Experiences of Adult Men Who Are Homeless Accessing Care: A Qualitative Study.

INTRODUCTION: Homeless individuals experience increased rates of chronic physical and mental health conditions. They also experience difficulty accessing care and poor health outcomes compounded by social and economic factors, such as housing insecurity, unemployment, and limited social support. The purpose of this study was to describe the perceptions of homeless individuals related to their health and experiences accessing care. METHOD: Qualitative descriptive methods and content analysis were used to gather, analyze, and interpret the data and identify themes. RESULTS: Three themes were identified: men who are homeless experience bias throughout their health care and interpersonal relationships, the best care is person-centered and considers patients' priorities, and care coordination resources are inadequate. DISCUSSION: The housing needs of homeless individuals are best contextualized by their health and social needs. In addition, their priorities must be taken into consideration to develop culturally congruent services that are appropriate and effective care for this population.

Dear Unknown: A Letter to a Teenage Gunshot Victim.

A medical student/adjunct clinical chaplain reflects on the significance of a young life lost to gun violence.

How Should Physicians Manage Neuroprognosis with ECPR?

Rapidly advancing technologies in the field of extracorporeal cardiopulmonary resuscitation (ECPR) have presented a new challenge in accurate neuroprognostication following cardiac arrest. Determination of brain state informs the prognostic picture and allows providers to begin effective communication regarding likelihood of meaningful neurological recovery as defined by patients or family members. The evolving role of sedation during ECPR and its impacts on ethical tension in decision-making is reviewed. Work surrounding the advancing field of neuroprognostication after cardiac arrest and hypothermia is summarized and implications of premature withdrawal of life-sustaining treatments are discussed. Advances that improve predictive value for neurological recovery are utilized in affirming and discussing the implications for end-of-life wishes of individuals in the setting of intensive resuscitative therapies.

Children with Short Stature and Growth Failure: Heightism, Gender and Racial Disparities.

Growth is the single most important indication of the health of a child. Identification of growth disorders in all children is crucial as growth failure can be the first sign of a number of acute and chronic conditions. However, gender and racial biases have resulted in inequities in the identification, referral and treatment of children with growth disorders. In addition, short children have been impacted by a number of psychosocial issues. Heightism is prejudice or discrimination against individuals based on height, and refers to discrimination against individuals whose height is not within the normal acceptable range. Studies have shown that short children have been affected by juvenilization, teasing, bullying, victimization, loss of independence/ overprotection, and exclusion. The role of the advanced practice nurse is critical in addressing heightism and racial and gender disparities in children with growth failure/short stature.