Notes

Tooth enameled surface disorders as well as mouth area expressions inside Asian individuals together with coeliac disease.
This history offers many crucial lessons about how new technologies can lead to new and valuable therapies but can also subtly shape and constrain medical thinking. Moreover, ventilators not only changed how respiratory disorders were conceived; they also brought new forms of respiratory illness into existence.
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Wittert G, Bracken K, Robledo KP, et al. Testosterone treatment to prevent or revert type 2 diabetes in men enrolled in a lifestyle programme (T4DM) a randomised, double-blind, placebo-controlled, 2-year, phase 3b trial. Lancet Diabetes Endocrinol. 2021;932-45. 33338415.Thyroid-like cholangiocarcinoma is a very uncommon variant of peripheral-type cholangiocarcinoma. To date, only 4 prior cases have been reported. The molecular features of this tumor have not been described. We report a case of a 60-year-old woman with a tumor that evolved over a period of 10 years. A left hepatectomy specimen showed an 11 cm tumor that on histology exhibited areas reminiscent of a thyroid tumor with follicular and insular features which were positive on immunohistochemistry for cytokeratin 7 and in-situ hybridization for albumin. A detailed molecular analysis failed to show mutations common to cholangiocarcinomas but revealed frameshift mutations in 2 chromatin-remodeling genes, CREBBP and KMNT2A. This case confirms that thyroid-like cholangiocarcinoma is a histologic variant of this tumor that is associated with relatively low growth. As most cholangiocarcinomas, it is diffusely positive for cytokeratin 7 and albumin by in-situ hybridization. Given its rarity, the molecular alterations in this specific histologic subtype remain to be fully elucidated.
Parents with metastatic cancer report unique concerns and challenges when discussing their illness with their minor children. Greater understanding of parents' communication experiences can facilitate these discussions. This study aimed to describe the challenges, approaches, and decisions related to discussing prognosis among a sample of mothers with metastatic cancer.

We conducted a web-based cross-sectional survey assessing the psychosocial concerns of 224 women with metastatic cancer who had minor children. This analysis focused on participant responses to structured and open-ended questions addressing communication with their children. We used descriptive statistics to summarize responses to the structured questions and qualitative content analysis for responses to open-ended questions.

Nearly 80% (n = 176) reported they had discussed their prognosis with at least one of their children; 79% identified at least one barrier to these discussions. The most common obstacles were participants' uncertaintvidence-based strategies to assist ill parents with their communication concerns.Optimising budgets in wound care is crucial if local health economy efficiencies are to be realised. How spending is managed and monitored can be difficult for community nursing services due to the variety of supply routes. Online wound management systems not on help tailor supply routes to reduce waste, thereby reducing cost, but also provide an audit platform for transparency across clinical practice. The non-prescription ordering system Formeo was implemented across City Health Care Partnership (CHCP), Hull, through a value-based industry collaboration. With its use, monthly spend on wound care reduced by approximately £5354 (11.9%), with a reduction in the total spend of £64 254. Further, Formeo enabled an audit of clinical practice to minimise products on the formulary. This provided CHCP, Hull, the opportunity to reduce variations in care, and therefore potentially improve clinical outcomes.There is a growing concern around the health and wellbeing of community nurses due to the high complexities of and demand on district nursing services. It is well recognised that district nursing services have no limits to their capacity, and they have been dealing with an increasing caseload, with no increases in resources or staff. Consequently, this has left community nurses feeling exhausted and experiencing burnout, which, in the long term, can lead to compassion fatigue, which can in turn compromise patient safety. Specialist practitioner qualified district nurses (SPQDN) require the skills and knowledge to promote health and wellbeing, in order to provide a positive work environment and limit work-related stress and burnout despite the challenges encountered. This article explores possible strategies to promote health and wellbeing among community nurses and the barriers that SPQDNs encounter in doing so.Management of pituitary conditions can be problematic with many patients experiencing long-term psychological and social difficulties that impact on their quality of life. This study aimed to identify psychosocial symptoms associated with pituitary conditions that lead to poor quality of life and identify differences in symptomatology between patient groups. A survey using measures of psychological and social symptoms was sent to 2000 members of the Pituitary Foundation in January 2016. The survey was completed by 1062 patients (683 female), aged under 18 to over 65 years, using categorical age ranges. Physical and psychosocial symptoms including appearance issues, fatigue, anxiety and depression were reported. Using correlational and regression analyses, significant variation in symptoms were identified across gender, age range and condition type that were impairing patients' long-term functioning and impacting quality of life. There is a need for greater patient information and advice surrounding psychosocial symptoms of pituitary conditions.This article explores the challenges in maintaining community nursing placements as dynamic learning experiences for student nurses during the pandemic and beyond. Opportunities to create new ways of working and learning are essential to ensure student nurses can continue to be exposed to community nursing care. Developing insight, understanding, knowledge and skills in this unique learning environment is instrumental to encourage the next generation of community nurses and increase the future workforce. Suggestions for alternative ways of providing learning experiences during the present period are discussed, which could also be embedded as long-term strategies in the future.Urinary incontinence is a common condition that affects both men and women, and with profoundly negative effects. Prevalence figures do show that it is more common in younger women than men, but as people age the difference decreases, with research identifying that one in three older men have continence issues. However, even with this increase, there is little direct best practice guidance on addressing male urinary incontinence compared to that for women. Professionals seem to be unaware that men have known existing barriers to accessing health care and this would be especially true of such an embarrassing condition. There seems to be a lack of education in identifying symptoms and assessing and little thought to appropriate management if required. This can also be true of manufacturers that provide continence management equipment. This article will look at some of these themes and highlight the gender gaps and give guidance on how professionals may address these.Parkinson's disease (PD) is an incurable and progressive neurodegenerative disorder. People with PD also have increased muscle weakness and the typical symptoms of tremor, stiffness, slowness, balance problems and/or gait disorders. Other symptoms may include an overactive bladder, urgency and nocturia which can often lead to incontinence. Treatment options vary are dependent on the cause of the incontinence and should focus on improving Quality of life with a multi-pronged diagnosis-specific approach that takes into consideration a patient's ability to comply with treatment. The article looks at the role of the community nurse in caring for patients with PD and lower urinary disorders. They have a key role in assessment of patients and supporting families with tailor made bladder training such as establish a regular toilet routine, education about pelvic floor exercises or supply of incontinence products.Students frequently generate mnemonic cues to help them remember difficult or abstract information (Tullis & Maddox, Metacognition and Learning, 2020, 15, 129). Self-generated mnemonics have the potential to be particularly effective means of remembering target information because they can transform abstract information into meaningful units, connect information to existing schema, and create distinct retrieval routes to the targets. Across five experiments, we compared the effectiveness of self-generated mnemonics to mnemonics generated by others for remembering chemistry information. Generating one's own mnemonics consistently boosted recall for both the chemistry content and the mnemonic itself. However, experimentally boosting recall of mnemonics through retrieval practice did not affect recall of associated chemistry content. These results indicate that improved recall of chemistry content is not caused by better recall of the mnemonic itself; rather, generating a mnemonic involves deep and effortful processing of chemistry content that boosts recall more than reading someone else's mnemonic. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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