Search

Background: COVID-19 propelled telehealth to the forefront of health care, forcing many advanced practice registered nurses (APRNs) to incorporate telehealth into their practice without sufficient education. Lack of training has been cited as a barrier to telehealth adoption. Purpose: This study evaluated provider adoption of telehealth based on the type of telehealth education received. Methods: A quantitative survey of telehealth providers (n = 224) was distributed through the listservs of 4 national organizations to determine whether there was a significant difference in provider levels of perceived usefulness, self-efficacy, perceived knowledge, satisfaction, and use of telehealth based on the type of telehealth education received. Results: Telehealth adoption was significantly associated with the type of telehealth education received (vendor, online, written instructions only, and on the spot). Conclusion: With telehealth utilization expected to endure postpandemic, faculty should incorporate the most effective telehealth education methods into APRN curricula, ensuring successful adoption by the future workforce. [ABSTRACT FROM AUTHOR]

To develop educational modules to improve vocal wellness and optimize communication in mask-wearing occupational voice users. Module development focused on identifying accurate, understandable, and actionable steps to improve vocal wellness in the workplace. We i) interviewed eight voice-specialized speech-language pathologists and researchers on current speech and voice recommendations for mask-wearers, ii) developed educational content using the standardized Patient Education Materials Assessment Tool (PEMAT), iii) assessed the ability of nine mask-wearing community members to learn educational content, and iv) compared behavioral, acoustical, and perceptual changes in four mask-wearing healthcare professionals following educational training. We created three educational modules that described key vocal health and communication strategies, including microphone amplification, postural alignment, clear speech, hydration, vocal naps, and vocal warm-ups. PEMAT scores were 96% and 93% on understandability and actionability, respectively. Mask-wearing healthcare professionals increased use of 4 out of the 6 strategies following educational training and were able to retain information at rates >90% at 1-week follow-up. We developed a set of free-to-use educational modules to promote vocal wellness among mask-wearing occupational voice users (see VSMechLab.com). Future work should examine the impact of these strategies on voice measures in a larger group of mask-wearing community members. [ABSTRACT FROM AUTHOR]

Background: Telehealth is a rapidly growing health care delivery modality with advanced practice nurses as key providers. This growth has occurred without critical consideration of provider training. Training requires the development of competencies situated within a framework. Problem: Standardized telehealth competencies for advanced practice nursing are missing. The purpose of this article is to describe the development of telehealth competencies for education and practice. Approach: Using the Four P's of Telehealth framework (planning, preparing, providing, and performance evaluation), a modified Delphi technique was used to identify, develop, and evaluate telehealth competencies. Outcomes: Competencies were arranged around telehealth domains, expected activities, and outcomes. Effective use of the competencies to guide curriculum development, practice, and future research related to telehealth was identified. Conclusions: Providing education with competencies aligned to the Four P's Telehealth framework will provide learners with tools to assume leadership roles in all phases of telehealth implementation, delivery, and refinement. [ABSTRACT FROM AUTHOR]

It has been hypothesised that attentional bias to environmental threats can contribute to persistent pain. It is unclear whether people with acute low back pain (LBP) have an attentional bias to environmental threats. We investigated if attentional bias of threat related words is different in people with acute LBP and pain-free controls. People with acute LBP and pain-free people completed a free viewing eye tracking task. Participants were simultaneously presented with two words, a threat related word and a neutral control word. Threat related words were general threat, affective pain and sensory pain. We conducted linear mixed models to detect differences between acute LBP and pain-free participants on five eye tracking outcome measures (dwell time, first fixation, latency to first fixation, first run dwell time and number of fixations). We calculated absolute reliability, (standard error of measure), and relative reliability (intraclass correlation coefficients [ICC 2,1]) for each eye tracking outcome measures. We recruited 65 people with acute LBP and 65 pain-free controls. Participants with acute LBP had a higher proportion of fixations towards the affective pain words (M=0.5009, 95% CI=0.4941, 0.5076) than the pain-free controls had (M=0.4908, 95% CI=0.4836, 0.4979), mean between group difference = −0.0101, 95% CI [−0.0198, −0.0004], p=0.0422. There was no difference between acute LBP and pain-free controls for the remaining eye tracking outcome measures (all p>0.05). The only outcome measure that had an ICC of more than 0.7 was the latency to first fixation (affective pain words ICC=0.73, general threat words ICC=0.72). When compared with pain-free controls, people with acute LBP looked more often at affective pain words relative to neutral control words. This may indicate a form of engagement bias for people with acute LBP. Attentional bias was not consistent across outcome measures or word groups. Further research is needed to investigate the potential role of attentional bias in the development of persistent pain. [ABSTRACT FROM AUTHOR]

Copyright of Ardeola is the property of Sociedad Espanola de Ornitologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Voice therapy plays a critical role in the treatment of voice disorders. Despite positive outcomes in patients who attend voice therapy, otolaryngologists, and speech-language pathologists continue to struggle with patient compliance. Previous studies evaluating the multidisciplinary clinic model have shown better completion, VHI-10 scores, and fewer cancelation and no-shows (NS). We sought to review our own patient experience to better identify factors that predict NS rates in voice therapy. A retrospective chart review of patients at a tertiary medical center were included if they had a scheduled appointment during a 6-month period that was cancelled or a NS. Charts were reviewed for age, gender, race, diagnosis, number of sessions attended, reason for discharge, and attending physician. NS percentage is calculated as a ratio of number cancellations to total number sessions scheduled. A multivariable general linear model was used to examine the association between NS and the listed covariates. The study included 146 patients mean (SD) age 52.7 (16.6), where 62% were female and 72.6% were white. There is evidence that not being seen in a multidisciplinary clinic is significantly associated with NS rates in voice therapy (χ2 = 4.09, P = 0.0431). There is also evidence that non-white race is significantly associated with NS rates in voice therapy (χ2 = 11.76, P = 0.0006). Data presented in this study further support the use of a multidisciplinary model to improve NS rates in voice therapy. The relationship between nonwhite patients and lower NS suggests another determining factor in nonadherence to voice therapy. [ABSTRACT FROM AUTHOR]

Voice therapy (VT) is an essential component to a successful treatment of laryngological disorders and thus patient outcomes depend on patient compliance with VT. As volume of VT patients' ebb and flow, there is often variation in wait times for initial VT sessions. There is a paucity research evaluating VT latency and missed appointments. It is important to find associations between latency and patient compliance to assist with increasing the quality of patient care in all voice and swallowing clinics and decreasing missed appointments for VT following. Should a clinical setting be able to make changes to better care for the patients, it may show a substantial change in missed appointments and patient outcomes. To determine what factors contribute to missed initial VT session and specifically whether patients who have a time interval of >4 weeks from their initial interdisciplinary evaluation to their initial VT session are more likely to not attend. Retrospective analysis of a database, at a tertiary academic voice and swallowing center. A prospective voice and swallowing database was evaluated for new voice patient evaluations starting from January 1, 2014 to December 31, 2017. Patients with a primary diagnosis of dysphonia or dyspnea and scheduled for VT after the initial patient evaluation in an interdisciplinary laryngology clinic were included. Three hundred and eighteen patients (mean age = 5.27, standard deviation 16.0) met the inclusion criteria. Patients were 73% (n = 231) female, and 81% White/Caucasian. Univariate analysis shows that insurance type, profession, body mass index, interval to VT appointment, Reflux Severity Index (RSI), and Eating Assessment Tool–10 scores were associated with missed appointment rates. Multivariate logistic regression model demonstrated interval to VT, RSI, race, and profession were significant factors in missed appointments. Patients with an interval >4 weeks, were more likely to miss their appointment, as compared to patients <4 weeks (odds ratio 2.07 95% confidence interval 1.18–3.60). The data presented suggests that patients who have their first VT appointment greater than 4-weeks from the time of their initial interdisciplinary evaluation have an increased risk of missed appointment. Race, RSI, and professional voice use also appear to play a role in missed appointment rates. [ABSTRACT FROM AUTHOR]

Teledentistry is an innovative technology that can be used to improve access to care and oral health outcomes. Dental students' intention to use teledentistry after completing dental school has not been investigated.Purpose: The unified theory of acceptance and use of technology (UTAUT) was used to predict intentions to use teledentistry among 4th-year U.S. dental students.Methods: A cross-sectional approach was performed for a 7-week period in Spring 2019. All U.S. dental schools (N = 66) were invited to participate and 16 schools agreed to participate. An anonymous survey link was emailed to academic deans for dissemination to students. A total of 1416 4th-year dental students received the anonymous survey link and 210 students completed the survey (response rate = 14.8%). The survey included questions and scales that measured the UTAUT constructs of performance expectancy (PE), effort expectancy (EE), social influence (SI), facilitating conditions (FC), and behavioral intentions (BI). Data were analyzed using SPSS version 24. The study was deemed exempt by institutional review board.Results: The dental students' BI to use teledentistry was significantly predicted by PE (R2 = 33%, P < 0.01), EE (R2 = 24%, P < 0.01), SI (R2 = 24%, P < 0.01), and FC (R2 = 14%, P < 0.01). The UTAUT model was statistically significant in predicting the BI and explained 40% of BI variance (R2 = .40, P < 0.01).Conclusions: Dental students' perceptions about PE, EE, SI, and FC were associated with BI. Therefore, exposure to teledentistry while in dental school could increase the likelihood of use as a practicing provider. [ABSTRACT FROM AUTHOR]

Trapezius paralysis following injury to the spinal accessory nerve can be a debilitating complication resulting from lymph node biopsy, radical neck dissection, or penetrating trauma in the region of the posterior cervical triangle. Disruption of the delicate muscular balance in the shoulder girdle may result in lateral scapular winging, ipsilateral upper extremity radiculopathy, and limited shoulder function and range of motion. Spontaneous recovery with nonoperative management is possible in some patients, and restoration of function after reparative neural procedures has been observed in patients undergoing timely repair. However, extended delays from the time of injury to surgery are common and may necessitate various muscle transfers to reestablish the complex biomechanics and balance of the shoulder girdle. We describe a modification to the classic Eden-Lange procedure with lateral transfer of the levator scapulae and rhomboid minor to the scapula spine and rhomboid major transfer with a small wafer of bone to the scapula body for chronic lateral winging of the scapula following injury to the spinal accessory nerve as the result of a cervical lymph node biopsy. [ABSTRACT FROM AUTHOR]

This literature review examines all treatments for behavioral insomnia in children under 6 years of age to determine which treatments have empirically demonstrated efficacy. Following PRISMA guidelines, three databases were investigated (Pubmed, Cochrane and Psychinfo) to select randomized controlled trials (RCTs) which assess treatments for behavioral insomnia in children under 6 years of age, all with neurotypical development. A total of 908 articles met the search criteria. 21 articles were selected and analyzed in their entirety for a total of 2363 children (ranging from 2 months to 6 years of age). Based on these studies, treatment of behavioral insomnia in young children under 6 years of age is primarily based on behavioral therapy. There is no evidence that pharmacological treatments are effective in the long term for neurotypical children. This review highlights the lack of RCTs in this field: new RCTs should be carried out among young children to refine and optimize the therapeutic approach and to address the risk of therapeutic abuse through the use of non-scientifically validated methods. [ABSTRACT FROM AUTHOR]