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g., unemployment) in shaping fully vaccinated rates; (3) The spatial process underlying fully vaccinated rates is largely local.
The findings challenge the 1-size-fits-all approach to designing interventions promoting COVID-19 vaccination and highlight the importance of a place-based perspective in ecological health research.
The findings challenge the 1-size-fits-all approach to designing interventions promoting COVID-19 vaccination and highlight the importance of a place-based perspective in ecological health research.
The coronavirus pandemic (COVID-19) has focused attention on healthcare workers' concerns about working during a pandemic, yet research on the effect of the pandemic specifically on paramedics is lacking. This literature review aims to critically examine the current knowledge of paramedics' experience of barriers to, and enablers of, responding to suspected or confirmed COVID-19 cases.
An integrative review was undertaken using articles found by a systematic search of four research databases. Inclusion criteria included paramedics or emergency medical technicians who had experience of barriers or enablers responding to patients during the coronavirus pandemic.
Nine articles met the inclusion and exclusion criteria. Barriers included communication and poor leadership, fear of infection to self and family, frequent changes in guidelines and inconsistencies across agencies, stress/burnout, and concerns with personal protective equipment. Enablers included job security, perceived social support, solidarity with other paramedics, and use of modern technologies for communication.
There are unique experiences of working during the COVID-19 pandemic in the prehospital environment. Particular challenges occurred with leadership, communication within the organisation and between agencies, and working in an unpredictable environment.
There are unique experiences of working during the COVID-19 pandemic in the prehospital environment. Particular challenges occurred with leadership, communication within the organisation and between agencies, and working in an unpredictable environment.
Nursing is becoming an increasingly stressful occupation, identified by high rates of burnout, compounded by a worldwide nursing shortage. Differing solutions to combat burnout have not provided long-term positive outcomes. This research explored emergency nurses' perspectives and experiences of one potential solution, known as joy in work, or professional joy.
A qualitative, descriptive design was used to conduct semi-structured interviews with six registered nurses from two New Zealand emergency departments. Thematic analysis techniques were used.
Professional joy was frequently experienced, despite the difficulties faced in the emergency environment. Joy was identified as being like a spark which provided an uplift. The experience of joy positively impacted the nurse, and beyond, and potentially provided a buffer that assisted with mitigating the daily challenges. Recalling or sharing experiences of joy evoked a sense of wellbeing in the nurse, which in turn provided motivation to keep on nursing. This research identified a link between nurse wellbeing, joy and the importance of a healthy work environment.
While this study was relatively small, the findings highlight the significant positive impact the experience of joy had on these nurses. Further research is recommended to gain greater understanding of this important topic.
While this study was relatively small, the findings highlight the significant positive impact the experience of joy had on these nurses. Further research is recommended to gain greater understanding of this important topic.A disruption in the well-orchestrated fetal-to-neonatal cardiopulmonary transition at birth results in the clinical conundrum of severe hypoxemic respiratory failure associated with elevated pulmonary vascular resistance (PVR), referred to as persistent pulmonary hypertension of the newborn (PPHN). In the past three decades, the advent of surfactant, newer modalities of ventilation, inhaled nitric oxide, other pulmonary vasodilators, and finally extracorporeal membrane oxygenation (ECMO) have made giant strides in improving the outcomes of infants with PPHN. However, death or the need for ECMO occurs in 10-20% of term infants with PPHN. Better understanding of the etiopathogenesis of PPHN can lead to physiology-driven management strategies. This manuscript reviews the fetal circulation, cardiopulmonary transition at birth, etiology, and pathophysiology of PPHN.
Atherosclerotic cardiovascular disease is a very common condition in routine practice and a leading cause of morbidity and mortality all around the world.
To determine the impact of a strategy based on strict control and close follow-up for patients with acute coronary syndrome (ACS) through the use of "post-ACS virtual lipid visits" on lipid-lowering therapy, low-density lipoprotein cholesterol (LDL-c), and outcomes.
Prospective study that consecutively included patients with ACS during 2020. All patients were discharged with high-intensity statins, and the lipid profile was determined after 1 month. At this time, patients were contacted by phone, and treatment was adjusted following the therapeutic algorithm of the Spanish Society of Cardiology. These visits were repeated every month until LDL-c reached <55 mg/dL. Patients were then transferred to scheduled conventional outpatient visits.
A total of 346 patients (67.3±2.3 years; 68.2% men) were included. Follow-up was 12-24 months (mean, 17.7±3.8in LDL-c control rates and low MACE and mortality rates.The presence of Polycyclic Aromatic Hydrocarbon (PAH) molecules in the interstellar medium, recently confirmed by the detection of cyano-naphthalenes, has renewed the interest of extensive spectroscopic and physical-chemistry studies on such large species. The present study reports the jet-cooled rovibrational infrared study of three centrosymmetric two-ring PAH molecules, viz., naphthalene (C10H8), [1,5] naphthyridine (C8H6N2), and biphenyl (C12H10), in the in-plane ring C-H bending (975-1035 cm-1) and C-C ring stretching (1580-1620 cm-1) regions. For the two most rigid PAHs, the accuracy of spectroscopic parameters derived in ground and several excited states (six for naphthalene and six for [1,5] naphthyridine) has significantly improved the literature values. In addition, comparison between experiments and quantum chemical calculations confirms the predictive power of the corrected calculated rotational parameters. The more flexible structure of biphenyl makes the analysis of high resolution jet-cooled spectra of ν19 and ν23 modes recorded at about 1601 and 1013 cm-1, respectively, particularly challenging. The presence of three torsional vibrations below 120 cm-1 together with small values of the rotational constants prevented us from determining the ground and v19 = 1 excited rotational constants independently. In the ν23 band region, the presence of two bands rotationally resolved and separated by only 0.8 cm-1 raises the question of possible splittings due to a large amplitude motion, most probably the torsion of the aliphatic bond between the two phenyl rings.The accuracy of any observable derived from multi-scale simulations based on Frozen-Density Embedding Theory (FDET) is affected by two inseparable factors (i) the approximation for the ExcT nad[ρA,ρB] component of the FDET energy functional and (ii) the choice of the density ρB(r) for which the FDET eigenvalue equation for the embedded wavefunction is solved. A procedure is proposed to estimate the relative significance of these two factors. Numerical examples are given for four weakly bound intermolecular complexes. Tofacitinib It is shown that the violation of the non-negativity condition is the principal source of error in the FDET energy if ρB is the density of the isolated environment, i.e., it is generated without taking into account the interactions with the embedded species. Reduction of both the magnitude of the violation of the non-negativity condition and the error in the FDET energy can be pragmatically achieved by means of the explicit treatment of the electronic polarization of the environment.In previous work, water's second glass transition was investigated based on an amorphous sample made from crystalline ice [Amann-Winkel et al., Proc. Natl. Acad. Sci. U. S. A. 110, 17720 (2013)]. In the present work, we investigate water's second glass transition based on the genuine glassy state of high-density water as prepared from micron-sized liquid water droplets, avoiding crystallinity at all stages. All the calorimetric features of water's second glass transition observed in the previous work are also observed here on the genuine glassy samples. This suggests that the glass transition indeed thermodynamically links amorphous ices continuously with deeply supercooled water. We proceed to extend the earlier study by investigating the effect of preparation history on the calorimetric glass transition temperature. The best samples prepared here feature both a lower glass transition temperature Tg,2 and a higher polyamorphic transition temperature Tons, thereby extending the range of thermal stability in which the deeply supercooled liquid can be observed by about 4 K. Just before the polyamorphic transition, we observe a spike-like increase of heat capacity that we interpret in terms of nucleation of low-density water. Without this spike, the width of water's second glass transition is 15 K, and the Δcp amounts to 3 ± 1 J K-1 mol-1, making the case for the high-density liquid being a strong liquid. We suggest that samples annealed at 1.9 GPa to 175 K and decompressed at 140 K to ≥0.10 GPa are free from such nuclei and represent the most ideal high-density amorphous glasses.Cross-linking is known to play a pivotal role in the relaxation dynamics and mechanical properties of thermoset polymers, which are commonly used in structural applications because of their light weight and inherently strong nature. Here, we employ a coarse-grained (CG) polymer model to systematically explore the effect of cross-link density on basic thermodynamic properties as well as corresponding changes in the segmental dynamics and elastic properties of these network materials upon approaching their glass transition temperatures (Tg). Increasing the cross-link density unsurprisingly leads to a significant slowing down of the segmental dynamics, and the fragility K of glass formation shifts in lockstep with Tg, as often found in linear polymer melts when the polymer mass is varied. As a consequence, the segmental relaxation time τα becomes almost a universal function of reduced temperature, (T - Tg)/Tg, a phenomenon that underlies the applicability of the "universal" Williams-Landel-Ferry (WLF) relation to many polymer materials. We also test a mathematical model of the temperature dependence of the linear elastic moduli based on a simple rigidity percolation theory and quantify the fluctuations in the local stiffness of the network material. The moduli and distribution of the local stiffness likewise exhibit a universal scaling behavior for materials having different cross-link densities but fixed (T - Tg)/Tg. Evidently, Tg dominates both τα and the mechanical properties of our model cross-linked polymer materials. Our work provides physical insights into how the cross-link density affects glass formation, aiding in the design of cross-linked thermosets and other structurally complex glass-forming materials.
