Investigating Moral Distress in Clinical Research Professionals-A Deep Dive into Troubled Waters.

Moral distress occurs when professionals are constrained from taking what they believe to be ethically appropriate actions or are forced to take actions they believe are ethically inappropriate, challenging their professional identities and representing systems-level issues within organizations. Moral distress has been recognized in a variety of health care-related fields; however, the phenomenon is still comparatively unexplored among clinical research professionals (CRPs). In this qualitative study, we interviewed ten CRPs to unearth root causes of moral distress in this ethically unique profession.

Securement of Tracheostomy Collar After Free Flap Surgery for Patients With Head And Neck Cancer.

Background: For patients with head and neck cancer who have undergone microvascular free flap surgery, securing a tracheostomy collar onto the neck using the traditional method (ie, with tracheostomy ties) is contraindicated because the ties may compress the newly vascularized tissue. However, no clear guidance exists for the use of other methods in these patients. Current techniques often use safety pins, which can cause injury to staff members.

Who Should Contribute to Decisions About Health Care Space Design?

This commentary on a case considers how and by whom decisions about health care structures and spaces should be made and suggests merits and drawbacks of shared decision-making as one approach to Certificate of Need assessments.

A Wireless and Wearable Multimodal Sensor to Non-Invasively Monitor Transabdominal Placental Oxygen Saturation and Maternal Physiological Signals.

Poor placental development and placental defects can lead to adverse pregnancy outcomes such as pre-eclampsia, fetal growth restriction, and stillbirth. This study introduces two sensors, which use a near-infrared spectroscopy (NIRS) technique to measure placental oxygen saturation transabdominally. The first one, an NIRS sensor, is a wearable device consisting of multiple NIRS channels.

Why Voting and Voter Disenfranchisement Matter to Health.

Nurses can play a crucial role as trusted advocates.

Assessing and Addressing the Determinants of Appalachian Population Health: A Scoping Review.

Introduction: Residents of Appalachia experience elevated rates of morbidity and mortality compared to national averages, and these disparities are associated with inequitable exposures to various determinants of population health. Social and environmental determinants of health are a useful lens through which to develop and evaluate programs to mitigate regional health disparities.

Methods: This 2023 scoping review was conducted of studies linking determinants of Appalachian health with leading causes of regional mortality and morbidity.

Lapses in Long-Term Care Insurance.

About a quarter of long-term care insurance (LTCI) policy holders aged 65 let their policies lapse prior to death, forfeiting all benefits. We find that lapse rates are substantially higher among the cognitively impaired in the Health and Retirement Study. This generates a pernicious form of dynamic advantageous selection, as the cognitively impaired are more likely to use care.

Tricarboxylic acid (TCA) cycle, sphingolipid, and phosphatidylcholine metabolism are dysregulated in infection-induced cachexia.

Cachexia is a life-threatening disease characterized by chronic, inflammatory muscle wasting and systemic metabolic impairment. Despite its high prevalence, there are no efficacious therapies for cachexia. Mice chronically infected with the protozoan parasite represent a novel animal model recapitulating the chronic kinetics of cachexia.

Fleeing Iraq with nothing but a dream.

Facing the harsh realities of life as a refugee in Jordan and the United States, an ambitious young man holds to a conviction: that he will, one day, get a PhD.

Remnant Blood Quantification: Informing the Definition of Minimal Risk in Clinical Research.

Guidelines from the Office for Human Research Protections regarding categories of research that institutional review boards (IRBs) may review through expedited procedures limit the volume of blood that can be obtained from research participants for minimal risk research purposes. As defined by the Common Rule, minimal risk research is research in which the probability and magnitude of harm or discomfort anticipated are not greater than the probability and magnitude of harm or discomfort encountered from routine clinical tests. For this study, we considered the volume of remnant blood following routine clinical tests in light of the current definition of minimal risk in research.

Thin Films on the Skin, but not Frictional Agents, Attenuate the Percept of Pleasantness to Brushed Stimuli.

Brushed stimuli are perceived as pleasant when stroked lightly on the skin surface of a touch receiver at certain velocities. While the relationship between brush velocity and pleasantness has been widely replicated, we do not understand how resultant skin movements - e.g.

Entrustable professional activities as a training and assessment framework in undergraduate medical education: A case study of a multi-institutional pilot.

In 2014, the Association of American Medical Colleges (AAMC) published 13 Core Entrustable Professional Activities (EPAs) that graduating students should be able to perform with indirect supervision when entering residency. A ten-school multi-year pilot was commissioned to test feasibility of implementing training and assessment of the AAMC's 13 Core EPAs. In 2020-21, a case study was employed to describe pilot schools' implementation experiences.

Topical autologous blood clot therapy: consensus panel recommendations to guide use in the treatment of complex wound types.

The etiology of acute and chronic wounds goes beyond those often reported in the literature, including those with exposed structures, those in which the entire wound bed cannot be visualized, and patients who are not candidates for typical standard of care. Treatment options for these patients may be limited. TABCT is a viable option for these complex wound types and is not hindered by logistical, procedural, or patient factors.

Sclerodermiform Lupus Erythematosus: A Series of Five Patients.

Background: Sclerodermiform lupus erythematosus (SDLE) is a rare Type 3 overlap syndrome of morphea and cutaneous lupus diagnosed with histopathologic features of both diseases present. It was first reported in 1976 by Umbert et al with a case series of four patients. SDLE is more common in young to middle-aged female patients.

Palliative Sedation Therapy: A Case Report.

Introduction: Despite repeated exposure to dying patients, critical care providers and nurses may not be familiar with palliative sedation. This case report describes a scenario in which palliative sedation therapy was considered for a patient dying in the intensive care unit.

Clinical Findings: A 72-year-old woman was transferred from an outside hospital for management of severe acute respiratory distress syndrome.

Strategies for successfully completing a DNP final project.

Completion of a final project is an essential component of Doctor of Nursing Practice programs. Strategies for successful project planning, implementation, and evaluation are outlined, from identifying an evidence-based practice or quality improvement project, advisor, and practice mentor through completion, presentation, and dissemination of your work.

Topical autologous blood clot therapy: an introduction and development of consensus panel to guide use in the treatment of complex wound types.

Complex or hard-to-heal wounds can be acute or chronic; the complexity is based on patient-specific local, systemic, and psychosocial factors. Use of autologous tissue can be a significant adjunct to wound closure. Grafts and flaps are the most common autologous tissue used in wound reconstruction.

Broad Consent-Are We Asking Enough?

Biobanks and health data repositories provide rich reservoirs of information for use in biomedical research. These repositories depend on participants donating identifiable health data and biospecimens that may be used in perpetuity by unlimited numbers of researchers for unnamed research topics. Since 1991, U.

Adolescent Patient, Parent, and Clinician Perceptions of Rehabilitation After Anterior Cruciate Ligament Reconstruction: A Qualitative Study.

Context: Rehabilitation after anterior cruciate ligament reconstruction (ACLR) is challenging for adolescent patients concurrently experiencing growth and development, changes in attitudes and social interactions, and a gradual shift toward independence.

Objective: To examine the perceptions of information sharing and interpersonal communication among adolescent patients going through ACLR, their parents, and physical therapists (PTs) treating adolescent patients with ACLR.

Design: Cross-sectional study.

Thin Films on the Skin, but not Frictional Agents, Attenuate the Percept of Pleasantness to Brushed Stimuli.

Brushed stimuli are perceived as pleasant when stroked lightly on the skin surface of a touch receiver at certain velocities. While the relationship between brush velocity and pleasantness has been widely replicated, we do not understand how resultant skin movements - e.g.

Screening for hypertrophic cardiomyopathy.

Hypertrophic cardiomyopathy (HCM) is the most common inherited cardiomyopathy and causes changes in the cardiac muscle affecting ventricular, valvular, and cellular functions. Because HCM is an inherited disorder, all age groups are affected; however, it commonly presents in adolescents, especially athletes. Many patients are asymptomatic and undiagnosed, putting them at risk for sudden cardiac death.