Notes

Late-Stage β-C(sp3)-H Deuteration associated with Carboxylic Acid.
The use of cognitive enhancers is gaining attention. Studies indicate that the theory of planned behavior (TPB) can model their use, with attitudes a key variable. However, the factors affecting attitude have been largely neglected. The aim of this study was to examine the relationship between learning approaches and individual competitiveness and attitudes toward cognitive enhancers in students. UK university students (N = 179) completed an anonymous online survey assessing their attitudes toward cognitive enhancers as well as competitiveness and learning approaches using the revised Study Process Questionnaire. Academic performance data were also collected. The analysis revealed that being competitive or having surface motives (i.e. wishing to work sufficiently to meet minimum requirements only) was predictive of a more positive attitude toward the drugs, whilst academic performance was a negative predictor. This research adds to previous work by demonstrating the importance of individual, rather than just institutional, competitiveness and identifying a role for learning approaches. Both offer avenues to target drug use because cooperation rather than competitiveness and deep rather than surface learning approaches can be driven from careful design of teaching and learning. This suggests that curriculum design could impact on attitudes toward cognitive enhancers, which in turn may alter the use of these drugs.BACKGROUND Patients with primary hypothyroidism are treated with levothyroxine in order to normalize their serum TSH. this website Finding the optimal dosage is a long-lasting process and a small change can have major impact. Currently, limited data are available on the impact of dose equivalent substitution between brands. This study aimed to determine the effect of the shortage of the levothyroxine brand Thyrax® in the Netherlands and the resulting dose-equivalent switch to another brand on plasma TSH concentrations in a large cohort of patients. METHODS Observational cohort study. Two registries representative for the Dutch population containing prescription and laboratory test data the Nivel Primary Care Database and the PHARMO database network. Patients using at least 25 μg Thyrax® daily for one year or longer were included. Two cohorts were formed a switch cohort consisting of patients who switched from Thyrax® to an alternative brand, and a Thyrax® cohort including patients who continued to use Thyrax®. Patients in levothyroxine brands induced biochemical signs of overdosing in an even larger proportion (24-63%) of patients. The results indicate that a dose-equivalent levothyroxine brand switch may necessitate a dose adjustment in a large number of patients.Betel nut chewing has become prevalent in Hunan Province, China. There are different voices over its health risks. In spite of this, the local government has not taken any effective measures to control its expansion. It is necessary to reveal the concern of interests and public health behind such voices. This study used qualitative and quantitative methods to investigate the dispute over the health risks of betel nut chewing. The different voices over the risks demonstrate the tension of power, interests and public health among the government, institution, business, media and medical elites. Discursive practices of these institutions and individuals are associated with the exercise of power and expression of interests. With the deep concern about its cancerogenicity, majority of the public hold a negative attitude, and agree that the related industry should be controlled. Faced with conflicting perspectives, the government has the responsibility to clarify the issue and express an official stance. Measures should be taken to protect public health.Does working with suicidal patients become easier with time? A representative national survey of 375 psychologists (72% women, Mean age 44 years) showed that years of experience (r = -.13, p = .01) and frequency of contact with suicidal patients (r = -.15, p = .004) correlated only weakly with perceived difficulty. Thematic analysis of respondents' descriptions of difficult suicide-related situations on an open survey-question yielded four themes Unreachable patients, choosing between therapy and security, therapist's boundaries and empathy with death-wishes. We conclude that improved confidence in coping with suicidality may require specific training rather than simply years of work.Abortion providers' approaches to patient-centred pregnancy tissue viewing (PCV) - when a patient requests to see their products of conception - is understudied in abortion care. This mixed-method study aimed to identify (1) if, when, and how PCV is facilitated at US independent abortion clinics; (2) how staff are trained to offer viewing; and (3) provider experiences facilitating PCV. We surveyed administrators from 22 independent abortion clinics affiliated with the Abortion Care Network about their PCV practices and then completed in-depth semi-structured interviews with 25 providers to better understand their experiences facilitating PCV. Results indicate that most of the clinics that provide PCV do so by patient request. A variety of providers facilitate viewing, including counsellors, educators, physicians, nurses, and medical assistants. Timing, viewing location, and staff training vary by facility. Benefits of and barriers to PCV emerged through three themes (1) patient-centred care; (2) misinformation about fetal tissue; and (3) personal navigations as providers. Providers and administrators report PCV aligns with their patient-centred clinic missions and offers patients opportunities for choice, closure, and access to information. Yet, anti-abortion misinformation about fetal tissue impacts the ways providers must navigate complex conversations about PCV professionally and personally. Clinic resources and concern about adverse patient reactions to identifiable fetal parts present barriers to offering viewing. Understanding providers' experiences and approaches to PCV is an important first step to developing quality practices that can be shared across clinics. The findings of this study support the need for more research and training on PCV in abortion care.
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