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Purpose: The purpose of this study was to examine the impact of the first year of COVID-19 pandemic on maternal and neonatal outcomes at a large military treatment facility in Southern California., Study Design and Methods: A retrospective review of maternal and neonatal medical records was conducted between January 1, 2019, and December 31, 2020. Outcomes measured included stillbirth rate, neonatal intensive care unit admission, neonatal death, cesarean birth, and postpartum hemorrhage., Results: A total of 4,425 records were analyzed. Rates of stillbirth between the years did not vary. The neonatal death rate decreased more than 50% in 2020 (p = .149). Cesarean births rose by 2.7% in 2020 (p = .046). Rates of postpartum hemorrhage did not vary between years., Clinical Implications: The impact of COVID-19 on maternal and neonatal outcomes at a military treatment facility in the first year of the COVID-19 pandemic provides guidance for optimizing perinatal health care. Vertical transmission of COVID-19 is low and routine testing of asymptomatic neonates of positive mothers may not be necessary. COVID-19 infections should not be an indication for cesarean birth and are not associated with neonatal deaths or NICU admission., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Context: Medical College Admission Test (MCAT) scores are widely used as part of the decision-making process for selecting candidates for admission to medical school. Applicants who learned English as a second language may be at a disadvantage when taking tests in their non-native language. Preliminary research found significant differences between English language learners (ELLs), applicants who learned English after the age of 11 years, and non-ELL examinees on the Verbal Reasoning (VR) sub-test of the MCAT. The purpose of this study was to determine if relationships between VR sub-test scores and measures of medical school performance differed between ELL and non-ELL students., Methods: Scores on the MCAT VR sub-test and student performance outcomes (grades, examination scores, and markers of distinction and difficulty) were extracted from University of California San Diego School of Medicine admissions files and the Association of American Medical Colleges database for 924 students who matriculated in 1998-2005 (graduation years 2002-2009). Regression models were fitted to determine whether MCAT VR sub-test scores predicted medical school performance similarly for ELLs and non-ELLs., Results: For several outcomes, including pre-clerkship grades, academic distinction, US Medical Licensing Examination Step 2 Clinical Knowledge scores and two clerkship shelf examinations, ELL status significantly affects the ability of the VR score to predict performance. Higher correlations between VR score and medical school performance emerged for non-ELL students than for ELL students for each of these outcomes., Conclusions: The MCAT VR score should be used with discretion when assessing ELL applicants for admission to medical school., (© Blackwell Publishing Ltd 2012.)

Caring for veterans with dementia is burdensome for family caregivers. This exploratory study tested the efficacy of an innovative, spiritually based mantram caregiver intervention delivered using teleconference calls. A prospective, within-subjects, mixed-methods, and 3-time repeated-measures design with 36-week follow-up telephone interviews was conducted. Sixteen caregivers (94% women, 94% Whites with mean age 69.2 years, SD = 10.35 years) completed the intervention. Significant effects for time and linear terms were found for decreasing caregiver burden, perceived stress, depression, and rumination and for increasing quality of life enjoyment and satisfaction, all with large effect sizes. Findings suggest that teleconference delivery of a spiritually based caregiver intervention is feasible.

Aim: This paper is a report of a study to describe nurses' practices, knowledge, and attitudes related to evidence-based nursing, and the relation of perceived barriers to and facilitators of evidence-based practice., Background: Evidence-based practice has been recognized by the healthcare community as the gold standard for the provision of safe and compassionate healthcare. Barriers and facilitators for the adoption of evidence-based practice in nursing have been identified by researchers. Healthcare organizations have been challenged to foster an environment conducive to providing care based on evidence and not steeped in ritualized practice., Methods: A descriptive, cross-sectional research study was conducted in 2006-2007 with a convenience sample of 458 nurses at an academic medical center in California (response rate 44.68%). Two reliable and valid questionnaires were electronically formatted and administered using a secured website. Relationships between responses to the two instruments were examined and results compared with previously published data., Results: Organizational barriers (lack of time and lack of nursing autonomy) were the top perceived barriers. Facilitators were learning opportunities, culture building, and availability and simplicity of resources. Statistically significant correlations were found between barriers and practice, knowledge and attitudes related to evidence-based practice., Conclusion: Similar barriers to the adoption of evidence-based practice have been identified internationally. Educators must work with managers to address organizational barriers and proactively support evidence-based practice.

Hispanics are a growing ethnic minority in the United States and one at significant risk for heart failure. Health-related quality of life (HRQL) is poor in individuals with heart failure, especially during and immediately following hospitalization. No prior research into the HRQL of Hispanics with heart failure was located. A sample of 80 individuals with heart failure, evenly divided by primary language and matched on functional status using the New York Heart Association classification system and age, was studied for 6 months following hospital discharge. Data on HRQL were collected using Spanish and English versions of the Minnesota Living with Heart Failure Questionnaire. Scores improved over time in both groups but significantly more so in the Hispanics when compared to the non-Hispanics. Group differences in HRQL could not be explained by demographics, clinical characteristics, treatment received, perceived support, or instrument response characteristics. Further exploration of this naturally occurring phenomenon may provide insight into how HRQL can be improved in the general heart failure population.