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We report the case of a young professional soccer player who underwent cardiac MRI (CMR) for work-up of discrete intermittent chest pain and subtle ST segment elevations in the ECG after having been tested positive for SARS-CoV-2 type B.1.1.529 despite full vaccination including recent mRNA booster. Troponin levels were significantly increased and myocarditis was suspected. Comprehensive CMR including CINE and late gadolinium enhancement as well as multi-parametric T1/T2 mapping techniques revealed local hypokinesia and swelling of the posterolateral wall with non-ischemic late gadolinium enhancement and increased T2 relaxation time compatible with acute viral myocarditis. The patient was admitted to a cardiology ward for rhythm and troponin monitoring and was discharged after two days of uneventful rhythm monitoring and with decreased troponin levels. Adhering to current recommendations the patient was advised to abstain from moderate- to high-intensity sports and exercise for 3-6 months. After 6 months of exercise avoidance, follow-up ECG showed regression of prior ST segment elevations, and Holter ECG as well as a treadmill exercise stress test did not reveal any abnormalities. Follow-up CMR was performed before return-to-sports which revealed persisting myocardial fibrosis but complete regression of myocardial edemam and excluded ongoing inflammation. This example underscores the value of multi-parametric CMR tissue characterization for the work-up of suspected SARS-CoV-2 associated myocarditis, as well as for follow-up before return-to-sports.Key Words: COVID-19, Late Gadolinium Enhancement, Cardiovascular MR, Myocardial Mapping

The author reflects on the value of peer reviews in academic writing, discussing the relationship between writers and the editors who provide feedback. According to the author, a good review has a clear understanding of the focus of the journal, comprehensive feedback, and constructive criticism. The article goes on to outline the peer review process and policies used by the "Journal of Social Work Education" (JSWE).

Goldman (1978) has proposed a formula derived from stable population theory for estimating growth rates from certain counts of younger and older sisters in a population. Computer microsimulation outputs show extraordinarily large statistical errors for estimation when stable population assumptions are modified to allow for random variability such as would be encountered with field work on small populations. A derivation of Goldman's formula on more interpretable lines than that in Goldman (1978) identifies a source of variance special to this particular formula so that the large statistical errors for this example need not count in general against the feasibility of estimating demographic rates from counts of kin. [ABSTRACT FROM AUTHOR]

The performance of format demographic feedback models, like Ronald Lee's, provides a test of whether theories of endogenous fertility adjustment, like Richard Easterlin's, can explain the cyclic swings in U.S, and other births that they were designed to explain. This paper shows how the specification of a demographic feedback model determines its ability to sustain cycles of a given period and amplitude observed in data. Only a few of the many versions of Easterlinastyle theories imply formal models which do prove capable of matching U.S. targets, and then only by narrow margins. The general methods presented here are suitable for a broad investigation of the possible role of age- specific feedback in the diversity of more and less cyclic patterns in birth series in the developed world. [ABSTRACT FROM AUTHOR]

Lee's (1974) formal demographic feedback models summarize the implications for births and age-structure of neo-Malthusian theories of baby booms such as those of Easterlin. For some parameter values, such models imply sustained cycles, so-called "limit cycles", in births. Frauenthal and Swick recently reestimated a continuous-age version of Lee's basic cohort model with U.S. series and, contrary to Lee's original findings, concluded that "limit cycles oscillations have been occurring in U.S. births." This article disputes their conclusion, ascribing it to an inconsistency in detrending procedures. Furthermore, it corrects Lee's original conclusion by showing that his alternative period labor-force feedback model, estimated from U.S. series, leads to cycles of implausibly long period. This article thus reopens the question of whether any feedback model could account for the observed cycles in U.S. births. [ABSTRACT FROM AUTHOR]

Cohort parity analysis (CPA) is a method for indirect measurement of the extent and timing of the adoption of fertility control within marriage. It uses information on the parity distribution of a cohort of women of specified marriage ages and durations. A multinomial model of parity provides a convenient framework for the computation of distributional parameters describing the extent to which marital fertility control has been accepted and characterizing the way control has been used within specific durations of marriage. This leads to a pair of easily implemented formulas for upper- and lower-bound estimates of the expected proportion of the population ever controlling and the distribution of controllers by parity. The power of CPA is illustrated, using census data for currently married couples in Dublin, Belfast, and other county boroughs of Ireland in 1911. [ABSTRACT FROM AUTHOR]

Background: As medical tourism rises globally, healthcare leaders are required to make strategic decisions about accepting international patients, as a means to diversify income, increase access to cancer care, and optimize patient experience. Hospital Infantil Teletón de Oncología (HITO), a free-standing pediatric oncology hospital in Mexico, currently has no international patients. Aim: We posed a hypothetical case to a group of HITO's senior leaders to understand the strategic priorities, examine the decision-making process around allocating beds for self-paying patients, and explore how changes in hospital governance influence the healthcare system. Methods: A literature review and prediscussion interviews were conducted, and IRB exemption was obtained. Two facilitators led the discussion using a structured case guide. Participants (N=13) were randomly assigned to teams supporting or opposing the decision to accept international patients. Thirty minutes were allocated for team discussion, thirty minutes for team presentation and group discussion. Session was recorded and transcribed. Results: Four themes emerged around ethics and equity, finance, operations, and community. Ethical considerations included concerns that this possibility disrupted HITO's mission to serve the Mexican population. Financial considerations focused on the creation of a new billing system and cost-efficiency questions. Operational issues included new processes and systems in care delivery to accommodate international patients such as transfer of records and hiring of translators. Community topics covered HITO's reputation and the impact on local economy. Conclusion: Our study revealed the importance of a multidisciplinary approach to complex decision-making and the need for systematic strategic planning that lead to system strengthening and improvement of childhood cancer outcomes. The use of a hypothetical case as a learning and consensus-building tool in exploring team dynamics and mapping strategies was also highlighted. With medical tourism as a potentially realistic scenario, healthcare leaders must be prepared to evaluate its impact on their organization, healthcare system, and society. [ABSTRACT FROM AUTHOR]

The purpose of this scoping review was to ascertain the scope and nature of the literature focused on intimate partner violence (IPV) among Afghans across contexts, including Afghanistan. The scoping review adopted a systematic approach to search for, identify, and include peer-reviewed articles published in English. Fifty-two articles were retained in the final analysis, which generated results on IPV prevalence; multi-level risk and protective factors; qualitatively derived contextual factors; associations of IPV with adverse physical and psychological outcomes; IPV-related help-seeking behaviors; programs and interventions; the role of religion; IPV-related policies; and the role of fiction. Findings indicate that past-year physical IPV prevalence ranged from 52% to 56% in Afghanistan and 79.8% among Afghan refugees displaced in Iran. Studies conducted in Afghanistan identified a range of IPV risk factors occurring at the individual (e.g., age and employment), interpersonal/household (e.g., acceptance of IPV and violence perpetrated by in-laws), and societal levels (e.g., conflict/displacement). The findings highlight a rich literature on IPV in Afghanistan and significant gaps in IPV research across the Afghan diaspora and in contexts of displacement and resettlement. The results advance understanding of the drivers of IPV in the diverse Afghan population and highlight context-specific gaps, and needs for intervention and future research. These gaps indicate the importance of conducting research elucidating how risk and protective factors associated with IPV shift in forced migration and resettlement, and an urgent need for the development and testing of services and programs that respond to the specific needs of Afghan women experiencing IPV across contexts., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Research about technology-based abuse (TBA) has primarily relied on youth-focused survey research, leading to gaps in knowledge about the experiences of TBA among adult populations. However, studies among adult intimate partner violence (IPV) survivors suggest that TBA is a pervasive problem warranting attention. This study builds on the limited existing literature about adult experiences of TBA by examining patterns of TBA among adult abuse survivors ( n  = 377). Latent class analysis showed three distinct patterns of TBA: technology-based emotional abuse, technology-based monitoring, and technology-based control. Multinomial regression analyses demonstrated that TBA co-occurs with offline IPV. Findings reinforce the significant role of TBA in adult IPV survivors' lives and highlight the importance of assessing for TBA among survivors., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interests with respect to the authorship and/or publication of this article.

This paper assesses literature regarding the sexual and reproductive healthcare (SRH) needs of resettled refugee women who experienced gender-based violence (GBV) and trauma-informed care (TIC) principles utilized among SRH service providers. A systematic search identified relevant studies published between 2000 and 2021; no articles found reflected both SRH and TIC principles among refugee women. The search was therefore separated into two aims: to review the literature about SRH needs for refugee women in resettlement countries who experienced GBV (Aim 1) and to examine the use of TIC principles in SRH care among women who experienced GBV (Aim 2). Thematic analysis of the articles identified key themes. Twenty-six articles were included in the analysis across both aims (Aim 1 = 8, Aim 2 = 18). Aim 1 articles shared three factors shaping the SRH needs of resettled refugee women: the centrality of violence and trauma; structural barriers to SRH care; and actions, practices, and resources for service providers. Aim 2 articles illustrated seven key principles of TIC used in SRH service provision, such as empowerment; trauma-specific services and integrated care; connection; safety; collaboration; identity culture and context; and trustworthiness. Resettled refugee women's experiences of violence necessitate trauma-informed SRH health care. While there is limited peer-reviewed literature regarding TIC-SRH care for refugee women, the findings regarding the SRH needs of refugee women and the findings regarding the implementation of TIC in SRH collectively frame recommendations for how SRH can be infused with TIC. An example from practice, in the form of the Refugee Women's Health Clinic, is included as an exemplar of TIC SRH principles in action for the health of resettled refugee women who have survived gendered violence.

Background: Approximately 5-15% of patients with acute coronary syndrome have myocardial infarction with unobstructed coronary arteries (MINOCA). Guidelines recommend invasive assessments to identify underlying causes for MINOCA such as coronary artery spasm (CAS), spontaneous coronary dissection, or microvascular disease as well as non-invasive assessments in search of myocarditis, takotsubo syndrome, or cardiomyopathies., Case Summary: A 54-year-old male patient presented with ST-segment elevation myocardial infarction (STEMI). Upon arrival, ST-segment elevation and symptoms had ceased. Emergency coronary angiography showed diffuse epicardial atherosclerosis with stenoses in the distal left anterior descending coronary artery (LAD) and second diagonal branch (D2); however, no epicardial occlusion was seen. Left ventriculography showed no clear wall motion abnormalities. Based on these findings, intracoronary acetylcholine (ACh) testing in search of CAS was performed. At 200 µg ACh intracoronary ST-segment elevation and chest pain recurred. Angiography showed occlusive epicardial spasm in the LAD and D2. Based on studies where the tendency of epicardial CAS was linked with the presence of epicardial atherosclerosis, the decision was made to perform PCI in the LAD and D2. ACh re-challenge after intracoronary nitroglycerine revealed only very mild symptoms, no demonstrable epicardial CAS, and no ST-segment elevation anymore. Cardiac enzymes reached their peak on day one [creatine kinase max 262 U/L (norm < 190 U/L), maximum of high-sensitivity troponin T 269 pg/mL ( n < 14 pg/mL)]., Discussion: There is a broad spectrum of patients with STEMI without culprit lesion regarding the extent of epicardial disease. In cases with an unclear culprit lesion, other causes for the acute presentation such as CAS should be investigated in an ad hoc fashion. The interplay of epicardial atherosclerosis and CAS should receive more attention in future trials., Competing Interests: Conflict of interest: None declared., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.)

This study aimed to systematically review current research on the application of existing social support scales in research with refugees in resettlement, assess their quality, and identify gaps in measurement to enhance research and practice. A scoping review was conducted on the extant literature published until March 2023. A team of researchers conducted search, sorting, and data extraction processes following best practices for scale development and validation. Of the 1185 studies collected from the search process, 41 articles were retained in the final analysis, from which 17 distinct social support instruments used in research with resettled refugees were identified. An assessment of all 17 instruments showed the presence of one or more limitations associated with construct, criterion, convergent, and/or discriminant validity. Test of reliability was assessed in all studies, with a range of 0.80 to 0.90. Our findings show that most of the research evaluating social support among resettled refugees is conducted without measurement instruments adequately validated in the resettlement context. This analysis highlights the need for rigorously developed social support scales that reflect the lived experiences, needs, and priorities of resettled refugees.

Community health workers are members of two groups whose short- and long-term health has been uniquely shaped by the COVID-19 pandemic: health workers and the oft-marginalized populations that they serve. Yet, their wellbeing, particularly of those serving resettled refugees, before and during the pandemic has been largely overlooked. Drawing from a holistic conceptualization of wellness, this study examined the effects of the COVID-19 pandemic on a group of cultural health navigators (CHNs), who serve resettled refugees. We conducted semi-structured individual interviews with CHNs at a southwestern U.S. hospital system between July and August 2020, a critical time in the pandemic. Our analysis produced four themes that encapsulate the effects of the pandemic on CHN wellbeing: (1) "You fear for your life": Chronic risk of COVID-19 exposure takes a toll on physical, emotional, and environmental wellbeing; (2) "It is stressful because it is completely new": Uncertainty diminishes occupational, financial, and emotional wellbeing; (3) "If you don't have the heart to help, you cannot do this job": CHNs remain committed while facing challenges to their occupational wellbeing on multiple fronts; and (4) "Now, you cannot release your stress": Loss of and shifts in outlets integral to social and spiritual wellbeing. The findings deepen empirical understanding of how the pandemic affected the holistic wellbeing of CHNs, as they continued to serve their communities in a time of crisis. We discuss the implications for addressing the multidimensionality of community health worker wellbeing in research, policy, and practice., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Introduction: Immigrant and forcibly displaced women and girls are disproportionately impacted by the harmful health consequences of intimate partner violence (IPV) in the USA. Economic and Social Empowerment (EA$E), a women's protection and empowerment intervention, has shown promising reductions in IPV and gender inequities among forcibly displaced populations (FDPs) in low-income and middle-income countries. However, research on the integration of gender equity interventions into economic empowerment programming for FDPs within the USA is lacking. Additionally, there is growing interest in integrating gender equity programmes among US-based refugee resettlement organisations, including the International Rescue Committee (IRC). We describe our study protocol for examining the feasibility, acceptability and appropriateness of EA$E for use with US-based FDPs, and recommendations for adaptation., Methods and Analysis: This is a convergent parallel study to guide the adaptation of EA$E for use with US-based FDPs. Mixed methods (quantitative and qualitative) will be used for the adaptation research. Quantitative data will consist of brief surveys, and qualitative data will consist of focus group discussions (FGDs). Our research will be guided by the 'administration' phase of the ADAPT-ITT framework, which entails pretesting the intervention with the new target audience and implementation context to examine acceptability, appropriateness and feasibility to receive feedback to inform modifications of the original intervention. This is done via theatre testing, an innovative approach to pretesting that allows the new target audience to experience the intervention and provide feedback. We will conduct FGDs with IRC staff (n=4, total of 24 participants) and refugee clients (n=8, total of 48 participants, women and men, French and English speaking)., Ethics and Dissemination: The study has received approval from the George Mason University Human Subjects Committee (#1686712-7) and IRC (via reliance agreement). Results will be made available to refugee resettlement organisations, policymakers, funders and other researchers. This study has been registered in Open Science Framework (https://doi.org/10.17605/OSF.IO/SZDVY)., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

In the recent Central American migrations spurred by violence, political instability, and economic insecurity, women grapple with whether and when to bring their children with them in pursuit of safety in another country, and with fulfilling their roles as mothers from afar. Drawing from the transnational motherhood literature and critical feminist theories, this interpretive qualitative study examined transnational motherhood grounded in the lived experiences of Central American women ( n = 19) over the course of their migrations to the US. Informed by the principles of grounded theory, the inductive analysis identified five processes in which migration and violence shaped meanings of motherhood: risking everything, embodying separation, braving reunification, mothering others, and experiencing motherhood due to sexual violence. The findings contribute knowledge of how violence shapes and informs women's migrations and decision-making, and the consequences women endure in taking action to mitigate threats of violence in their own and their children's lives. The analysis furthermore highlights the specific and profound effects of family separation on mothers. The voices, perspectives, and experiences of migrating mothers and the ways in which migration and violence shapes notions and lived experiences of motherhood are imperative to research, practice, and advocacy to change oppressive immigration policies.

In 2020, healthcare workers faced the COVID-19 pandemic amidst other salient sociopolitical stressors. This study, therefore, set out to examine associations between personal, work-related and contextual factors and three outcomes - stress, burnout and turnover intention - at a critical juncture in the pandemic. In December 2020, we recruited a broad array of healthcare workers (n = 985) in a public safety net healthcare system serving socially and economically marginalised communities in the Southwest region of the United States using a cross-sectional online survey. The results indicated that more health problems were associated with higher stress and burnout symptoms. While seeking emotional support and using drugs or alcohol to cope were associated with higher stress, a positive social outlook was associated with lower stress. Lower quality of work-life was associated with higher burnout symptoms and turnover intention. Negative effects of the pandemic on wellbeing and higher number of COVID-19-related concerns were associated with higher stress and burnout symptoms. Contrary to the original hypotheses, self-care was not associated with any of the three outcomes, and effects of the political climate and issues of racism on wellbeing were not associated with stress, burnout or turnover intention. However, identifying as a Person of Colour was associated with higher stress, as well as lower burnout. The findings on worker health, social outlook, quality of work-life and race/ethnicity, in particular, suggest a critical need for healthcare systems to address the wellbeing of workers through equitable organisational policy and practice., (© 2022 John Wiley & Sons Ltd.)

Women engage in multiple strategies to cope with the impact of intimate partner violence (IPV). Prior research has focused predominantly on women's service utilization and help seeking as individual acts, yet it is likely that women engage in distinct patterns of multiple help-seeking strategies to achieve safety. As such, the current article examines patterns of service-related help-seeking strategies survivors employ. This article also investigates demographic factors, relationship characteristics, and mental and physical health effects of IPV associated with patterns of help seeking. Using a web-based survey, data were collected from service-engaged adult female IPV survivors ( n = 369) in the Southwest region of the United States. Latent class analysis (LCA), a person-centered analytical approach, was used to identify survivors' patterns of help seeking. A 3-class LCA model was determined to be the best fit for the data. Among the sample, 50% of women broadly engaged formal and informal networks, 15% primarily engaged informal networks, and 35% broadly engaged networks but avoided legal systems while seeking other formal services. Findings indicated varying and significant associations between class membership and race/ethnicity, foreign-born status, number of children, IPV severity, and mental health symptoms. The findings reinforce the need for practitioners to be aware of the varied ways women choose or avoid seeking help and explore women's preferences. Comprehensive and collaborative service networks are necessary for early detection and holistic care. Addressing structural factors is imperative for expanding the range of viable support options available to IPV survivors, particularly women of color.

Gaps in knowledge related to occupational stress among the intimate partner violence (IPV) and sexual assault (SA) workforce remain. This study examined associations between key risk factors for occupational stress and compassion fatigue among a sample of IPV/SA service providers in the Southwestern United States ( N = 520). Results of the hierarchical regression analysis identified microaggressions, age, recent life stress, direct practice, and workload as factors associated with compassion fatigue. The findings point to the importance of incorporating trauma-informed organizational approaches to address microaggressions, reduce workload, and support staff experiencing recent stress and providing direct services.

A qualitative study examined factors that hinder help seeking for intimate partner violence among women who resettled to the United States as refugees. A refugee resettlement agency recruited female clients ( n = 35) and service providers and stakeholders ( n = 53) in the metropolitan area. The study employed individual interviews and focus group discussions to collect data. An inductive and interpretive thematic approach guided the analytical process. The analysis revealed challenges related to information gaps and communication struggles complicating help-seeking processes. The findings point to the importance of bolstering information sharing within and across informal and formal networks to help women navigate support and services in resettlement.

Gaps in knowledge remain regarding how and from whom women resettling to the United States as refugees seek help for intimate partner violence (IPV), and what happens when they do. This study examined ways in which women seek help for IPV across varied contexts and at different times both pre- and postresettlement. Researchers used a purposive sampling approach to recruit women who resettled to the United States as refugees ( n = 35). An inductive approach to thematic analysis led to an examination of the role of family in seeking help for IPV and seeking help in the absence of family. The findings speak to the importance of applying a social support lens to theory, practice, and research concerned with women's help-seeking for IPV in the resettlement context.

This study reviewed social support research with refugees in resettlement by assessing the scope of scholarship and examining methodological approaches, definitions, theoretical frameworks, domains, and sources of support. The scoping review followed a systematic approach that retained 41 articles for analysis. The findings indicate that refugee resettlement studies seldom conceptualizes social support as a central focus, defines the concept, draws from related theory, or examines multifaceted components of the construct. The review nevertheless yielded promising findings for future conceptual and empirical research. The analysis identified a wide range of relevant domains and sources of social support, laying the foundation for a socio-ecological model of social support specific to refugee experiences in resettlement. The findings also indicate an imperative to examine and theorize social support vis-à-vis diverse groups as a main outcome of interest, in connection to a range of relevant outcomes, and longitudinally in recognition of the temporal processes in resettlement., (© The Author(s) 2021. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Immigrant and refugee women may experience considerable multifaceted and interrelated barriers that place them at heightened risk for intimate partner violence (IPV). The objective of this analysis was to increase our understanding of immigrant and refugee women's responses to abuse. We conducted in-depth interviews with 84 women who immigrated from Africa, Asia, and Latin America. Engendering Resilience to Survive emerged as the core category explaining women's strength to stay safe and survive IPV experiences. In the face of the violence they experienced, women in this sample demonstrated remarkable resilience and the ability to harness their strength to survive. Resilience as a process and outcome could facilitate empowerment, and self-directedness to access health services and resources to stay safe. The developed Engendering Resilience to Survive Model can be utilized as a framework to inform research, policy, and practice to support abused women., Competing Interests: Disclosure of Interest: All authors, VNC, BS, JTM, CS, AWL, CF, and JC, declare they have no real or perceived conflicts of interest to report.

A Message From Asco’s President: Shortly before I was elected President of ASCO, I attended the 65th birthday party of a current patient. She had been diagnosed 10 years earlier with metastatic breast cancer and hadn't been sure she wanted to move forward with further treatment. With encouragement, she elected to participate in a clinical trial of an investigational drug that is now widely used to treat breast cancer. Happily, here we were, celebrating with her now-married daughters, their husbands, and three beautiful grandchildren, ages 2, 4, and 8. Such is the importance of clinical trials and promising new therapies.Clinical research is about saving and improving the lives of individuals with cancer. It's a continuing story that builds on the efforts of untold numbers of researchers, clinicians, caregivers, and patients. ASCO's Clinical Cancer Advances report tells part of this story, sharing the most transformative research of the past year. The report also includes our latest thinking on the most urgent research priorities in oncology.ASCO's 2020 Advance of the Year-Refinement of Surgical Treatment of Cancer-highlights how progress drives more progress. Surgery has played a fundamental role in cancer treatment. It was the only treatment available for many cancers until the advent of radiation and chemotherapy. The explosion in systemic therapies since then has resulted in significant changes to when and how surgery is performed to treat cancer. In this report, we explore how treatment successes have led to less invasive approaches for advanced melanoma, reduced the need for surgery in renal cell carcinoma, and increased the number of patients with pancreatic cancer who can undergo surgery.Many research advances are made possible by federal funding. With the number of new US cancer cases set to rise by roughly a third over the next decade, continued investment in research at the national level is crucial to continuing critical progress in the prevention, screening, diagnosis, and treatment of cancer.While clinical research has translated to longer survival and better quality of life for many patients with cancer, we can't rest on our laurels. With ASCO's Research Priorities to Accelerate Progress Against Cancer, introduced last year and updated this year, we've identified the critical gaps in cancer prevention and care that we believe to be most pressing. These priorities are intended to guide the direction of research and speed progress.Of course, the effectiveness or number of new treatments is meaningless if patients don't have access to them. High-quality cancer care, including clinical trials, is out of reach for too many patients. Creating an infrastructure to support patients is a critical part of the equation, as is creating connections between clinical practices and research programs. We have much work to do before everyone with cancer has equal access to the best treatments and the opportunity to participate in research. I know that ASCO and the cancer community are up for this challenge.Sincerely,Howard A. "Skip" Burris III, MD, FACP, FASCOASCO President, 2019-2020.

The intimate partner violence (IPV) and sexual assault (SA) workforce faces significant occupational stressors yet little is known about positive occupational outcomes associated with this work. Therefore, this study analyzed factors associated with compassion satisfaction among the IPV/SA workforce in one southwestern U.S. state ( n  = 623). Drawing from the Resilience Portfolio Model (Grych et al. 2015), researchers examined the possible role of coping behaviors in mediating associations between compassion satisfaction and workplace resources / assets, perceived job security, and resilience. Analyses revealed partial mediation in the models that included workload, values, and resilience as independent variables, suggesting that these factors both influence workers' coping behaviors and have an independent association with compassion satisfaction. Models investigating control, rewards, community, fairness, and perceived job security indicated significant total effects of the independent variables on compassion satisfaction. Overall, IPV/SA workers who engaged more frequently in a range of coping behaviors reported higher levels of compassion satisfaction. The findings point to implications for organizational and employee practice, including building in worktime for key individual coping behaviors, balancing workloads among staff members, and enhancing organizational level coping strategies, such as team supervision and team care planning., (© Springer Science+Business Media, LLC, part of Springer Nature 2019.)

Objective: Evidence-based clinical resources (EBCRs) have the potential to improve diagnostic and therapeutic accuracy. The majority of US teaching medical institutions have incorporated them into clinical training. Many EBCRs are subscription based, and their cost is prohibitive for most clinicians and trainees in low-income and middle-income countries. We sought to determine the utility of EBCRs in an East African medical school., Setting: The University of Rwanda (UR), a medical school located in East Africa., Participants: Medical students and faculty members at UR., Interventions: We offered medical students and faculty at UR free access to UpToDate, a leading EBCR and conducted a cohort study to assess its uptake and usage. Students completed two surveys on their study habits and gave us permission to access their activity on UpToDate and their grades., Results: Of the 980 medical students invited to enrol over 2 years, 547 did (56%). Of eligible final year students, 88% enrolled. At baseline, 92% of students reported ownership of an internet-capable device, and the majority indicated using free online resources frequently for medical education. Enrolled final year students viewed, on average, 1.24 topics per day and continued to use UpToDate frequently after graduation from medical school. Graduating class exam performance was better after introduction of UpToDate than in previous years., Conclusions: Removal of the cost barrier was sufficient to generate high uptake of a leading EBCR by senior medical students and habituate them to continued usage after graduation., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

This study examined multi-level factors associated with turnover intention and job satisfaction among the intimate partner violence and sexual assault workforce. Researchers conducted a cross-sectional analysis with data from 530 respondents. Key measures included turnover intention, job satisfaction, burnout, secondary traumatic stress, compassion satisfaction, and areas of work-life fit. Regression analyses examined multi-level associations with turnover intention and job satisfaction. In the first model, lower satisfaction with supervision, higher burnout scores, lower salaries and identifying as African American were significantly associated with higher turnover intention. In the second model, workplace community and control, lower rates of secondary traumatic stress, and increased use of coping were associated with higher job satisfaction. Lower satisfaction with unpaid and paid leave predicted lower job satisfaction. Implications for practice and research are discussed., (© Copyright 2019 Springer Publishing Company, LLC.)

Background: Coronary artery disease (CAD) is associated with poorer outcomes after aortic valve replacement (AVR). For high-risk patients with complex CAD, combined transcatheter aortic valve replacement (TAVR) plus off-pump/minimally-invasive coronary artery bypass (OPCAB/MIDCAB) has been proposed., Methods: A prospective registry analysis was performed to compare the characteristics and outcomes of patients undergoing TAVR+OP/MIDCAB with those undergoing TAVR plus percutaneous coronary intervention (PCI) and surgical AVR plus coronary artery bypass grafting (CABG) between 2008 and 2015 at a single site in Germany., Results: 464 patients underwent SAVR+CABG, 50 underwent TAVR+OP/MIDCAB, and 112 underwent TAVR+PCI. The mean ages (p < 0.001) and logistic EuroSCOREs (p < 0.001) were similarly higher in TAVR+OP/MIDCAB and TAVR+PCI patients compared to SAVR+CABG patients. Prior cardiac surgery was more common in TAVR+PCI than in TAVR+OP/MIDCAB and SAVR+CABG patients (p < 0.001). Procedural times were shortest (p < 0.001), creatine kinase (muscle brain) levels least elevated (p < 0.001), pericardial tamponade least common (p = 0.027), and length of hospital stay shortest (p = 0.011) in TAVR+PCI, followed by TAVR+OP/MIDCAB and SAVR+CABG patients. In-hospital mortality was highest for TAVR+OP/MIDCAB patients (18.0%) with comparable rates for TAVR+PCI and SAVR+CABG groups (9.0 and 6.9%; p = 0.009). Mortality by 12 months was more probable after TAVR+OP/MIDCAB (HR: 2.17, p = 0.002) and TAVR/PCI (HR: 1.63, p = 0.010) than after SAVR+CABG, with the same true of rehospitalisation (HR: 2.39, p = 0.003 and HR: 1.63, p = 0.033)., Conclusions: TAVR+OP/MIDCAB patients share many characteristics with TAVR+PCI patients, with only slightly poorer long-term outcomes. In patients ineligible for SAVR+CABG and TAVR+PCI, hybrid interventions are reasonable second-line options.

This review aims to provide an overview on recent data to evaluate minimally invasive (MVAD) and conventional (CVAD) left ventricular assist device (LVAD) implantation. A comprehensive literature search of PubMed, Cochrane Library, and ClinicalTrials.gov was conducted up to April 2017. A total of 183 studies were identified; 13 studies met inclusion criteria. The review revealed a trend toward a lower rate of transfusion, and shorter time for cardiopulmonary bypass, as well as a lower 30-day mortality rate for MVAD. This review indicates that there are possible benefits of minimally invasive LVAD implantation, even though the state of literature is poor., Competing Interests: The authors have no conflicts of interest or financial ties to disclose., (Georg Thieme Verlag KG Stuttgart · New York.)