Retrospective chart review of patient socioeconomic status and language preference associated with live video telehealth in a pediatric dermatology practice

Pediatric teledermatology rapidly expanded with the COVID-19 pandemic, and the impacts of this expansion on patients' access to care have not yet been entirely defined. In this retrospective study of 3027 patients in an academic pediatric dermatology practice, patients who identified as having a primary language other than English were less likely to access pediatric dermatology care during the COVID lockdown. This study did not identify a significant or meaningful difference in age, geography, socioeconomic status, ethnicity, or race between patients who were offered pediatric dermatology care that was either in-person or via synchronous telehealth. These findings are overall reassuring that there were not major disparities in telehealth utilization during the COVID shelter-in-place mandate, although highlight the need for institutions to ensure systems are in place to enhance telehealth access for patients with non-English primary language.     

What nurses of color want from nursing philosophers

Scholars of color have been instrumental in advancing nursing knowledge development but find limited spaces where one can authentically share their philosophical perspective. Although there is a call for antiracism in nursing and making way for more diverse and inclusive theories and philosophies, our voices remain at the margins of nursing theory and philosophy. In nursing philosophy, there continues to be a lack of racial diversity in those who are given the platform to share their scholarship. Five nurse scholars of color attended the International Nursing Philosophy Conference in August 2022. We established a collective system of support by sharing our experiences as researchers, scholars, and educators with each other. The theory of emancipatory nursing praxis informed this process. In this dialogue, we reflected on what it is like to present at and attend predominantly white nursing conferences. We shared our experiences of how we exist as nurse scholars, our philosophical views, and our thoughts on how we create spaces where scholars of color can feel welcomed and acknowledged for their contributions to advancing nursing knowledge.     

Decolonizing nursing through the lens of Black maternal health

In the United States, there is a long history of racial disparities in maternal health, with Black women disproportionately representing poor maternal health outcomes. Black women are three to four times more likely to die from a pregnancy-related complication and twice as likely to experience severe maternal morbidity when compared to white women. Where are nurses in the development of knowledge to improve maternal health outcomes among Black birthing people? This dialogue discusses how decolonizing nursing can occur by examining the history of Black maternal health in the United States and using the works of nursing scholars of color to inform nursing education, research, and clinical practice.     

Morphological,biochemical, ultrastructural,tissue culture and clinical observations of typical and aggressive craniopharyngiomas

Summary Craniopharyngiomas are tumors of the suprasellar area, which are often cystic, encapsulated and slow-growing. Certain of these tumors can behave in an aggressive manner and either invade surrounding structures or recur.In order to determine characteristics which may aid in distinguishing typical from atypical lesions, a study of biopsy and tissue culture specimens from 25 human craniopharyngiomas was undertaken. Tissue culture observations reveal two distinct cell populations.Typical lesions grew in culture in an orderly epithelial pattern and had desmosome-tonofibril aggregates and smooth surface topography demonstrable by electron microscopy.In the atypical tumors the cell growth was irregular, with mitotic activity, cholesterol crystals and features characteristic of neoplastic transformation, such as surface microvilli, an increase of cytoplasmic basophilia, size and number of nucleoli and retraction of cytoplasm.Correlation with the clinical status of the patients suggests that tumors of the four patients which exhibited atypical features in culture behaved more aggressively.     

Motivational interviewing training to promote Head Start children's adherence to oral health care recommendations: results of a program evaluation

Objectives: Motivational interviewing (MI) is a research‐supported, patient‐centered counseling technique to support health behavior change. We evaluated training to help teachers use MI for oral health promotion in a multi‐site, diverse, urban Head Start organization. Methods: MI training was evaluated based on the intervention's reach, effectiveness, adoption, implementation, and maintenance. Results: MI was introduced to 150 Head Start staff and 32 received intensive training. Trainees had greater knowledge and willingness to use MI 6 months after training than non‐trained staff, and reported increased use of MI‐consistent counseling techniques. Additionally, the rate of completed dental visits improved slightly across all families served by this Head Start program after teachers used MI with a subset of families. Maintenance is likely based on ongoing organizational interest. Conclusions: Trainees reported successfully using MI techniques in this community‐based educational setting. Additional efforts are needed to increase the reach of training and to ensure sustainability.     

Mild diabetic neuropathy affects ankle motor function.

OBJECTIVE: To evaluate the effect of age and diabetic neuropathy on ankle motor function in the frontal plane in terms of rate of torque development and capability for balance recovery. DESIGN: Case control study. Six older women with diabetic neuropathy compared to six women without neuropathy, matched for age and presence of diabetes mellitus; and nine healthy young women. BACKGROUND: Neuropathy causes a distal impairment in lower extremity sensory function which increases fall risk. Impairments in ankle inversion/eversion proprioceptive thresholds have been identified, but the effect of neuropathy on ankle motor strength in the frontal plane is unknown. METHODS: Subjects' abilities to recover from a lateral lean (with center of gravity offset as percentage of foot width) while standing on one foot, and to rapidly generate inversion torque about the ankle, were quantified. RESULTS: All nine of the young, but only one of six older, control subjects recovered from a 10% lean (P=0.0052). Three of six older controls, but no neuropathy subject, recovered from a 5% lean (P=0.083). Neuropathy subjects demonstrated half the ankle rate of torque development [78.2 (50.8) N m/s; P=0.016] of the young and older controls [162.0 (54.6) and 152.7 (22.2) N m/s, respectively]. CONCLUSIONS: Diabetic neuropathy leads to a decrease in rapidly available ankle strength which impairs balance recovery among older women. Younger women demonstrate similar ankle strength but superior balance recovery compared to older women without neuropathy.     

Utility of peripheral blood cultures in bacteremic pediatric cancer patients with a central line

Purpose  

The utility of peripheral blood cultures in febrile neutropenic children with cancer and central venous catheters (CVC) is controversial. Our primary objective was to describe true bloodstream infections detected only by peripheral culture. Our secondary objectives were to describe true bloodstream infections detected only by CVC culture and to describe probable contaminants detected in both types of blood cultures.