Virtual postoperative visits following robotic gynecologic surgery: a study of patient satisfaction, safety, and feasibility.

Since the onset of the COVID-19 pandemic the use of telehealth has burgeoned. Numerous surgical specialties have already adopted the use of virtual postoperative visits, but there is data lacking in both robotics and gynecology. In this single-institution prospective cohort study we sought to evaluate the patient satisfaction, feasibility and safety of postoperative telehealth visits following robotic gynecologic surgery. Thirty-three patients undergoing robotic gynecologic procedures participated in a postoperative telehealth visit approximately 2 weeks following surgery, of which 27 completed a survey which assessed participant satisfaction with the telehealth visit, overall health-related quality of life following surgery, exposure to telehealth visits, and social determinants of health. The mean satisfaction score was just below 'excellent'. Only 2 participants (6.3%) required an in-person visit. Postoperative telehealth visit satisfaction score was significantly associated only with BMI (Pearson r = 0.45, p = 0.018). These data suggest that telehealth visits following robotic gynecologic procedures appear to be safe and feasible, and are associated with a high level of patient satisfaction.

A Coala-T-Cannabis Survey Study of breast cancer patients' use of cannabis before, during, and after treatment.

BACKGROUND: The goal of this study was to characterize cannabis use among patients with breast cancer, including their reasons for and timing of use, their sources of cannabis information and products, their satisfaction with the information found, their perceptions of its safety, and their dialogue about cannabis with their physicians. METHODS: United States-based members of the Breastcancer.org and Healthline.com communities with a self-reported diagnosis of breast cancer within 5 years (age ≥ 18 years) were invited to participate in an anonymous online survey. After informed consent was obtained, nonidentifiable data were collected and analyzed. RESULTS: Of all participants (n = 612), 42% (n = 257) reported using cannabis for relief of symptoms, which included pain (78%), insomnia (70%), anxiety (57%), stress (51%), and nausea/vomiting (46%). Furthermore, 49% of cannabis users believed that medical cannabis could be used to treat cancer itself. Of those taking cannabis, 79% had used it during treatment, which included systemic therapies, radiation, and surgery. At the same time, few (39%) had discussed it with any of their physicians. CONCLUSIONS: A significant percentage of survey participants (42%) used cannabis to address symptoms; approximately half of these participants believed that cannabis could treat cancer itself. Most participants used cannabis during active cancer treatment despite the potential for an adverse event during this vulnerable time. Furthermore, most participants believed that cannabis was safe and were unaware that product quality varied widely and depended on the source. This study reviews the research on medicinal cannabis in the setting of these findings to help physicians to recognize its risks and benefits for patients with cancer. LAY SUMMARY: Almost half of patients with breast cancer use cannabis, most commonly during active treatment to manage common symptoms and side effects: pain, anxiety, insomnia, and nausea. However, most patients do not discuss cannabis use with their physicians. Instead, the internet and family/friends are the most common sources of cannabis information. Furthermore, most participants believe that cannabis products are safe and are unaware that the safety of many products is untested.

Athletic Trainer-Reported Prevalence of Mental Health, Substance Use, and Barriers to Health in Secondary Schools.

CONTEXT: Where a person lives can have a significant effect on health. Limited access to health care, food insecurity, lack of affordable housing, and violence increase a person's likelihood of poor health. Athletic trainers (ATs) can contribute to identifying and improving the determinants of health that affect student-athletes. OBJECTIVES: (1) What were the current perceptions ATs had about the health behaviors (specifically mental health and substance use) of high school student-athletes? (2) What were the barriers that ATs experienced when providing health services to high school student-athletes? (3) How did the developed environment affect the health behaviors and barriers that ATs observed? DESIGN: Qualitative study. SETTING: Online survey. PATIENTS OR OTHER PARTICIPANTS: Certified National Athletic Trainers' Association members employed in the secondary school setting. MAIN OUTCOME MEASURE(S): Demographics of ATs were collected, and the ATs' perceptions of the health of student-athletes across developed environments, prevalence of mental health issues, tobacco and substance use, barriers to health care services, and housing and food insecurities among student-athletes were surveyed. Descriptive statistics for the outcome measures were reported. RESULTS: A total of 7600 electronic surveys were distributed to the ATs and 911 responded (females = 62%, average age = 36 years, average experience = 12.5 years). The school setting was identified by 82.5% as public and the environment as suburban by 43.7%, rural by 30.1%, and urban by 26.1%. Participants perceived a high average prevalence of mental health concerns (32%), e-cigarette use (31.7%), and marijuana use (26.9%) among student-athletes. Significant perceived barriers to health included limited access to transportation, poverty, and housing and food insecurities. CONCLUSIONS: This study highlights the health disparities and barriers ATs observed when addressing the health care needs of student-athletes. Understanding the determinants of health in order to identify the causes of health disparities may better prepare ATs to manage the health needs of underserved student-athletes.

Athletic Training and Population Health Science.

OBJECTIVE: To define and discuss the role of population health as a framework to improve care and clinical decision making in athletic training practice. BACKGROUND: Athletic trainers (ATs) are allied health professionals who are uniquely suited to provide preventive and educational health and wellness programs to improve health outcomes across a physically active population. Athletic trainers are often the first contacts for high school athletes seeking health and wellness education, which may allow ATs to be the first intervention or prevention point for reducing or eliminating negative health behaviors and outcomes among their patients. CONCLUSIONS: Integrating a population-health framework into the athletic training setting prepares ATs to address complex health concerns in communities that result from factors that influence determinants of health. The field of athletic training could benefit from a population-health approach to care by broadening consideration of the factors that affect the health of homogeneous populations that are served by ATs.

The Prevalence of Traumatic Brain Injury and On-Campus Service Utilization Among Undergraduate Students.

OBJECTIVE: (1) To examine the prevalence of college-aged students on campus who had a history of concussion(s) or traumatic brain injury (TBI) and associated symptoms and (2) to evaluate the rate of campus service utilization among students who had a TBI. SETTING: A representative sampling, randomly selected campus-wide e-mail was sent out with a Qualtrics online survey. PARTICIPANTS: College-aged students (N = 466, n = 429) at a northeastern US university responded and consented to participate in the online survey. DESIGN: Descriptive study using an online survey to evaluate the prevalence of TBI and subsequent utility of campus services. MAIN OUTCOME MEASURES: The survey assessed concussion history and the diagnosing clinician, activity in which it occurred, level of consciousness, associated symptoms, and utilization of campus services for academic accommodation. RESULTS: Prevalence of concussion/TBI in the study population (51.7%) is notably higher than previous reporting in adult and college populations (∼10%-25%). Campus disability and accommodative services were underutilized (10%-13%) and were accessed more readily by the female population. In addition, there were reportable increases in symptom prevalence and service utilization with a greater number of previous concussions. CONCLUSIONS: Awareness and utilization of accommodative services, especially with a history of concussions, need to be improved in order to ensure academic and occupational success of students.