"They're very passionate about making sure that women stay healthy": a qualitative examination of women's experiences participating in a community paramedicine program.

BACKGROUND: Community paramedicine programs (i.e., physician-directed preventive care by emergency medical services personnel embedded in communities) offer a novel approach to community-based health care. Project Swaddle, a community paramedicine program for mothers and their infants, seeks to address (directly or through referrals) the physical, mental, social, and economic needs of its participants. The objective of this process evaluation was to describe women's experiences in Project Swaddle. By understanding their experiences, our work begins to build the foundation for similar programs and future examinations of the efficacy and effectiveness of these approaches. METHODS: We completed 21 interviews with women living in Indiana (July 2019-February 2020) who were currently participating in or had graduated from Project Swaddle. Interviews were audio-recorded, transcribed, and analyzed using a six-phase approach to thematic analysis. RESULTS: Program enrollment was influenced by the community paramedics' experience and connections, as well as information received in the community from related clinics or organizations. Participants viewed the community paramedic as a trusted provider who supplied necessary health information and support and served as their advocate. In their role as physician extenders, the community paramedics enhanced patient care through monitoring critical situations, facilitating communication with other providers, and supporting routine healthcare. Women noted how community paramedics connected them to outside resources (i.e., other experts, tangible goods), which aimed to support their holistic health and wellbeing. CONCLUSIONS: Results demonstrate Project Swaddle helped women connect with other healthcare providers, including increased access to mental health services. The community paramedics were able to help women establish care with primary care providers and pediatricians, then facilitate communication with these providers. Women were supported through their early motherhood experience, received education on parenting and taking control of their health, and gained access to resources that met their diverse needs.

Evaporation of low-volatility components in polymeric dental resins.

OBJECTIVES: This study provides measurement of the volatility of selected photoinitiators and monomers used in dental adhesive resins. A detailed determination of the spatial and temporal character of camphorquinone (CQ) volatilization with respect to air flow conditions as well as media viscosity is assessed to gauge the effect of evaporative loss on the photopolymerization process and the photopolymers formed. METHODS: Vapor pressures of materials are measured by thermogravimetric analysis. A quantitative model assuming one-dimensional Fickian diffusion with surface evaporation is presented and compared with measured photoinitiator volatilization from viscous and non-viscous resin samples, obtained by spectrophotometry and confocal microscopy. Model resins are prepared and subject to airthinning followed by photocuring, monitored in real-time by Fourier transform infrared spectrometry. RESULTS: Vapor pressure measurements of the individual components of the adhesive resin span nearly four orders of magnitude, with the photoinitiator CQ near the middle (0.6Pa) and the monomer HEMA at the upper end (10Pa). We see depth-averaged CQ loss from non-viscous open films, while depthresolved measurements of viscous droplets show strong surface-localized CQ depletion. Good agreement is observed between measurements and the model. Finally, air-thinning of samples prepared with more-volatile photoinitiator and monomer is shown to cause longer induction times, slower early-stage polymerization rates and lower late-stage degree of conversion. SIGNIFICANCE: Widely used compounds with vapor pressures as low as 0.6Pa (0.001Torr) undergo significant volatilization from samples ventilated under conditions generally representative to clinically used air-thinning procedures, with the potential to adversely affect the photopolymerization of both viscous and non-viscous resins. The inverse relationship between air-thinning and adhesive bond strength, observed elsewhere, may be partially caused by this same effect.

Radical diffusion limits to photoinhibited superresolution lithography.

Photoinhibited superresolution (PInSR) lithography is a two-color, one-photon scheme that promises high throughput far-field patterning at deep subwavelength scales. The technique requires that active species are confined for some minimum time to the illuminated area where they are generated. We investigate here the extent to which this condition is met for published materials. Using spatial and temporal control of focused beams as well as fluorescence recovery after photobleaching (FRAP), we probe the dynamics of photoinhibition in the PInSR material system. Our results indicate fast out-diffusion of unreacted photoinhibitor from the submicron optical spot during the polymerization interval, resulting in uniform rather than structured inhibition. Published results are consistent with this mechanism, indicating that superresolved polymer confinement with PInSR has not yet been shown with structured inhibition. To address the issue, we propose modifications to the material and exposure to slow inhibitor out-diffusion and accelerate polymer gelation.