Validation of Trauma-Informed Care Instruments: Emergency Department Environment and Transitional Secondary Environment.

BACKGROUND: Trauma-informed care is a paradigm of care that requires health care practitioners to understand multiple types of traumas and their effects on the trauma survivor and then incorporate that knowledge into practice. However, there are few psychometrically robust instruments to evaluate trauma-informed care, and none have been applied in the trauma patient setting. OBJECTIVE: The purpose of this article is to validate two trauma-informed care instruments in the trauma patient setting. METHOD: Exploratory factor analysis and simultaneous pairwise marginal independence testing procedures were conducted on the "Emergency Department Environment" and the "Transitional Secondary Environment" instruments from September 2020 to November 2020. Descriptive statistics were reported for the content experts participating in the instrument validation. RESULT: Exploratory data analysis results for each trauma-informed care statement in the tools indicate multidimensionality of trauma-informed care core values, with statistically significant (p < .05) overlap between two or more trauma-informed care core values. After accounting for item interdependence, the associations between the trauma-informed care core values do not appear to be spurious consequences of response interdependence. CONCLUSION: The two instruments showed high levels of internal consistency supporting the multidimensional models posited by the trauma-informed care framework. The findings will allow for routine monitoring and early detection of gaps in health care provider behaviors in the individualized care of trauma survivors. This will enable identification of trends in trauma care delivery and inform trauma-informed care education for health care providers, ultimately enhancing the healing of trauma survivors.

Analysis of Cancer Knowledge, Attitudes, and Practices in Adolescents and Young Adults in Two Texas Rural Communities.

The Youth and Young Adults Cancer Knowledge Attitudes and Practices (C-KAP) exploratory study in 2 rural underserved areas in a border community. C-KAP is an interdisciplinary research pilot project led by university scholars in psychology and social work in partnership with community partners. The exploratory cross-sectional mix-method study recruited 141 (n=141) youth and young adults (ages 18-39). This study was informed on empirical research and a bilingual online questionnaire was field-tested, and data was collected via QuestionPro Software. Quantitative analysis was conducted using SPSS version 27. Descriptive statistics and frequency analysis were used for demographics and basic statistics. Chi square tests and Fisher's exact tests between variables were ran to find statistically significant associations. For the qualitative data, independent coders conducted recurrent content analysis to identify themes. Salient themes include knowledge about cancer types; access to health care; prevention; and the perceived impact of COVID-19 pandemic. Findings highlight a lack of knowledge and orientation on cancer in youth and young adults suggesting the need for community tailored education and screening interventions. Other findings reflect gender differences in knowledge and practices, which indicates that a gender-specific lens is needed when delivering education.

Sphenoid sinus mucosal thickening in the acute phase of pituitary apoplexy.

PURPOSE: In pituitary apoplexy (PA), there are preliminary reports on the appearance of sphenoid sinus mucosal thickening (SSMT). SSMT is otherwise uncommon with an incidence of up to 7% in asymptomatic individuals. The aim of this study was to evaluate the incidence and clinical significance of SSMT in patients with PA and a control group of surgically treated non-functioning pituitary adenomas (NFPAs). METHODS: Retrospective review of clinical and imaging variables in PA and NFPA patients. Sphenoid sinus mucosal thickness was measured on the presenting MRI scan by a blinded neuroradiologist. Pathological SSMT was defined as >1 mm adjacent to the pituitary fossa. Forward stepwise logistic regression was used to identify factors associated with SSMT. RESULTS: There were 50 NFPA and 47 PA patients. PA patients were managed conservatively (N = 11) or surgically (N = 36). The median sphenoid sinus mucosal thickness was greater in the PA than NFPA groups (2.0 vs. 0.5 mm; p < 0.001). In multivariate analysis of both the PA and NFPA groups, the presence of PA was the only factor associated with SSMT (OR 0.043, 95% CI 0.012-0.16; p < 0.001). In multivariate analysis of the PA group alone, a shorter time from symptom onset to presenting MRI scan (OR 0.12, 95% CI 0.026-0.54; p = 0.006) and a more severe grade of apoplexy (OR 7.29, 95% CI 1.10-48.40; p = 0.04), were associated with SSMT. CONCLUSION: The incidence of SSMT is higher in patients with PA, especially during the acute phase of PA. The aetiology of SSMT in PA is unclear and may reflect inflammatory and/or infective changes.