A Consolidated Framework for Implementation Research-based process to develop theoretically-informed human papillomavirus vaccination educational materials for young adults.

OBJECTIVE: To develop theory-informed human papillomavirus (HPV) vaccine education materials that appeal to 18-26-year-olds. METHODS: First, draft materials informed by Theory of Planned Behavior (TPB) and Health Belief Model (HBM) were developed. Next, an initial set of Consolidated Framework for Implementation Research (CFIR)-guided interviews were conducted with 18-26-year-old participants to receive feedback about content, format, appeal, implementation facilitators and barriers, and potential delivery modalities. Then, interviews were transcribed, coded, and analyzed using thematic analysis. Next, materials were modified based upon feedback. Finally, another set of interviews was conducted. RESULTS: Most participants (n = 15) were female (93%), White (60%), and non-Hispanic (93%). All (100%) had heard of HPV and the HPV vaccine, and 80% reported having received the vaccine. Participant feedback on materials included emphasizing vaccine benefits and efficacy, rewording to enhance comprehension, and adding images represent diversity beyond race/ethnicity and sexual orientation. Suggested delivery methods included social media, print materials, and posters. CONCLUSION: Qualitative interviews with young adults suggest that HPV education materials targeted to 18-26-year-olds should include health behavior theory-aligned messaging, inclusive imagery, and be disseminated through multiple modalities. PRACTICE IMPLICATIONS: Providers should consider utilizing theory-based education materials that are relevant and appealing to young adults.

Iatrogenic Rupture of Saline Breast Implant Following Robotic-Assisted Lung Surgery.

Breast implants are prevalent in the United States. Patients with breast implants may be susceptible to iatrogenic implant rupture during cardiothoracic surgery. To our knowledge, however, this complication has never been described following robot-assisted thoracic surgery (RATS). We described a patient who developed a rupture of a saline breast implant after undergoing a robot-assisted left lower lobectomy. We hypothesized that a tear to the breast implant may have occurred either during the extraction of one of the surgical ports or during the forceful extraction of the resected specimen. This case highlights another potential complication of minimally invasive thoracic surgery. For patients with breast implants undergoing thoracic RATS, extra care should be made to the site of port placement and the avoidance of excessive force during surgery.

The broad spectrum of tyrosine kinase inhibitors. Treatment of a rare EGFR R776H mutation with Osimertinib: Case report.

EGFR mutations comprise a sizeable portion of non-small cell lung cancers. While the most common EGFR mutation consists of exon 19 in-frame deletions and exon 21 point mutations, rare EGFR mutations have become a more frequent occurrence. Currently, no clinical guidelines exist for the treatment of such mutations. In this case, we see a 68-year-old non-small cell lung cancer male patient with a history of smoking presenting with a rare exon 20 R776H EGFR mutation who demonstrates a response to Osimertinib, further exploring potential standard treatments for patients with rare EGFR mutations.