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Addressing "total pain" is a concept commonly practiced in palliative care. Spiritual healing in a Navy Veteran led to a significant improvement in pain allowing a voluntary taper of opioid medication. The Veteran was able to reconcile his faith in God and participated in several spiritual practices daily. selleck chemical The palliative care pharmacist assisted the team in developing an opioid taper process per Veteran's request as he had a strong conviction that he was spiritually healed. A reduction in opioid morphine equivalent daily doses (MEDD) were 87.5% without any symptoms from the clinical opioid withdrawal scale (COWS). The Veteran died peacefully during an opioid taper in hospice care.This study investigated the association between parental long working hours and the depression of children living with their parents even after becoming adults in South Korea. Data from two years of the Korean National Health and Nutrition Examination Survey (KNHANES) in 2014 and 2016 were analyzed using a cross-sectional study. Logistic regression analyses were performed to determine the association between parental long working hours and their adult children's depression. Adult children of mothers who worked more than 60 hours per week were more likely to have depression than 40 hours or less per week. Comprehending aging mothers' weekly working hours is an important factor for understanding the reason of adult children's depression.Health disparities are primarily driven by structural inequality including systemic racism. Medical educators, led by the AAMC, have tended to minimize these core drivers of health disparities. Instead, it has adopted a culture-based agenda through the framework of cultural competence to address disparities despite a paucity of supporting data. Cultural competence is ethnocentric in orientation and its content sustains biases that are long-standing in health care. Moreover, Cultural competence is based on a number of flawed assumptions and is not structured around a set of clearly stated ethical values. In this paper, we will demonstrate ways in which Cultural competence reflects embedded ethnocentrism, perpetuates entrenched biases, and fails to recognize the depth and breadth of systemic racism as these relate to the stated goal of Cultural competence-the mitigation of health disparities. In addition, we offer a reframed approach to health disparities in medical education.This study was carried out to determine the effect of dietary flaxseed meal (FSM) supplemented with dried tomato pomace (DTP) and dried grape pomace (DGP) on performance, egg quality, biochemical parameters traits and antioxidant status of laying hens. Birds (1825 ± 87 g of body weight) were divided into 12 dietary groups with six replicates per group (eight birds per replicate), under a completely randomized design with factorial arrangement 2 × 3 × 2 consisted of two levels of DTP (0 and 15%), three FSM levels (0, 4 and 8%) and two levels of DGP (0 and 5%). As a result of this study, there were no significant differences in egg production and weight as well in feed conversion ratio (FCR) among treatments (p > 0.05). Feeding of DGP reduced significantly feed intake and egg mass when compared to control group (p  0.05). Based on findings, FSM and DTP supplements did not significantly impact most of hens' performance indicators and egg quality parameters, whereas significant improvements were observed by feeding of 15% DTP and 5% DGP on egg traits, in particular on egg-yolk color that plays a key-role in consumer's choice. However, the supplementation of FSM and DTP or DGP even in laying hen diet is still controversial and further research is needed.Ochratoxin A (OTA) and staphylococcus enterotoxin A (SEA) are highly toxic contaminants and have induced human health problems. They commonly occur in milk and milk products. A competitive fluorescent immunoassay was developed for rapid and simultaneous determination of these toxins in milk samples. The procedure was based on the competitive immunoreactions between antigens in sample and antigen-fluorescent dye conjugates with immobilised antibodies on magnetic nanoparticles (MNPs). Each monoclonal antibody specifically recognises its corresponding toxin (antigen), and there is no cross-reactivity in the assay. First, monoclonal antibodies against OTA and SEA were produced. The activity of the obtained antibodies was determined by fluorescent-linked immunosorbent assay. Then, the monoclonal antibodies were immobilised on MNPs. The amounts of immobilised anti-OTA antibody and anti-SEA antibody were determined to be 20 and 22 μg mL-1, respectively. The antigen-fluorescent dye conjugates OTA-OVA-ATTO620 and SEA-FITC were prepared. The optimal amount of immobilised antibodies for competitive immunoassay was determined. It was found that the linear range of OTA in buffer was larger (0.001-100 ng mL-1) than the linear range of SEA (0.001-20 ng mL-1). The results for simultaneous determination of OTA and SEA in sixfold diluted milk were almost the same in buffer; the linear range for OTA was from 0.005 to 100 ng mL-1 and for SEA from 0.005 to 20 ng mL-1. The detection limit for both OTA and SEA in milk was 0.004 ng mL-1. The developed method took half the time of the individual assays (20 min). The assay was evaluated using spiked milk samples. The influences of somatic cell count, fat, pH and protein concentration in milk on immunoassay were studied. In summary, this developed immunoassay could provide an effective and rapid approach for detecting multi-toxins in milk samples.Stomatodynia is an oral dysesthesia with a psychosomatic component. Twelve consecutive patients with stomatodynia were offered hypnosis sessions. Measures of anxiety, depression, and pain were administered before the first and after the last hypnosis session. Pain severity was assessed with a Numeric Rating Scale (NRS). Anxiety and depression were assessed with the Hospital Anxiety and Depression Scale (HADS). The data were collected retrospectively from medical records on the 12 patients. The difference between NRS pain ratings and HADS scores before and after hypnosis was significant (p less then .05). Six patients reported receiving treatment for stomatodynia before hypnotherapy; 3 of them stopped treatment for stomatodynia before completion of the hypnosis intervention. Results provide support for potential positive effects of hypnosis intervention for stomatodynia and point to the need for additional research on this issue.