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Background: The use of remote visual monitoring (RVM) technology as a “telesitter” in hospitals can reduce falls and increase the efficiency of patient observation. Purpose: This study aimed to examine RVM effectiveness as a strategy to decrease patient falls and investigate nurses’ acceptance and perceived usefulness of RVM technology. Methods: Remote visual monitoring was implemented within a health system in the Southeastern United States. Falls data 6 months prior to and postimplementation were analyzed, and 106 nurses completed a survey evaluating their acceptance of the RVM technology. Results: There was a significant 39.15% reduction in falls with injury (P = .006), and 70.6% of the RVM redirections were successful. Nurses’ acceptance and perceived usefulness of RVM were moderate. Conclusion: Implementing RVM has the potential to enhance patient safety by reducing falls with injuries and is considered acceptable and useful by nurses. [ABSTRACT FROM AUTHOR]

The nurse leader role is a vital role in ensuring quality, safety, and staff retention in the health care setting. A new nurse manager often receives little mentoring support when assuming a new role. Fifteen mentor/mentee pairs were provided with 6 training sessions specifically designed using the Hale Mentoring Up theoretical framework. Surveys and focus groups were conducted at mid- and endpoints. Data were digitally recorded, transcribed verbatim, and loaded into NVivo 12. Two attributes that facilitated a positive mentoring relationship emerged from the qualitative analysis: interpersonal and organizational skills. Interpersonal skills included a mentor-mentee relationship that was built upon trust, flexibility, and learning and development; and organizational skills included building relationships both internally and externally. Furthermore, time was identified as a barrier to mentoring. A mentoring program is a vehicle to help support new nurse leaders through an educational intervention and mentoring support program. The development of a mentoring pilot program helps to strengthen future nursing leadership to support new leaders in their roles. [ABSTRACT FROM AUTHOR]

Summary Background Data: Patients with severe acute liver failure (ALF) have extreme physiologic dysfunction and often die if transplantation is not immediately available. Patients may be supported with MARS (Baxter International Inc., Deerfield, IL) until transplantation or spontaneous recovery occurs. We present the largest series in the United States of MARS therapy as temporary hepatic replacement for ALF. Methods: MARS was used to support patients with severe liver trauma (SLT), in ALF patients as a bridge to transplantation (BTT), and as definitive therapy for toxic ingestion or idiopathic liver failure (DT) in a level 1 trauma center and large transplant center. Patient demographics, etiology of ALF, and laboratory values were recorded. Endpoints were patient survival ± liver transplant and/or recovery of liver function. Results: Twenty-seven patients with severe ALF received MARS therapy. Five patients with SLT had a 60% survival with recovery of liver and renal function. Thirteen patients received MARS as a BTT, of which 9 were transplanted with a 1-year survival of 78% (program overall survival 85% at 1 year). All 4 who were not transplanted expired. Nine patients with ALF from toxic ingestion received MARS as DT with liver recovery and survival in 67%. MARS therapy resulted in significant improvement in liver function, coagulation, incidence of encephalopathy, and creatinine. Conclusions: MARS therapy successfully replaced hepatic function in ALF allowing time for spontaneous recovery or transplantation. Spontaneous recovery was remarkably common if support can be sustained. [ABSTRACT FROM AUTHOR]

Cardiac arrest in pregnancy is a rare event, and the speed of resuscitation response is critical to the outcome of both the mother and the fetus. The management of the unresponsive pregnant woman differs from that of the traditional adult resuscitation. In this article, causes of maternal arrest, management of proper cardiopulmonary arrest in pregnancy, and implementation of perimortem cesarean delivery are discussed. [ABSTRACT FROM AUTHOR]

The article focuses on the simulation model to provide quality end-of-life care (EOL). The Robert Wood Johnson Foundation and Institute of Medicine Report on the Future of Nursing stressed the need for nurses to gain greater interdisciplinary collaboration to enhance patient outcomes. It discussed the process and structure of the 2-day experience that includes a 4-hour didactic presentation and an 8-hour clinical simulation process.

Significant health disparities exist among culturally diverse minority populations in the United States. The ways in which healthcare providers recognize and respond to this issue is critical. Methods must be effective, culturally appropriate, and engage the community if they are to be utilized, and they also need to be sustainable to make a significant impact. American Indians and Alaska Natives face many unique health disparities and challenges and they confront many barriers when seeking care and treatment. These obstacles make it essential for healthcare professionals to engage the community in the development of culturally appropriate strategies with which to address health issues. This article describes a community-based participatory approach that was executed successfully by the Choctaw Nation of Oklahoma. By utilizing the Community Readiness Model, it effectively built on the culture and resiliency that exists in each of 10 communities to more successfully implement community-responsive health prevention and treatment. This article discusses the experience of the Choctaw Nation in its assessment and engagement of the community in addressing cardiovascular disease. Data are presented that reflect the successful use of the Community Readiness Model and discussion is provided. This article emphasizes the use of an effective community-based participatory method, Community Readiness, that enabled the Choctaw Nation to make strong 'inroads' into its respective service area through successful community engagement. [ABSTRACT FROM AUTHOR]

Although HIV/AIDS prevention has presented challenges over the past 25 years, prevention does work! To be most effective, however, prevention must be specific to the culture and the nature of the community. Building the capacity of a community for prevention efforts is not an easy process. If capacity is to be sustained, it must be practical and utilize the resources that already exist in the community. Attitudes vary across communities; resources vary, political climates are constantly varied and changing. Communities are fluid—always changing, adapting, growing. They are “ready” for different things at different times. Readiness is a key issue! This article presents a model that has experienced a high level of success in building community capacity for effective prevention/intervention for HIV/AIDS and offers case studies for review. The Community Readiness Model provides both quantitative and qualitative information in a user-friendly structure that guides a community through the process of understanding the importance of the measure of readiness. The model identifies readiness- appropriate strategies, provides readiness scores for evaluation, and most important, involves community stakeholders in the process. The article will demonstrate the importance of developing strategies consistent with readiness levels for more cost-effective and successful prevention efforts. [ABSTRACT FROM AUTHOR]

The severity of effect as a function of skeletal radiation dose for induced skeletal malignancy was investigated among a relatively large group of beagle dogs singly injected as young adults with soluble radionuclide. Boneseeking radionuclides considered were 239Pu, 226Ra, 228Ra, 224Ra, 228Th, and 90Sr. Variables included skeletal radiation dose, tumor growth rate, maximum tumor volume, sex of the animals, growth period of the tumor, degree of calcification of the tumor, skeletal location of the tumor, year of death, and occurrence of metastases. Except for a significant relationship between tumor volume and metastatic process and for growth rate and tumor volume, no significant dependence of any two of these factors could be established. It is concluded from available data on skeletal malignancies among beagles exposed to bone-seeking radionuclides that the severity of the disease is not dependent upon skeletal radiation dose. [ABSTRACT FROM AUTHOR]

Objective: To develop state-level estimates of the annual number of nonfatal cases of traumatic brain injury (TBI) resulting in hospitalization. Methods: The estimation process incorporates annual nonfatal TBI hospitalization case counts from 15 states funded by the Centers for Disease Control and Prevention to conduct TBI surveillance; annual fatal TBI case counts based on National Center for Health Statistics data for all 50 states; and an index reflecting the urban/rural character of each state. These data are used to develop a negative binomial regression model that yields estimates of the annual number of nonfatal TBI hospitalization cases for each state not funded to conduct TBI surveillance. Results: Sensitivity analysis suggests that on average the estimates fall within ±15% of the case counts that would be obtained directly from surveillance. Conclusion: In combination, the TBI case count data and the urban/rural index support effective modeling and estimation of annual nonfatal TBI hospitalization case counts at the state level. [ABSTRACT FROM AUTHOR]

This article addresses the need to refocus the view of the natural environment as a family-chosen placement for early intervention services and suggests ways to achieve this end. Psycho-ecological theories are used to broaden the conception of the natural environment and illuminate possibilities for early intervention that utilize community and home resources while respecting the wishes of the family. As a result, families are enabled to choose the settings in which services will be provided, while meeting the needs of the child according to the spirit of the Individuals with Disabilities Education Act. Copyright © 2002 by Aspen Publishers, Inc. [ABSTRACT FROM AUTHOR]

This article addresses the need to refocus the view of the natural environment as a family-chosen placement for early intervention services and suggests ways to achieve this end. Psycho-ecological theories are used to broaden the conception of the natural environment and illuminate possibilities for early intervention that utilize community and home resources while respecting the wishes of the family. As a result, families are enabled to choose the settings in which services will be provided, while meeting the needs of the child according to the spirit of the Individuals with Disabilities Education Act. [ABSTRACT FROM AUTHOR]

Traumatic brain injury (TBI) is a leading cause of death and disability among persons in the United States. Each year, an estimated 1.5 million Americans sustain a TBI. As a result of these injuries, 50,000 people die, 230,000 people are hospitalized and survive, and an estimated 80,000-90,000 people experience the onset of long-term disability. Rates of TBI-related hospitalization have declined nearly 50% since 1980, a phenomenon that may be attributed, in part, to successes in injury prevention and also to changes in hospital admission practices that shift the care of persons with less severe TBI from inpatient to outpatient settings. The magnitude of TBI in the United States requires public health measures to prevent these injuries and to improve their consequences. State surveillance systems can provide reliable data on injury causes and risk factors, identify trends in TBI incidence, enable the development of cause-specific prevention strategies focused on populations at greatest risk, and monitor the effectiveness of such programs. State follow-up registries, built on surveillance systems, can provide more information regarding the frequency and nature of disabilities associated with TBI. This information can help states and communities to design, implement, and evaluate cost-effective programs for people living with TBI and for their families, addressing acute care, rehabilitation, and vocational, school, and community support. Key words.' brain injury, disability, epidemiology, incidence, mortality, patient care, prevalence, prevention, public health, surveillance [ABSTRACT FROM AUTHOR]

Statistical analysis of bone tumor growth rates as a function of age at initiation of radiation-induced skeletal malignancies in our animal colony indicated that the p value for an association between these parameters was < 0.05, suggesting a correlation in beagle dogs. The youngest animals appeared to exhibit the most slowly growing tumors, and the trend was toward more rapidly growing tumors with increasing age. Less effective immune systems in older animals were invoked as a possible explanation of this relationship. [ABSTRACT FROM AUTHOR]

Objective: This study evaluated health care workers' (HCWs') knowledge and confidence in using elastomeric half-mask respirator (EHMR) attributes known to influence usage., Methods: Health care workers were surveyed regarding their EHMR donning and doffing experience. Respondents were categorized into competency categories based on their scores. Category differences were analyzed using χ 2 and multiple logistic regression., Results: Seventy-two percent showed high levels of EHMR donning and doffing knowledge and confidence (mastery); however, 21% had greater confidence than knowledge (misinformed). Respiratory therapists had greater odds of mastery than other HCWs ( P < 0.05), whereas those working in medical/surgical and pediatric units had greater odds of doubt than other HCWs ( P < 0.01)., Conclusions: Although most HCWs show high knowledge and confidence with EHMR use, strategies to confirm respirator use competency may ensure greater HCWs protection., Competing Interests: Conflict of interest: Dr. Hines receives research funding to her institution from the Department of Defense, the Department of Veterans Affairs, and CleanSpace Technology, a respirator manufacturer for a different research study. One of her family members works as a trainer for a respirator manufacturer of a different respirator style than that described in the paper. Caitlin McClain is part of the team from NIOSH/NPPTL that contracted the lead author to gather data and take point on publications., (Copyright © 2022 American College of Occupational and Environmental Medicine.)

Objective: To assess physicians' knowledge and practices of modern methods of natural family planning., Methods: A questionnaire was mailed to 840 physicians selected randomly from Missouri state licensing records for obstetrics-gynecology, family practice, general practice, and general internal medicine., Results: The response rate was 65%. A total of 375 physicians (69% of respondents) saw women for reproductive issues. About half (46%) of physicians reported that they mentioned natural family planning to at least some women when discussing family planning issues. Observing vaginal discharge of cervical mucus was discussed by 40% of physicians in the context of avoiding pregnancy and by 36% of physicians in the context of helping a couple achieve pregnancy. Twenty-two percent of physicians estimated the best possible effectiveness of natural family planning to avoid pregnancy to be greater than 90%, and 35% estimated the actual effectiveness to avoid pregnancy to be greater than 70%. (The threshold rates of 90% best possible effectiveness and 70% actual effectiveness were chosen to be somewhat less than those reported in medical literature.) Physicians who gave higher estimates of effectiveness of natural family planning and physicians who were aware of an instructor in their community were more likely to provide women with relevant information about natural family planning., Conclusion: Most physicians, especially those unaware of availability of instructors in their areas, underestimate the effectiveness of natural family planning and do not give information about modern methods to women.