Mental Health and Black Male Graduate Students.

The purpose of this study was to understand how masculinity and race impact mental health among Black male graduate students. A qualitative study using in-depth interviews recruited Black male graduate students enrolled at a private university in the southern United States. Data were collected over zoom and recorded. Interviews were transcribed and the data were analyzed for similar themes. Twenty-nine Black male graduate students 23 to 51 were recruited. Participants reported the three main elements that impacted their mental health were (1) expectations, (2) pressure, and (3) being strong. These findings suggest that colleges need to develop programming to help Black men learn how to handle racial discrimination in positive ways. Additionally, findings also highlight the need for culturally relevant mental health services that let Black men know seeking help is ok and is what men do.

Impact of COVID-19 on access to and delivery of sexual and reproductive healthcare services in countries with universal healthcare systems: A systematic review.

OBJECTIVES: The COVID-19 pandemic has caused unforeseen impacts on sexual and reproductive healthcare (SRH) services worldwide, and the nature and prevalence of these changes have not been extensively synthesized. We sought to synthesise reported outcomes on the impact of COVID-19 on SRH access and delivery in comparable countries with universal healthcare systems. METHODS: Following PRISMA guidelines, we searched MEDLINE, Embase, PsycInfo, and CINAHL from January 1st, 2020 to June 6th, 2023. Original research was eligible for inclusion if the study reported on COVID-19 and SRH access and/or delivery. Twenty-eight OECD countries with comparable economies and universal healthcare systems were included. We extracted study characteristics, participant characteristics, study design, and outcome variables. The methodological quality of each article was assessed using the Quality Assessment with Diverse Studies (QuADS) tool. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were followed for reporting the results. This study was registered on PROSPERO (#CRD42021245596). SYNTHESIS: Eighty-two studies met inclusion criteria. Findings were qualitatively synthesised into the domains of: antepartum care, intrapartum care, postpartum care, assisted reproductive technologies, abortion access, gynaecological care, sexual health services, and HIV care. Research was concentrated in relatively few countries. Access and delivery were negatively impacted by a variety of factors, including service disruptions, unclear communication regarding policy decisions, decreased timeliness of care, and fear of COVID-19 exposure. Across outpatient services, providers favoured models of care that avoided in-person appointments. Hospitals prioritized models of care that reduced time and number of people in hospital and aerosol-generating environments. CONCLUSIONS: Overall, studies demonstrated reduced access and delivery across most domains of SRH services during COVID-19. Variations in service restrictions and accommodations were heterogeneous within countries and between institutions. Future work should examine long-term impacts of COVID-19, underserved populations, and underrepresented countries.

Real-world evidence generation from patients, their caregivers and physicians supporting clinical, regulatory and guideline decisions: an update on Disease Specific Programmes.

OBJECTIVE: To update on and describe the role of Disease Specific Programmes (DSPs), a multi-perspective real-world data (RWD) source, in the context of the evolution of the value and acceptance of real-world evidence (RWE) in clinical, regulatory and guideline decision-making. METHODS: DSPs are multi-national, multi-subscriber, multi-therapy cross-sectional surveys incorporating retrospective data collection from patient, caregiver and physician perspectives. Information collected covers the patient journey, including treatment/prescribing patterns and rationale, patient-reported outcomes, impact on work and everyday activities, attitudes towards and perceptions of the condition, adherence to treatment and burden of illness. Published peer-reviewed DSP papers were aligned with current key RWE themes identified in the literature, alongside their contribution to RWE. RESULTS: RWE themes examined were: using RWE to inform clinical practice, patient and caregiver engagement, RWE role in supporting health technology assessments and regulatory submissions, informing value-driven healthcare decisions, real-world patient subgroup differences and therapeutic inertia/unmet needs; highlighting patients' and caregivers' experience of living with a disease, disconnect from their physicians, unmet needs and educational gaps. CONCLUSIONS: DSPs provide a wealth of RWD in addition to evidence generated by registries, clinical trials and observational research, with wide use for the pharmaceutical industry, government, funding/regulatory bodies, clinical practice guideline insights and, most importantly, informing improvements in people's lives. The depth, breadth and heritage of information collected via DSPs since 1995 is unparalleled, extending understanding of how diseases are managed by physicians in routine clinical practice and why treatment choices are made, patients' perceptions of their disease management, and caregiver burden.

"Addressing the bigger picture": A qualitative study of internal medicine patients' perspectives on social needs data collection and use.

BACKGROUND: There is increasing interest in collecting sociodemographic and social needs data in hospital settings to inform patient care and health equity. However, few studies have examined inpatients' views on this data collection and what should be done to address social needs. This study describes internal medicine inpatients' perspectives on the collection and use of sociodemographic and social needs information. METHODS: A qualitative interpretive description methodology was used. Semi-structured interviews were conducted with 18 patients admitted to a large academic hospital in Toronto, Canada. Participants were recruited using maximum variation sampling for diverse genders, races, and those with and without social needs. Interviews were coded using a predominantly inductive approach and a thematic analysis was conducted. RESULTS: Patients expressed that sociodemographic and social needs data collection is important to offer actionable solutions to address their needs. Patients described a gap between their ideal care which would attend to social needs, versus the reality that hospital-based teams are faced with competing priorities and pressures that make it unfeasible to provide such care. They also believed that this data collection could facilitate more holistic, integrated care. Patients conveyed a need to have a trusting and transparent relationship with their provider to alleviate concerns surrounding bias, discrimination, and confidentiality. Lastly, they indicated that sociodemographic and social needs data could be useful to inform care, support research to inspire social change, and assist them with navigating community resources or creating in-hospital programs to address unmet social needs. CONCLUSIONS: While the collection of sociodemographic and social needs information in hospital settings is generally acceptable, there were varied views on whether hospital staff should intervene, as their priority is medical care. The results can inform the implementation of social data collection and interventions in hospital settings.

Corticosteroid-Induced Psychosis: A Report of Three Cases.

Corticosteroids are commonly used for pain management and inflammatory conditions but can cause neuropsychiatric complications ranging from anxiety to severe mood and psychotic symptoms. These complications can occur shortly after steroid treatment begins or at any point during therapy, and even after treatment has stopped. We present three cases of corticosteroid-induced psychosis in patients being treated for pain. The mechanism behind these complications is not fully understood, but stress on the hypothalamic-pituitary-adrenal (HPA) axis is thought to play a role. Clinicians should be cautious and regularly evaluate patients to minimize the risk of complications. More research is needed to understand the underlying pathophysiology.

It's the Experience: A Course Redesign to Shift Student Perspectives on Population-Centered Nursing.

ABSTRACT: An innovative experiential learning activity in an online undergraduate population health nursing course provided an authentic experience that connected course content with abstract concepts and patient situations. To address identified application needs, the design incorporated social determinants of health to enhance realism and applicability and build readiness for nursing practice through the experience.

Impact of Patient and Physician Disconnect on Satisfaction with Treatment for Atopic Dermatitis in Japan.

INTRODUCTION: Atopic dermatitis (AD) is an inflammatory disease causing severe skin itching. Data on patient-physician disconnect on treatment satisfaction in patients with AD in Japan are limited. We investigated patient-physician disconnect on treatment satisfaction in AD and if it influences treatment patterns, clinical characteristics, and patient-reported outcomes (PROs). METHODS: Data were drawn from the Adelphi AD Disease Specific Programme (DSP), a real-world, point-in-time survey of physicians and patients with AD conducted in Japan from April to July 2019. Patients and physicians were grouped according to level of treatment satisfaction ("extremely satisfied" to "extremely dissatisfied"); with any level of dissatisfaction recorded as "less than satisfied." Data were collected on treatment patterns, clinical characteristics, and PROs including the Dermatology Life Quality Index (DLQI), Patient-Oriented Eczema Measure (POEM), EQ-5D-3L questionnaire, and Work Productivity and Activity Impairment (WPAI) questionnaire. RESULTS: Data were provided by 184 patients with AD and 56 physicians; 72.8% of patient-physician pairs reported a fair (kappa coefficient: 0.40) level of agreement on treatment satisfaction, 51.6% of patient-physician pairs were both satisfied, and 21.2% were both less than satisfied. Satisfied physicians prescribed a mean 1.2 fewer treatments than dissatisfied physicians (p < 0.05). Cases where both physician and patient were less than satisfied or where patients were less satisfied than their physicians reported the worst PROs, DLQI (both less than satisfied: mean 10.7 versus patient less satisfied than physician: 10.6 versus overall: 7.9), POEM (19.5 versus 17.3 versus 17.0), EQ-5D-3L (0.82 versus 0.81 versus 0.87) (all, p < 0.05). Work impairment was highest when both patient and physician were less than satisfied (p < 0.05). Physicians cited treatment efficacy and patients cited efficacy and usability as main reasons for dissatisfaction. CONCLUSION: Overall, 12.0% of patients were less satisfied with their AD treatment than the physician, demonstrating some of the worst PROs, suggesting unmet need that could be improved by better patient-physician communication.

Collection and Use of Social Determinants of Health Data in Inpatient General Internal Medicine Wards: A Scoping Review.

BACKGROUND: There is growing interest in incorporating social determinants of health (SDoH) data collection in inpatient hospital settings to inform patient care. However, there is limited information on this data collection and its use in inpatient general internal medicine (GIM). This scoping review sought to describe the current state of the literature on SDoH data collection and its application to patient care in inpatient GIM settings. METHODS: English-language searches on MedLine, Embase, Web of Science, CINAHL, Cochrane, and PsycINFO were conducted from 2000 to April 2021. Studies reporting systematic data collection or use of at least three SDoH, sociodemographic, or social needs variables in inpatient hospital GIM settings were included. Four independent reviewers screened abstracts, and two reviewers screened full-text articles. RESULTS: A total of 8190 articles underwent abstract screening and eight were included. A range of SDoH tools were used, such as THRIVE, PRAPARE, WHO-Quality of Life, Measuring Health Equity, and a biopsychosocial framework. The most common SDoH were food security or malnutrition (n=7), followed by housing, transportation, employment, education, income, functional status and disability, and social support (n=5 each). Four of the eight studies applied the data to inform patient care, and three provided community resource referrals. DISCUSSION: There is limited evidence to guide the collection and use of SDoH data in inpatient GIM settings. This review highlights the need for integrated care, the role of the electronic health record, and social history taking, all of which may benefit from more robust SDoH data collection. Future research should examine the feasibility and acceptability of SDoH integration in inpatient GIM settings.

How the Term 'Self-Management' is Used in HIV Research in Low- and Middle-Income Countries: A Scoping Review.

This scoping review assessed how the term 'self-management' (SM) is used in peer-reviewed literature describing HIV populations in low- and middle-income countries (LMIC). This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. OVID Medline, Embase, CAB Abstracts, and EBSCO CINAHL, Scopus, and Cochrane Library were searched up to September 2021 for articles with SM in titles, key words, or abstracts. Two team members independently screened the titles and abstracts, followed by the full-text. A data extraction tool assisted with collecting findings. A total of 103 articles were included. Since 2015, there has been a 74% increase in articles that use SM in relation to HIV in LMIC. Fifty-three articles used the term in the context of chronic disease management and described it as a complex process involving active participation from patients alongside providers. Many of the remaining 50 articles used SM as a strategy for handling one's care by oneself, with or without the help of community or family members. This demonstrates the varied conceptualizations and uses of the term in LMIC, with implications for the management of HIV in these settings. Future research should examine the applicability of SM frameworks developed in high-income settings for LMIC.

Management of Psychosis Associated with Graves' Disease: A Rare Case Report.

Graves' disease is an autoimmune disease in which patients can rarely present with psychiatric symptoms. In these patients, detailed history with psychiatric evaluation using a mental status examination is crucial for the early identification of psychiatric manifestations. Early intervention with medical and surgical therapy can help effectively treat the condition and prevent adverse outcomes such as catatonia. We reported the case of a 25-year-old African American female with Graves' disease who had significant stressors and presented with auditory hallucinations. She was diagnosed with psychosis secondary to Graves' disease and was managed medically using antithyroid drugs and beta-blockers. On failure of medical therapy, a surgical approach was employed. The patient was managed successfully, and her condition improved. Our case highlights that the importance of early intervention in these cases can lead to successful outcomes in patients with Graves' disease-induced psychosis.

Tipping Point: Integrating Social Determinants of Health Concepts in a College of Nursing.

BACKGROUND: State health rankings, national nursing education reform, and increasing awareness of social injustices propelled a college of nursing to transform its strategic plan, infrastructure, and curriculum. The prevalence of social determinants of health (SDOH) in South Carolina indicates a need for the state's health workforce to understand the impact of SDOH and recognize strategies to address and ameliorate SDOH. With the paradigmatic integration of diversity, equity, and inclusion in nursing education, there is a need for programmatic and curricular integration of SDOH to increase awareness, foster understanding, and transform perspectives among nursing faculty, staff, and students. METHOD: Institutional changes were made to improve inclusive excellence, and the evolutionary process is described. RESULTS: SDOH-rich resources and experiential learning have been integrated across a college of nursing. CONCLUSION: This journey is ongoing and essential for preparing nurses to advance patient advocacy, health equity, and social justice for diverse populations. [J Nurs Educ. 2021;60(12):703-706.].

Bimetallic Mn, Fe, Co, and Ni Sites in a Four-Helix Bundle Protein: Metal Binding, Structure, and Peroxide Activation.

Bimetallic active sites in enzymes catalyze small-molecule conversions that are among the top 10 challenges in chemistry. As different metal cofactors are typically incorporated in varying protein scaffolds, it is demanding to disentangle the individual contributions of the metal and the protein matrix to the activity. Here, we compared the structure, properties, and hydrogen peroxide reactivity of four homobimetallic cofactors (Mn(II)2, Fe(II)2, Co(II)2, Ni(II)2) that were reconstituted into a four-helix bundle protein. Reconstituted proteins were studied in solution and in crystals. All metals bind with high affinity and yield similar cofactor structures. Cofactor variants react with H2O2 but differ in their turnover rates, accumulated oxidation states, and trapped peroxide-bound intermediates. Varying the metal composition thus creates opportunities to tune the reactivity of the bimetallic cofactor and to study and functionalize reactive species.

Fish can use hydrostatic pressure to determine their absolute depth.

Hydrostatic pressure is a global cue that varies linearly with depth which could provide crucial spatial information for fish navigating vertically; however, whether fish can determine their depth using hydrostatic pressure has remained unknown. Here we show that Mexican tetras (Astyanax mexicanus) can learn the depth of a food site and consistently return to it with high fidelity using only hydrostatic pressure as a cue. Further, fish shifted their search location vertically as predicted if using pressure alone to signal depth. This study uncovers new sensory information available to fish which allows them to resolve their absolute depth on a fine scale.

"I FELT THE CONNECTION": A QUALITATIVE EXPLORATION OF STANDARDIZED PATIENTS' EXPERIENCES IN A DELIVERING BAD NEWS SCENARIO.

BACKGROUND: Little research has examined standardized patient experiences in stressful simulation scenarios. METHODS: Qualitative, secondary data analysis. RESULTS: Emergent themes included: "Those kinds of things are important": The incorporation of personal experiences enhances communication accommodation experiential learning; "She was trying to buffer the bad news": How SPs recognize and address problematic divergent behaviors; and "The emotions come up": Interactions with excellent communication accommodation behaviors can lead to SP emotional and physical distress. CONCLUSION: Standardized patient expertise enhances scenario realism and communication skills evaluation. To minimize distress, simulation educators should tailor safety measures specifically for the individual standardized patient and the scenario.

Rapid Transition to Online Learning for Baccalaureate Students: Teamwork During a Pandemic.

BACKGROUND: This article describes how a college of nursing (CON) converted its traditional undergraduate academic program to a 100% online program within 2 weeks of being informed of the need for curricular modifications due to the COVID-19 pandemic. METHOD: The college faculty met online prior to implementation to discuss student needs and special considerations. Clinical simulation experiences were developed based on International Association for Clinical Simulation and Learning (INACSL) standards and delivered through virtual simulation. RESULTS: Students evaluated the clinical simulation experiences in each course using Likert-style measures and reported positive experiences overall. Each cohort of students, including the May 2020 graduating seniors, successfully completed all of their classes for progression to the next semester or graduation. CONCLUSION: The successful conversion of traditional academic programs into a virtual environment requires leadership, collaboration, and teamwork. This CON had positive outcomes and offers lessons learned for future implementation. [J Nurs Educ. 2021;60(7): 397-399.].

Hydrophobic AlOx Surfaces by Adsorption of a SAM on Large Areas for Application in Solar Cell Metallization Patterning.

A resist-free metallization of copper-plated contacts is attractive to replace screen-printed silver contacts and is demonstrated on large-area silicon heterojunction (SHJ) solar cells. In our approach, a self-passivated Al layer is used as a mask during the plating process. In this study, Al/AlOx or Al2O3 plating masks are further functionalized by a self-assembled monolayer (SAM) of octadecyl phosphonic acid (ODPA). The ODPA adsorption is characterized by X-ray photoelectron spectroscopy (XPS), Fourier transform infrared spectroscopy in attenuated total reflectance (FTIR-ATR) (in situ), and contact angle measurements to link the surface chemical composition to wetting properties. The SAM leads to homogeneous hydrophobic surfaces on large-area textured solar cells and planar flexible printed circuit boards (PCBs), which allows reproducible patterning of narrow lines by inkjet printing of an etchant. Selective copper plating is then performed to complete the metallization process and produce Cu contacts in the patterned areas. Silicon heterojunction (SHJ) solar cells metallized by the complete sequence reached up to 22.4% efficiency on a large area.

Outcomes That Matter Most to Young Adults Diagnosed with Cancer: A Qualitative Study.

Purpose: The purpose of this study is to provide insight for improvement in care for young adults diagnosed with cancer (YADC), by identifying underemphasized outcomes that strongly matter to YADC and the gaps in care that may limit achieving these outcomes for this unique and vulnerable population. Methods: Twenty-seven YADC, ages 25-39, participated in unstructured discussions focusing on topics relating to diagnosis, daily experiences living with cancer outside of the clinical setting, goals, concerns, and clinical care experience. Most participants engaged in group discussions using Experience Group methodology. Discussions were designed to collect information on three dimensions of health: capability, comfort, and calm (CCC). Data were coded using thematic analysis with NVivo software. Results: Several themes were identified within the CCC framework: capability in terms of confronting mortality at a young age, losing youthful identity and control over major life course decisions, especially fertility, and debilitating side effects, comfort in terms of the lack of understanding from peers and family and the fear of cancer recurrence, and calm was discussed as the difficulty of making complex medical decisions, financial toxicity, and loss of clinical support in survivorship. Conclusion: This research highlighted four care additions that are important for YADC: (1) concise and understandable education about their condition and treatment; (2) same-age support groups; (3) fertility support; and (4) better care transitions for life after cancer. These findings emphasize the importance of creating a collaborative, multidisciplinary care team and a holistic approach with care innovations that support clinicians to meet the unique needs of YADC.

Guideline No. 395-Female Genital Cutting.

OBJECTIVES: To decrease the likelihood that the practice of female genital cutting (FGC) be continued in the future and to improve the care of girls and women who have been subjected to FGC or who are at risk by providing (1) information intended to strengthen knowledge and understanding of the practice, (2) information regarding the legal issues related to the practice, (3) guidance for the management of its obstetrical and gynaecological complications, and (4) guidance on the provision of culturally competent care to girls and women affected by FGC. OPTIONS: Strategies for the primary, secondary, and tertiary prevention of FGC and its complications. OUTCOMES: The short- and long-term consequences of FGC. INTENDED USERS: Health care providers delivering obstetrical and gynaecological care. TARGET POPULATION: Women from countries where FGC is commonly practised and Canadian girls and women from groups who may practise FGC for cultural or religious reasons. EVIDENCE: Published literature was retrieved through searches of PubMed, CINAHL, and the Cochrane Library in September 2010 using appropriate controlled vocabulary (e.g., Circumcision, Female) and key words (e.g., female genital mutilation, clitoridectomy, infibulation). Searches were updated and incorporated in the guideline revision December 2018. VALIDATION METHODS: The quality of evidence in this document was rated using the criteria described in the Report of the Canadian Task Force on Preventive Health Care. BENEFITS, HARMS, AND COSTS: There are no anticipated harms or costs to health care facilities with implementation of this guideline. Benefits may include a greater willingness of women living with FGC to seek timely care. SUMMARY STATEMENTS: RECOMMENDATIONS.

Directive clinique No 395 - Excision génitale féminine.

OBJECTIFS: La présente directive clinique vise à diminuer la probabilité que la pratique de l'excision génitale féminine (EGF) se poursuive et à améliorer les soins prodigués aux filles et aux femmes qui ont subi une EGF ou qui risquent d'en subir une en fournissant (1) des renseignements destinés à améliorer les connaissances et la compréhension de la pratique, (2) des renseignements sur les enjeux juridiques liés à cette pratique, (3) des directives relatives au traitement des complications obstétricales et gynécologiques connexes et (4) des directives sur la compétence culturelle dans la prestation de soins aux filles et femmes touchées par l'EGF. OPTIONS: Des stratégies de prévention primaire, secondaire et tertiaire de l'EGF et de ses complications. RéSULTATS: Les conséquences à court et à long terme de l'EGF. UTILISATEURS CIBLES: Les fournisseurs de soins de santé qui fournissent des soins obstétricaux et gynécologiques. POPULATION CIBLE: Les femmes originaires de pays où l'EGF est couramment pratiquée ainsi que les filles et femmes canadiennes issues de groupes où l'EGF est parfois pratiquée pour des motifs culturels ou religieux. DONNéES PROBANTES: Des recherches ont été effectuées en septembre 2010 dans le moteur PubMed et les bases de données CINAHL et Cochrane Library au moyen d'une terminologie contrôlée appropriée (p. ex. Circumcision, Female) et de mots-clés en anglais (p. ex. female genital mutilation, clitoridectomy, infibulation) afin de rassembler la littérature publiée sur le sujet. Les recherches ont été mises à jour et intégrées à la révision de la directive clinique en décembre 2018. MéTHODES DE VALIDATION: La qualité des données probantes contenues dans le présent document a été évaluée en fonction des critères décrits dans le rapport du Groupe d'étude canadien sur les soins de santé préventifs. AVANTAGES, PRéJUDICES, ET COûTS: Aucun coût ni préjudice n'est anticipé pour la mise en œuvre de cette directive clinique dans les établissements de santé. Au nombre des avantages, la directive pourrait inciter les femmes ayant subi une EGF à solliciter rapidement des soins. DÉCLARATIONS SOMMAIRES: RECOMMANDATIONS.

Room-temperature cycling of metal fluoride electrodes: Liquid electrolytes for high-energy fluoride ion cells.

Fluoride ion batteries are potential "next-generation" electrochemical storage devices that offer high energy density. At present, such batteries are limited to operation at high temperatures because suitable fluoride ion-conducting electrolytes are known only in the solid state. We report a liquid fluoride ion-conducting electrolyte with high ionic conductivity, wide operating voltage, and robust chemical stability based on dry tetraalkylammonium fluoride salts in ether solvents. Pairing this liquid electrolyte with a copper-lanthanum trifluoride (Cu@LaF3) core-shell cathode, we demonstrate reversible fluorination and defluorination reactions in a fluoride ion electrochemical cell cycled at room temperature. Fluoride ion-mediated electrochemistry offers a pathway toward developing capacities beyond that of lithium ion technology.