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Emergency department (ED) visits for opioid-related overdoses continue to rise across the United States, particularly among Black, Latinx, and American Indian/Alaskan Native communities. A minority of people with opioid use disorder (OUD) engages in formal addiction treatment and there are racial disparities in treatment access. ED visits for opioid overdose are crucial opportunities to link individuals with OUD to harm reduction and treatment services. However, we know little about whether racial inequities exist in ED treatment after opioid overdose.

This observational, cross-sectional study examined differences in services provided to overdose patients who were discharged after an ED visit for opioid overdose by patient race-ethnicity. Primary outcomes included provision of take-home naloxone, ED-based behavioral counseling, and linkage to treatment. Race-ethnicity differences in post-overdose ED services were evaluated using chi-square analyses, and multivariable logistic regression analyses were condal and behavioral health care systems, and limited provider training in addiction medicine and motivational interviewing. These inequities add to the known racial disparities in ED patient care. Further research should elucidate barriers to behavioral counseling within ED settings and factors contributing to racial inequities in post-overdose emergency care.This study aims to describe the short-term therapeutic results of patients treated with operative arthroscopy and medical infiltration with platelet-rich fibrin in upper and lower articular space. The study design is descriptive observational with retrospective case series of patients with Wilkes II and III. These patients were managed with operative arthroscopy viscosupplementation with platelet-rich fibrin (PRF) and were followed up for up to 8 months to evaluate their response to treatment. 17 patients were included in the study. In the pre-surgical assessment (T1) mean VAS was 7.1 and MID was 22.2 mm. Eight months later (T4) a relevant improvement in both mentioned variables MID 38.2 ± 4.1 and VAS 1.1 ± 0.2 was observed. Regarding the reduction of pain, a significant improvement in symptoms were found, this being 84.6% ± 3.5% and in mandibular mobility satisfactory results were also obtained, improving in 41.7% ± 20.9%. Within the limitations of the study temporomandibular joint arthroscopy and medical infiltration platelet-rich fibrin viscosupplementation is a procedure of limited invasiveness that shows promising results.Patient death in critical care is not uncommon. Rather, the provision of end-of-life care is a core feature of critical care nursing, yet not all nurses feel adequately prepared for their role in the provision of end-of-life care. For this reason, the Australian College of Critical Care Nurses (ACCCN) supported the development of a Position Statement to provide nurses with clear practice recommendations to guide the provision of end-of-life care, which reflect the most relevant evidence and information associated with end-of-life care for adult patients in Australian critical care settings. A systematic literature search was conducted between June and July, 2020 in CINAHL Complete, Medline, and EMBASE databases to locate research evidence related to key elements of end-of-life care in critical care. Preference was given to the most recent Australian or Australasian research evidence, where available. Once the practice recommendations were drafted in accordance with the research evidence, a clinical expert review panel was established. The panel comprised clinically active ACCCN members with at least 12 months of clinical experience. The clinical expert review panel participated in an eDelphi process to provide face validity for practice recommendations and a subsequent online meeting to suggest additional refinements and ensure the final practice recommendations were meaningful and practical for critical care nursing practice in Australia. ACCCN Board members also provided independent review of the Position Statement. This Position Statement is intended to provide practical guidance to critical care nurses in the provision of adult end-of-life care in Australian critical care settings.

Partnering with patients and families to make decisions about care needs is a safety and quality standard in Australian health services that is often not assessed systematically.

The objective of this study was to retrospectively evaluate satisfaction with care and involvement in decision-making among family members of patients admitted to the intensive care unit (ICU).

A retrospective cohort analysis of a satisfaction survey administered to family members of patients admitted to an ICU in an Australian metropolitan tertiary care hospital from 2014 to 2019 was conducted. The Family Satisfaction in the Intensive Care Unit questionnaire (FSICU) questionnaire was used to assess overall satisfaction, satisfaction with care, and satisfaction with decision-making on a scale from "poor" (0) to "excellent" (100).

In total, 1322 family members fully completed the survey. Respondents were typically direct relatives of ICU patients (94.2%) with an average age of 52.6 years. Most patients had an ICU length of staing to improve family satisfaction with decision-making and care in ICU settings and meet national standards.

Very high satisfaction levels were reported by family members during this study. Routine, prospective evaluations of family member satisfaction with ICU experiences are feasible and can be leveraged to provide insight for clinicians and administrators seeking to improve family satisfaction with decision-making and care in ICU settings and meet national standards.

For over a decade, patients experiencing clinical deterioration have been attended to by specialised nurses, the most senior of which are intensive care unit liaison nurses (ICU LNs) or critical care outreach nurses. These roles have evolved without consistent and formal recognised educational preparation. To continue to advance patient safety, an understanding of the educational requirements for these vital roles is required.

The aim of this study was to ascertain nurses' perceptions of the curriculum required to perform the roles of ICU LNs or critical care outreach nurses within an acute care sector rapid response system.

An exploratory descriptive study was conducted at an international rapid response system conference in 2016 following ethics approval. Using convenience sampling, extended response surveys were completed by nurses with rapid response system leadership experience and roles. Data were analysed using content analysis according to a priori themes of theoretical knowledge, skills, and atn descriptions and expectations of employers regarding the skill set expected in these leadership roles.Unsuccessful mandibular reconstruction occasionally occurs, leaving the patient with undesirable function and contours. In such cases, second- or third-time corrective operations are challenging. However, published studies on the complicated retreatment of such patients are scarce. Selleckchem BSJ-4-116 A retrospective analysis covering the years 2015-2019 was conducted in three centers. All 17 patients included had undergone prior failed mandibular reconstructions in other institutions. Salvage secondary or tertiary reconstructive surgeries were attempted and the results are presented. link2 Major factors for these failed reconstructions included exposed non-vascularized bone grafts (n = 7, 41.2%), flap loss (n = 4, 23.5%), exposed artificial joint (n = 3, 17.6%), skewed occlusion with deformity (n = 1, 5.9%), non-union (n = 1, 5.9%), and recurrence (n = 1, 5.9%). Fibula flaps were transferred in 15 patients, while iliac flaps were used in two patients for mandibular re-do reconstructions. Virtual surgical designs were conducted in nine (52.9%) patients, with navigation-guided approaches performed in three cases. Postoperative functions were relatively favorable in these complicated mandibular re-do reconstruction cases. Mandibular symmetry (mandibular length and height; P = 0.002) and condylar position (P less then 0.001) were regained after these re-do attempts. Secondary or tertiary mandibular re-do reconstruction can still achieve good functional outcomes with appropriate preoperative selection and well-conceived designs, especially with the aid of virtual surgery and navigation.To forecast climate change impacts across habitats or taxa, thermal vulnerability indices (e.g., safety margins and warming tolerances) are growing in popularity. Here, we present their history, context, formulation, and current applications. We highlight discrepancies in terminology and usage, and we draw attention to key assumptions underpinning the main indices and to their ecological and evolutionary relevance. In the process, we flag biases influencing these indices that are not always evaluated. These biases affect both components of index formulations, namely (i) the characterisation of the thermal environment; and (ii) an organism's physiological and behavioural responses to more frequent and severe warming. Presently, many outstanding questions weaken a thermal vulnerability index approach. We describe ways to validate vulnerability index applications and outline issues to be considered in further developing these indices.Trichinella spp. causes human trichinellosis by means of the consumption of raw or inadequately treated meat from domestic or game animals. In the Americas, as well as in other continents, Trichinella infection is a health issue for humans and has a negative impact on the pork meat market, generated by people's fear of becoming infected with the parasite. The distribution of human cases and the sources of this disease in humans and animals were analysed in this report, which summarizes the information available regarding Trichinella infection in animals and humans in South America. Within South America, human infection with Trichinella was documented in Argentina and Chile during the period 2005-2019. Trichinellosis is endemic in these countries for, with human cases and foci in domestic and wild animals. In Argentina, human cases occur throughout the country, with foci found in pigs and wild animals. In Argentina, during the period 2012-2018, the number of suspected human cases reached 6,662. T. spiralis was In Bolivia, antibodies were also found in humans. Peru, Colombia and Uruguay have no documented presence of Trichinella spp. in animals and humans. There is insufficient information regarding the presence of Trichinella spp. link3 in domestic and wild animals, as well as in humans, since only a very limited number of surveys have been carried out. No papers with information on Trichinella spp. circulating in animals or humans have been published regarding the situation in Guyana, Surinam, French Guiana, Venezuela and Paraguay. Considering the growth of the guinea pig meat market in the Andean region, and the high prevalence of the disease reported in free range pigs and wild boars, as well as other game animal species, it is important to focus on the role of biosecurity and risk management, while improving meat market regulations, and detection of infection prior to consumption, in order to reduce the risk of transmission of this zoonotic disease to humans.