Flemingknapp5051
Predictors of elevated stress included inability to provide adequate pain control, inability to reconcile patient requests with physician orders, and heavy workload. Although most nurses had end-of-life care experience, fewer than half reported receiving related education. The lack of knowledge and skill related to end of life care was a primary contributor to stress.
Korean nurses providing end-of-life care for cancer patients need additional education and support to help them manage high stress levels. Further study is needed to identify strategies for meeting nurses' end-of-life care education needs and of improving their overall performance in such practice.
Korean nurses providing end-of-life care for cancer patients need additional education and support to help them manage high stress levels. selleck products Further study is needed to identify strategies for meeting nurses' end-of-life care education needs and of improving their overall performance in such practice.
To examine the changes in measures of sleep apnea severity and hypoxemia on the first postoperative night following implantation of the hypoglossal nerve stimulator.
This was a single-arm prospective cohort study.
A single academic sleep surgical practice.
Subjects with moderate to severe obstructive sleep apnea underwent implantation of the hypoglossal nerve stimulator (HGNS) and were discharged to home the same day as surgery. A single-night WatchPAT study was performed on the night immediately following surgery (PON 1) and was compared to baseline sleep testing.
Twenty subjects who were an average of 58.6 ± 2.5 years old, were 25% female, and had a mean body mass index of 28.1 ± 0.9 kg/m
completed the study. Mean O
nadir at baseline was 79.6% ± 1.1% compared to 82.7% ± 0.9% (
= .013) on PON 1. One patient demonstrated a >10% worsening in O
nadir. Only 2 additional patients demonstrated a worsening in O
nadir on PON 1, each by only 1 percentage point. Neither mean time spent below SpO
88% nor oxygen desaturation index (ODI) worsened postoperatively (mean time spent below oxygen saturation of 88%, 27.8 ± 7.85 vs 11.2 ± 5.2,
= .03; mean ODI, 29.6 ± 5.2/h vs 21.0 ± 5.4/h,
= .10). Mean obstructive apnea hypopnea index (AHI) was no worse (40.6 ± 4.7/h to 28.7 ± 4.2/h,
= .02), with only 2 patients experiencing an obstructive AHI >20% more severe than baseline. Only 1 patient demonstrated a clinically meaningful increase in central AHI on PON 1.
Overall, AHI and measures of nocturnal hypoxemia are stable, if not improved, on PON 1 following HGNS implantation. These findings support the safety of same-day discharge following implantation of the hypoglossal nerve stimulator.
Overall, AHI and measures of nocturnal hypoxemia are stable, if not improved, on PON 1 following HGNS implantation. These findings support the safety of same-day discharge following implantation of the hypoglossal nerve stimulator.The process of receiving and scheduling residency interviews for otolaryngology-head and neck surgery positions is chaotic, inducing unnecessary anxiety for applicants and introducing inefficiencies for programs. With incomplete information, applicants often accept all invitations they receive, resulting in interview hoarding and late cancellations. Various specialties have attempted to improve the interview offer and scheduling process through standardization of interview offer dates. In this commentary, we propose that otolaryngology programs adopt a uniform interview offer and scheduling date. We also advise programs commit to limiting the number of interview invitations to the number of interview slots available, and we review best practices to optimize the interview offer and scheduling process for both applicants and programs.Women are the silent sufferers of war, they have higher rates of anxiety and depression after terror events than men who have been similarly exposed. In this study, we aim to explore the prevalence of anxiety, depression and suicidal thoughts/attempts among Iraqi women post-conflict. A sample of 1000 women was collected in this cross-sectional study that was conducted in Baghdad city from January through September 2020. Their mental state was addressed by assessing anxiety and depression on symptomatic basis using standard questions from the Diagnostic and Statistical Manual of Mental Health Disorders (DSM-5) scale. The results showed that the vast majority (91.1%) of the sampled women had experienced war-related trauma since 2003. Anxiety symptoms were reported by 39.7% of the women, depressive symptoms by 34.2% and suicidal thoughts/attempts by 35.8%. More than two-thirds of the women experienced difficulties in their social life and relationships. The majority of the studied women had negative expectations regarding their future and more than half of them expressed their intention to emigrate. The findings of this study indicate that anxiety, depression and suicidal thoughts/attempts are prevalent among this sample of Iraqi women post-conflict. Significant associated factors were losing a husband and having early married girls in the household.
To describe risk of recurrence and recurrence characteristics between ever- and never-smoking patients with human papillomavirus-associated oropharyngeal squamous cell carcinoma (HPV+ OPSCC) when stratified by primary tumor subsite.
Retrospective observational study.
Tertiary care center.
Retrospective chart review of 171 patients with HPV+ OPSCC with primary treatment between 2008 and 2019. Five-year recurrence-free survival and risk of recurrence were evaluated through Kaplan-Meier curves with log-rank test and Cox proportional hazards models, respectively.
Of 171 patients with HPV+ OPSCC, 81.9% were male, and the average age was 63.9 years. Eighty patients (46.8%) had a smoking history (average, 17.7 pack-years), including 4 current smokers. Recurrence occurred in 31 patients (18.1%), 19 of whom were ever smokers. The recurrence rate for ever smokers with primary base of tongue (BOT) cancer was 41.7%, while 5.1% of never smokers with BOT primaries had recurrence. For primary tonsillar disease, 9.
