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Transplantation is a high‐risk, high‐cost treatment for end‐stage diseases and is the most strictly regulated area of healthcare in the United States. Thus, achieving success for patients and the program requires skillful and collaborative leadership. Various factors, such as outcomes, volume, and financial health, may measure the success of a transplant program. Strong collaboration between clinical and administrative leaders is key to achieving and maintaining success in those three categories. Clinical leaders of adult programs, such as medical and surgical directors, bear the primary responsibility for a program's volume, outcomes, and patient safety, while administrative directors are focused on business intelligence and regulatory compliance. This paper aims to provide readers with insights into the critical role of collaborative leadership in running a successful program, with a focus on clinical, business, and regulatory perspectives. [ABSTRACT FROM AUTHOR]

The majority of U.S. states have legalized marijuana for medical use and some states have legalized marijuana for recreational use; yet, marijuana remains illegal federally. Given the misalignment between state and federal policies, this paper seeks to explore how hospitals handle inpatients' medical marijuana use in states where medical marijuana is legal. To examine this phenomenon, we conducted an anonymous, online, cross-sectional survey of nurse leaders working in acute care inpatient settings in states that had legalized medical marijuana. Using descriptive statistics, we report on these nurse leaders' experiences. There were 811 survey responses—291 who worked in an acute care inpatient setting in a state that had legalized medical marijuana. Among those respondents, only a small percentage reported that inpatients had some access to their medical marijuana: 5.8% reported that the drug was kept in the pharmacy and dispensed like other prescriptions; another 3.4% indicated that patients kept the medical marijuana in their rooms and took it, as needed. Most respondents (55.6%) reported that patients were switched to an alternative medication during their inpatient hospital stays. Almost half (49.4%) of the nurse leaders who reported that alternative medications were used, reported that opioids were substituted, and the majority reported that the marijuana was safer than the opioids. These findings are concerning given the increase in opioid overdose deaths. [ABSTRACT FROM AUTHOR]

Abortion is a common medical procedure in the United States that is frequently the target of political and legal restrictions. These restrictions can negatively impact care and interfere with the patient-provider relationship. In this paper, we aim to review the historic context in which feticidal agents became more utilized in later abortion; describe current practices and protocols of using feticidal agents use for later abortion by dilation and evacuation and induction of labor; evaluate patient and provider perspectives on feticidal agent use; and propose areas of further ethical and research inquiry to characterize the use of these agents in later abortion procedures. [ABSTRACT FROM AUTHOR]

Alcohol use disorder (AUD) is highly prevalent among adults in the US and is associated with substantial personal and societal costs. Yet only a small percentage of adults with AUD initiate treatment, including those with severe AUD symptoms who are most in need of treatment. In this paper we use latent profile analysis (LPA) to describe differences in symptoms of AUD severity and alcohol-related consequences among untreated adults with severe AUD symptoms who were recruited from the community. Identification of such differences will result in better understanding of this population and will improve methods of treatment outreach. The LPAs were conducted on the baseline data of 403 (50% male, 77% White, M age = 40.74 with severe AUD recruited from the community and enrolled in a trial of an intervention designed to encourage treatment initiation. Participants reported no prior AUD treatment history. The LPAs were based on indicators of AUD severity, alcohol-related negative consequences, and self-reported intention to initiate AUD treatment. The LPAs revealed 4 profiles. Profile membership was predicted by baseline participant sex and whether they were living with a partner and was associated with baseline past 30-days alcohol consumption. The findings characterize and describe the variability among adults in the community with untreated severe AUD on variables that tend to motivate such individuals to seek treatment, which could significantly advance treatment outreach efforts. [ABSTRACT FROM AUTHOR]

Culture can broadly be defined as "the values, norms, and assumptions that guide human action" (Wilson 2008, 14). In contrast with the broader civilian society, the experiences and environments within the military community create a unique cultural subset. The United States armed forces are unified by their primary mission to provide external defense, security, and protection, and each branch (Army, Navy, Marine Corp, Air Force, Coast Guard and National Guard) shares a unique core set of values and norms. Because this culture is so complex and unique, it can sometimes be a challenge for many civilian professionals to work with this community, so having a strong competency in understanding military culture, as well as knowledge of specific conflicts and wars, one is not only able to begin to understand the lives and personalities of our soldiers but also able to recognize that this culture aids in survival. This paper will demonstrate and discuss the importance of competency in military culture when practicing music therapy or other interdisciplinary approaches within the process of group therapy with veterans. Other topics covered will include: issues of social transmission as it relates to transitioning into civilian society; the importance of being a witness to veterans' stories; and facilitators' ethical responsibilities when working with this population. [ABSTRACT FROM AUTHOR]