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Targeted screening for sexual abuse is needed for social workers to accurately identify those at risk. Drawing on a cumulative disadvantage framework, this study investigates how parental addictions, parental mental illness, and exposure to domestic violence, both individually and cumulatively, are associated with childhood sexual abuse (CSA). Two waves of regionally representative data were analyzed. Bivariate and logistic regression analyses were conducted using the 2010 Brief Risk Factor Surveillance Survey (BRFSS) (n = 9,241 men, n = 13,627 women) and replicated using the 2012 BRFSS (n = 11,656 men, n = 18,145 women). The 2010 data indicated that 8.5 percent of men who had endured all three childhood adversities reported that they had experienced CSA, compared with 0.6 percent of men who did not experience any of these adversities. Levels of CSA for women in 2010 were 28.7 percent for those experiencing all three risk indicators, and 2.1 percent for women with no risk indicators. Results were similar in the BRFSS 2012. Those with two or more risk factors had between five- and eightfold higher odds of CSA. Social workers may be able to decrease false positives if they screen for CSA based on the presence of two or more risk factors.

Posaconazole-induced pseudohyperaldosteronism (PIPH) has been associated with elevated posaconazole serum concentrations. Clinicians are faced with the difficult task of managing patients with PIPH while maintaining the efficacy of antifungal therapy. Commonly, modifications to posaconazole therapy are utilized in managing PIPH, including dosage reduction of posaconazole or switch to an alternative antifungal.

To characterize the management of patients diagnosed with PIPH and their response to various therapeutic interventions.

We retrospectively reviewed 20 consecutive adult patients diagnosed with PIPH. Patient data collected included blood pressure, electrolytes, endocrine laboratory values and posaconazole serum concentrations collected before and after therapeutic intervention.

Of 20 patients included, 17 patients (85%) underwent therapeutic modification, with posaconazole dose reduction (n = 11) as the most common change. Vismodegib Other modifications included discontinuation (n = 3), switch to an alternae utilized a stepwise approach for management, starting with posaconazole dose reduction and repeat assessment of clinical and laboratory parameters. If resolution of PIPH is not achieved, an alternative triazole antifungal or the addition of an aldosterone antagonist are additional potential interventions. It is possible for PIPH to persist after therapeutic modification despite these interventions. Thus, early diagnosis and continuous monitoring is warranted.

Clinician burnout is widespread throughout medicine, affecting professionalism, communication, and increases the risk of medical errors, thus impacting safe quality patient care. Previous studies have shown Peer Support Programs (PSPs) promote workforce wellness by supporting clinicians during times of heightened stress and vulnerability. Although these programs have been implemented in large institutions, they have not been used in military hospitals, which have high staff turnover and added stressors of deployments.

In December 2018, 50 physicians received 5 hours of PSP training at a military hospital from a nationally recognized PSP expert, following the programmatic structure described by Shapiro and Galowitz (2016). Utilization of the program was tracked from December 2018 to December 2019, recording only classification of provider type, triggering event, and provider specialty to maintain confidentiality. Qualitative comments from recipients and supporters were saved anonymously for quality improve healthcare worker resilience, and service member readiness.

Implementation of a PSP at our institution led to rapid utilization across multiple hospitals in the military health system, a model that could easily expand to deployed settings and remote locations. Access to peer support across the military health system could both mitigate the increased risks of military clinician burnout, and improve patient safety, healthcare worker resilience, and service member readiness.Aspirin is the most commonly used medication worldwide. Beside its well-known anti-inflammatory effects, a role has emerged in the prevention of cardiovascular events. However, a significant benefit has been demonstrated in secondary cardiovascular prevention only, while there is limited evidence supporting a role in primary prevention. This discrepancy might depend on the that so far, the high-risk populations that will achieve the greatest benefits yet experiencing minimal harmful side effects have not been identified. Patients with autoimmune systemic rheumatic diseases have an increased risk of cardiovascular complications compared with the general population, which makes aspirin of potential value in these subjects. Moving from general aspects of aspirin pharmacology and specific issues in general population, the aim of this study is to review the evidence about the role of low-dose aspirin in primary cardiovascular prevention in autoimmune systemic rheumatic diseases.

The diagnosis of sarcopenia is based on the analysis of strength, functionality and muscle mass. The objective was to verify the factors associated with sarcopenia in institutionalized elderly.

In total, 219 elderly individuals (≥60years old) living in long-term institutions in Natal/RN were included in the study. After defining the elderly as sarcopenic or non-sarcopenic, anthropometric, biochemical, sociodemographic and health-related were analyzed. The Student t-test and Mann-Whitney test were used to analyze the quantitative, while the chi-square test was used for the qualitative variables. Finally, Poisson regression was used to provide prevalence ratios for those variables that presented differences in the bivariate analyses.

Physical capacity and anthropometry were associated with sarcopenia. For each 1cm of knee height, the elderly presented 2.71% more chance of not having sarcopenia, and eutrophic or overweight individuals (according to BMI) presented 37.71 and 91.81% chances, respectively, of not presenting sarcopenia.