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Developments in the field of organic-inorganic lead halide perovskite based solar cells have metaphorically opened the door to an exciting new solid state photovoltaic technology that retains the low cost and processability benefits of dye sensitised solar cells (DSCs). Encouraging device efficiencies of greater than 10% on both titania and alumina, and as a planar device, have been reported in the literature. Here we report the characteristics of a series of lead iodide/bromide perovskites. As one might expect, changing the halide(s) alters the crystal structure and band gap of the perovskite which results in the possibility of vivid and colourful solar cells; a characteristic which is seen as one of the main benefits of DSCs. X-ray diffraction and scanning electron microscopy with elemental mapping via energy dispersive X-ray analysis has been used to characterise perovskites on sensitised thin films. UV-vis and diffuse reflectance has been used to study the optical characteristics of crystallised perovskite thin films. Finally device performance is evaluated and suitability for use in photovoltaic devices is discussed. [ABSTRACT FROM AUTHOR]

E-cigarettes are electronic devices that deliver vaporised nicotine liquid into the lungs. Since the introduction of e-cigarettes in 2004, the market in the UK has rapidly expanded and increasingly people are asking health professionals about them. This article gives an overview of e-cigarettes, their use, their regulatory status and evidence for their safety, quality and efficacy. Advice about e-cigarettes for dental health professionals to give patients is provided, as well as the five questions, proposed by Action on Smoking and Health, to consider when deciding whether to permit or prohibit use of e-cigarettes on premises. [ABSTRACT FROM AUTHOR]

Anhydrous ruthenium dioxide powder spontaneously decomposes to ruthenium metal on irradiation in a 1000 W domestic microwave oven to form microwires of about 5–30 μm diameter and up to several millimetres in length. Localised differences in temperature during irradiation and arcing close to the material lead to the assembly of wire structures with different morphologies and dimensions. Nanorods (250 nm diameter) of metal/oxide material are also observed to form emanating from the spine of some wires. [ABSTRACT FROM AUTHOR]

The effects of two plasticisers, one phthalate and one sulphonic acid ester, on the photodegradation of TiO2 pigmented polyvinylchloride films are reported. The loading of each plasticiser was altered in the range 0–70% relative to the polyvinylchloride and the effects on the rates of photomineralisation were determined using a closed loop flow system to detect the carbon dioxide evolution. All plasticiser additions lead to an initial acceleration in CO2 evolution over the non-plasticised cases. Non-plasticised films show a marked acid catalysis due to HCl evolution which leads to an acceleration in the rate of oxidation with time. Following initial rapid oxidation of preadsorbed plasticiser, the phthalate systems demonstrated a reduced rate of CO2 production and no acid catalysis. The sulphonic acid ester plasticiser is broken down to produce sulphonic acid and sulphuric acid fragments which are sufficiently acidic to catalyse the TiO2 when plasticiser loadings are >50%. The carboxylic acid fragments from the phthalates seem incapable of catalysis even at the highest levels used in the present work. [ABSTRACT FROM AUTHOR]

Most organic coatings, regardless of colour, are pigmented with titanium dioxide (TiO2) to increase their covering power. TiO2 in its anatase crystal form is highly photoactive under ultraviolet (UV) irradiation. Photo activation of TiO2 causes the formation of free radicals, which can interact with the organic matrix, causing accelerated degradation of the polymeric coating. This releases carbon dioxide (CO2) via a series of reactions initiated by surface bound hydroxyl radicals. To identify which type and concentration of coloured pigment provides the most photostable formulation of TiO2 containing organic coating, model coatings containing different coloured pigments and loadings have been assessed using a novel flat panel irradiation reactor. The rate of CO2 evolved by the irradiated sample, measured using a Fourier transform infrared (FTIR) spectrometer, has been used to quantify the degradation induced by individual pigment combinations. Yellow chromium titanate pigments are ineffective in stabilisation of the TiO2 driven oxidation largely owing to poor light absorption properties and carbon black pigments are only effective at higher loadings where light absorption outweighs charge percolation. Red organic pigments can potentially sensitise degradation while the blue and green pigments tested offer the best stabilisation of TiO2 driven degradation over the range 0·1–10% per hundred resin (PHR) owing to their superior absorption of near ultraviolet A (UVA) light (at 380 nm) which activates the TiO2. [ABSTRACT FROM AUTHOR]

A range of bentonite clays such as Wyoming (W), hybond (H), cat litter (CL) and versions exchanged with Ce3+, Y3+, La3+ and Ca2+ cations used as the corrosion inhibitors in the 5 μm polyester primer layer applied to 0·7 mm gauge hot dip zinc (0·15%Al) galvanised steel materials, over coated with a 20 μm architectural polyester coating. Similar primer systems have been prepared containing strontium chromate (Cr), Shieldex (Shd) and titanium dioxide (TiO2) for the purposes of comparison. The scanning vibrating electrode technique (SVET) was used to probe the corrosion kinetics at sample cut edges immersed in 5%NaCl on a limited number of the coatings based on the Wyoming bentonite. The SVET determined zinc losses for the pigments tested over 24 h were as follows: Shd (920 μg), Cr (740 μg), W–Y (655 μg), W–Ce (560 μg), W (550 μg) and W–Ca (496 μg). The same samples together with all of the other pigmented coatings were also subjected to salt spray testing. The average maximum cut edge corrosion delamination distances were: Cr (14 mm), Shd (20 mm), TiO2 (100 mm), W (13 mm), H (17 mm), CL (14 mm), W–Ca (10 mm), H–Ca (15 mm) W–Ce (9 mm), H–Ce (10 mm), W–Y (13 mm) and H–Y (15 mm). The performance trends over 1000 h of salt spray testing were in broad agreement with the 24 h SVET data for those samples tested in both ways. The ion exchanged and naturally occurring bentonites appear to be promising corrosion inhibitors for coated galvanised steel. In order to maximise performance, a fully formulated system has been developed on a 4·5Al–95·5Zn galvanised substrate which has a PVC plastisol top coat. A bentonite matrix with higher ion exchange capacity (>1 mequiv g-1) and low silica content has been developed (IM–X, where X is Ce3+, Ca2+ or Zn2+). In this system delamination distances have been reduced to extremely low levels of IM–Ce 0·3 mm, IM–Ca 0·45 mm and IM-Zn 0·37 mm. [ABSTRACT FROM AUTHOR]

Hydrotalcite additions (up to 10 PHR) are shown to stabilise unplasticised polyvinylchloride (UPVC) against TiO2 photocatalysed degradation. Without stabilisation, hydrogen chloride, produced through dehydrochlorination, catalyses the TiO2 sensitised degradation after a set period of reaction leading to an increase in rate from 13 to 32 μmol m-2 min-1. Hydrotalcite removes chloride by anion exchange releasing carbonate ions in the PVC removing this autocatalytic pathway. [ABSTRACT FROM AUTHOR]

Increasing experience with positron emission tomography (PET) scanning in breast cancer patients is revealing a significant role for this imaging modality. This report summarizes the experience of 2-[F18]fluoro-2-deoxy-D-glucose (FDG) PET scanning in 165 breast cancer patients from the BC Cancer Agency, British Columbia, Canada, and reviews the literature on this topic. Using the database at PETSCAN Vancouver, we identified imaged patients with a diagnosis of breast cancer. We then conducted a retrospective review of these patients' BC Cancer Agency charts to extract demographic and follow-up information. Between November 2000 and March 2003 we identified 165 patients with histologically confirmed breast cancer who had undergone PET scanning, were registered at the BC Cancer Agency, and had follow-up information. The median patient age was 52 years. The sensitivity of PET in detecting axillary metastases was 28%, and the specificity was 86%. At diagnosis, 5% of patients were diagnosed with distant metastases. In patients undergoing PET scanning because of suspected recurrence, the sensitivity and specificity for detecting recurrence were 89% and 88%, respectively. Distant metastases were demonstrated in 30% of patients who were thought only to have local-regional recurrence. The results suggest that there are two clinical situations in which PET appears to be particularly valuable. The first is in the evaluation of patients who are suspected of having a tumor recurrence. The other is in identifying patients with multifocal or distant sites of malignancy who otherwise appear to have an isolated, potentially curable, local-regional recurrence. [ABSTRACT FROM AUTHOR]

The scanning vibrating electrode technique (SVET) is shown to be a reasonably reliable and very rapid test method for ranking the cut edge corrosion resistance of zinc aluminium alloy galvanised steels. The data obtained in 24 h relates directly to the organic coating delamination, determined by 5 years external weathering, and zinc metal ion runoff resistance, determined by up to 24 months external exposure. By altering the chemical composition and the processing conditions of the 4·5%Al containing zinc galvanising layer on 0·7 mm gauge steel, the volume percentage of primary zinc evolved during solidification has been carefully controlled to increase from 27(±0·25)% to 30(±0·25)%. In addition, the number of primary zinc dendrites was also significantly altered from ca 600 to ca 1600 mm-2. SVET corrosion tests performed on the cut edge of organically coated samples of these materials revealed that as the volume percentage of primary phase and number of dendrites increased the intensity of corrosion increased (with SVET determined current density maxima increasing from 8 A m-2 to 13 A m-2). The average total zinc loss (tzl) measured using SVET in the 24 h exposure also increased (from 166 μg to 309 μg). Zinc ion enriched rain water collected as runoff from externally weathered samples (industrial/marine location) revealed similar performance trends to those from the SVET, with the primary zinc volume fraction controlling the zinc ion release in each case. This is repeated for zinc runoff measurements recorded between 3 and 24 months exposure. Analysis of the total organic coating delamination area after five years external weathering showed direct correlation with zinc ion runoff levels from the coating over the first 24 months and also to the SVET zinc losses measured in 24 h. Hence, the SVET appears to be a reliable and rapid tool for metallic coating optimisation, and associated runoff measurements can be used as an environment specific corrosion test with an accurate performance indication within 3 months. [ABSTRACT FROM AUTHOR]

A closed system incorporating FTIR continuous monitoring of the gas phase and a novel gas cell for the UV irradiation of flat panels of organic coatings is described. This has been used to probe various aspects of the photocatalysed degradation of TiO2 pigmented polymer films under UVA illumination. The flat panel cell is machined from a single block of aluminium and is specifically designed to minimise dead volumes, enable rapid gas mixing and be suitable for the investigation of flat coupons of material up to 220 × 100 mm in size. The cell incorporates a gas input and output channel in its base feeding and fed by small bore holes drilled in such a way as to maximise the exhaustive effects on the contents of the cell. To demonstrate the effectiveness of the design the effect of TiO2 pigment photoactivity on the rates of degradation of a commercial acrylic emulsion paint using commercial photostable TiO2 grades is reported. In testing using this new reactor configuration it has been possible to correlate photoactivities obtained over periods of several thousand hours Xenon Arc exposure, which is the most reliable test currently available. The test cell has also been used to evaluate other coating components. Using unplasticised PVC films we have found that the rate of photogenerated CO2 falls by up to 40% when a simple molecular UV absorber (2 hydroxybenzophenone) is added at levels of up to levels of 1.5% per hundred resin (PHR). Beyond this there is little further reduction in photoactivity. Finally the test cell has been used to investigate the effects of TiO2 loading on the rates of CO2 evolution from irradiated unplasticised PVC films pigmented with 0–70 PHR TiO2. The initial rate of photodegradation (over 100 min) follows a linear trend to increased CO2 evolution rates up to 50 PHR TiO2. There is a transition to a secondary rate after the production of 1.8 mmol m-2 of CO2 suggesting that after a set amount of degradation there is a change in the reaction rate. This rate is still proportional to the concentration of TiO2. It is likely that this is due to a combination of acid catalysis and the generation of porosity in the irradiated surface, the latter enabling greater oxygen access to the irradiated TiO2. [ABSTRACT FROM AUTHOR]

The effect of cooling rate on the coating microstructure and corrosion resistance of Zn - 4.5 wt-%Al alloy galvanising coatings applied to 0.7 mm gauge strip steel substrates is presented. Increasing the cooling rate by the use of a high powered air cooler does not significantly alter the volume fraction of primary zinc in the alloy coating layer, which remains at ~ 14 vol.-%. There is, however, a dramatic change in the number and size of dendrites with far greater numbers (changing from 270 to 1500 mm[sup 2]) of smaller dendrites as the cooling rate is increased using cooler outputs of 55 and 100%, respectively. This corresponds to a change in the surface appearance of the material with the surface spangle (i.e. eutectic cell) size being reduced from 7.5 to 2.1 mm as the cooling rate is increased. Since the volume fraction of the primary zinc remains roughly constant and the dramatic change is in the size and numbers of dendrites, it appears that this phenomenon is related to increased nucleation of primary zinc. The scanning vibrating electrode technique (SVET) has been used to investigate the effects of these microstructural changes on the corrosion mechanism and kinetics. The SVET isocurrent contour maps show a dramatic reduction in corrosion intensity with increasing cooling rate. This is borne out by metal loss calculations, which show that the zinc losses from the coating are 2500, 1200 and 200 μg at cooler outputs 55, 80 and 100%, respectively. More significantly, the anodes display shorter lifetimes and lower intensities for the materials produced at the higher cooling rate. One quarter of the anodes in the specimen cooled at 55% remained active throughout the 24 h immersion period compared with 4% of the anodes in the specimen cooled at 100%. The spangle size is directly related to the cooling rate and the microstructure and can be related directly to the cut edge corrosion resistance as determined by SVET. [ABSTRACT FROM AUTHOR]

A scanning Kelvin probe technique has been used to study the influence of pretreatment and pigment interaction on the kinetics and mechanism of corrosion driven delamination processes affecting model polyvinyl butyral coatings adherent to the intact zinc surface of hot dip galvanised steel. The effects of incorporating dispersions of strontium chromate (SrCrO[sub 4]), silica and bentonite based Cerium (III) cation exchange pigments within the polyvinyl butyral coating are investigated on galvanised steel specimens in the absence and presence of a mixed oxide/chromate rinse surface pretreatment. Placing aqueous sodium chloride electrolyte onto a penetrative coating defect establishes an electrochemical delamination cell in which cathodic O[sub 2] reduction at the delamination front is coupled to anodic zinc dissolution at the coating defect by a thin layer of electrolyte which ingresses beneath the delaminated polyvinyl butyral film. The SrCrO[sub 4] pigmented polyvinyl butyral films allow CrO[sub 4][sup 2-] diffusion directly into the underfilm electrolyte layer and profoundly inhibit delamination both in the presence and absence of pretreatment. Without pretreatment delamination is progressively retarded by increasing SrCrO[sub 4] pigment volume fraction. The addition of the pretreatment decreases the delamination rate in all cases by around between 20 and 50%, probably through improved adhesion to the metal substrate. In contrast, polyvinyl butyral films containing dispersed cerium exchanged bentonite clay (CEB) and cerium exchanged Shieldex (CES) pigments do not efficiently inhibit delamination in the absence of the mixed oxide pretreatment. In the presence of pigment volume fractions of up to 0[sup .]15, the delamination rate is only decreased to ~20% of its original value. However, when used in conjunction with a pretreated surface, both CEB and CES pigments profoundly inhibit corrosion driven delamination, with observed rates reduced to levels below those measured for the SrCrO[sub 4] pigmented system. Thus there appears to be a synergy between the CEB and CES pigments and the mixed oxide (chromate rinse) pretreatment. This synergy is believed to be related either to the ease with which a cerium hydr(oxide) inhibition film can form on the oxide covered surface of the pretreated material, or to the underfilm interaction of pigment derived cathodic (Ce[sup 3+]) and pretreatment derived anodic (CrO[sub 4][sup 2-]) inhibitors. [ABSTRACT FROM AUTHOR]

The authors report a case of metastatic breast carcinoma that on investigation was shown to have a negative bone scan in spite of multiple densely sclerotic metastases on radiography and CT and a positive bone biopsy. The literature is reviewed with regard to the subject of negative bone scans in this situation. [ABSTRACT FROM AUTHOR]

Supplemental intravitreal gas injection was used in the early postoperative period in an attempt to achieve long term retinal reattachment in 11 cases of failed scleral buckling surgery. Success was dependent on the presence of a correctly placed scleral buckle underlying all breaks. Surgical revision was thereby avoided in these patients. However, when the scleral buckle was inadequate the technique failed. [ABSTRACT FROM PUBLISHER]

A dose of ascorbic acid 1 G. daily restores normal sweating in 1 week, in areas of skin in which hypohidrosis and prickly heat have been induced by polythene occlusion for 48 hr. [ABSTRACT FROM AUTHOR]

Purpose: To assess the impact of attenuation and scatter corrections on the calculation of single photon emission computed tomography (SPECT)-weighted mean dose (SWMD) and functional volume segmentation as applied to radiation therapy treatment planning for lung cancer.Methods and Materials: Nine patients with lung cancer underwent a SPECT lung perfusion scan. For each scan, four image sets were reconstructed using the ordered subsets expectation maximization method with attenuation and scatter corrections ranging from none to a most comprehensive combination of attenuation corrections and direct scatter modeling. Functional volumes were segmented in each reconstructed image using 10%, 20%, …, 90% of maximum SPECT intensity as a threshold. Systematic effects of SPECT reconstruction methods on treatment planning using functional volume were studied by calculating size and spatial agreements of functional volumes, and V(20) for functional volume from actual treatment plans. The SWMD was calculated for radiation beams with a variety of possible gantry angles and field sizes.Results: Functional volume segmentation is sensitive to the particular method of SPECT reconstruction used. Large variations in functional volumes, as high as >50%, were observed in SPECT images reconstructed with different attenuation/scatter corrections. However, SWMD was less sensitive to the type of scatter corrections. SWMD was consistent within 2% for all reconstructions as long as computed tomography-based attenuation correction was used.Conclusion: When using perfusion SPECT images during treatment planning optimization/evaluation, the SWMD may be the preferred figure of merit, as it is less affected by reconstruction technique, compared with threshold-based functional volume segmentation. [ABSTRACT FROM AUTHOR]

Pancreatic insulinomas are rare tumours of the islet cells of the pancreas, which account for the majority of functional neuroendocrine tumours of the pancreas. There is often a typical history of recurrent hypoglycaemic collapse and dizzy spells. Insulinomas are usually solitary, and the vast majority are intra-pancreatic in location. They are characteristically small with approximately 66% being less than 2cm at presentation. Insulinomas continue to pose a diagnostic challenge to physicians, surgeons and radiologists alike. The role of imaging is to detect and provide precise anatomical localization and staging of tumours prior to surgery. Due to their small size at clinical presentation, they are notoriously difficult to localize radiologically, and specifically designed protocols are necessary to aid detection. In this review, we describe the current “state of the art” imaging protocols that may be used in the preoperative localization of insulinomas. [Copyright &y& Elsevier]

Background: Finding the balance of good postoperative analgesia while facilitiating mobility is important for a safe and satisfactory patient experience during Total Knee Arthroplasty (TKA). This study aimed to compare the efficacy of intrathecal morphine, adductor canal block, and their combination in optimizing pain management and postoperative recovery in TKA patients. This retrospective analysis of prospectively collected data evaluated postoperative pain scores, time to mobilisation, and length of hospital stay., Methods: 1006 consecutive patients undergoing elective TKA across two large tertiary centres were included over six years. They were divided into one of four groups according to the type of analgesia received: Group N patients received no neuraxial morphine or regional block. Group B patients received adductor canal block (ACB) only. Group M patients received intrathecal morphine (ITM) but no regional block. Group BM patients received both ACB and ITM., Results: Patients who received an ACB had faster postoperative mobilization compared to those without (p < 0.001). Patients in Group BM had the lowest pain scores at rest (Visual Analogue Scale (VAS) 2.9) and with movement (VAS 5.3), while Group B patients experienced the highest pain scores at rest (VAS 3.7) and on movement (VAS 6.5) (p = 0.005). Patients who received ITM had the lowest opioid requirements (p < 0.001). There was no significant differences between groups in requirement for rescue pain management strategies (p = 0.06)., Conclusions: The combination of ITM and ACB in patients undergoing TKA provides improved postoperative analgesia with lower postoperative opioid requirement and earlier mobilization compared with ACB or ITM alone., (© 2024. Crown.)

Purpose: This study examines the diagnostic accuracy of brain perfusion SPECT for mild traumatic brain injury (mTBI)., Patients and Methods: A systematic review and meta-analysis was performed according to PRISMA guidelines (PROSPERO: CRD42023484636). Five databases were searched for studies evaluating brain perfusion SPECT in adult patients with mTBI (GCS 13-15). Study quality was assessed using a modified QUADAS-2 tool. A meta-analysis was performed to pool proportions of hypoperfusion abnormalities across brain lobes., Results: Of 4735 records, 22 studies (5 longitudinal [40% high quality], 17 cross-sectional [24% high quality]) were included totaling 800 patients (mean age, 37.4 ± 12.6 years; 36.4% female). Meta-analysis of proportions indicated that the frontal lobe most frequently showed hypoperfusion on brain perfusion SPECT (pooled proportion 40.1% [95% confidence interval, 31.2% to 49.8%], 99/254, I2 = 54.5%), followed by the temporal lobe (26.1% [95% confidence interval, 19.9% to 33.6%], 68/254, I2 = 30.7%). Several studies found that hypoperfusion abnormalities were associated with neuropsychological findings. Also, brain perfusion SPECT could detect abnormalities not seen on MRI. Abnormalities in perfusion on brain perfusion SPECT may be more readily detected with a quantitative assessment compared with a visual assessment alone, although there appears to be no consensus on the optimal method for image interpretation. Evidence evaluating the sensitivity and specificity of brain perfusion SPECT for mTBI was limited. Using the GRADE framework, the evidence was rated as low., Conclusions: Although perfusion abnormalities can be seen in patients with mTBI, commonly in the frontal and temporal lobes, the findings are nonspecific and may derive from various factors. Ultimately, brain perfusion SPECT provides additional information for mTBI, but the final added value for the detection of mTBI is unknown., Competing Interests: Conflicts of interest and sources of funding: none declared., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Research Design: Community-engaged qualitative study using inductive thematic analysis of semistructured interviews., Objective: To understand Latine immigrants' recent prenatal care experiences and develop community-informed strategies to mitigate policy-related chilling effects on prenatal care utilization., Background: Decreased health care utilization among immigrants due to punitive immigration policies (ie, the "chilling effect") has been well-documented among Latine birthing people both pre and postnatally., Patients and Methods: Currently or recently pregnant immigrant Latine people in greater Philadelphia were recruited from an obstetric clinic, 2 pediatric primary care clinics, and 2 community-based organization client pools. Thematic saturation was achieved with 24 people. Participants' pregnancy narratives and their perspectives on how health care providers and systems could make prenatal care feel safer and more comfortable for immigrants., Results: Participants' recommendations for mitigating the chilling effect during the prenatal period included training prenatal health care providers to sensitively initiate discussions about immigrants' rights and reaffirm confidentiality around immigration status. Participants suggested that health care systems should expand sources of information for pregnant immigrants, either by partnering with community organizations to disseminate information or by increasing access to trusted individuals knowledgeable about immigrants' rights to health care. Participants also suggested training non-medical office staff in the use of interpreters., Conclusion: Immigrant Latine pregnant and birthing people in greater Philadelphia described ongoing fear and confusion regarding the utilization of prenatal care, as well as experiences of discrimination. Participants' suggestions for mitigating immigration-related chilling effects can be translated into potential policy and programmatic interventions which could be implemented locally and evaluated for broader applicability., Competing Interests: D.M.W. is supported by the National Institutes of Health K23HD102526. The remaining authors declare no conflict of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Moderately preterm infants (MPTI) comprise a large proportion of NICU admissions and are an understudied population. The unique experience of families with MPTIs has yet to be examined in the literature. Describing MPTI parent needs and preferences may inform interventions to improve care and outcomes for this population., Methods: Semistructured qualitative interviews were performed with English-speaking birth parents of infants born between 32 and 34 weeks gestation to describe their NICU experience and identify areas for improvement specifically surrounding care team inclusion, education, discharge, and communication. Interviews were recorded, transcribed, and analyzed using directed content analysis. Enrollment ceased when the data reached thematic saturation., Results: Sixteen birth parents participated. Four themes emerged around parent-medical team connectedness, parental confusion, discharge readiness, and the desire for a use of a mix of in-person and electronic communication methods (e-mail, texting, apps, etc) for communication. MPTI parents valued a strong connection with the medical team; however, they described a lack of knowledge regarding the reasons for admission and ongoing management. Near discharge, parents desired more information regarding feeding, reflux, and breathing patterns. Parents preferred in-person discussions but described a role for electronic methods to improve their understanding of their infant and discharge readiness., Conclusions: From the MPTI parent perspective, clinicians can focus improvement efforts on communication, specifically around reasons for admission, discharge planning, and anticipatory guidance. These results may serve as a foundation for initiatives to improve the MPTI parent experience and potentially parent and MPTI outcomes., (Copyright © 2024 by the American Academy of Pediatrics.)

Background: The child and adolescent mental health boarding crisis (i.e., prolonged stays in acute care hospitals for patients awaiting mental health treatment) continues to challenge acute care hospital staff and resources. We sought to understand clinician's experiences while caring for patients experiencing mental health boarding., Methods: We conducted semistructured qualitative interviews with clinicians who care for patients experiencing mental health boarding in an acute care freestanding children's hospital with no inpatient psychiatric unit. We used an inductive approach to determine interview themes and major findings., Results: The study included 48 clinician participants from diverse specialties, including 13 social workers, 11 nurses, five psychiatric technicians, six pediatric residents, four attending pediatric hospitalists, four attending psychiatrists, one psychologist, and four other mental health specialists. We identified emergent themes in five domains: (1) frustrations with the mental healthcare system, (2) lack of training in mental healthcare skills, (3) feelings of helplessness, (4) ineffectiveness of medical model of care during mental health boarding, and (5) resilience and support factors., Conclusions: Caring for patients with mental health boarding has negative effects on clinicians, and health system efforts to prevent boarding could improve workforce retention and reduce burnout., (© 2024 Society of Hospital Medicine.)