Telehealth Utilization in Response to the COVID-19 Pandemic: Current State of Medical Provider Training

Background: The COVID-19 pandemic accelerated the development of telehealth services and thus the need for telehealth education and training to support rapid implementation at scale. A national survey evaluating the current state of the telehealth landscape was deployed to organizational representatives, and included questions related to education and training. Materials and Methods: In the summer of 2020, 71 survey participants (31.8%) completed an online survey seeking to determine the utilization of telehealth services across institutional types and locations. This included data collected to specifically compare the rates and types of formal telehealth education provided before and during the pandemic. Results: Thirty percent of organizations reported no telehealth training before COVID-19, with those in suburban/rural settings significantly less likely to provide any training (55% vs. 82%) compared with urban. Pandemic-related training changes applied to 78% of organizations, with more change happening to those without any training before COVID-19 (95%). Generally, organizations offering training before the pandemic reported deploying COVID-19-related telehealth services, while a higher percentage of those without any training beforehand reported that they either did not plan on providing these services or were in the early planning stages. Discussion: Telehealth education is moving from elective to essential based on the need to prepare and certify the workforce to support high-quality telehealth services. Conclusions: As telehealth continues to evolve to meet the future health care service needs of patients and providers, education and training will advance to meet the needs of everyday clinical encounters and broader public health initiatives

Building Telehealth Teams of the Future Through Interprofessional Curriculum Development: A Five-Year Mixed Methodology Study

Building the next generation of telehealth enabled professionals requires a mixture of team-based, interprofessional practice with novel technologies that connect providers and patients. Effective telehealth education is critical for the development of multidisciplinary training curricula to ensure workforce preparedness. In this study, we evaluated the impact of a formal telehealth education curriculum for interprofessional students through an online elective. Over 12 semesters, 170 students self-selected to enroll in the 3-credit hour interprofessional elective and took part in structured didactic, experiential and interprofessional learning opportunities. Mixed-method assessments show significant knowledge and confidence gains with students reflecting on their roles as future healthcare providers. The results from five years’ worth of course data shows not only an opportunity to advance the individual knowledge of trainees, but a larger movement to facilitate changes in practice toward population health goals. Recent global health events have further highlighted the need for a rapid response to public health emergencies by highly trained provider teams who are able to utilize technology as the cornerstone for the continuity of care

Spectroscopic Hα and Hγ survey of field Be stars: 2004-2009

Massive O- and B-type stars are cosmic engines in the Universe and can be the dominant source of luminosity in a galaxy. The class of Be stars are rapidly rotating B-type stars that lose mass in an equatorial, circumstellar disk (Porter & Rivinius 2003) and cause Balmer and other line emission. Currently, we are unsure as to why these stars rotate so quickly but three scenarios are possible: they may have been born as rapid rotators, spun up by binary mass transfer, or spun up during the main-sequence evolution of B stars. In order to investigate these scenarios for this population of massive stars, we have been spectroscopically observing a set of 115 field Be stars with the Kitt Peak Coudè Feed telescope in both the Hα and Hγ wavelength regimes since 2004. This time baseline allows for examination of variability properties of the circumstellar disks as well as determine candidates for closer examination for binarity. We find that 90% of the observed stars show some variability with 8% showing significant variability over the 5-year baseline. Such values may be compared with the significant variability seen in some clusters such as NGC 3766 (McSwain 2008). Also, while ~20% of the sample consists of known binaries, we find that another 15-30% of the sample shows indications of binarity. © International Astronomical Union 2011

Pediatric Telehealth in the COVID-19 Pandemic Era and Beyond

The coronavirus disease 2019 (COVID-19) pandemic led to an unprecedented demand for health care at a distance, and telehealth (the delivery of patient care using telecommunications technology) became more widespread. Since our 2018 state-of-the-art review assessing the pediatric telehealth landscape, there have been many changes in technology, policy, payment, and physician and patient acceptance of this care model. Clinical best practices in telehealth, on the other hand, have remained unchanged during this time, with the primary difference being the need to implement them at scale.Because of the pandemic, underlying health system weaknesses that have previously challenged telehealth adoption (including inequitable access to care, unsustainable costs in a fee-for-service system, and a lack of quality metrics for novel care delivery modalities) were simultaneously exacerbated. Higher volume use has provided a new appreciation of how patients from underrepresented backgrounds can benefit from or be disadvantaged by the shift toward virtual care. Moving forward, it will be critical to assess which COVID-19 telehealth changes should remain in place or be developed further to ensure children have equitable access to high-quality care.With this review, we aim to (1) depict today's pediatric telehealth practice in an era of digital disruption; (2) describe the people, training, processes, and tools needed for its successful implementation and sustainability; (3) examine health equity implications; and (4) critically review current telehealth policy as well as future policy needs. The American Academy of Pediatrics (AAP) is continuing to develop policy, specific practice tips, training modules, checklists, and other detailed resources, which will be available later in 2021

Telehealth: Opportunities to Improve Access, Quality, and Cost in Pediatric Care

The use of telehealth technology to connect with patients has expanded significantly over the past several years, particularly in response to the global coronavirus disease 2019 pandemic. This technical report describes the present state of telehealth and its current and potential applications. Telehealth has the potential to transform the way care is delivered to pediatric patients, expanding access to pediatric care across geographic distances, leveraging the pediatric workforce for care delivery, and improving disparities in access to care. However, implementation will require significant efforts to address the digital divide to ensure that telehealth does not inadvertently exacerbate inequities in care. The medical home model will continue to evolve to use telehealth to provide high-quality care for children, particularly for children and youth with special health care needs, in accordance with current and evolving quality standards. Research and metric development are critical for the development of evidence-based best practices and policies in these new models of care. Finally, as pediatric care transitions from traditional fee-for-service payment to alternative payment methods, telehealth offers unique opportunities to establish value-based population health models that are financed in a sustainable manner

Effects of Ibuprofen On Muscle Hypertrophy and Inflammation: A Review of Literature

Purpose of Review: Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used for post-exercise recovery and reduction of muscle soreness and pain. While many studies have contradictory results on whether NSAIDs hinder the post-exercise recovery process, this study sought to identify more clearly the effects of NSAIDs on the exercise-induced inflammatory response, muscle protein synthesis, and overall post-exercise muscle recovery. Recent Findings: NSAID ingestion is common for the reduction of delayed onset muscle soreness after exercise or to decrease pain and inflammation during the rehabilitation of a muscle injury. However, there is evidence that while NSAIDs reduce the activity of cyclooxygenase (Cox-2) which generates prostaglandins that mediate inflammation and pain, they may also play a role in the reduction of protein synthesis and slow the restoration of functional recovery by disrupting the natural anti-inflammatory response during muscle recovery. Summary: While most of the ten articles selected for this review had low-participant numbers, they provided evidence that large doses of NSAIDs used after high-intensity interval training can reduce muscle protein synthesis and hypertrophy while lower doses have little to no effect on these factors. Thus, taking large doses of NSAIDs can be detrimental to muscle recovery and hypertrophy after exercise training. Further research is required to determine the varying effects of different NSAIDs and dosages

Telehealth: Improving Access to and Quality of Pediatric Health Care

All children and adolescents deserve access to quality health care regardless of their race/ethnicity, health conditions, financial resources, or geographic location. Despite improvements over the past decades, severe disparities in the availability and access to high-quality health care for children and adolescents continue to exist throughout the United States. Economic and racial factors, geographic maldistribution of primary care pediatricians, and limited availability of pediatric medical subspecialists and pediatric surgical specialists all contribute to inequitable access to pediatric care. Robust, comprehensive telehealth coverage is critical to improving pediatric access and quality of care and services, particularly for under-resourced populations