Alexandersentrue6521
were relatively proficient in opioid overdose knowledge, but did not feel they were competent enough to respond to an overdose. learn more Attitudes toward patients with SUDs were mixed. Approximately half of the students thought naloxone distribution should be unrestricted, but many were uncertain whether naloxone receipt would deter individuals from seeking treatment or increase opioid use. Students' previous experiences in healthcare (e.g., employment) results in significantly different knowledge and attitudes toward opioid overdose response. Conclusions These incoming medical students have greater healthcare experience and level of opioid overdose knowledge than the general population, but still harbor significant misinformation and stigma toward patients with SUDs. These findings provide a foundation upon which to tailor didactic efforts, starting early in medical school, so that graduating physicians can be adequately prepared for clinical care.
This study evaluated the risk posed by attachment type in the development of anxiety or depression symptomatology in Mexican adults.
This was case-control study in which anxiety and depression symptomatology levels were compared according to the attachment type reported by 3,666 participants.
It was found that insecure attachment is a risk factor (p≤.001) for the development of severe levels of depression (OR = 2.12, CI 95% 1.66-2.70) and anxiety symptomatology (OR = 1.52, 95% CI 1.30-1.77). Findings are discussed based on their implications for psychiatric nursing practice.
The findings of this study enable nurses to consider the empirical validity of attachment theory for studying psychosocial aspects of mental health and to design intervention strategies that promote secure attachment in populations without psychiatric diagnoses to prevent anxiety and depression symptomatology.
The findings of this study enable nurses to consider the empirical validity of attachment theory for studying psychosocial aspects of mental health and to design intervention strategies that promote secure attachment in populations without psychiatric diagnoses to prevent anxiety and depression symptomatology.This reflection outlines experiences as a mentee within the field of gerontology, and highlights strategies for students and junior scholars to bolster mentorship opportunities.In recognition of GSA's 75th anniversary, I recently re-read Dr. M. Powell Lawton's autobiography. I had the good fortune to conduct a clinical fellowship at the Philadelphia Geriatric Center in 1979 where Powell was the director of research. He became my role model. Not so much for his research, though he had several seminal publications, but because of his character and compassion for older adults. Powell believed in advocacy and applied research that offered tangible results for older adults. As a mentor, he respected emerging gerontologists and imbued enthusiasm and dispensed constructive criticism that improved one's product. In my teaching, I convey his philosophy and care to my students with the hope that they will pass on his legacy to their mentees in their service to older adults.This study investigated the recovery process for individuals engaged in treatment for substance use disorders (SUDs) who had co-occurring anxiety and depression. The participants were eight individuals engaged in treatment. The results of a Grounded Theory design and methods revealed the core category and substantive theory, Stumbling toward Vulnerability. Four phases in which the participants progressed in a linear way emerged. The study results have implications for the role of the advance practice psychiatric-mental health nurse in the early assessment of mental illness for clients with SUDs by providing integrated treatment for these individuals, and focusing on health and wellness as a recovery outcome. Based on the findings, hypotheses for further research are recommended.Most respirators employed in health care settings, and often in first responder and industrial settings, are intended for single-use the user dons the respirator, performs a work activity, and then doffs and discards the respirator. However, in the current COVID-19 pandemic, in the presence of persistent shortages of personal protective equipment, extended use and reuse of filtering facepiece respirators are routinely contemplated by many health care organizations. Further, there is considerable current effort to understand the effect of sterilization on the possibility of reuse, and some investigations of performance have been conducted. While the ability of such a respirator to continue to provide effective protection after repeated sanitization cycles is a critical component of implementing its reuse, of equal importance is an understanding of the impact that reusing the respirator multiple times in a day while performing work tasks, and even extending its wear over multiple days, has on the workplace protective performance. In this study, we subjected a stockpiled quantitatively fitted surgical style N95 filtering facepiece respirator device to extreme reuse and extended wear conditions (up to 19 uses over a duration of 5 days) and measured its protective performance at regular intervals, including simulated workplace protection factor measurements using total inward leakage. With this respirator, it was shown to be possible to maintain protection corresponding to an assigned protection factor greater than 10 under extreme usage conditions provided an individual is properly trained in the use of, and expertly fitted in, the respirator. Other factors such as hygiene and strap breakage are likely to place limits on reuse.
The Chronic Kidney Disease in Children Study (CKiD) equation for children and the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation for adults are recommended serum creatinine (SCr)-based calculations for estimating glomerular filtration rate (GFR). However, these equations, as well as their combination, have limitations, notably the problem of implausible changes in GFR during the transition from adolescence to adulthood and overestimation of GFR in young adults. The full age spectrum (FAS) equation addresses these issues but overestimates GFR when SCr levels are low.
To develop and validate a modified FAS SCr-based equation combining design features of the FAS and CKD-EPI equations.
Cross-sectional analysis with separate pooled data sets for development and validation.
Research and clinical studies (
= 13) with measured GFR available.
11251 participants in 7 studies (development and internal validation data sets) and 8378 participants in 6 studies (external validation data set).
Clearance of an exogenous marker (reference method), SCr level, age, sex, and height were used to develop a new equation to estimate GFR.
The new European Kidney Function Consortium (EKFC) equation is a FAS equation with low bias (-1.2 mL/min/1.73 m
[95% CI, -2.7 to 0.0 mL/min/1.73 m
] in children and -0.9 mL/min/1.73 m
[CI, -1.2 to -0.5 mL/min/1.73 m
] in adults) across the FAS (2 to 90 years) and SCr range (40 to 490 µmol/L [0.45 to 5.54 mg/dL]) and with fewer estimation errors exceeding 30% (6.5% [CI, 3.8% to 9.1%] in children and 3.1% [CI, 2.5% to 3.6%] in adults) compared with the CKiD and CKD-EPI equations.
No Black patients were included.
The new EKFC equation shows improved accuracy and precision compared with commonly used equations for estimating GFR from SCr levels.
Swedish Research Council (Vetenskapsrådet).
Swedish Research Council (Vetenskapsrådet).
The Kidney Disease Improving Global Outcomes (KDIGO) organization developed a clinical practice guideline in 2020 for the management of patients with diabetes and chronic kidney disease (CKD).
The KDIGO Work Group (WG) was tasked with developing the guideline for diabetes management in CKD. It defined the scope of the guideline, gathered evidence, determined systematic review topics, and graded evidence that had been summarized by an evidence review team. The English-language literature searches, which were initially done through October 2018, were updated in February 2020. The WG used the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach to appraise evidence and rate the strength of the recommendations. Expert judgment was used to develop consensus practice points supplementary to the evidence-based graded recommendations. The guideline document underwent open public review. Comments from various stakeholders, subject matter experts, and industry and national organizations were considered before the document was finalized.
The guideline includes 12 recommendations and 48 practice points for clinicians caring for patients with diabetes and CKD. link2 This synopsis focuses on the key recommendations pertinent to the following issues comprehensive care needs, glycemic monitoring and targets, lifestyle interventions, antihyperglycemic therapies, and educational and integrated care approaches.
The guideline includes 12 recommendations and 48 practice points for clinicians caring for patients with diabetes and CKD. This synopsis focuses on the key recommendations pertinent to the following issues comprehensive care needs, glycemic monitoring and targets, lifestyle interventions, antihyperglycemic therapies, and educational and integrated care approaches.Coix seed is an important food and traditional Chinese medicine in China and other Asian countries. Notably, coix seed is currently being used as a traditional medicine for the treatment of COVID-19 in China. However, coix seeds are generally contaminated by mycotoxins, and this risk cannot be ignored. In this paper, we developed a method that involves direct extraction and UHPLC-HRMS analysis for the simultaneous detection of 24 mycotoxins in coix seeds. UHPLC-HRMS instrument and data acquisition parameters, and the sample pretreatment were optimised. link3 One-step extraction showed several advantages compared to the three commercial solid-phase extraction clean-up methods, including ease of use, reduced time of sample preparation, low cost, good recovery, and acceptable matrix effect. The method validation results indicate that all mycotoxins have good linearity and sensitivity. Recoveries were between 74.2-101.1%, and RSD ranged from 0.1-5.8%. The LOQs for 24 mycotoxins were in the range of 0.5-100 µg/kg. To survey the contamination levels of these mycotoxins in commercial coix seeds, more than 70 samples were collected from Chinese markets and were analysed using the newly developed method. Zearalenone (positive ratio 98.7%, range1.1-1562 µg/kg), deoxynivalenol (positive ratio 87%, range 8.4-382.5 µg/kg), nivalenol (positive ratio 85.7%, range 26.8-828.2 µg/kg), fumonisin B1 (positive ratio 84.4%, range2.5-314.5 µg/kg), fumonisin B2 (positive ratio 75.3%, range1.6-72.8 µg/kg), fumonisin B3 (positive ratio 48%, range1.0-203.6 µg/kg), aflatoxin B1 (positive ratio 29.9%, range 0.39-14.7 µg/kg), sterigmatocystin (positive ratio 29.9%, range 1.4-51.6 µg/kg), and tenuazonic acid (positive ratio 19.5%, range 36.1-105.7 µg/kg) were the most frequent mycotoxin contaminants. These results highlight the importance of routine monitoring and control of mycotoxins in coix seeds.
