Frontier State Research Articles

Characterization of the viral genome of Omicron variants of SARS-CoV-2 circulating in Tripura, a remote frontier state in Northeastern India.

From 2020, with advent of COVID-19 pandemic, Tripura has experienced SARS-CoV-2 viral evolution in accordance with other parts of India. Since January 2022, the Omicron variant of SARS-CoV-2 virus became the predominant lineage circulating in India and neighboring countries. This study characterizes the viral genome of the omicron variant circulating in the state since its inception to June, 2023. The current study was performed on nasopharyngeal and oropharyngeal samples received from the various departments of AGMC, as well as eight district hospitals from Tripura. The positive samples with a cycle threshold value of 25 or less for the E and/or N gene were considered for whole genome sequencing using Illumina Miseq NGS platform. Majority of the sequences belonged to Clade 21L, with BA.5.2 being the major sub variant detected during the study period. Majority of the mutations were detected in the Spike protein region, including L24-, P25-, P26-, V213G, G339D, S371F, S373P, S375F, T376A, D405N, R408S, K417N, S477N, T478K, Q498R, Y505H, Q954H and N969K. All the sequences uniquely showed the mutations A27S and G142D in N terminal domain in Spike protein, not being reported from other Indian sequences like BA.5 variants. T9I, A63T and P13L were major substitutions in E, M and N protein regions respectively. Escape of mutants from vaccine induced immunity was mostly observed in BA.2 sub variants, majority endowed with the triplet mutation of K417N + E484K + N501Y. The current study indicates that Omicron variants circulating in the state of Tripura is comparable to other regions of India and the neighbouring country of Bangladesh. Genetic mutations increasing viral transmissibility have been identified in the circulating viral genomes.

Genomic Surveillance of SARS-CoV-2 Sequence Variants at Universities in Southwest Idaho.

Although the impact of the SARS-CoV-2 pandemic on major metropolitan areas is broadly reported and readily available, regions with lower populations and more remote areas in the United States are understudied. The objective of this study is to determine the progression of SARS-CoV-2 sequence variants in a frontier and remote intermountain west state among university-associated communities. This study was conducted at two intermountain west universities from 2020 to 2022. Positive SARS-CoV-2 samples were confirmed by quantitative real-time reverse transcription-polymerase chain reaction and variants were identified by the next-generation sequencing of viral genomes. Positive results were obtained for 5355 samples, representing a positivity rate of 3.5% overall. The median age was 22 years. Viral genomic sequence data were analyzed for 1717 samples and phylogeny was presented. Associations between viral variants, age, sex, and reported symptoms among 1522 samples indicated a significant association between age and the Delta variant (B 1.167.2), consistent with the findings for other regions. An outbreak event of AY122 was detected August-October 2021. A 2-month delay was observed with respect to the timing of the first documented viral infection within this region compared to major metropolitan regions of the US.

(Invited) Computing the Newns-Anderson Chemisorption Function from First Principles

In analysing the interactions of adsorbates with extended surfaces, theory, and to a large degree also experiments, tend to rely on adsorption models such as the famous Newns-Anderson model. There, the interaction of adsorbate and substrate is represented by the interaction of the adsorbate's one-electron frontier orbitals with the delocalised Bloch states of the substrate. Together with its simplified cousin, the d-band model, such adsorption models yielded significant insight into the chemistry of extended surfaces.The Newns-Anderson Model gives rise to a so-called chemisorption function, a density of states weighted by the electronic coupling between adsorbate and substrate states, measuring the line broadening of an adsorbate frontier state upon adsorption. In my contribution, I will describe our efforts to compute the chemisorption function from first principles, employing a diabatization scheme to estimate electronic couplings between states. Recognizing the periodic nature of the substrate and the finite extent of computational supercells, we extend the original chemisorption function by a Brillouin zone integration to account for the (generally localized) adsorbate states' coupling to different substrate states at different points in reciprocal space. Including this integration, the chemisorption function not only converges well with both lateral simulation cell size and slab depth, but also compares well with experiments. We test our approach against highly accurate experimental measurements of ultrafast charge transfer of a probe Ar atom on various metal surfaces and find that the chemisorption function reproduces both absolute transfer rates and rate asymmetries due to spin on magnetic surfaces. Next to its predictiveness, though, the Newns Anderson chemisorption function allows us to investigate the charge transfer mechanism in terms of e.g. contributions of states with different angular momentum character, showing the importance of phase cancellation effects in interpreting charge transfer at surfaces.

An examination of an adapted Project ECHO model series during the COVID‐19 pandemic in Idaho

AbstractIntroductionIdaho is a medically underserved and rural state comprised mostly health professional shortage areas for primary and specialty care. Given the state shortages and barriers to access care, the testing and treatment of COVID‐19 may be improved through the implementation of telementoring education programs such as Project Extension for Community Healthcare Outcomes (ECHO). The purpose of this article was to assess session attendance and self‐reported healthcare clinician perceptions of the ECHO Idaho COVID‐19 series (2020 and 2021), a modified Project ECHO model provided during the COVID‐19 pandemic in Idaho.MethodsECHO Idaho developed a COVID‐19 ECHO series for healthcare providers to attend in 2020 and 2021. The sessions included COVID‐19 updates specific to Idaho, didactic presentations on prevention, screening, diagnosis, and evidence‐based treatments for COVID‐19, and case‐based presentations.ResultsA total of 664 individuals attended the 2020 series and 260 individuals attended the 2021 series, with 1752.5 continuing medical education hours being claimed. Participants reported series participation increased overall knowledge of COVID‐19, knowledge of best practices for treatment, and awareness of resources available in Idaho. Further, series participation was perceived to reduce feelings of isolation, enhance access to information, and support healthcare professionals (e.g., provided resources) during the pandemic.ConclusionResults of this evaluation indicate that the ECHO Idaho COVID‐19 series was a useful and valuable program to implement during a pandemic in a rural and frontier state to improve physician knowledge and specialty training.

Carbon Emission Efficiency and Reduction Potential Based on Three-Stage Slacks-Based Measure with Data Envelopment Analysis and Malmquist at the City Scale in Fujian Province, China

Increased carbon emissions led to extreme weather, global warming, and other environmental problems. In order to control energy input and reduce carbon emissions, this study first combines a three-stage Slacks-Based Measure with Data Envelopment Analysis (SBM-DEA) and uses the Malmquist index to quantify energy consumption at the city scale and the related carbon emission efficiency in Fujian Province for the period 2015–2020. Second, we explore the carbon reduction potential on the city scale from the perspective of improving carbon emission efficiency. Our results demonstrate that (i) the carbon emission efficiency of the nine cities increases overall in the first stage, when technical efficiency approaches the efficiency frontier state and efficiency shortage is mainly caused by the lack of pure technical efficiency. (ii) Regression by stochastic frontier analysis in the second stage reveals that the secondary industry correlates positively at 1% significance with fossil energy consumption and power consumption, indicating that the carbon emission efficiency decreases as the secondary industry increases. (iii) Putian and Xiamen reduced their carbon emission efficiency in the third stage due to (a) the input redundancy of fossil energy and social power consumption and (b) excessive undesirable output carbon emissions. (iv) There were improvements in carbon emission efficiency peaks in 2015, with Longyan, Ningde, and Sanming improving by about 50%. This improvement then decreased up to the year 2020, when the improvement in the carbon emission efficiency of Ningde and Zhangzhou was 6.02% and 9.50%, respectively, and that of all other cities was less than 1%. Therefore, we suggest that carbon emission reduction in the future can be further improved by improving technology, optimizing industrial structure, and various other ways to further improve carbon emission efficiency.

Interpreting ultrafast electron transfer on surfaces with a converged first-principles Newns-Anderson chemisorption function.

We study the electronic coupling between an adsorbate and a metal surface by calculating tunneling matrix elements Had directly from first principles. For this, we employ a projection of the Kohn-Sham Hamiltonian upon a diabatic basis using a version of the popular projection-operator diabatization approach. An appropriate integration of couplings over the Brillouin zone allows the first calculation of a size-convergent Newns-Anderson chemisorption function, a coupling-weighted density of states measuring the line broadening of an adsorbate frontier state upon adsorption. This broadening corresponds to the experimentally observed lifetime of an electron in the state, which we confirm for core-excited Ar*(2p3/2-14s) atoms on a number of transition metal (TM) surfaces. Yet, beyond just lifetimes, the chemisorption function is highly interpretable and encodes rich information on orbital phase interactions on the surface. The model thus captures and elucidates key aspects of the electron transfer process. Finally, a decomposition into angular momentum components reveals the hitherto unresolved role of the hybridized d-character of the TM surface in the resonant electron transfer and elucidates the coupling of the adsorbate to the surface bands over the entire energy scale.

How the West Can Help Ukraine: Three Strategies for Achieving a Ukrainian Victory and Rebirth | Como pode o Ocidente ajudar a Ucrânia: Três estratégias para alcançar a vitória e o renascimento da Ucrânia


 The geopolitical salience of the Russia–Ukraine War and the remoteness of Ukraine’s accession to the European Union or NATO call for intensification and modification of and innovation in current Western approaches. While some existing instruments can be strengthened and adapted, new tools are needed, accompanied by better explanations of the rationale for long-term Western aid to Ukraine. Such support is not just about international solidarity, but Western states’ national security, as well as winning not only the war but also the peace afterward and renewing rather than merely rebuilding Ukraine. Ukraine’s defence, security, transport, communications and energy infrastructures are priority areas for support. Reconstruction should be closely linked to Ukraine’s staged accession to the EU as well as further decentralization. More direct contacts between Ukrainian and Western communities and companies could be promoted through simplified residence rules for EU and other citizens and insuring foreign investors and trading partners against political risk, among other things. Central to conditions for continuing Western help will be Kyiv’s ongoing strengthening of the rule of law and fight against corruption. Even after the current war, strong armament of Ukraine as a European frontier state will be unavoidable before the country’s full accession to NATO and beyond.

Expanding access to treatment for stimulant use disorder in a frontier state: A qualitative study of contingency management and TRUST program implementation in Montana

BackgroundThe client population eligible for treatment services supported by State Opioid Response (SOR) grant funding, administered by the Substance Abuse and Mental Health Services Administration (SAMHSA), was expanded to include individuals with a stimulant use disorder (stimUD) in 2020. Due to a significant need to improve services for individuals with stimUD in Montana, the Behavioral Health and Developmental Disabilities Division (BHDD) of the Montana Department of Public Health and Human Services used the grant opportunity to work with experts in the field of stimUD to pilot contingency management (CM) and the Treatment for Individuals who Use Stimulants (TRUST) treatment model. The CM protocol included twice weekly visits for twelve weeks, using an escalating schedule of gift card incentives contingent upon stimulant-negative urine samples. TRUST is a multi-component treatment program, incorporating exercise, group therapy, and individual therapy with content guided by cognitive behavioral therapy (CBT) and clinical research associate (CRA) materials. In addition to SOR dollars, BHDD used additional funding for CM reinforcers provided by state tax dollars to meet research-supported target incentive totals. MethodsIn this pilot project, TRUST/CM was implemented by four state-approved treatment providers and three Federally Qualified Health Centers (FQHCs), all of which had little prior experience with CM as a component of their treatment programs for stimUD. This article examines the processes of training staff, the experiences among staff with initial implementation of the treatment model, and the client characteristics of initial pilot treatment cohorts. Data for this study include primary qualitative data collected from providers, as well as client characteristics collected on the SAMHSA Government Performance and Results Act (GPRA) data collection form. ResultsSeven sites were trained in TRUST/CM, and these sites enrolled a total of 70 patients in the program. Qualitative data collected through interviews with site staff revealed the following themes: the value of intensive technical assistance being integrated in the program, concerns about staff retention and loss of expertise, adjustments of target client populations, and the importance of creative strategies for the provision of evidence-informed incentive totals. ConclusionsTRUST/CM was implemented throughout Montana, including rural and urban communities. Qualitative and quantitative data support that providers viewed the CM component as beneficial for treatment retention and improved outcomes for people with stimUD. These implementation study results provide insight into challenges and solutions for providers who are considering the implementation of CM within either a state-approved substance use treatment clinic or FQHC.

Evaluating a Project Extension for Community Health Outcomes Pediatric Behavioral Health Series in a Rural and Frontier State: An Exploratory Investigation.

Idaho, a predominately rural state, has a high prevalence of mental illness with minimal access to care. Barriers in diagnosis and treatment of pediatric behavioral health disorders could be mitigated with an accessible and effective specialty training program. A 10-session Project Extension for Community Health Outcomes (ECHO) series was designed to expand provider knowledge about pediatric behavioral health conditions and improve perceived clinical practice skills. Pre- and postseries evaluation surveys and individual session evaluations were used to assess the program. A total of 148 individuals attended at least 1 of the 10 sessions. Participants reported high satisfaction with individual sessions and indicated that attendance positively impacted their knowledge and competency. Participants also reported that the knowledge and skills gained from the series would benefit more than half of their patients or clients. The short ECHO series appears to be a viable and valuable option to provide Idaho providers with effective specialty training that is well attended and well received.

The Saints and the State: The Mormon Troubles in Illinois

The Saints and the State: The Mormon Troubles in Illinois

Leveraging community health workers in extending pediatric telebehavioral health care in rural communities: Evaluation design and methods.

The pandemic exacerbated and intensified pediatric behavioral health and access needs in rural and underserved areas due to long-standing workforce shortages, lack of resources, and multigenerational poverty and trauma. Kansas is a predominantly rural and frontier state with 94% of counties designated as mental health professional shortage areas. The Telehealth ROCKS (THR) program is among the first of its kind to increase the behavioral health workforce capacity by integrating trained school-based community health workers (CHWs) directly into rural communities. CHWs facilitate the coordination of behavioral health appointments and access to social determinants of health needs. We plan to assess the implementation, clinical outcomes, quality of care, and access to care through a mixed-methods design to evaluate the process and impact of expanding the rural behavioral health workforce via CHWs. Preliminary program data suggest CHWs have supported over 90 students/families around social determinants of health in the first 6 months. The THR program aims to bring childserving systems of care together, cultivate relationships with rural communities, empower and increase workforce capacity in health care and education, and build trust to enhance acceptance and thus program sustainability. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

‘It’s the same thing as giving them CPR training’: rural first responders’ perspectives on naloxone

The Substance Abuse and Mental Health Services Administration’s (SAMHSA) Harm Reduction grant program expanded access to several harm reduction strategies to mitigate opioid overdose fatalities, including expanding access to naloxone. Interviews with first responders in a frontier and remote (FAR) state were conducted to understand their job responsibilities in relation to overdose response and prevention and their perceptions of training laypersons to administer naloxone. This study includes 22 interviews with law enforcement, EMS and/or fire personnel, and members of harm reduction-focused community organizations. The study finds widespread support for increasing access to naloxone and training laypersons in naloxone administration throughout Montana, due to rural first responders’ inability to meet the needs of residents and an overall lack of resources to address addiction and the effects of fentanyl. Participants from harm reduction-focused community organizations convey support for training lay persons, but also illuminate that real and perceived cultural opposition to harm reduction strategies could reduce the likelihood that laypeople enroll in naloxone training. This study adds to the literature because it focuses on first responders in a FAR area that would benefit from layperson naloxone education and administration training due to its geographic expansiveness and the area’s overall lack of access to medications for opioid use disorder or other treatment services. Expanding harm reduction approaches, like increasing access and training laypersons to administer naloxone, might be FAR residents’ best chance for surviving an opioid overdose.

Taming the ‘rude’ and ‘barbarous’ tongues of the frontier:Bor Saheps, Sutu Sahepsand their encounters with languages, scripts, and texts (1835–1904)

This article looks at an alternative history of colonial expansion in the North-East Frontier region during the nineteenth century by exploring the crucial role of colonial officers deployed there, who were locally known as Bor/bura saheps, sutu saheps or simply saheps. Scholarship on these officials has studied their roles as diplomats, administrators and military commanders, while this study instead examines their encounters with local languages, scripts and texts as well as their linguistic projects in the former frontier state of Manipur. The region was described as a recalcitrant frontier space, inhabited by ‘savages’ speaking ‘rude’ and ‘barbarous’ tongues. Yet the saheps’ knowledge of its languages, scripts, and local literature was vital for information-gathering as well as for their daily administrative work. This article raises questions about the ramifications of these colonial linguistic projects on the process of colonial expansion and consolidation and the concomitant establishment of language hegemony. It argues that the early linguistic projects were not only an indispensable instrument for colonial conquest but also produced rudimentary philological knowledge of the languages of the region, calcifying differences and hierarchies along linguistic lines and contributing to the methodical state-funded linguistic projects undertaken in the early twentieth century.

Administrations of Lunacy: Racism and the Haunting of American Psychiatry at the Milledgeville Asylum by Mab Segrest

Reviewed by: Administrations of Lunacy: Racism and the Haunting of American Psychiatry at the Milledgeville Asylum by Mab Segrest Dennis Doyle Administrations of Lunacy: Racism and the Haunting of American Psychiatry at the Milledgeville Asylum. By Mab Segrest. (New York and London: The New Press, 2020. Pp. xvii, 396. $28.99, ISBN 978-1-62097-297-7.) Scholar-activist Mab Segrest's latest book is not simply another entry in the growing list of publications arguing for the centrality of the South, race, and African Americans to the history of U.S. asylums and psychiatry. Segrest's ultimate aim is different. Administrations of Lunacy: Racism and the Haunting [End Page 554] of American Psychiatry at the Milledgeville Asylum is an ambitious retelling of the history of long-nineteenth-century Georgia that presents the now-defunct Milledgeville Asylum as a touchstone whose microhistory mirrors larger shifts in both the state and the South. Segrest conceives of antebellum Georgia as, first and foremost, a white settler society erected on land forcibly wrested from Indigenous peoples and transformed into a cotton kingdom through racial slavery. All of that was accomplished through violence and exploitation of the vulnerable, aided and abetted by a cheerleading state insensate to the pain it inflicted. That is when the Milledgeville Asylum entered the story in 1842. As the largest institution in Georgia's public sector, it served the state's interest. And this frontier state had a vested interest in both growing its plantation-based extractive economy and ignoring the suffering that racial slavery inflicted on the people it exploited. According to Segrest, archival records reveal that doctors served that interest by taking in the white victims of such a violent settler society while conveniently eliding the possibility that racial slavery could inflict pain and suffering on Black people. Georgia's leading alienists theorized that people of African descent were somehow racially immune to stress, helping justify the exclusion of Black people from the asylum and render invisible the plantation system's cruelty. The key to Segrest's thesis is that the asylum doctors' obliviousness to the violence and racism endemic to Georgia endured well after slavery's end. It lasted through the Civil War, with psychiatrists hesitating to attribute the cause of the soldiers' and refugees' ills to the horrors of war. Segrest then argues that in 1867, as the asylum became racially segregated, it joined the Black Codes, the Milledgeville penitentiary, a convict-lease system, and chain gangs in providing postbellum Georgian elites with a carceral state that could compel Black labor. As African Americans suffered terrorism, lynching, debt peonage, and the indignities of Jim Crow, the asylum's clinicians helped the state overlook that violence by blaming Black asylum commitments on the Black race's alleged lack of emotional fitness for emancipation. As the asylum entered the twentieth century, the superintendents' tendency to blame Black illness on racial heredity led them to ignore how the asylum's overcrowding and inadequate menus produced disease. Segrest rounds out her narrative by contending that by eventually embracing eugenics and therapeutic nihilism, the asylum superintendents located the blame for the failings of racial capitalism squarely within the biology of Georgia's citizens. Segrest ultimately argues that Georgia and the South's current reliance on mass prison incarceration to care for mentally ill African Americans is a legacy of a society that habitually confined suffering African Americans rather than reckon with how it caused that suffering in the first place. Administrations of Lunacy is engaging, but advanced graduate students might find its epistemology, methods, and style problematic. Almost every chapter makes use of an individual patient's record to create illustrative vignettes, but it is unclear how representative these cases are. More troubling, Segrest takes liberties in second-guessing the clinicians, imposing contemporary diagnoses, and speculating on disease causation. She also falls back on techniques of narrative fiction to imagine a historical actor's perspective or life [End Page 555] details when the historical record is silent. Undergraduates will be more likely to overlook these flaws, as Segrest's style is irreverent and conversational, makes no apologies for her support of prison abolitionism, and enlivens the page with gripping and...

Evaluation of an opioid and addiction treatment tele-education program for healthcare providers in a rural and frontier state.

To develop and evaluate a relevant and readily accessible post-professional opioid use disorder (OUD) education program for a rural and frontier state. Observational study. Healthcare providers enrolled in Extension for Community Healthcare Outcomes (ECHO) Idaho Opioid, a tele-mentoring education program. Participant-level demographics of those that attended the ECHO Idaho Opioid program and post-session and program evaluation -surveys. A total of 273 individuals attended at least one ECHO Idaho Opioid session (per session average = 22.8); 183 post-session evaluations (per session average = 6.3) and 42 program evaluations were completed. The program was well received by providers in a rural and frontier state and may be a viable option to enhance patient care for OUD patients in these communities. The Project ECHO model is successful at reaching providers across diverse geographic regions, overcoming barriers associated with attending advanced trainings or developing peer networks to improve patient care. The model can be used to develop educational content and delivery that participants believe is satisfactory, valuable, and applicable to their profession and practice.

Electronic control of strong magnetic anisotropy in Co-based single-molecule magnets

The observation of large swings in the magnetic anisotropy in ligated ${\mathrm{Co}}_{2}$ dimers has motivated further calculations on single-center Co qubits in quasitetrahedral and quasioctahedral symmetries. In all cases our results indicate that it is the creation of an unquenched orbital moment due to a half-occupied frontier state at the Co center that directly drives large changes in the magnetic anisotropy barriers regardless of whether it is through symmetry breaking, a change in the charge state, or orbital energy reordering. While these observations are computationally demonstrated through our results on both monomers and dimers, the origin of orbital reordering at the Fermi level is not describable in terms of single physical changes. For example, in ligated ${\mathrm{Co}}_{2}$ the appearance of an unquenched orbital moment in one of the Co centers is correlated with a change from antiferromagnetic to ferromagnetic ordering at an energy that is uncharacteristically high for such transitions. Because this raises the spector of electromagnetically switchable quantum devices that operate at higher temperatures relative to that of the first-generation magnetic qubits, we carefully discuss subtle details associated with single-center qubits in realistic atomistic environments.

Barriers for Implementing the Hub and Spoke Model to Expand Medication for Opioid Use Disorder: A Case Study of Montana.

Purpose:Access to medication for opioid use disorder (MOUD) varies across the rural-urban continuum. The Hub & Spoke Model (H&S) emerged to address these gaps in service whereby hubs with staff expertise in MOUD support delivery of specialized care to a network of spoke locations, often located in rural communities with workforce shortages. This paper presents a case study of efforts to implement the hub and spoke model in a frontier and rural (FAR) state: Montana.Methods:The primary data are structured interviews with 65 MOUD program staff in hub and spoke locations within Montana. Both inductive and deductive coding were used to analyze the transcripts.Findings:Using the H&S structure to expand access to MOUD in Montana led to mixed results. There were consistent themes identified in the interviews about the reasons why hubs struggled to successfully recruit spokes, including (1) geographic barriers, (2) a lack of interest among medical providers, (3) fears about excessive demand, (4) concerns about the financial viability of the model, and (5) a preference for informal technical assistance rather than a formal H&S relationship. In addition to these 5 themes, efforts to implement H&S across different medical systems were unsuccessful, whereas the H&S model worked more effectively when H&S locations were within the same organization.Conclusion:This case study identified limits to the H&S model utility in supporting states’ abilities to expand access to MOUD treatment and offers suggestions for adapting it to accommodate variation across divergent rural contexts. We conclude with recommendations for strategies that may assist in expansion of MOUD in rural communities that are like those found in Montana.

Prospects and pitfalls of Namibia's oil and gas sector

Namibia is an oil and gas frontier state. Expectations of a coming boom with ensuing positive effects for the entire economy are high. The author assesses the prospects of the Namibian oil and gas sector, drawing on the concept of ‘linkages’. Because the corresponding literature neglects political challenges, the author complements the linkage concept with the resource curse approach so as to elaborate on important pitfalls, advancing the state of the art in terms of theories. The empirical analysis is based on a survey of Namibian newspapers, a database and reports on elite capture related to oil and gas as well as 14 interviews with domestic and foreign companies, consultants and public authorities. It is shown that important economic benefits result from the oil and gas sector. They will further increase if large-scale extraction begins. Whereas many political downsides of resource booms do not apply to Namibia, the elite appear to have turned the licensing system for exploration into a means of self-enrichment. This implies that tremendous amounts of money that should have been available to the state – and thus to the Namibian society as a whole – have ended in private pockets.

Geographic distance greater than 50 miles is associated with better overall survival for ovarian cancer patients treated at a frontier state NCI-designated cancer center

Geographic distance greater than 50 miles is associated with better overall survival for ovarian cancer patients treated at a frontier state NCI-designated cancer center

Reinforcing Telehealth Competence Through Nurse Practitioner Student Clinical Experiences.

Telehealth is becoming increasingly integral in providing improved access to care, especially for patients who reside in frontier and rural areas. Nurse practitioner (NP) faculty are charged with preparing NP students through curriculum and clinical experiences that align with the health care environment and the health care access needs of the populations they serve. To meet this need, NP faculty at a land-grant university located in a frontier and rural midwestern state reinforced NP student telehealth curriculum and competency through application in a clinical environment. Participants included 22 family NP (FNP) students and 19 clinical preceptors. According to the evaluations, the FNP students met seven of the eight competency criteria, and the preceptors met eight of the 13 evaluation criteria. Outcomes indicate telehealth curriculum competency can be reinforced through application in a clinical setting to prepare NP students to meet the needs of patients and changing health care environments. [J Nurs Educ. 2020;59(7):413-417.].