"I'll fill in the gaps": perspectives of HHAs on promoting aging in place for older adults with low incomes.

Older adults with low incomes experience disproportionate rates of cognitive and functional impairment and an elevated risk of nursing home admission. Home health aides (HHAs) may have insight into how to optimize aging in place for this population, yet little is known about HHAs' perspectives on this topic. We conducted 6 focus groups with 21 English-speaking and 10 Spanish-speaking HHAs in Pennsylvania and New Jersey. Transcripts were analyzed using qualitative thematic analysis, and three themes emerged. First, HHAs described the uniqueness of their role within multidisciplinary care teams. Second, HHAs shared concrete interventions they employ to help their clients improve their function at home. Third, HHAs discussed barriers they face when helping clients age in place. Our findings suggest that HHAs have important insights into improving aging in place for older adults with low incomes and that their perspectives should be incorporated into care planning and intervention delivery.

Celebrating Magnet® Nursing Excellence - Meet the Recipients of the 2022 National Magnet Nurse of the Year Awards and ANCC Magnet Prize.

This month's Magnet® Perspectives column spotlights the recipients of the 2022 ANCC Magnet Program National Magnet Nurse of the Year (MNOY) Awards and the ANCC Magnet Prize, sponsored by Oracle Cerner, announced during the colocated ANCC National Magnet Conference® and the ANCC Pathway to Excellence® Conference in Philadelphia, Pennsylvania, on October 13 to 15, 2022.

A Tribute to Margaret Grace Stineman, MD.

The field of physical medicine and rehabilitation mourns the death of Margaret Grace Stineman, MD. She was an incredibly productive researcher who helped to shape the delivery of rehabilitation care. She was a trusted colleague, mentor, and friend to many. Her outstanding accomplishments were acknowledged by her numerous awards and her election into honorary societies. Dr Stineman spent her career at the University of Pennsylvania and retired as Professor Emeritus in 2014. She is survived by her mother and innumerable colleagues and friends who were touched by her passion, intelligence, and dedication.

Why I am a Member (and Why You Should be Too).

Membership is the single biggest issue for the association moving forward into the future. While these may be sobering words to hear; it is the hard truth and we all must face this fact. The Pennsylvania Dental Association and the American Dental Association both know this and have been investing resources to increase the value of membership. I have had the amazing fortune to sit on the PDA Membership Comn-dttee for nearly five years and to be the Chair these last two years. I have seen firsthand just how conunitted the PDA!s staff and volunteer dentists are to building value and increasing membership. I wish to share a little about my story.

[Charlotte Yhlén--the first Swedish woman becoming a medical doctor. She had to move from Sweden to work as a physician]. / Charlotte Yhlén--första svenskan att ta läkarexamen. Hon måste flytta från Sverige för att få arbeta som doktor.

Charlotte Yhlén (1839-1919) was the first Swedish woman with medical education. New research has shed light on this forgotten pioneer. Charlotte was born in a Southern Sweden in a family without academical tradition. In her youth she got inspired by the woman emancipation movement. At an age of 28 she emigrated to the USA and studied at the Woman's Medical College of Pennsylvania. Her student thesis dealt with glaucoma. After graduation, Charlotte applied for work in Sweden but got rejected. Therefore, she moved back to the USA to work at Woman's Hospital of Philadelphia and later with a private practice as a general practitioner. In 1874, she married a Norwegian engineer and the couple got two children. Her husband's successful company Tinius Olsen Company was probably the reason why she gave up her medical career in her 50s. The article describes the conditions for love and work for the first Swedish women with academical education.

Rural Availability of Sexual Assault Nurse Examiners (SANEs).

PURPOSE: Sexual assault care provided by sexual assault nurse examiners (SANEs) is associated with improved health and prosecutorial outcomes. Upon completion of SANE training, nurses can demonstrate their experience and expertise by obtaining SANE certification. Availability of nurses with SANE training or certification is often limited in rural areas, and no studies of rural certified SANEs exist. The purpose of this study is to describe rural SANE availability. METHODS: We analyze both county-level and hospital-level data to comprehensively examine SANE availability. We first describe the geographic distribution of certified SANEs across rural and nonrural (ie, urban or suburban) Pennsylvania counties. We then analyze hospital-level data from semistructured interviews with rural hospital emergency department administrators using qualitative content analysis. FINDINGS: We identified 49 certified SANEs across Pennsylvania, with 24.5% (n = 12) located in 8 (16.7%) of Pennsylvania's 48 rural counties. The remaining 37 certified SANEs (75.5%) were located in 13 (68.4%) of Pennsylvania's 19 nonrural counties. Interview data were collected from 63.9% of all eligible rural Pennsylvania hospitals (n = 63) and show that 72.5% (n = 29) have SANEs. Of these, 20.7% (n = 6) have any certified SANE availability. A minority of hospitals (42.5%; n = 17) have continuous SANE coverage. CONCLUSIONS: Very few SANEs in rural Pennsylvania have certification, suggesting barriers to certification may exist for rural SANEs. Though a majority of hospitals have SANEs, availability of SANEs was limited by inconsistent coverage. A lack of certified SANEs and inconsistent SANE coverage may place rural sexual assault victims at risk of receiving lower quality sexual assault care.

Bernard J. Miller: MD, ScD. (Hon), FACS: Lifelong Surgeon-Scientist and Critical Contributor to the Gibbon Heart-Lung Machine.

Bernard J. Miller, MD, ScD. (Hon), FACS, is known as a critical contributor for his work in the John H. Gibbon, MD, laboratory for his work on the heart-lung machine (HLM). In this setting, Dr. Miller developed the fluid control servo system, which was necessary to prevent malfunctioning of the HLM and prevent air emboli. Additionally, Dr. Miller assisted in conceiving and testing the left ventricular vent, the positive-negative pressure ventilator, and the HLM oxygenator; these inventions were all the product of extensive collaboration between the International Business Machines Corporation and the members of Dr. Gibbon's laboratory. Furthermore, Dr. Miller was a surgical assistant and perfusionist in the first successful open-heart surgery. Herein, we seek to describe Dr. Miller's story and his contributions to the HLM, as well as the contributions that were developed by the laboratory at that time. Additionally, we describe critical events leading up to the first successful use of the HLM on May 6, 1953, including a previously unreported use of the HLM for partial bypass of the right heart at Pennsylvania Hospital in 1952. Finally, we present the rest of Dr. Miller's professional and personal successes after his work on the HLM ended.

Finding a faster route to practice: from medical student to board certified physician.

An examination of two types of educational tracks used by medical students seeking a faster route to practice: 1) "3+3" programs that combined the final year of medical school with the first year of a primary care residency, and 2) graduating from medical school after only three years. The "3+3" programs were discontinued despite reports indicating their success. Three year medical school options are still available at a handful of medical schools. Finally, the paper will explore why and how medical schools might wish to enact a three year curricular option.

Creating a Generation of Sustainable Nurses: Sustainability Efforts in Nursing Education.

Emerging nurse leaders are not adequately prepared to handle the pervasive health care problems and threats related to the changing environment. Nurse educators prepare nurses for an extensive variety of roles and responsibilities necessary to meet the health care needs of society. The Penn State College of Nursing implemented several initiatives to support environmental sustainability within the college and nursing education. The inclusion of environmental sustainability in nursing education is foundational if students are to become informed members and emerging leaders of a broader health care team, advocates for conscientious and ethical resource use, and contributors to improved patient outcomes.

Investigating the Efficacy of a Hybrid EMT Course.

The Pennsylvania College of Technology implemented a region-wide hybrid emergency medical technician (EMT) training course in 2015, following the release of the National Emergency Medical Services Education Standards as well as the Commonwealth of Pennsylvania's transition away from a state-developed EMT exam and towards the EMT exam developed by the National Registry of EMTs. Previous classes were conducted by the training sites in the region utilizing a traditional, classroom-based model. 79.32% of students who completed training within the classes offered by the region between 2007 and 2013 successfully passed the state exam and became certified as EMT's (n=418), compared to 80.52% of the students who completed the current training program conducted by Penn College (n=186). This analysis finds the Penn College program's pass rates on the NREMT cognitive exam (both first attempt and within three attempts) exceed the previous pass rates on the state exam for the region and mirror the national pass rate metrics during the study period. This study concludes that the Penn College hybrid EMT course is an effective method of training new providers for the region.

The pipeline from dental education to practice: the Pennsylvania experience.

The pipeline from Pennsylvania dental education to Pennsylvania practice, rural practice, and low service area practice is described and analyzed. The article contends that pipeline development is an effective vehicle in meeting the public health mandate of ensuring access to dental care for all residents. Data from the American Dental Association served as the basis for addressing the two major research questions: 1) what are the educational origins of the dentist workforce in Pennsylvania, in rural areas of Pennsylvania, and in underserved areas of Pennsylvania? and 2) what is the proportion of Pennsylvania-educated dentists who practice in Pennsylvania, in rural areas of Pennsylvania, and in underserved areas of Pennsylvania? As an overall assessment, one can consider the Pennsylvania dental pipeline inadequate to meet the Commonwealth's public health goals. The pipeline is not adequately developed to repopulate the current Pennsylvania-educated dentist workforce, especially in the most needy areas. Understanding the prospects for further pipeline development is best achieved by considering the pipeline within the context of the practice model of dentistry and the current and future supply of dentists.

To Keep Patients, Some Physicians Get Creative.

In the face of growing competition, traditional practices have begun trying to guarantee same-day appointments.