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Access status: Open Access ,
GLP-1 Receptor Agonist Medications: Patient Education
(Medsurg Nursing) Liggett, Laura; Bell-McClure, Elizabeth
Access status: Open Access ,
Community Health Workers in the Veterans Administration: Exploring Opportunities and Barriers to Integration for Rural and Caregiver Populations.
(Medical care, 2026-07) Harker, Katlin; Howard, Teresa; Smith, Battista; Pinheiro, Sandro; Boucher, Nathan A
<h4>Background</h4>Rural Veterans and caregivers face challenges related to health care access, care coordination, and institutional trust-areas where Community Health Workers (CHWs) are well positioned to make an impact. Despite their potential, CHW integration into complex federal systems such as the US Department of Veterans Affairs (VA) remains limited. CHWs represent a promising strategy to enhance access and care continuity for rural Veterans and caregivers.<h4>Objectives</h4>To examine perceptions of community and institutional partners regarding integration of CHWs into the VA to support rural Veterans and their family caregivers.<h4>Methods</h4>We conducted virtual, semistructured interviews with 24 key informants from community organizations and VA-affiliated institutions (October 2024 to February 2025). Interviews explored key informant views on CHW roles, responsibilities, training needs, and implementation considerations. A community advisory board of CHWs guided all aspects of the project.<h4>Results</h4>Four themes emerged: (1) CHW scope of work, (2) barriers and facilitators to CHW implementation, (3) CHW support needs, and (4) training and requisite knowledge.<h4>Conclusions</h4>Effective CHW integration into the VA will require role clarity, robust support systems, and context-specific training tailored to this population. To ensure sustainability, VA leadership will need to standardize role definitions across clinical and community domains. A strong business case-demonstrating improved care coordination, reduced emergency department use, and enhanced screening for social determinants of health-will be critical to secure funding and supportive policy. CHW integration could also offset staff burden within the VA.
Access status: Open Access ,
Reconfigurable quantum computer juggles 98 qubits.
(Nature, 2026-07) Noel, Crystal
A quantum computer based on trapped ions can connect any two quantum bits, reaching performance levels that conventional computers cannot match.
Access status: Open Access ,
How to Build a Community Advisory Board (CAB): Tips and Lessons Learned from the Hospital-to-Home (H2H) Transitional Care Study for Children and Youth with Special Health Care Needs (CYSHCN) Community Advisory Board
(2026-07-15) Kmitch, Laura; Ediae, Esosa; Ming, David; deJong, Neal; McDermott, Nathan; Sanwo, Daniel; Robinson, Dalya
Access status: Open Access ,
Hospital and operator procedural volumes and one-year outcomes for TAVR in the United States: A STS/ACC TVT Registry Analysis
Vemulapalli, Sreekanth
Background: Prior analyses have demonstrated an inverse association between transcatheter aortic valve replacement (TAVR) procedural volume and short-term outcomes. However, less is known regarding the relationship between procedural volume and 1-year outcomes in the contemporary TAVR era. Objectives: To evaluate the association between annual hospital and operator TAVR procedural volumes and 1-year clinical outcomes in a contemporary national cohort. Methods: Clinical records from the Society of Thoracic Surgeons (STS)/American College of Cardiology (ACC) Transcatheter Valve Therapies (TVT) Registry for patients undergoing commercial TAVR between January 2020 and December 2022 were linked to Centers for Medicare & Medicaid Services administrative claims. Annualized hospital and operator TAVR volumes were modeled continuously and categorized into tertiles. Primary outcomes included 1-year all-cause mortality, stroke, the composite of mortality or stroke, and all-cause readmissions. Hierarchical risk-adjusted models accounting for patient clustering within sites were used to evaluate associations between procedural volume and outcomes. Results: Among 215,335 patients undergoing TAVR at 788 hospitals by 3,444 operators between 2020 and 2022, median annual hospital and operator volumes were 74 (IQR: 43-115) and 16 (IQR: 10-32), respectively. Volume was then categorized into tertiles (low, medium and high). Compared with high-volume hospitals (≥102/year), low-volume hospitals (≤52/year) had higher adjusted rates of 1-year all-cause mortality (Odds Ratio (OR): 1.10 [95% CI: 1.05-1.16]), stroke (OR: 1.10 [95% CI: 1.01-1.19]), mortality or stroke (OR: 1.10 [95% CI: 1.05-1.15]), and all-cause readmissions (OR: 1.05 [95% CI: 1.00-1.09]). Compared with high-volume operators (≥25/year), low-volume operators (≤11/year) had higher adjusted rates of stroke (OR: 1.16 [95% CI: 1.05-1.28]) and mortality or stroke (OR: 1.09 [95% CI: 1.03-1.15]) but not other endpoints. Conclusions: In a large, contemporary national TAVR registry, lower annual hospital (≤ 52/year) and operator (≤ 11/year) procedural volumes were independently associated with worse 1-year clinical outcomes. These findings suggest that procedural experience continues to influence outcomes despite maturation of contemporary TAVR practice.