Lohmannweiner5216

Carbachol at 3 μmol/L reduced the pinacidil-activated IK-ATP under voltage-clamp conditions. Acetylcholine lengthened the ventricular action potential under simulated ischemia condition. In this study, we found that acetylcholine inhibits the IK-ATP and thus suppresses the ventricle-Purkinje APD dispersion. We conclude that parasympathetic tone may reduce the arrhythmogenic substrate exerting a complex antiarrhythmic mechanism during hypoxic conditions.This case report describes a 39-year-old male with remote history of polysubstance use disorder and depression who developed tinnitus after use of inhaled N,N-dimethyltryptamine (DMT). Although development of ear ringing was attributed to use on a single occasion, tinnitus occurred within the context of a larger self-experiment involving weekly microdoses of lysergic acid diethylamide (LSD). Distress and anxiety over the ear ringing prompted evaluation by an audiologist, primary care physician, and consultant psychopharmacologist. Tinnitus persisted for several months, although intensity and ability to cope with symptoms improved over time. A microdose of psilocybin mushrooms exacerbated tinnitus on two separate occasions, after which psychedelics were discontinued. Psychedelics are associated with a range of acute sensory changes including auditory phenomenon, although have not previously been associated with tinnitus in medical literature. Here, we present a probable case of tinnitus associated with DMT use and review potential underlying mechanisms connecting psychedelics and tinnitus.

Hope is important for patients with end-stage renal disease receiving haemodialysis (HD) and hope is associated with quality of life (QoL). Studies examining hope among the HD population are limited and, as far as the authors know, have not been undertaken in Jordan.

To examine levels of hope and QoL and to examine the association between hope and QoL in HD patients in Jordan.

A cross-sectional design was used. A convenience sample of 202 patients from six different dialysis centres was recruited. The World Health Organization QOL-BREF and the Herth Hope Index were used.

Moderate levels of hope (M=32.3±4.1) were reported. Respondents reported low mean scores for the physical domain of QoL (M=48.3±21.1) but not for the psychological and social relationship domains. Higher hope scores were associated with better QoL.

The findings suggest a positive relationship between the level of hope and QoL in people receiving HD. Encouraging hope while caring for HD patients in clinical settings may improve their QoL. Understanding the relationship between hope and QoL may help healthcare providers to improve the quality of care for patients and their families.

The findings suggest a positive relationship between the level of hope and QoL in people receiving HD. Encouraging hope while caring for HD patients in clinical settings may improve their QoL. Understanding the relationship between hope and QoL may help healthcare providers to improve the quality of care for patients and their families.John Tingle, Lecturer in Law, Birmingham Law School, University of Birmingham, discusses the need for an integrated approach to patient safety, and the argument that error is inevitable and risk can only be managed.COVID-19 is a new disease. Most research into the disease has focused on prevention of viral spread and treatment, but little is known about how patients recover. Nurses, whether in hospital, the community or in primary care, have a key role in supporting recovery from COVID-19. In this article, direct evidence from studies of COVID-19, and indirect evidence from studies of infections caused by other coronaviruses (eg SARS, MERS) and of the ICU experience are explored to identify the potential course of recovery and areas where nurses can help. Most people will have an uncomplicated recovery. However, it appears that a more complicated recovery is likely to be associated with severe disease. A minority, possibly those needing hospitalisation, and/or with pre-existing physical or psychological comorbidities, may experience long-term physical effects, fatigue and mental health difficulties. The support that nurses, as part of a multidisciplinary team, can provide to facilitate recovery is discussed.Emeritus Professor Alan Glasper, from the University of Southampton, discusses a King's Fund review that investigates how workplace transformations can enhance the delivery of compassionate and high-quality care.Susanne Christie, Arrhythmia Nurse Specialist, NHS Tayside (susanne.christie@nhs.scot), runner-up in the Cardiovascular Nurse of the Year category of the BJN Awards 2020.Part two of this series on the care of the surgical patient introduces readers to some of the additional risks associated with patients who are undergoing surgery and taking oral anticoagulants. It explores the use of vitamin K antagonists and heparin. Some of the management strategies and additional considerations that need to be addressed during the perioperative care continuum will also be discussed.In this article, an intensive care unit (ICU) nurse provides some reflections on caring for patients with COVID-19 and relates her lived experience to the concept of resilience. Similarities and differences to pre-pandemic understandings of resilience are drawn out and factors that mediate acute stress, resilience and psychological recovery during a pandemic are considered. Resources to support ICU nurses and other healthcare staff to manage stress and promote wellbeing are signposted, and important research directions that warrant attention are recommended. The story is one of learning and hope and, importantly, it captures key lessons that can equip healthcare staff with positive coping strategies in a time of unprecedented pressure.Richard Griffith, Senior Lecturer in Health Law at Swansea University, considers the role of the nearest relative, a statutory friend, appointed for patients detained under the Mental Health Act 1983.When it comes to determining what constitutes nursing workload, there are a number of approaches that represent and characterise the work of nursing across the three traditional shift patterns (morning/day, afternoon/evening and night). These are observational, self-reporting and work-sampling techniques. A review of the quantitative and qualitative literature to examine workload distributions between the three nursing shifts was undertaken. Using data sourced from the CINAHL, Scopus and Medline databases, the findings suggest that there is an inadequacy in establishing nursing productivity that is perhaps representative of the methods used to decipher nursing workload. This may contribute to poor quality care, and the high cost of excess nursing time contributes to the increasingly high costs of care. Linked to this is the nurse's job satisfaction. Quality of care and job satisfaction are important factors for the sustainability of the nursing workforce. There are few high-quality nursing articles that detail the workload distributions across the three nursing shifts and this is a potential area for further research.Sam Foster, Chief Nurse, Oxford University Hospitals, reflects on the need for regulators to take into account the care context, particularly with some trusts under more pressure than others from a second wave of COVID-19.Electromagnetic (EM) guided enteral tube placement may reduce lung misplacement to almost zero in expert centres, but more than 60 undetected misplacements had occurred by 2016 resulting in major morbidity or death.

Determine the accuracy of manufacturer guidance in trace interpretation against what is referred to as the 'GI flexure system'.

The authors prospectively observed the accuracy of the 'GI flexure system' of trace interpretation against manufacturer guidance in primary nasointestinal (NI) tube placements.

Contrary to manufacturer guidance, 33% of traces deviated >5 cm from the sagittal midline and 26.5% were oesophageal when entering the lower left quadrant, incorrectly indicating lung and gastric placement, respectively. Conversely, the GI flexure system identified ≥99.4% of GI traces when they reached the gastric body flexure; 100% at the superior duodenal flexure. All lung misplacements were identified by the absence of GI flexures.

Current manufacturer guidance should be updated to the GI flexure system of interpretation.

Current manufacturer guidance should be updated to the GI flexure system of interpretation.Becky Bonfield, Lead Advanced Nurse Practitioner, University Hospital Southampton NHS Foundation Trust (Becky.Bonfield@uhs.nhs.uk), runner-up in the Renal Nurse of the Year category in the BJN Awards 2020.The increased reports of escalation of social inequalities, xenophobic and racist ideologies during the COVID-19 pandemic presents a growing concern. Nurses are not immune to xenophobia and racism, both as perpetrators and as victims. Although COVID-19 brings a new wave of xenophobia and racism, healthcare organisations have been tackling discriminatory and racist practices for decades. However, racist practice quite often goes undetected or unchallenged due to its associated sensitivity and a lack of understanding of its complexity. There is a need for a more open and non-judgemental discourse around interpretations of racism and its predisposing factors as a means of combating the growing reports. This discussion paper proposes a practice-orientated conceptualisation of racism and outlines some particular and sustainable areas for consideration for nurses to use in their daily practice. Developing self-awareness and nurturing the courage, confidence and commitment to challenge self and others is critical for transforming ethnocentric and racist ideologies.Caring for a patient with suspected sepsis is a challenging nursing role. Early recognition and appropriate management of a patient with sepsis saves lives. Nurses play a fundamental role in detecting changes in physiological observations that could indicate the onset of sepsis. Additionally, an awareness of the pathophysiology of sepsis allows the nurse to better understand how rapid intervention prevents the onset of septic shock. Furthermore, knowledge and use of clinical guidelines and sepsis screening tools are established methods to help reduce patient mortality. Nurse familiarity with 'red flag' criteria for sepsis and thorough completion of early warning scores facilitate earlier recognition and time critical intervention. Delivery of the 'sepsis six' within 1 hour of suspected sepsis saves lives.

Although health care professionals' increased job demands and strain have generated much public debate in recent years, the way in which occupational therapists' job strain has developed remains unknown.

To examine how Finnish occupational therapists working in municipalities experienced job demands and control in 2014-2018 compared with physiotherapists and registered nurses.

Occupational therapists (OT,

 = 107), physiotherapists (PT,

 = 331) and registered nurses (RN,

 = 1389) responded to repeated surveys in the Finnish Public Sector Study in 2014-2018. We used the Job Content Questionnaire and analyzed the data using repeated measures analysis of variance and multiple linear regression with generalized estimating equations to identify the trends and differences.

More OTs had lower job demands and higher job control than PTs and RNs in each year of study. These differences were statistically significant. Most OTs had low job strain. The changes in job control and job demands of participants in different years were not statistically significant.