Malignant Pleural Mesothelioma: A Comprehensive Review.

Mesotheliomas are hyperplastic tumors that envelop the serosal membranes that safeguard the body\u27s external surfaces. Although certain instances may exhibit indolent characteristics, a significant number of tumors demonstrate rapid progression and a poor prognosis. Mesotheliomas are typically categorized as benign or malignant, with malignant mesothelioma being more frequently linked to asbestos exposure. Malignant pleural mesothelioma (MPM) predominantly impacts males and often emerges in the late 50 s or beyond, characterized by a median age of early 70 s among patients exposed to asbestos lasting from 2 to 4 decades. Respiratory exposure to asbestos particles leads to the development of malignant mesothelioma, characterized by recurrent inflammation, disruption of cell division, activation of proto-oncogenes, and generation of free radicals. In pleural mesothelioma, BAP1, CDKN2A, and NF are the most often mutated genes. Accurate diagnosis and assessment usually require the use of chest computed tomography (CT) scans, magnetic resonance imaging (MRI), and positron emission tomography (PET). Radiation therapy, immunotherapy, chemotherapy, and surgery are some of the treatment options that are currently available. This systematic review provides a comprehensive analysis of the latest research, biomarkers, evaluation, and management strategies for malignant pleural mesothelioma

Parent social media use and gaming on mobile phones, technoference in family time, and parenting stress.

Possible effects of parent phone use on parent–child interactions and child behavior are of concern, warranting research to understand parent phone use. In this survey study of 183 families with a young child (M = 2.89 years), we examined parents’ phone use for texting/calling, social media (SM) use, mobile gaming (MG), and perceptions of cutting into family time; we also examined differences between mothers and fathers and associations with parenting stress. Mothers engaged in greater SM use but less MG compared to fathers; 61% of mothers and 38% of fathers used SM 31+ min per day, while 23% of fathers and 16% of mothers played mobile games 31+ min. Mothers were also more likely to feel their SM use, but not MG, cut into family time. Greater parenting stress was associated with greater MG and perceptions of SM or MG as cutting into family time. As differences were found between mothers and fathers on phone activities, it may be beneficial to adapt interventions based on type of activity and parent gender. Moreover, as perceived interference from phone use in family interactions is more likely when parents are stressed, we call for future research to consider the context/purpose of phone use and coping strategies

Inquire, Act, Empower: Resilience Strategies for Adolescent Mental Wellness

Presented at the 2024 Parkview Nursing Research Symposium. Background/Problem: Adolescence is a pivotal period for mental health development, with many experiencing stressors that may contribute to the onset of mental health disorders. Research has identified key resilience factors that enhance mental well-being and mitigate the risk of these disorders. Translating this research into practical nursing interventions promotes mental wellness among adolescents. Objectives/Aim/Purpose: This poster aims to explore evidence-based resilience factors in adolescents and present action-oriented nursing interventions that can be integrated into clinical practice to empower young individuals in maintaining mental wellness and preventing mental health disorders. Methods: A systematic review of research was conducted to identify resilience factors relevant to adolescents, such as strong social connections, effective coping mechanisms, emotional regulation, and supportive environments. Based on these findings, a series of practical nursing interventions were developed for implementation in various clinical and community settings. Results: The review highlights several actionable strategies for nursing practice, including: 1. Enhancing Social Support Networks: Encouraging peer and family involvement through group activities and family therapy. 2. Coping Skills Development: Implementing stress management education that teach adolescents healthy coping strategies and problem-solving techniques. 3. Fostering Emotional Regulation: Integrating mindfulness practices and emotional awareness exercises into nursing care to help adolescents better manage their feelings. 4. Building Self-Efficacy: Develop programs that help adolescents set and achieve personal goals, fostering a sense of accomplishment and control over their lives. Conclusion: Adolescent mental health care should prioritize resilience-building interventions that are evidence-based and practical for nurses to implement. By integrating these strategies into nursing practice, nurses can play a vital role in promoting mental well-being and preventing the onset of mental health disorders in adolescents. This poster highlights the transition from resilience research to actionable interventions, offering a roadmap for nurses to advance adolescent mental health care

Enhancing Nurse Confidence and Efficiency in Chest Tube Management: Implementation of a Structured Troubleshooting Checklist

Presented at the 2024 Nursing Research Symposium Background: Chest tube management is critical in pulmonary care, yet challenges arise with unexpected events such as air leaks, dislodgement, failed clamping trials, and tubing disconnections. Concerns raised by the Pulmonology team highlighted nurses\u27 uncertainties and the frequent need for guidance during these events. This prompted the development of a troubleshooting checklist aimed at providing clear, step-by-step instructions for managing these scenarios. By following structured checklists, nurses can reduce the risk of errors, ensure adherence to best practices, and enhance patient safety. Objectives/Purpose: The primary aim of this quality improvement project was to enhance nurses\u27 confidence in managing chest tube complications through the implementation of a structured troubleshooting checklist. Specifically, the project aimed to assess baseline confidence levels, implement targeted training and checklist utilization, and evaluate post-intervention improvements in confidence and reduction in reliance on immediate clinical support. Methods: Nurse leads from units 6 Medical, 6 South, and 7 Medical participated in initial training sessions focused on the troubleshooting checklist. Following this, training was integrated into the curriculum of acute care professional development days, ensuring broad implementation across relevant nursing staff for all acute care nurses. Pre- and post-training surveys were distributed initially to the nurse leads on 6 Medical, 6 South and 7 Medical and a post survey following professional development days for all acute care nurses at PRMC. Results: Analysis of survey data revealed a significant increase in nurses\u27 confidence levels post-training and checklist implementation. Prior to training, only 61% of nurse leads felt confident in managing chest tube complications, compared to 100% post-training. Following the implementation of the checklist training at acute care professional development days, 99% of nurses reported an increase in confidence in caring for a chest tube patient. There was a notable decrease in the frequency of calls to Pulmonology or managing providers regarding chest tube issues, indicating improved autonomy and proficiency among nursing staff. Conclusion: The implementation of a structured chest tube troubleshooting checklist effectively enhanced nurses\u27 confidence in managing unexpected events. This project demonstrates the importance of targeted training and standardized tools in improving clinical outcomes and reducing reliance on immediate clinical support

Daily smartphone use predicts parent depressive symptoms, but parents\u27 perceptions of responsiveness to their child moderate this effect.

INTRODUCTION: Smartphone use during caregiving has become increasingly common, especially around infants and very young children, and this use around young children has been linked with lower quality and quantity of parent-child interaction, with potential implications for child behavior, and parent-child attachment. To understand drivers and consequences of parent phone use, we were interested in the daily associations between parent phone use and depressed mood, as well as the potential for parent perceptions of their responsiveness toward their infant to alter the association between parent phone use and mood. METHODS: In the present study, we explored associations between day-to-day changes in parent smartphone use (objectively-measured via passive sensing) around their infant, depressed mood, and parent perceptions of their responsiveness to their infants among a sample of 264 parents across eight days. We utilized multilevel modeling to examine these within-person daily associations. RESULTS: Objectively-measured parent smartphone use during time around their infant was significantly associated with depressed mood on a daily basis. Interestingly, this was not true on days when parents perceived themselves to be more responsive to their infant. DISCUSSION: These results suggest that parent judgements and perceptions of their parenting behavior may impact the potential link between parent phone use and parent mood. This is the first study utilizing intensive daily data to examine how parent perceptions may alter the felt effects of phone use on their parenting. Future work examining potential impacts of smartphone use on parenting should consider the effects of both actual use and perceptions about that use

Issue 8: Pulmonary & Critical Care Insider

Pulmonary & Critical Care Insider Issue 8 Compiled by Bharat Bajantri, MD, and librarian Sarah Ellsworth, MLS for the clinicians of the Pulmonary and Critical Care team of Parkview. The Pulmonary & Critical Care Insider newsletter was created by Dr. Bharat Bajantri, MD and Sarah Ellsworth, MLS in 2023 as a form of current awareness for current practice at our hospital, Parkview Health. The content resides within critical care and pulmonary related topics and this information is compiled into four main formats. Original Study Summaries: New research publications are read, reviewed, then concisely summarized for clinical interpretation with professional perspectives. Viewpoints: Editorial clinical perspective pieces on current practices. This includes mini-reviews. Snapshots: Quick reference of updated clinical practice or guidance. Contributions: Relevant submissions from other professionals. All content in Pulmonary & Critical Care Insider is reviewed and referenced by healthcare and library professionals. Information provided is intended to disseminate new information and encourage best practices through perspective and discussion. --------- Topics: VIEWPOINTS- Steroids in the ICU- Septic Shock, ARDS, and Severe CAP ORIGINAL STUDY SUMMARIES: Bronchoscopic Lung Volume Reduction (BLVR) Are we looking at the wrong outcomes? ORIGINAL STUDY SUMMARY & PERSPECTIVE First.... Do NO HARM with PPI! Despite generally favorable safety profiles, extended PPI use has been linked to heightened risks of serious complications Being Well While Doing Well - Distinguishing Necessary from Unnecessary Discomfort in Training (Graduate Medical Education Corner) Key ACLS Best Practice Recommendations 2024 SNAPSHOTS: COPD- Beat it with Beets

Outcomes of Mechanical Circulatory Support in STEMI Patients with Cardiogenic Shock: Insights from the National Inpatient Sample

Background Cardiogenic shock has been associated with a high mortality rate despite advances in mechanical circulatory support. Data is inconsistent as the majority of patients in the current trials are SCAI stage E, or data is combined with heart failure and STEMI cardiogenic shock. Methods Data was extracted from the 2020 United States National Inpatient data set. The diagnosis criteria were “STEMI” and “Cardiogenic shock”. The primary outcome of interest was comparing mortality in those patients who received mechanical circulatory support vs. those who did not in STEMI Cardiogenic shock. Results There were 4,302 patients with STEMI and cardiogenic shock, and 65.3% were males. The mean age was 66.7 years (SD 12.3), and the mean length of hospital stay was 7.9 days (SD 10.03). 36% of the patients died during hospital admission. 29% received an intra-aortic balloon pump (IABP), 15.5% had Impella left ventricular support, 3.2% had veno-arterial extracorporeal membrane oxygenation (ECMO), 2.2% had both IABP and Impella, 1.3% had both Impella and ECMO and 1.0% had both IABP and ECMO. The Kaplan-Meier analysis showed that IABP use was associated with decreased in-hospital mortality (p\u3c0.001). In the multivariate analysis, age (OR 1.034, 95% CI 1.028-1.04, p\u3c0.001), female (OR 1.26, 95% CI 1.1-1.45, p\u3c0.001), acute kidney injury (OR 1.96, 95% CI 1.71-2.25, p\u3c0.001), ECMO (OR 1.74, 95% CI 1.22-2.50, p=0.003), and Impella (OR 1.72, 95% CI 1.45-2.06, p\u3c0.001) were associated with increased in-hospital mortality. Conversely, using IABP (OR 0.65, 95% CI 0.56-0.76, p\u3c0.001) was associated with decreased in-hospital mortality. Conclusions Mechanical circulatory support devices are used individually and in combination with each other in patients with cardiogenic shock, with IABP being the most commonly used. However, in-hospital mortality remains high, but using IABP was associated with decreased in-hospital mortality. The patients with IABP were more likely SCAI stage C rather than SCAI stage E; therefore, this could have contributed to the decrease in-hospital mortality

2023 Parkview Research Repository Library Report - Infographic

A infographic compilation of data regarding readership and metrics of content in the Parkview Research Repository for the year of 2023. The platform, Digital Commons, is provided by Elsevier and the institutional repository is managed by the Parkview Research Library. This institutional repository (IR) was started in 2017 and is accessible worldwide

Nationwide Outcomes in Intermediate to High-Risk Pulmonary Embolism Treated with Catheter-based Therapies

Background The mortality rate of pulmonary embolism is as high as 30% and affects 900,000 individuals in the United States per year. Catheter-based therapies (CBT), including catheter-directed thrombolysis (CDT) and mechanical thrombectomy (MT), have been developed to treat patients with intermediate- and high-risk pulmonary embolisms. This study aims to characterize the outcomes in patients admitted with intermediate or high-risk pulmonary embolism treated with MT compared with CDT. Methods The 2020 National Inpatient Sample data was used to analyze outcomes in hospitalized pulmonary embolism patients who received CDT and MT. The primary and secondary outcomes were in-hospital mortality, length of hospital stay, and significant bleeds, including gastrointestinal or brain bleeds. Results 82,179 cases of pulmonary embolism were identified. 2,951 cases (3.6%) received catheter-based therapies (CBT), of which 1,513 (51.27%) received CDT, 1308 (44.32%) received MT, and 130 (4.41%) received a combination of CDT and MT. There were no differences in the incidence of major complications between the MT and CDT groups, including gastrointestinal bleeding (p=0.14) and intracranial bleeding (p=0.26). The length of stay (6.65 vs. 5.46 days, p\u3c0.001) was higher in the MT group than in the CDT. In the multivariate analysis, MT was associated with increased all-cause inpatient mortality (OR 2.41, 95% CI 1.72-3.39, p\u3c0.001). In addition, patients were more likely to get MT than CDT if they had saddle pulmonary embolism (OR 1.28, 95% CI 1.10-1.50, p=0.002), were admitted to medium-sized (OR 1.45, 95% CI 1.14-1.84, p=0.002) or large-sized hospitals (OR 1.73, 95% CI 1.39-2.15, p\u3c0.001), were admitted to urban teaching hospitals (OR 1.93, 95% CI 1.26-2.93, p=0.002), or were older (OR 1.009, 95% CI 1.004-1.014, p\u3c0.001). Conclusions Our study shows that CBT use is still limited in PE patients, and the use of MT is lower than CDT. Patients who received MT had increased all-cause inpatient mortality compared to those who received CDT

Discharge antibiotic use in patients hospitalized with chronic obstructive pulmonary disease (COPD) exacerbations.

Presented at the ASHP Midyear Clinical Meeting. New Orleans, LA This medication use evaluation identified opportunities for improved prescribing in this population. The majority of patients receiving antibiotics had increased dyspnea only. Because of this, 90% of patients did not receive antibiotics appropriately; 94% received an excessive duration. The majority of patients had no prior to admission COPD maintenance therapy, potentially related to lack of baseline FEV1 data required for initiating therapy classification