The most commonly reported barriers to telehealth adoption were insufficient payment and billing issues. Multivariable regression models indicated that pediatricians in rural areas, the West, and subspecialists were most likely to report telehealth use, and identifying barriers was negatively associated with telehealth use. Among nonusers, over half indicated they would consider adopting telehealth if they were paid for the visits. Conclusion Telehealth is considered an important health care delivery mechanism, but only 15% of pediatricians in 2016 reported having used telehealth. Reducing barriers will be instrumental in promoting future telehealth adoption. Many barriers have been reduced during the response to COVID-19, and the impact of these policy changes will need further study.Background There are limited training opportunities for pediatricians in caring for children with medical complexity (CMC) in the home and community. Prior studies have described a lack of comfort caring for CMC among pediatric residents. Objective 1) To evaluate the impact of participation in a virtual home visit curriculum on pediatric residents' confidence, knowledge, and application of knowledge in complex care; 2) to explore changes in perspectives relating to the care of CMC after participation in the curriculum. Methods This was a prospective pre-post intervention study in 2019 with first-year pediatric residents, using quantitative and qualitative methods. The intervention, co-created with a family partner, was an online video-based curriculum followed by an in-person seminar. Pre- and postassessments were compared using paired t tests. Follow-up interviews and focus groups were performed 5 to 8 weeks after training. Transcripts were analyzed using inductive thematic analysis. Results Twenty-four residents (100%) participated. Residents reported increased confidence in all aspects of complex care presented in the curriculum, with significant increase in knowledge and application of knowledge (all P less then .001). Twelve residents (50%) participated in a follow-up interview or focus group. Four themes were identified 1) recognizing prior attitudes toward complexity, 2) new mental framework for complex care at home, 3) drivers of behavior change, and 4) commitment to change practice. Conclusions Participation in this curriculum was associated with increased confidence, knowledge, and application of knowledge in complex care outside of the hospital. Qualitative findings align with transformative learning theory, lending insight into effective approaches to complex care training.Objective Describe the demographics of pediatric and internal medicine/pediatric residents participating in global health (GH) experiences and examine relationships between GH involvement and self-perceived burnout, resilience, mindfulness, empathy, and spirituality. Methods The Pediatric Resident Burnout and Resilience Study Consortium developed a national longitudinal study through collaboration with the Association of Pediatric Program Directors' Longitudinal Educational Assessment Research Network. Electronic surveys were administered to pediatric trainees annually (2016-2018). GH and well-being data were extracted. Descriptive statistics were calculated. Results Of 9653 eligible pediatric and medicine/pediatric residents from 55 institutions, 6150 responded to the survey in one or more years, with average completion rate of 63.7% over a three year period. Controlling for repeat survey-takers, 12.7% (536/4213) of residents reported involvement in a GH-specific pathway, curricula or track. GH participants were significantly more likely to be unmarried (p less then 0.001), childless (p=0.003), and medicine/pediatric trainees (p less then 0.001). Controlling for repeated measures and demographic factors, GH participants demonstrated higher levels of empathic concern (p less then 0.001) and higher spirituality scores in 2 of 3 domains (p less then 0.01/ less then 0.05). GH involvement was not associated with lower reports of burnout or improved resilience/mindfulness. Conclusion Although GH involvement is associated with increased levels of empathy and spirituality, it was not protective against burnout in this study. This highlights the need to study and promote the well-being of all residents, and perhaps especially those experiencing the challenges of working in low-resource settings. Future efforts should determine the impact of pre-departure training, programmatic support, and post-trip debriefing on resident well-being.Coronavirus disease 2019 (COVID-19) can cause severe respiratory failure requiring mechanical ventilation. The abnormalities observed on chest computed tomography (CT) and the clinical presentation of COVID-19 patients are not always like those of typical acute respiratory distress syndrome (ARDS) and can change over time. This manuscript aimed to provide brief guidance for respiratory management of COVID-19 patients before, during, and after mechanical ventilation, based on the recent literature and on our direct experience with this population. We identify that chest CT patterns in COVID-19 may be divided into three main phenotypes 1) multiple, focal, possibly overperfused ground-glass opacities; 2) inhomogeneously distributed atelectasis; and 3) a patchy, ARDS-like pattern. Each phenotype can benefit from different treatments and ventilator settings.  https://www.selleckchem.com/products/AZD0530.html  Also, peripheral macro- and microemboli are common, and attention should be paid to the risk of pulmonary embolism. We suggest use of personalized mechanical ventilation strategies based on respiratory mechanics and chest CT patterns. Further research is warranted to confirm our hypothesis.Cancer continues to be one of the leading contributors towards global disease burden. According to NIH, cancer incidence rate per year will increase to 23.6 million by 2030. Even though cancer continues to be a major proportion of the disease burden worldwide, it has the lowest clinical trial success rate amongst other diseases. Hence, there is an unmet need for novel, affordable and effective anti-neoplastic medications. As a result, a growing interest has sparkled amongst researchers towards drug repurposing. Drug repurposing follows the principle of polypharmacology, which states, "any drug with multiple targets or off targets can present several modes of action". Drug repurposing also known as drug rechanneling, or drug repositioning is an economic and reliable approach that identifies new disease treatment of already approved drugs. Repurposing guarantees expedited access of drugs to the patients as these drugs are already FDA approved and their safety and toxicity profile is completely established. Epidemiological studies have identified the decreased occurrence of oncological or non-oncological conditions in patients undergoing treatment with FDA approved drugs.