary care pathway.

Affective domain predictors of PharmD student pursuit of and successful matching for postgraduate pharmacy residency training.

Purpose: A study was conducted to identify significant associations between affective domain (AD) features identified using the Birkman Method assessment and students' likelihood to pursue and to successfully match for postgraduate residency training (PGRT), while controlling for demographic and academic variables known to impact PGRT match rates.

Methods: A retrospective analysis of 3 graduating classes of PharmD students from 2 colleges of pharmacy was performed. Data points such as PGRT match results, PGRT pursuit, student demographics, academic performance information, and AD data from the Birkman assessment were analyzed.

External Support for Saphenous Vein Grafts in Coronary Artery Bypass Surgery: A Randomized Clinical Trial.

Importance: Intimal hyperplasia and subsequent saphenous vein graft failure may have significant adverse clinical effects in patients undergoing coronary artery bypass surgery. External support of saphenous vein grafts has the potential to prevent vein graft dilation and hence slow the rate of intimal hyperplasia and increase long-term vein patency.

Objective: To determine efficacy, as measured by intimal hyperplasia, and safety of an external saphenous vein graft support device in patients undergoing a coronary bypass graft procedure.

The Continued Impact of the COVID-19 Pandemic on Pediatric Obesity: A Commentary on the Return to a Healthy New "Normal".

Two years into this pandemic, mental health symptoms are more prevalent in children and adolescents, routine wellness visits have decreased, individuals and families are experiencing increased stress, and food and nutrition insecurity are on the rise. Pediatric overweight and obesity are yet another health condition that has been impacted by the pandemic. The current commentary aims to (a) summarize a variety of factors contributing to worsening obesity and healthy lifestyle choices in youth throughout the pandemic and to (b) provide recommendations for healthcare providers on navigating this challenge.

Low initial in-hospital end-tidal carbon dioxide predicts poor patient outcomes and is a useful trauma bay adjunct.

Introduction: Appropriate triage of the trauma patient is critical. Low end-tidal carbon dioxide (ETCO2) is associated with mortality and hemorrhagic shock in trauma, but the relationship between low ETCO2 and important clinical variables is not known. This study investigates the association of initial in-hospital ETCO2 and patient outcomes, as well as the utility of ETCO2 as a predictive aid for blood transfusion.

Outcomes after emergency general surgery and trauma care in incarcerated individuals: An EAST multicenter study.

Background: The US incarcerates more individuals than any other country. Prisoners are the only population guaranteed health care by the US constitution, but little is known about their surgical needs. This multicenter study aimed to describe the acute care surgery (ACS) needs of incarcerated individuals.

Analysis of accumulated SARS-CoV-2 seroconversion in North Carolina: The COVID-19 Community Research Partnership.

Introduction: The COVID-19 Community Research Partnership is a population-based longitudinal syndromic and sero-surveillance study. The study includes over 17,000 participants from six healthcare systems in North Carolina who submitted over 49,000 serology results. The purpose of this study is to use these serology data to estimate the cumulative proportion of the North Carolina population that has either been infected with SARS-CoV-2 or developed a measurable humoral response to vaccination.

A randomized double-blind, placebo-controlled pilot trial of mirtazapine for anxiety in children and adolescents with autism spectrum disorder.

This study was a 10-week double-blind, placebo-controlled pilot trial of mirtazapine for anxiety in youth with autism spectrum disorder (ASD). Participants were ages 5 to 17 years with ASD and clinically significant anxiety (Pediatric Anxiety Rating Scale [PARS] score ≥10). Thirty participants were randomized to mirtazapine (7.

Medications for opioid use disorder during pregnancy: Access and continuity in a state women's prison facility, 2016-2019.

Background: Although medications to treat opioid use disorder (MOUD) are the standard of care during pregnancy, there are many potential gaps in the cascade of care for pregnant people experiencing incarceration.

Methods: We conducted a retrospective cohort study of pregnant people with opioid use disorder incarcerated in a Southeastern women's prison from 2016 to 2019. The primary outcomes were access to MOUD during incarceration and continuity in the community.

Novel use of a sequential standardized oral board exam to assess PGY1 resident progression.

Purpose: A standardized oral board exam was created to longitudinally assess postgraduate year 1 (PGY1) pharmacy residents in key domains.

Summary: We provide a descriptive review of a novel oral board exam administered quarterly to our PGY1 pharmacy residents. Preceptors from our core rotations (internal medicine/infectious diseases, adult critical care, oncology, pediatrics, and administration/health policy and outcomes) developed questions based on situations commonly encountered by PGY1 residents to assess residents' communication; the content of their response, assessment, and plan; and coachability.

Rationale and design of a randomized trial evaluating an external support device for saphenous vein coronary grafts.

Background: Coronary artery bypass grafting (CABG) is the most common revascularization approach for the treatment of multi-vessel coronary artery disease. While the internal mammary artery is nearly universally used to bypass the left anterior descending coronary artery, autologous saphenous vein grafts (SVGs) are still the most frequently used conduits to grafts the remaining coronary artery targets. Long-term failure of these grafts, however, continues to limit the benefits of surgery.

Lessons Learned from a Quality Improvement Initiative: Adverse Childhood Experiences Screening in a Pediatric Clinic.

Unlabelled: Universal screening for adverse childhood experiences (ACEs) is recommended by the American Academy of Pediatrics due to downstream health risks. However, widespread screening practices have not been adopted.

Methods: We used quality improvement methods to establish ACEs screening in a busy pediatric clinic that serves primarily Medicaid-insured and Spanish-speaking patients.

Causes of death following discharge after trauma in North Carolina.

Background: While a "fourth peak" of delayed trauma mortality has been described, limited data describe the causes of death (CODs) for patients in the years following an injury. This study investigates the difference in COD statewide for patients with and without a recent trauma admission.

Methods: This retrospective cohort study compared COD for trauma and nontrauma patients in North Carolina.

Characteristics of an Outbreak of E-cigarette, or Vaping, Product Use-Associated Lung Injury-North Carolina, 2019.

In August 2019, the North Carolina Division of Public Health (NCDPH) began investigating e-cigarette, or vaping, product use-associated lung injury (EVALI) cases as part of a national response. We describe clinical, epidemiologic, and laboratory findings of North Carolina EVALI patients. NCDPH requested that physicians report cases of respiratory illness or bilateral pulmonary infiltrates or opacities in patients who reported using e-cigarette, or vaping, products and had no infection or alternative plausible diagnoses.

An Innovative Nurse Staffing Model: Nurses Are Happy2Help and Strike the Right Balance.

Objective: The aim of this study was to develop a flexible nurse reallocation solution.

Background: Successful nurse reallocation supports appropriate staffing and may enhance workforce flexibility.

Methods: An innovative program incentivizing regular nursing staff to volunteer for extra shifts systemwide was implemented at a large healthcare organization.

Management of blunt traumatic abdominal wall hernias: A Western Trauma Association multicenter study.

Background: Blunt traumatic abdominal wall hernias (TAWH) occur in approximately 15,000 patients per year. Limited data are available to guide the timing of surgical intervention or the feasibility of nonoperative management.

Methods: A retrospective study of patients presenting with blunt TAWH from January 2012 through December 2018 was conducted.

Prehospital end-tidal carbon dioxide is predictive of death and massive transfusion in injured patients: An Eastern Association for Surgery of Trauma multicenter trial.

Background: Prehospital identification of the injured patient likely to require emergent care remains a challenge. End-tidal carbon dioxide (ETCO2) has been used in the prehospital setting to monitor respiratory physiology and confirmation of endotracheal tube placement. Low levels of ETCO2 have been demonstrated to correlate with injury severity and mortality in a number of in-hospital studies.

The Impact of Vaping on Primary Spontaneous Pneumothorax Outcomes.

Introduction: Cigarette smoking is associated with primary spontaneous pneumothorax (PSP). Electronic cigarettes (E-cigarettes) are touted as a healthier alternative to cigarettes; however, the impact E-cigarette use has on PSP management is not known. The goal of this study was to determine if E-cigarette use is associated with inferior outcomes after PSP, compared to never smokers and cigarette smokers.