Individuals with heart failure (HF) are often readmitted within 30 days of discharge from the hospital. Telehealth has been developed to help manage HF during this critical period. However, association of telehealth with improved HF outcomes is still unclear. There is a need to identify the patients who benefit most from telehealth and explore factors that work in conjunction with telehealth to improve HF outcomes. Therefore the purpose of this study was to explore the patient characteristic factors that impact health status and healthcare utilization outcomes of patients with HF who use telehealth in a homecare setting. A descriptive, correlational study design using retrospective chart review was employed. The sample comprised Medicare patients admitted to a New England homecare agency, with HF as a diagnosis and had used telehealth from 2008 to 2010. OASIS and electronic documentation at the homecare agency served as data sources. Descriptive statistics, logistic and multiple regression analysis were used to analyze association of patient demographic, psychosocial status, and disease characteristics with HF outcomes of patients on telehealth. The sample size was 403, of whom 70% were over 75 years of age, 55% were female, and 94% were Caucasian. Number of nursing contacts ranged 1 to 26 with a median value of 10. There were 118 (29.3%) all-cause readmissions, 76 cardiac-related hospitalizations (18.9%), 17 cases with mortality (4.2%) and 52 (12.7%) abrupt terminations of telehealth. For patients with HF on telehealth, patient characteristics such as: anxiety, high number of medications, acute cardiac events, musculoskeletal, psychiatric and anemia type of co-morbidity were associated with high nursing utilization patterns; dyspnea, high number of medications, obesity, ACEI/ARB and beta-blockers were associated with hospitalizations; and renal, psychiatric and cancer type of co-morbidities and female gender were associated with unplanned termination of telehealth. Abrupt termination of telehealth was also found to be correlated with hospitalizations. The findings of this study contribute to our understanding of healthcare utilization by patients with heart failure on telehealth.

This study adopted a narrative inquiry methodology in order to explore paramedic experiences and perceptions about their student preceptorship and their role as a preceptor. The questions that this research sets out to answer are: What are the experiences of practising paramedics in Ontario in their roles as preceptors? Additionally, what were the preceptor’s experiences as students during their own preceptorship? There were six participants within the region of Ontario that took part in individual in-depth narrative interviews. In order to understand the data collected, a sociocultural theoretical framework was used, focusing on Rogoff’s guided participation (2003). The findings revealed four main themes: i) the role of education in preceptorship, ii) the importance of interpersonal relationships, iii) the need for enhanced communication among institutional levels, and iv) the role of compensation in preceptorship. Taken together, the themes reveal the preoccupations and concerns of the paramedics who recounted their experiences both during their student preceptorship and as paramedic preceptors. All of the participants recommended further education and a modification to the current preceptor practises. They stressed the value of creating safe environments through good relationships with their students. The lack of communication between the paramedic service and educational bodies as well as between the paramedic service and the preceptors was also of concern to the participants. Finally, regarding compensation, the participants spoke about both the positive and negative aspects of compensation for the preceptor.

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Approximately 78–87% of high school students are involved in an extracurricular activity, with nearly 57% of those students involved in a sport/sports team program (Caldarella et. al, 2019). High school male wrestling has been identified to be one of the leading sports in which student-athletes will experience mental health issues related to depression, anxiety, stress, disordered eating, rapid weight loss, eating disorders, aggression, and more (Sarkar & Fletcher, 2014). Occupational therapy practitioners (OTPs) are limited in school systems, where their role is related solely to students’ academic attainment and achievement, yet education is only one of four occupations experienced within the secondary school setting. OTPs are trained in both physical and psychosocial rehabilitation. This presents potential for the profession to be integrated within school-based athletic programming to provide mental health and wellness services for adolescent male wrestlers. The purpose of this project is to determine if active presence and facilitation of mental health services by OTPs within athletics would enhance a student athlete’s sport performance and promote their holistic health and wellness for long-lasting health care management.

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