Dr. Jo-Ann Moore is a Board Certified Adult Nurse Practitioner who has her Doctor of Nursing Practice.  She has over 40 years of experience as a RN, Nurse Practitioner and Nurse Educator.  She has practiced in numerous fields including Oncology. Cardiology, Home Care, Urology, Primary and Urgent Care.

Currently, she is a Board Certified Urology Nurse Practitioner as well as an Associate Professor of Nursing at Johnson and Wales University.  She has taught in both undergraduate and graduate nursing programs as well as a preceptor for  numerous NP students throughout her long career.

She has been an invited speaker on both a local and National level and has presented on various topics for the Nurse Practitioner Alliance of RI, the American Urological Association and the Society of Urological Nurses and Associates.

Dr. Behnke is a highly seasoned nurse practitioner who is an experienced lecturer.  Her wisdom, broad experience, and sense of humor is appreciated by many who attend her lectures.  She has practiced in rural areas for most of her career, served as an assistant professor at the University of Michigan – Flint, and has used telehealth for multiple contacts. As a practicing clinician, she can see the pros and cons of the use of telehealth from the primary care as well as the psychiatric perspective.

Brandon Lucke-Wold was born and raised in Colorado Springs, CO. He graduated magna cum laude with a BS in Neuroscience and distinction in honors from Baylor University. He completed his MD/PhD, Master's in Clinical and Translational Research, and the Global Health Track at West Virginia University School of Medicine.

James Waterson is a registered nurse and has specialist qualifications in Children’s Critical Care, Offshore Medicine and in Renal Nursing.

He has Master’s Degrees in Medical Education from the University of Dundee, and in Health Economics and Pharmacoeconomics from Pompeu Fabra University School of Management, Barcelona.

He has published papers on medication safety, alarm fatigue, medical device interoperability, introducing robotics into compounding and dispensing units, and on managing critically ill paediatric patients in adult facilities, and is a peer reviewer for the Journal of Infusion Nursing, Applied Clinical Informatics Journal, and the Journal of Pediatric Pharmaceutical Therapeutics.

MYSELF DR RADHA M G IS A SENIOR CONSULTANT INTENSIVIST WORKING IN RAMAIAH MEMORIAL HOSPITAL BENGALURU-INDIA. I HAVE VAST EXPERIENCE IN CRITICAL CARE FOR MORE THAN 15 YEARS NOW. After graduating from prestigious Mysuru medical college ,did post-graduation in medicine from st johns medical college . had the privilege of getting trained in reputed institutions like pd Hinduja mumbai and manipal hospitals Bengaluru in critical care medicine by stalwarts like Kapadia sir and jose sir .i feel it is my responsibility to continue the legacy . I have special interests in infections in icu , tropical infections ,antimicrobial stewardship ,communication and end of life .

In the last 2 years , have done many certification courses like palliative care ,critical care infectious diseases , integrated digital intensive care medicine ,quality assurance and accreditation by reputed organisations .

My moto is to do better everyday

Pediatric Stroke: Improving Diagnosis and Management Strategies
Pediatric stroke is an important cause of mortality and morbidity in children. There is a paucity of clinical trials pertaining to pediatric stroke management, and solidified universal guidelines are not established for children as they are for the adult population. Diagnosis of pediatric stroke can be challenging, and it is often delayed or mischaracterized which can result in worse outcomes. Understanding risks and appropriate therapy is paramount to improving care.

The views and experiences of nursing and midwifery academics regarding LGBTQ+ health education in pre-registration programmes: Qualitative findings from a mixed-methods study
The visibility of LGBTQ+ people within society has increased in recent decades and is supported by inclusive legislation in some countries. Despite these developments many continue to experience discrimination and exclusion and some live in fear of their lives. From a health perspective, LGBTQ+ people can experience significant health needs and health inequalities. This impacts negatively on their health and well-being and life expectancy. Due to their health concerns, LGBTQ+ people require access to all areas of health services. However, some LGBTQ+ people are reluctant to access health services due to barriers and may encounter negative attitudes from health professionals who may lack the knowledge, skills and attitudes necessary to meet their needs.

Development of a Public Health Model for Translation of Best Practices in Addressing Vitamin D Deficiency
Vitamin D deficiency (VDD), defined as 25(OH)D <20ng/ml, is a global public health concern. An international group of vitamin D researchers recommends targeting optimal blood levels of 40-60ng/ml to decrease global prevalence of VDD, improve patient outcomes, population health, and decrease costs. A literature review revealed no public health model of evidence-based vitamin D best practices for translating research into practice, and healthcare professionals lack vitamin D knowledge and confidence in translating evidence into practice.

"Nutritional Status Predicts Fatty Acid Uptake from Fish and Soybean Oil Supplements for Treatment of Cancer-Related Fatigue: Results from a Phase II Nationwide Study."
Cancer-related fatigue is a prevalent and debilitating condition that persists for years into survivorship. Studies evaluating both fish oil supplementation on fatigue and associations between fish oil consumption and fatigue have shown mixed effects; it is unknown what factors contribute to these differential effects. Herein, we investigate whether the nutritional status of cancer survivors was associated with serum omega-3 concentration or change in serum omega-3s throughout a fish oil supplementation study, and then if any of these factors were associated with fatigue. Breast cancer survivors 4-36 months post-treatment with moderate-severe fatigue were randomized to take 6 g fish oil, 6 g soybean oil, or 3 g of each daily for 6 weeks. Baseline nutritional status was calculated using the Controlling Nutritional Status tool (serum albumin, lymphocytes, cholesterol). At baseline and post-intervention, serum fatty acids were quantified and fatigue was assessed using the Multidimensional Fatigue Symptom Inventory.

Changes in the Trauma ICU Staff Mindset After Implementation of Early Mobilization Protocol for Ventilated Trauma Patients
Background: The purpose of this study was to explore multidisciplinary trauma team`s perceptions of a nurse driven early mobilization of mechanically ventilated patients (EMVP) protocol in the Trauma ICU (TICU) setting. Several recent studies suggested that the EMVP in the intensive care unit is effective in shortening the duration of recovery, improving the quality of life and reducing healthcare costs. Methods: The pre and post survey method was used to explore TICU multidisciplinary team`s (nurses, physicians, therapists, patient care technicians, managers) perceptions of EMVP protocol with nursing driven inclusion /exclusion criteria before and after implementation. Exploratory descriptive validated survey tool with seven items and five-point Likert scale evaluation was use. Survey questionnaire was re-administered to TICU multidisciplinary staff five months after the implementation. Pre-survey responses (n=47) were compared to post-survey results (n=47). Data was analyzed by the multidisciplinary Trauma Team

Decreasing 30 Day CHF Hospital Readmissions by Implementing a NP Home Based Clinical Pathway
Congestive heart failure (CHF) is a major health concern in the United States. It affects approximately 5 million people annually, with a cost of $34.4 billion per year in 2015. The cost per year in 2022 was $30.7 billion.. (1) The national average for 30-day readmission rates for CHF patients on Medicare in 2015 was 23%. The readmission rate in 2021 was 21.3%. (2) Purpose/Goal: The purpose of this project was to evaluate the efficacy of a home-based Clinical Pathway for CHF patients > 65 years of age. Methods and Results: 22 CHF patients (mean age 78-78.33 years) were entered onto a CHF Clinical Pathway Program between 12/1/2014 and 3/31/2015. Two out of 22 patients were admitted to an acute facility within 30-days reflecting a 9% 30-day readmission rate.

A Path Model for Burnout in Community Mental Health Professionals
The purpose of this research is to identify a path model to explain burnout in community mental health professionals based on the compassion satisfaction–compassion fatigue (CS-CF) model. A total of 125 mental health professionals, including nurses, social professionals, and psychologists working in mental health welfare centers in various regions across South Korea were surveyed using a structured questionnaire. A path analysis was conducted using SPSS 24.0 and AMOS 24.0. The results showed that compassion satisfaction and compassion fatigue are significant predictors of burnout

Telehealth, increasing access to care
Access to care has been a challenge for people who have lived in rural areas for a long time. COVID-19 highlighted this difficulty and the importance of telehealth in an attempt to improve this social determinant of health. The use of telehealth for specialty consultation and diagnostic assistance has been shown to be beneficial. Concerning patient care, many opportunities exist, especially in the field of mental health. For telehealth to be effective, there are pillars to providing excellence in telehealth care. This talk will review critical issues to enhance a telehealth program. Examples of appropriate interviews/interventions will be presented as well as interviews that may need to be more effective will be provided. Critical information for the telehealth visit will be provided as well.

Leadership behaviors, attitudes and characteristics to support a culture of safety
It has been estimated that medical errors are the third highest-ranking cause of death in the United States. A patient safety culture has been touted for many years as best practice to reduce medical error. While there is a general agreement of its importance, it has remained elusive for many. This study sought to learn how strengthening leadership skills within a health care organization could catalyze patient safety culture improvement. The research asked the following to gain an appreciation for that question: How does a leader ensure consistency in policies, practices, and protocols to create a patient safety culture? What attitudes, beliefs, and collective efficacy are needed to produce a patient safety culture? What leadership characteristics are needed to create a patient safety culture? The research participants were the employees who make up the patient safety department in a large academic health care system. Information was gathered to capture their view of leadership’s role in patient safety culture and to gain knowledge relative to their individual experiences following a medical error.

The associations between lipid profiles and visceral obesity among gastrointestinal cancer patients: a cross-sectional study
Visceral obesity is associated with cancer incidence and prognosis. Altered lipid profiles are frequently seen in visceral obese patients. The blood test of lipid profiles is more convenient and has no radical side effects than computed tomography (CT), which is presently the most accurate way to measure visceral fat area. This article aims to investigate the associations between lipid profiles and visceral obesity in gastrointestinal cancer patients. Methods: In total, 399 patients newly diagnosed with gastrointestinal cancer were enrolled in this observational study. Lipid profiles were obtained from blood samples, and visceral fat mass area (VFA) was measured by CT

With the goal of humanization of intensive care : How can we implement the human-centered care in the ICU?
Patients often feel dehumanized while treated in the ICUs. This is because people tend to dehumanize someone who is unable to express their feelings or intensions, or depends on life-supporting machines. What can we do to pursue patient- and family- centered care in such environment? We implemented an out-of-the-ICU activity program, which includes indoor excursion, outdoor excursion, and bathing, as an early rehabilitation strategy and provide both ICU patients and family members with more enjoyable and meaningful experiences. Herein, we introduce the practice and the safety of the out-of-the-ICU program and the staff’s perception of it.

Student nurses' educational experiences during COVID-19: A qualitative study
Due to the COVID-19 pandemic, many unexpected changes occurred in healthcare. With the abrupt change to online education in 2020, nursing students experienced challenges with virtual learning which impacted their perception of preparedness to practice. There were few qualitative studies completed in the U.S. that investigated the nursing students’ experiences. The aim of this study was to explore pre-licensure nursing students’ experiences with the transition to virtual learning and their perception of nursing amidst a pandemic. Objectives: This study investigated nursing students’ experiences and perceptions of the nursing profession amidst a pandemic and explored whether students would continue pursuing a career in nursing.

Association between Depression, Happiness, and Sleep Duration: Data from the UAE Healthy Future Pilot Study
The United Arab Emirates Healthy Future Study (UAEHFS) is one of the first large prospective cohort studies in the region which examines causes and risk factors for chronic diseases among the nationals of the United Arab Emirates (UAE). The aim of this study is to investigate the eight-item Patient Health Questionnaire (PHQ-8) as a screening instrument for depression among the UAEHFS pilot participants. Methods The UAEHFS pilot data were analyzed to examine the relationship between the PHQ-8 and possible confounding factors, such as self-reported happiness, and self-reported sleep duration (hours) after adjusting for age, body mass index (BMI), and gender.

Challenges and opportunities in the design of multicenter observational studies of severe acute respiratory infections
COVID-19 pandemic, thus motivating the need to study their natural history, prognostic biomarkers, and clinical and personal risk factors. This talk describes the development and implementation of a protocol for, and the associated challenges and opportunities arising through, the Severe Acute Respiratory Infection – Preparedness (SARI-PREP) study. SARI-PREP is a multicenter observational study, featuring the collaboration of multiple clinical networks, of patients admitted to an acute care ward or intensive care unit from a geographically diverse set of hospital systems across the United States.

Applying the Toyota production system to decrease the time required to transport patients undergoing surgery from the general ward to the operating room and reviewing the essence of lean thinking
Delayed patient transport causes the patient to go hungry for a longer time, aggravating the patient’s physical discomfort and psychological stress. The issue of delays in transporting inpatients to the operating room has rarely been discussed in the literature. The Toyota production system (lean management) is a very effective thinking model and an excellent scientific method of reducing waste and increasing efficiency. The main goal of this presentation is to use the Toyota method to decrease the time required to transport the inpatient to the operating room and to review the concepts underlying lean thinking.

Targeting COVID-19 Vaccine Hesitancy among Nurses in Shanghai: A Latent Profile Analysis
A population-based cross-sectional online survey was conducted on Shanghai nurses from July to August 2021 (N = 1,928). In the online survey, participants were asked to report their sociodemographic, the 5C vaccine hesitancy components, their knowledge level of COVID-19 vaccine and vaccination, and the COVID-19 vaccination uptake intention and attention to vaccine news. Latent profile analysis was used to reveal distinct profiles of vaccine hesitancy. The results revealed four profiles, including "believers" (68.9%; high confidence and collective responsibility), "free riders" (12.7%; similar characteristics to believers, except for a low collective responsibility), "middlemen" (14.6%; middle in all 5C constructs), and "contradictors" (3.7%; high in all 5C constructs). Compared to believers, middlemen were younger, more likely to be female, childless, less educated, held lower professional titles, had fewer years of nursing service, sometimes or never complied with recommended vaccinations, had satisfactory or poor self-assessed health status, had no work experience.

Association Between Maternal Plasma Total Antioxidant Capacity And Birth Size Outcomes
: Maternal antioxidants intake and plasma total antioxidant capacity (TAC) concentration during pregnancy might influence on birth outcomes. This study was conducted to determine the association between plasma TAC during pregnancy with birth outcomes. METHODS: Overall, 220 mother–infant pairs were recruited in the first trimester of pregnancy. Maternal whole blood was collected and TAC was determined by the ELISA kit. Birth size measurements including birth weight, length, and head circumference were measured according to standardized protocols. RESULTS: The characteristics of mothers and their children are presented in Table 1. The maternal plasma TAC was positively correlated with birth weight in both unadjusted and adjusted models (beta (SE) =2.75 (1.35); P=0.043, beta (SE) =3.43 (1.50); P=0.023, respectively). In addition, the adjusted model showed a significant positive relationship between the maternal plasma TAC and birth length (beta (SE) =0.023 (0.009); P=0.01). CONCLUSION: This study showed the positive association of maternal plasma TAC with birth weight and length.

Perceptions of Postpartum Mothers of Their Experiences During COVID-19 Crisis: A Phenomenological Study
COVID-19 pandemic led to drastic changes in in-hospital health care delivery causing major policy and protocol changes regarding labor and delivery and postpartum care of maternity patients. We strove to describe and understand the perceptions of laboring and postpartum mothers’ care received through interviews in a hospital during the COVID-19 pandemic. Using a phenomenological study design, we interviewed 13 postpartum mothers. Five major themes and 10 subthemes were extracted. Major themes, both positive and negative, included genuine concern of care givers, adverse breastfeeding experiences, feeling of left alone loss of expectations and uncertainty. Primipara women had major impact on their psychological wellbeing and breastfeeding experiences. Isolation and feelings of left alone adversely affects postpartum mothers’ coping, newborn care, bonding, meeting basic needs of sleep and hygiene, breastfeeding experiences and potential postpartum recovery and psychosocial wellbeing including fear of future pregnancies. Therefore, ‘partner presence’ throughout the L&D and postpartum period should be a ‘call to action’ for the nurses, especially with first-time mothers.

Metamodernism as a Framework for Moving Forward in Education, Practice and Research.
Metamodernism an essential shift in theoretical perspectives that moves beyond the ideals of modernism and postmodernism to move the profession forward in education, practice, and research. Modernism developed the strong traditions and ensured the survival of nursing practice as a distinct profession with a unique set of values and knowledge. Postmodernism pushed the profession towards achievement, advanced degrees, and the extensive production of theories and nursing science to identify and explain real world problems in healthcare. However, neither of these perspectives encompass the current needs of the nursing profession. As a profession, nursing needs the opportunity to heal from the trauma of the last several years and move forward with solutions to practicing in a world that will never be perfect. Metamodernism embraces a solution-focused framework that appreciates both the distinct knowledge of nursing and the problems faced by individuals, families, and communities due to generational issues, healthcare landscape uncertainty, and the growing population of individuals with complex care needs. The signs of metamodernism within the profession already exist, however recognizing and supporting the shift towards this perspective is essential to create n a unified message and commitment to the advancement the nursing profession.

Peer supported Open Dialogue in the U.K. National Health Service: implementing and evaluating a new approach to Mental Health Care
Open Dialogue is an internationally developing approach to mental health care based on collaboration between an individual and their family and social network. Our quest for better approaches to Mental Health Care with improved carer and service user experience led us to develop and test a model of Peer Supported Open Dialogue (POD). There is no research currently looking at the implementation and effectiveness of a standalone POD team in the NHS so we evaluate its implementation, clinical outcomes and value to service users and their families. Method A before-after design was used. 50 service users treated by the POD Team were recruited and participants from their family and wider social network. Service user self report questionnaires covering wellbeing, functioning, satisfaction were collected and one carer self report measure; at baseline, three and six months. A clinician reported measure was collected at baseline and six months. Clinicians perceptions of practice were collected following network meetings.

Case presentation: treating chimeric antigen receptor-T cell therapy complications
The purpose of the oral presentation is to review patient cases who experienced complications while undergoing chimeric antigen receptor-T (CAR-T) cell therapy and how to treat those complications. CAR-T cell therapy has become more readily available for treating relapsed or refractory hematologic malignancies and requires proficient and adequate treatment of side effects and complications. Cytokine release syndrome (CRS) has been observed in 42-92% of recipients received autologous anti-CD19-directed CAR-T cell therapy [1]. CRS can manifest as a variety of symptoms ranging from flu-like symptoms to more severe life-threatening manifestations of an overstimulated inflammatory response (hemophagocytic lymphohistiocytosis and macrophage activation syndrome-like response). Effective treatment for CRS includes fluid resuscitation, vasopressors for hypotension, supplemental oxygen as needed for hypoxia, the interleukin-6-receptor blocking antibody tocilizumab [2], steroids, and potentially other immunosuppressants in refractory cases

Risks of Severe COVID-19 Outcomes Among Patients With Diabetic Polyneuropathy in the United States
Diabetic neuropathy (DN) affects more than 50% of diabetic patients who are also likely to have compromised immune system and respiratory function, both of which can make them susceptible to the SARS-CoV-2 virus. Objective: To assess the risk of severe COVID-19 illness among adults with DN, compared with those with no DN and those with no diabetes. Setting: The analysis utilized electronic health records from 55 US health care organizations in the TriNetX research database. Design: A retrospective cohort study. Participants: The analysis included 882 650 adults diagnosed with COVID-19 in January 2020 to June 2021, including 16 641 with DN, 81 329 with diabetes with no neuropathy, and 784 680 with no diabetes. Outcome measures: The presence of health care utilization (admissions to emergency department, hospital, intensive care unit), 30-day mortality, clinical presentation (cough, fever, hypoxemia, dyspnea, or acute respiratory distress syndrome), and diagnostic test results after being infected affected by COVID-19. Results: The DN cohort was 1.19 to 2.47 times more likely than the non-DN cohorts to utilize care resources, receive critical care, and have higher 30-day mortality rates. Patients with DN also showed increased risk (1.13-2.18 times) of severe symptoms, such as hypoxemia, dyspnea, and acute respiratory distress syndrome.

Patients’ Perceptions of Importance for Self -Administered Correct Site Surgery Checklist: A Multi-site Study
Wrong site surgery occurs over 40 times per week in hospitals and clinics in the United States resulting in catastrophic situations for both the patient and surgeon.1,2 Purpose: The purpose of this study was to describe and evaluate patients’ perceptions of importance of patient involvement and responsibility for safe surgery using a self-administered correct site surgery checklist. Design: A multi-site non-experimental, quantitative, descriptive study Methods: A convenience sample of 173 adult patients and who were scheduled for surgery with laterality from the 4 academic and community Medical Centers in different geographic sites were obtained. Institutional Review Board approved protocol. Research Team member explained purpose of the study/process and obtained consent from volunteered participants. Participants rated survey questions using a four point Likert Scale from 1 not important to 4 extremely important before and day of surgery.

Understanding breast health awareness in an Arabic culture: qualitative study protocol
To explore breast health awareness and the early diagnosis and detection methods of breast cancer from the perspective of women and primary healthcare providers in the Jizan region of the Kingdom of Saudi Arabia. Background: Although there is a high incidence of advanced breast cancer in young women in the Kingdom of Saudi Arabia, there is no standardized information about breast self-examination, or is there a national screening programme involving clinical breast examination and mammography available. Design: Qualitative exploratory study. Methods: Data collection will consist of 36 face-to-face semi-structured interviews: 12 with general practitioners; 12 with nurses at primary healthcare centres and with 12 women who attend the health centres. This study will be carried out in eight states across the Jizan region (four rural and four urban) to reflect the cultural diversity of Jizan. The data will be analysed using thematic content analysis. Research Ethics Committee approval was obtained in June 2015.

Self efficacy among nursing students at RAKMHSU U.A.E.
Self-efficacy is a key component of nursing education, determining the success of nursing students. Nurse educators therefore play a crucial role in supporting the development of self-efficacy and creating conducive environment. Purpose : to assess the self efficacy among nursing students. Methods : 214 undergraduate nursing students who gave consent from RAKMHSU participated in the cross-sectional survey which was conducted from 1st January 22 - 30th April 22. Generalized Self-Efficacy scale developed by Schwarzer, R., & Jerusalem, M. (1995)1 was used for assessing self efficacy among nursing students. Data was analyzed by using SPSS 25 version2. Results : Majority of the participants were females (82.7%),unmarried (91.6%)and between age group of 18-22 years. High level of self efficacy was observed among 56% students followed by moderate in 35.51% and low among 8.41%. One way ANOVA did not revealed significant association among nursing students as per their level of education. However significant difference in self efficacy score was observed between first and forth year nursing students . No significant association between level of self efficacy and age, gender, and birth order was observed.

Biomarkers for Early Detection of Osteosarcopenia
Sarcopenia, which was only included in the International Disease Code in 2017 remains largely undiagnosed and undertreated because of the lack of a universally accepted definition, effective ways to measure it, and identification of the outcomes that should guide treatment efficacy. An ever-growing number of clinicians and researchers along with funding and regulatory agencies have gradually recognized that sarcopenia is a human condition that requires both prevention and treatment. Another very common disease of aging, osteoporosis commonly occurs along with sarcopenia, and while more frequently diagnosed is also misdiagnosed or when it is finally diagnosed loss of bone has already occurred. What could effectively be done to prevent that both osteoporosis and sarcopenia advance to stages that are so devastating to individuals and such a burden to society? We believe that the answer is “early reliable biomarkers”. Our research group developed both targeted Lipidomics and Metabolomics approaches and using bone and muscle cells models, mouse models, and samples for humans

Experiences of COPD Patients using the Apple Watch Series 6 Versus the Manual Pulse Oximeter for SpO2 Home Monitoring
Amid the rise in digital health, the Apple Watch 6 has the capability to measure peripheral blood oxygen saturation (SpO2). Although the company indicated that the Watch is not a medical device, evidence suggested that SpO2 measurements among patients with Chronic Obstructive Pulmonary Disease (COPD) are accurate in controlled settings. Yet, to our knowledge no evidence exists using the SpO2 app with COPD patients in real life. Purpose: This qualitative study explored the experiences of patients with COPD using the Apple Watch 6 versus the traditional finger pulse oximeter for SpO2 home monitoring. Methods: Individual semi-structured interviews were conducted with 8 female and 2 male participants with moderate to severe COPD, and transcripts were content analyzed. All received a Watch to monitor their SpO2 for 5 months. Results: Due to respiratory distress, the Watch was unable to collect reliable SpO2 measurements as it requires the patient to remain in a stable position. However, despite the physical limitations and lack of reliable SpO2 values, participants overwhelmingly expressed a preference towards the Watch

Factors influencing poor use of contraceptives among Swazi women
Fifty-seven out of fifty-nine health facilities in Eswatini offer contraceptives at no financial costs to users ensuring a vast availability of family planning. Optimum use of contraceptives prevents unplanned pregnancies, thus decreasing the number of births that women experience and subsequently reducing pregnancy and birth-related morbidity and mortality.1 The fertility rate is 3.8 births per woman and is even higher in rural areas despite the abundance of contraceptives.2 Maternal mortalities in Eswatini were as high as 37% due to the illegal termination of unwanted pregnancies. This could be attributed to the underutilization of contraceptives by childbearing women. The study aimed to investigate the factors affecting optimum contraceptive use among postpartum women in Eswatini.

Perceptions Of Pregnant Teenagers Towards Utilisation Of Antenatal Health Care Services In Eswatini
Well-timed and quality antenatal care is a key determinant of maternal mortality prevention and it is considered as a necessary element of universal health coverage.1 Significant underutilization of antenatal care has been noted among pregnant teenagers living in poverty, low education and poor awareness.1 The study aimed to investigate the perceptions of pregnant teenagers towards utilization of antenatal health care (ANC) services in order to ensure the provision of adolescent-friendly services in Eswatini. Method: A qualitative exploratory research approach was used in this study conducted in one maternity department of a government hospital and two health care clinics in the Southern Hhohho region of Eswatini. Pregnant teenage mothers between the 13 – 19 years admitted to delivery in the maternity unit of a government hospital, and those attending antenatal care in the two health care clinics of the Southern Hhohho region. Purposive sampling was used to obtain a sample size of 12 participants and individual interviews were used to collect data. Thematic analysis was used to analyze the data

Emotional and ethical impacts on healthcare professionals performing cardiopulmonary resuscitation
Myriad studies exist outlining poor outcomes related to cardiopulmonary resuscitation (CPR) administered to patients who are elderly and/or have comorbid medical conditions with sudden cardiac arrest (SCA). Patients with asystole or pulseless electrical activity (PEA) have worse outcomes. Studies show 10% of patients with out of hospital cardiac arrest, and initial asystole survive until they reach the hospital. Less than 5% survive until hospital discharge with good neurologic function. Given the data for certain patients undergoing CPR for SCA, the question arises: what are the impacts on the healthcare personnel providing this type of aggressive intervention? Can healthcare systems address these goals-of-care discussions to avoid aggressive interventions that might be considered non-beneficial to patients?

Imagining care after the pharmaceuticalization in Africa
The last decades saw increased expectations that the ubiquitous use of pharmaceuticals can be a rapid and cost-effective method for improving the health of populations in the Global South. Such interventions include universal HIV treatment and mass drug administration to eliminate parasites. This presentation draws on two ethnographic studies concerning HIV treatment in Ethiopia and epileptic care in Uganda. It illuminates the problems accompanied by excessive emphasis on pharmaceuticals and explores ways for alternative actions through which claims of meaningful care are addressed.

An Assessment of Critical Care Nurses' Knowledge of Correct Line Types for Administration of Common Intravenous Medications.
An Assessment of Critical Care Nurses' Knowledge of Correct Line Types for Administration of Common Intravenous Medications.

As a Member of the Surgical Team, the Nurse Anesthetist’s View of Using the WHO Surgical Safety Checklist in Swedish Health Care
In Sweden, during specialty training, the nurse anesthetist learns how to ensure patient safety in a health care setting by implementing the surgical checklist measures during perioperative care. To date, there are still considerable shortcomings when it comes to implementing these patient safety measures in Swedish hospitals. Aim: The purpose of this study is to describe the use of the WHO surgical safety checklist (WHOSSC) by surgical teams, with special emphasis on nurse anesthetists to increase patient safety. Materials and Methods: This descriptive questionnaire based study was performed between September 2018 and March 2019 and included 196 health care professionals who completed the questionnaire. The survey was carried out among all the health care professionals at two surgical units at a university hospital during the data collection period.

Supporting Innovative Person-Centred Care in Financially Constrained Environments: The WE CARE Exploratory Health Laboratory Evaluation Strategy
The WE-CARE project was a multi-disciplinary consortium of experts supported by the Horizon EU FP7 research programme to investigate healthcare cost containment and healthcare quality across Europe. It did this by creating an evidenced based roadmap blending person-centred care (PCC) and health promotion. These two key drivers of quality and cost containment were supported by five critical enablers: information technology, quality measures, infrastructure, incentive systems, and contracting strategies. Subsequent funding was received from the European Cooperation for Science and Technology (COST) programme. COST Action 15222, the COST CARES project, expanded the network of individuals interested in person-centred to even more countries. COST CARES had four Working Groups. This paper presents the work of Working Group 3, whose aim was to develop an overview evaluation strategy for testing ‘Exploratory Health Laboratories’, as an implementation vision of the roadmap. Representing the wider COST CARES Action

Automated ECG Interpretation
Automated ECG interpretation has been available for over 30 years but has reached a cross-roads with the advent of artificial intelligence offering a different approach to analysis of the ECG. Notwithstanding, there are still basic problems in electrocardiography which are overlooked. Principal amongst these is electrode placement and there is still a huge misunderstanding and lack of care in the application of electrodes prior to ECG recording whether or not automated interpretation is involved. Despite many publications on the topic, it is clear that ECGs continue to be recorded poorly, particularly by non-specialists.

Student participation during initiation of international clinical placements
International placements challenge healthcare students to find the right level of participation in practice. Differences in healthcare systems, local language and treatment time may affect student’ engagement in patient-related tasks or team activities. This study sought to unpack the initiation process during international clinical placements with the ultimate aim to achieve active student participation. Methods We followed a constructivist grounded theory approach, conducting two individual interview rounds with 15 undergraduate healthcare students. Interviews were taken before departure and during placement. An iterative process of data collection and constant comparative analysis was applied to identify emerging themes. Further analysis was supported by several team discussions, enabling us to arrive at a more conceptual level of theory.

Outcomes of the National League for Nursing’s Certification of Academic Nurse Educators in a Global Perspective
The National League for Nursing’s certification of academic nurse educators was initiated in 2005 with the first group of educators certified by examination to achieve the certification. Since that time, the program has exponentially grown to more than 14,000 certified nurse educators. The program opened to nurse educators internationally in 2018. The program currently offers three levels of certification: certified academic nurse educator (CNE®), certified clinical nurse educator (CNE®cl), and certified novice nurse educator (CNE®n). The outcomes of the change to global eligibility and availability of the three certifications need to be examined.

Delirium in older out-patients, prevalence, risk-factors and outcomes
Delirium is a serious neuropsychiatric syndrome, which requires timely treatment. However, it is easily missed, especially in older patients with premorbid cognitive disorders. Objectives The aim of the study is to investigate the prevalence and risk factors of delirium in older outpatients with and without dementia. Method We assessed 444 patients referred to the memory clinic of a psychiatric hospital between March 2013 and March 2014. Demographic information, medical history, impairments in daily living activities (ADL) and referral information were registered. Patients underwent a psychiatric examination using the Delirium Rating Scale-Revised-98 and cognitive tests, a physical examination and laboratory tests. We recorded medication use and changes before and after the onset of symptoms.

Pediatric nurse practitioners in adult congenital heart disease care
Adults with congenital heart disease (ACHD) represent a growing population of highly complex patients who commonly receive care at university-affiliated children’s hospitals. Their outcomes from heart surgery are optimized by involvement with specialized congenital heart surgeons, but the best locus of surgical and postoperative care (whether in a pediatric hospital or an adult facility), and the credentialling requirements for those who provide that care, remain controversial. We reviewed the 104 ACHD cases performed at our university-affiliated, free-standing children’s hospital over the period from 7/2018-11/2022. Using STAT categories 1 through 5, with STAT 5 associated with the highest mortality, 23(22%) underwent STAT 3 or 4 procedures. Postoperatively, 56(54%) were extubated in the operating room. Median length of stay was 5(IQR:4-7) days, with postoperative ICU length of stay of 2(IQR:1-3) days. Readmission within 30 days occurred in 10(10%) patients. At a median follow-up of 169(IQR:15-657) days, there were no mortalities. These outcomes were achieved despite the fact that pediatric nurse practitioners (PNPs) in our state are barred by law from caring for ACHD patients over age 21. As a result, other advanced practice providers, such as physician assistants, were enlisted ad hoc for clinical ICU coverage which disrupted team function and efficiency.

"Prevalence of burnout and its impact on self-reported patient care among primary health care physicians at King Abdul-Aziz Medical City in Riyadh region"
Background: Burnout is known worldwide as a work-related syndrome associated with physical illness and mental health problems. It has a significant impact on doctors’ health and patient care. Aim: To assess the prevalence of burnout, its associated risk factors, and its impact on self-reported patient care among the doctors of the Family Medicine Department in King Abdul-Aziz Medical City (KAMC), Riyadh. Method: A cross-sectional study was conducted among 150 physicians. Data were collected using the 22-items Maslach Burnout Inventory (MBI) to measure emotional exhaustion, depersonalization, and personal achievement as well as questions about demographic factors, work characteristics, and impact of burnout on self-reported patient care. Results: A total of 150 physicians responded to the questionnaire.

SHIFT DUTIES AND THEIR EFFECT ON STRESS AND SLEEP
Sleep is very essential for healthy mind and body. For ages, sleep was considered passive whereas recent theories and research have proved otherwise. Circadian rhythm is generated due to night and day cycles. Healthcare workers especially nurses, must go through shift duties which not only hampers the quantity as well as quality of the sleep. It is important to have a healthy sleep schedule and regularity of sleep to have a healthy and balanced state of mind and body. Too many shift works without proper sleep can disrupt the homeostatic mechanisms of the body. It can result in burnouts, anxiety, mental distress and immunity disorders among various other health and mental problems. Healthcare workers deal with pain, suffering and sickness which requires highest level of concentration and compassion. Shift work adds to the woes and in long term, these sleep disturbances may lead to various health disorders

Components for providing person-centred palliative healthcare
Person-centred palliative healthcare is an important approach to maintaining and improving patients' quality of life living with a chronic non-communicable disease and their partners when they need long-term care. Such an approach can reduce unnecessary hospitalisation, holistically address the patient and their partners' needs, and help develop an advance care plan. The aim was to assess, analyse, and synthesise the currently existing international guidelines for providing person-centred palliative care and identify the key components for providing a high-quality approach.

Nurse Adaptability and Post-traumatic Stress Disorder Symptoms During the COVID-19 Pandemic: The Effects of Family and Perceived Organizational Support
To examine the effect of family and perceived organizational support on the relationship between nurse adaptability and their experience with COVID-related PTSD (post-traumatic stress disorder) symptoms in frontline nurses working on COVID-19 units. Background Proximity to and survival of life-threatening events contribute to a diagnosis of PTSD, which is characterized by avoidance of reminders of trauma, intrusive thoughts, flashbacks of events, sleep disturbances, and hypervigilance. Using the job-demands and resource model, we examined the effect of adaptability, family support, and perceived organizational support on PTSD symptoms for nurses during the COVID-19 pandemic. Specifically, we tested whether perceptions of environmental supports—i.e., family and organizational support—moderated the relationship between nurse adaptability and COVID-related PTSD symptoms.

How important is nursing care in patients' overall evaluation of hospital services? Some evidence from Italy
Nursing system has two key functions: 1) to effectively steward nursing resources and 2) to transform available resources into nursing services that address patients' needs. The patient perception of experience with care and the patient satisfaction are key indicators of care quality. The literature emphasizes that nurses affect the overall patient satisfaction and experience1, and, consequently, the need to continuously evaluate and improve the quality of nursing care using measurable and objective indicators that are sensitive to various aspects of nursing care2-5. Several Italian Regions have adopted a multi-dimensional performance evaluation system (PES), designed by the Sant'Anna School in Pisa, to assess their health systems. The PES of Tuscany Region includes patient-reported indicators

Patient-reported and Clinical Outcomes Among Patients with Calciphylaxis
Patients were identified from the Partners Research Patient Data Registry and the Partners Calciphylaxis Registry and Biorepository (Clinicaltrials.gov ID: NCT03032835). Patients with calciphylaxis requiring hospitalization for at least 14 consecutive days during the study period from May 2016 through December 2021 were included. Pain intensity was assessed using patient-reported pain scores on numerical rating scales from 0 to 10. Associations between pain improvement and clinical outcomes including lesion improvement, amputation, and mortality were examined in univariate and multivariate regression models.

Reusable Silicone Male External Catheter for urinary drainage in hospitalized patients : Clinical Proof testing
Hospitalized patients who need urinary drainage typically get an indwelling catheter such as foley or an external condom catheter (Texas style) mostly adhesive to penile skin does not typically stay longer and can cause skin irritation and skin damagein 15-30% of male patients. Male external catheters should be included in CAUTI (Catheter associated urinary tract infection) prevention and nurse driven protocols to reduce CAUTI in hospitals. This newer silicone washable and reusable male external catheter was introduced to address these problems. It attaches with adhesive strips on either side of hip areas away from hairy pubic area. Cuff holders can be used for additional security and stability during patient turning and movements. The catheter can be easily removed from the straps due to snap button feature by simply unsnap to remove and snap to put it back for washing and reuse daily for up to 5 days. Reuse can potentially reduce cost on long term.

Anxiety provoking behaviors of nursing clinical instructors and effects on undergraduate nursing students’ wellbeing: A mixed methods design
This study aimed to investigate the relationships between anxiety-provoking teaching behaviors in clinical settings and nursing students’ self-reported anxiety levels, perceived quality of life and demographic characteristics. Anxiety has been consistently reported in the literature as a major barrier to nursing education. Peplau’s Interpersonal Relations Theory (1992, 1997) served as a theoretical framework in the study to explore anxiety-provoking teaching behaviors in clinical settings. Design: A cross-sectional, correlational, mixed methods design was used. Methods: Fifty-eight participants were recruited from the undergraduate nursing program at a Canadian university in the spring of 2021. An online survey, including demographic characteristics, the State-Trait Anxiety Inventory (STAI) and World Health Organization Quality of Life Instruments (WHOQOL-BREF), was distributed to the participants before a face-to-face interview

Anxiety provoking behaviors of nursing clinical instructors and effects on undergraduate nursing students’ wellbeing: A mixed methods design
This study aimed to investigate the relationships between anxiety-provoking teaching behaviors in clinical settings and nursing students’ self-reported anxiety levels, perceived quality of life and demographic characteristics. Anxiety has been consistently reported in the literature as a major barrier to nursing education. Peplau’s Interpersonal Relations Theory (1992, 1997) served as a theoretical framework in the study to explore anxiety-provoking teaching behaviors in clinical settings. Design: A cross-sectional, correlational, mixed methods design was used. Methods: Fifty-eight participants were recruited from the undergraduate nursing program at a Canadian university in the spring of 2021. An online survey, including demographic

Construction of wheeled model of nurses interpersonal communication knowledge system
This study intends to use the literature and comparative research method along with Delphi method to construct a nurses interpersonal communication knowledge system, so to guide nurses interpersonal communication teaching or training and provide a basis for the compilation and reform of related teaching materials

Measure of Moral Distress -Healthcare Professionals (MMD-HP) adaptation of the scale in Latvia
The level of moral distress is considered in the studies mainly on the basis of the MDS Corley scale, which was developed in 2001. Several researchers worldwide have modified and adapted the Moral Distress Scale in accordance with the specific nature of their country and health care system.

Reduction of Infusion Time Using a 10% Immunoglobulin Product During Staffing Shortages Due to COVID-19
The recent healthcare crisis due to the novel Coronavirus disease 2019 (COVID-19) has created an increased demand for infusions administered within the home environment. Patients with immunodeficiencies who are receiving intravenous immune globulin (IVIg) are at greater risk for contracting infections, like COVID-19. Hospital and outpatient clinics providing scheduled infusions have referred patients to specialty pharmacy organizations in order to make availability for critically ill patients and reduce COVID-19 exposure risk to patients and employees. Due to increased demand for home infusion, it has become imperative to reduce nurse visit times to minimize COVID-19 exposure risk to nurses and patients while meeting these increased demands. The purpose of this study is to determine if a 10% immune globulin (Ig) product with a 15-minute titration protocol has a shorter total infusion time and could therefore reduce the amount of time spent in a patient’s home.

VARIED PRESENTATION OF ARRHYTHMOGENIC RIGHT VENTRICULAR DYSPLASIA/CARDIOMYOPATHY (ARVD): A CASE SERIES
Arrhythmogenic right ventricular dysplasia (ARVD) is genetically predisposed form of cardiomyopathy that mainly affects young individuals resulting in fatal ventricular arrhythmias leading to sudden cardiac death1 . ARVD has 50% of cases that involve both the right ventricle (RV) and left ventricle (LV), but only a small number of cases involve isolated left ventricle. It cause of sudden cardiac death in young adults, accounting for 11% of all cases and 22% of cases among athletes 2,3. The structural abnormalities in ARVD result from the fatty infiltration and fibrosis of the RV myocardium. This leads to progressive RV dilatation and dysfunction. The left ventricle (LV) is less commonly involved, and the septum is relatively spared 4 The prognosis is worse in patients with LV involvement5 In this case series, five patients (four males and one female) with diagnosis of ARVD presented to our center with varied clinical presentations across a wide range of age groups. Familial cases account for 30%-90% of cases6. The MRI of all cases showed dilated right atrium (RA)/RV with right ventricular free wall dyskinesia. Cardiac MRI showed aneurysmal outpouching with diffuse free wall enhancement. (AICD) was implanted uneventfully in all five patients, and the patients were discharged with oral medical therapy.

Using governance and patient flow strategies to improve healthcare service efficiency
The presentation will describe the findings of a case study regarding the implementation of strategies targeted to increase healthcare service efficiency in the Hospital In The Home setting. During a retrospective review of clinical data of Queensland’s Hospital In The Home services in 2017, it was noted that there were variations in the average length of stay of patients when comparing public–private models and state funded Hospital In The Home models of care with no variation in outcomes. To understand the reasons for the differences, average length of stay and readmission data from 2017 for 10 high volume diagnoses were retrospectively compared across five Hospital

Understanding the role of social exchange orientation in mentoring intentions for nurses and midwives working in acute care settings: Mixed methods study
the aim of the study was to explore role of negotiated exchange orientation in explain the intentions to participate in future mentoring programs. Background: Formal mentoring programs are continuously being designed to recruit, retain nurses and midwives in acute care settings. In social exchange relationships, individual evaluate the costs and benefits of the interaction as well as possible alternatives before engaging in such relationships as mentoring. Negotiated exchange orientation, a form of social exchange, can therefore explain the relationship between perceived cost of mentoring and clinicians’ intentions to participate in future formal mentoring programs.

Obstetric and neonatal outcomes of extremely obese pregnant women after late preterm gestation
To determine the obstetric and neonatal outcomes of pregnant women with extreme obesity at birth after late preterm gestation In extremely obese women at delivery in late preterm gestation, the obstetric outcomes for preterm labor and adverse neonatal respiratory outcomes seemed to be higher for the women who were not that much obese before pregnancy than those who were already extremely obese. Therefore, weight gain during pregnancy needs to be closely monitored for pregnant women especially when obese.

Stress load of Chinese nurses in Fangcang Shelter Hospitals during the COVID-19 pandemic: A latent profile analysis
The Omicron wave of the COVID-19 pandemic significantly affected Shanghai, China, from March to June 2022. Numbers of Fangcang Shelter Hospitals (FSHs) were conversed from stadiums and exhibition centers to tackle the pandemic. This study aimed to identify the stress load profiles of nurses working in FSHs and explore the characteristics and factors influencing stress load profiles.

Innovating Nurse Education with AI-based adaptive learning technology - 21st Century Learning in health education
Statement of the Problem: NurseEd (Nurse Education) is a 4-years innovative research and development project, forming a new didactic design for 21st century nursing education, based on the digital learning platform Rhapsode™. By accelerating theory learning, nursing becomes more differentiated and practice-oriented by releasing more time for capability teaching in the Sim-Lab. Methodology & Theoretical Orientation: Based on state-of-the-art research in digital learning tools we do apply a data-driven approach to adjust the path and pace of learning, thus enabling delivery of personalized learning at scale.

exploration of factors influencing nurses’ preparedness and response to the covid-19 outbreak
Introduction and Objective Nurses as the core of the health care workforce affect an organization's preparedness and response. This study explores the factors and unique determinants influencing nurses’ preparedness and response to the coronavirus disease 2019 (COVID-19) outbreak in Singapore. Methods This qualitative phenomenological study utilized purposive sampling and in-depth interviews with 10 registered nurses and two enrolled nurses who had worked or were still working in an infectious disease (ID) hospital during the COVID-19 outbreak at the point of recruitment. The data were collected from September 2020 to December 2020.

Digitizing Scoring System with Extended Online Feedback in Formative OSCE
Objective structured clinical examinations (OSCEs) are common for formative assessment. We developed an Online Smart Communicative Education System and aimed to explore the factors that affect the perceptions in teachers and students. Methods: A two-year cross-sectional cohort study was undertaken. The program includes three parts. Part I Pre-OSCE: an online flipped class in preparation for task-related knowledge and skills. II OSCE-day: 10 tasks in one track formative OSCE. III Post-OSCE: extended online feedback for participants with further questions after the exam and raters with more feedback after reviewing their performance online. Principal component analysis with varimax rotation was performed to analyze the perceptions of students and teachers to the Online System by questionnaires.

Spiritual care in mental health from the perspective of staff
The aim was to describe our initial work utilizing the EPICC Spiritual Care Competencies Self-Assessment Tool among mental health staff competencies in spiritual care. A mixed method pilot study assisted scholars to identify best approaches for mental health staff in relation to spiritual care training

Fiction and Storytelling
The place at which social work stories meet fiction was the starting point for my PhD research project, thesis, and upcoming book. Fiction can provide a purview into other worlds not every practitioner could reasonably be expected to have seen. Fiction is being used in a range of university courses – mostly in the medical fields - which would not traditionally include that medium. My research explored how it is that fiction can evoke empathy, extend emotional range, make theories more accessible, provoke critical thinking and provide ethical decision-making practice. The research question at the centre of the thesis was an exploration of the ways the utilisation of fictional literature in teaching can contribute to the social work pedagogical experience. The findings, however, hold applicability for all professions and all educators interested in creative ways of teaching.

Association between cortisol level and performance in a clinical simulation: A systematic review
Realistic simulation is a training method being explored in teaching laboratories and simulation centers, bringing benefits in the learning and improvement process. Therefore, has already been described as a stressful experience. Therefore, stress can lead to cognitive impacts such as decreased concentration, memory degradation, increased number of errors, difficulty and delay in responding to stimuli. Objective: To identify the available evidence on the level of stress experienced by participants in simulation-based education through salivary cortisol and its association with performance.

Easier, quicker, safer: an enhanced instrument count procedure
To keep our patients and staff safe during complex procedures, I identified a need to change the way the scrub team count surgical instruments at the beginning and the end of cases. Orthopaedic surgery uses many trays containing large amounts of instruments. These trays were often difficult to manage, creating a risk of miscounting or retaining items. I took the decision to address this safety concern and also improved efficiency. In order to achieve a practical, value-adding enhanced instrument count procedure (EICP), I worked with a variety of stakeholders and earned senior management support by presenting the benefits of having illustrated instrument folders. I worked collaboratively with nursing colleagues, surgeons, company representatives and sterile services to optimise tray content, resulting in the rationalisation of instruments in the trays. I took detailed pictures of each tray and developed photographic folders to illustrated the range of instruments and their locations in the trays.

A Nurse In Icu -Instrumental For Good Outcomes
ICU IS A PLACE IN ANY HOSPITAL WHERE, THE MOST CRITICALLY ILL PATIENTS ARE TAKEN CARE. CARING PATIENTS IN ICU IS CHALLENGING AND DEMANDING AS TARJECTORIES ARE DYNAMIC. THIS DYNAMICS NEED AT MOST VIGILANCE AND CLINICAL ACUMEN . STARTING FROM MY TRAINING TO EXPERIENCED SENIOR CONSULTANT INTENSIVIST, FOR MORE THAN 15 YEARS INTO ICU PRACTICE, I CAN RECOLLECT MANY INSTANCES WHERE NURSES HAVE PLAYED KEY ROLE -WHETHER NEED FOR INTUBATION OR WEANING FROM VENTILATOR OR TRANSITION TO NIV OR ESCALATION OF ANTIBIOTICS OR COMMUNICATION WITH THE PATIENT OR HANDLING BAD NEWS AND MORE IMPORTANTLY ADHERING TO INFECTION CONTROL PRACTICES LIKE -HAND HYGEINE ,FOLLOWING UNIVERSAL PRECAUTIONS etc….

The stresses and strains of palliative carers
The palliative care worker is, frequently, faced with difficult patients and demanding or even unruly families who may not know how to cope with losing a loved one. The stresses that are heaved upon those care workers include: The end-of-life experience encompasses feelings of hopelessness, death anxiety, guilt, and loneliness. People who are ill and dying may pose particular demands for their carers. The dying patient may behave strangely, due to - for instance- brain tumors, cardiovascular diseases, or other illnesses. Psychological factors and psychiatric disorders may turn the patient into a demanding and difficult person to handle; examples of such factors are anger, mistrust, fear, or depression and paranoia which disrupts theirs and the lives of those close to them. The patient’s symptoms may be so unpalatable to others so as to make them not want to visit or be with the patient, such as gross disfigurement, malodor, poor response to symptom management, or behavioral changes.

Physicians’ perceptions about collaborating with speech-language pathologists for dysphagia treatment in interprofessional healthcare
Swallowing disorders affect over 15 million people across the United States. Dysphagia is a complex disorder and occurs co-morbidly with other diagnoses. As such, there is frequent collaboration amongst healthcare professionals, including speech-language pathologists, to appropriately assess and manage the dysphagia.

Does the impact of cardiovascular health on cognitive aging in midlife differ by race? The Study of Women's Health Across the Nation (SWAN)
Dementia is often preceded by a decade or more of cognitive decline, suggesting subtle cognitive function changes may begin in midlife. Better cardiovascular health (CVH) slows the rate of cognitive decline in white people, but it is unclear whether this occurs in other racial groups.

Reducing variations in Clinical Nurse Educator roles: a service improvement project standardising roles and career pathways
There is limited research evaluating the implementation and effectiveness of Clinical Nurse Educator (CNE) roles in clinical practice. Employers in the United Kingdom tend to use generic nursing job profiles, although the definition, expectations and implementation of clinical nurse educator roles are interpreted differently between employers.

Professional competency standard of the health care staff in primary and secondary schools in China
This study developed and confirmed a professional competency inventory for integrated school healthcare staff in the Chinese schooling system. It generated initial competency items through job task analyses, group interviews, and expert consultations, which proposed competency items in the following fields: general quality, primary health service, school health education, and school health management. Exploratory factor analyses(EFA) extracted nine domains and 70 competency items based on 312 data from school health