Exploring plagiarism.

ABSTRACT: Plagiarism is a common issue in academic and professional communities. This article discusses ways to avoid plagiarism by identifying valuable resources, such as appropriate paraphrasing, creative work organizing, and new technology. Understanding copyright law safeguards is critical to avoiding plagiarism.

Five Steps to Integrating Telehealth Into APRN Curricula.

The COVID-19 pandemic suddenly changed the scene of primary care visits. As clinics abruptly transitioned to telehealth visits, health care providers and students were required to use digital technologies to deliver health care from a distance. This article highlights 5 steps used by faculty to integrate telehealth concepts into the graduate curriculum for all advanced practice registered nurse programs. As patients and providers recognize its widespread acceptance, telehealth will likely have a permanent place in traditional health care delivery long after the COVID-19 pandemic.

An Evaluation of Interprofessional Patient Navigation Services in High Utilizers at a County Tertiary Teaching Health System.

EXECUTIVE SUMMARY: The Affordable Care Act holds health systems accountable for patient outcomes. Patients with low socioeconomic status are at highest risk of lacking a primary care provider, receiving lower quality of care, and being readmitted. These patients also have elevated risks of all-cause readmissions and death after discharge. The purpose of this study was to determine if an interprofessional patient navigation program (PNP) decreases emergency department (ED) visits and hospital admissions for these high utilizers of care, thus promoting the implementation of PNPs in other healthcare settings. We performed a retrospective, single-centered, chart review of patients who were enrolled in the PNP. We compared utilization, including ED visits and hospital admissions, for patients two years prior to enrollment to their utilization after enrollment. We found significant reductions in hospital utilization through patient navigation in the predominantly indigent, culturally diverse population of high utilizers of the healthcare system. In addition, our investigation of costs associated with implementing a PNP indicates the potential for cost avoidance.

Spiritual Darkness: Reflections on a Medical Mission.

This is a reflective analysis on the lived experience of a medical mission in a third world country, where young women are abused and trafficked for sex. Practices of Scripture study, Lectio Divina, and contemplative prayer enabled me to deal with the spiritual darkness we encountered. Opening a dialogue with community members to view males and females in a different manner and battling alongside the local mission and ministers against sex trafficking, are not easy tasks. The perseverance found in the Bible gives us hope to be witnesses and healers in our broken world, and a small part in change that can take root with prayer.

Stakeholder perceptions of the efficacy, barriers, and facilitators of telemental health clinical experiences during COVID for nurse practitioner students.

BACKGROUND: Telemental health services grew during the COVID pandemic, resulting in psychiatric-mental health nurse practitioner students obtaining clinical hours through this modality. Although patient outcome data demonstrate the efficacy of telemental health services, data on the efficacy of learning through telehealth clinical experiences are lacking. PURPOSE: To explore perceptions of learning through telehealth clinical experiences by students, preceptors, and faculty and to identify perceived barriers and facilitators to facilitating telehealth clinical experiences. METHODOLOGY: Mixed-methods exploratory study using web-based, researcher-designed, cross-sectional surveys eliciting perceptions of learning and perceived barriers and facilitators to telemental health clinical experiences sent to current and former PMHNP students and their preceptors of a state university in the southwest along with PMHNP faculty in the National Organization of Nurse Practitioner Faculties. Students and preceptors were offered the option to participate in a semistructured interview. RESULTS: Twenty students (35.7%), 22 preceptors (24.7%), and 19 faculty (25.3%) participated in the surveys. Three preceptors and three students volunteered for interviews. Telemental health clinicals were perceived by students as equivalent to or superior to in-person learning. Preceptors rated the teaching/learning environment through telemental health as equivalent or better as compared with in-person clinicals with two exceptions. Faculty-rated greatest barrier to telemental health clinicals was telephone visits because of technology issues. CONCLUSIONS: Telemental health clinicals can provide a high-quality learning experience for students. IMPLICATIONS: Preceptors should be provided with resources for facilitating telemental health clinicals. Ongoing discussions regarding the number of clinical hours recommended through telehealth are needed.

Effect of pioglitazone on platelet aggregation in a healthy cohort.

BACKGROUND: Peroxisome proliferator-activated receptor (PPAR) agonists can favorably influence atheroma proliferation, lipoprotein metabolism and macrovascular complications. Pioglitazone, one of the thiazolidinedione compounds, is a PPAR ligand activator and a clinically important PPAR agonist. There is controversy in the literature about its potential antiplatelet effects. Its direct platelet inhibition is a novel hypothesis tested in animal models and in human populations with underlying diabetic and/or cardiovascular diseases. The present study was aimed to test the hypothesis of direct platelet aggregation inhibition with the use of pioglitazone in a healthy population. METHODS: This prospective study was started after obtaining institutional review board approval. The platelet aggregation response to adenosine diphosphate, epinephrine, collagen and arachidonic acid was measured in healthy subjects before and after treatment with pioglitazone. The fasting lipid profile including total cholesterol, low-density lipoprotein, very-low-density lipoprotein and high-density lipoprotein was also measured. RESULTS: Twenty subjects, 12 males and 8 females, were enrolled with a mean age of 31.5 ± 7.6 years (range 24-46). Two subjects did not complete the study and were excluded. The mean HbA1C was 5.4% (range 4.7-5.7). The study showed a non-significant platelet aggregation reduction after taking a 7-day pioglitazone course. The adenosine diphosphate-mediated platelet aggregation difference was not significant (p = 0.99); the arachidonic acid-mediated platelet aggregation difference was 0.6% (p = 0.93), for epinephrine 0.9% (p = 0.88) and for collagen 0.2% (p = 0.94). Further, it did not show a favorable response of lipoprotein profile with a non-significant reduction in all lipid panel values even though there is a slight reduction in total cholesterol, triglyceride, low-density lipoprotein and very low-density lipoprotein and a slight increase in high-density lipoprotein. CONCLUSIONS: We conclude that pioglitazone does not have a direct platelet aggregation inhibition effect in a healthy population, nor does it have a favorable effect on lipoprotein profile after a short treatment period.

Faculty Reflections on International Travel to Reach the Medically Underserved.

One approach to preparing students to engage in culturally diverse health-care settings around the world is to incorporate faculty-led short-term cultural immersion programs in medically underserved nations. This reflective summary analyzes the impact of a faculty-led international health-care trip on students' global health-care experience and needed health-care services in developing countries. A content analysis of the journals of two advanced practice registered nurse (APRN) faculty members was performed to gain perspectives on a trip with undergraduate and graduate nursing students and medical students to a small city in Nicaragua. This article examines the personal and professional growth achieved, and the challenges faced, when managing acute and chronic diseases with limited resources in an unfamiliar country. Themes identified included anxieties of planning, provider versus faculty role, students in action, networking, nurturing behaviors, advocating, and mentoring self-sustainability. Faculty-led international health-care trips both add a needed service to developing countries' health-care needs and offer students the experience of health care from a global perspective.

Health out of foster care as young adults age out of foster care: A phenomenological exploration of seeking healthcare services after aging out of the US foster care system.

Some adolescents in the United States who have been abused and/or neglected by caregivers and placed in permanent custody of the state leave, or "age out" of foster care at 18 years of age. Poor health outcomes among individuals who age out are notable, yet few studies describe the phenomenon of seeking healthcare services after leaving foster care. The investigators specifically queried the phenomenon of seeking healthcare services after foster care drawing from the Phenomenology of Practice approach. We interviewed 13 young adults who aged out of care. Investigators extracted lived experience descriptions (LEDs) from interview transcripts and analyzed under phenomenological themes. Healthcare experiences were marked by avoiding self-disclosure, having no choice but to wait, missing family history, and relying on the kindness of strangers. Healthcare providers who integrate the findings into care delivery models will engage young adults with more understanding and sensitivities of ethical practice.