Notes

Consumption of microplastics from the estuarine polychaete, Namalycastis sp. from the Setiu Wetlands, Malaysia.
We present a case of a 53-year-old male living with well-controlled HIV who, as part of routine monitoring, was noted to have an unexpected decline in renal function. His antiretrovirals were switched accordingly. It subsequently transpired that he had recently started taking creatine supplements in order to build muscle mass. He underwent specialist renal review and further investigation with a chromium-labelled scan which revealed his renal function was, in fact, stable. He continues under renal and HIV follow-up. It is now more widely recognised that creatine can affect renal function, and result in difficulty in interpretation of traditional renal blood tests. However, the further investigations that may be undertaken in such settings and HIV treatment considerations are not as widely reported. This case serves as a reminder to ensure over-the-counter and herbal supplements are part of routine questioning in HIV clinics, and outlines the specialist investigations that may be undertaken in cases of apparent renal decline.
Despite evidence on the positive impact of trust in a doctor-patient relationship on health outcomes, there are limited studies conducted in Pacific Island Countries including Fiji. This study was conducted to assess the current level of patient trust in doctors and investigate its determinants in Fiji. Method A random sample of 410 participants attending the outpatient services completed the self-administered structured questionnaire. The response rate was 91% (N=375) and data was analyzed using descriptive statistics and analytic analysis using logistic regression. Result Mean age of participants was 38years (±15yrs). The majority of patients had partial trust in their doctors compared to full trust (61.6% vs 38.4%). More than half of the participants perceived doctor's communication behavior as fair rather than good (53.6% vs 45.6%). Those over 50 years (OR 1.96; p=0.007, 95% CI 1.198-3.226) and those who perceived doctors' communication behavior as good (OR 8.48; p=0.0001, 95% CI 5.257-13.709) were sign age of participants was 38years (±15yrs). The majority of patients had partial trust in their doctors compared to full trust (61.6% vs 38.4%). Donafenib inhibitor More than half of the participants perceived doctor's communication behavior as fair rather than good (53.6% vs 45.6%). Those over 50 years (OR 1.96; p=0.007, 95% CI 1.198-3.226) and those who perceived doctors' communication behavior as good (OR 8.48; p=0.0001, 95% CI 5.257-13.709) were significantly more likely to have full trust in the doctors. Conclusion This study reveals that age and communication are determinants of trust in Fiji. In view of the current perception of the doctors' communication behavior, Fiji's Ministry of Health and Medical Services should implement policies to give equal importance to the communication skills of the doctors together with their clinical skills and enforce it in the medical schools.
Coordination of various physical and mental aspects of individuals, including the ability to control difficult conditions and situations has an effect in the prevention and development of various diseases, such as diabetes, and the improvement of the quality of life. Therefore, the purpose of this study was is to determine the effect of emotional intelligence on the quality of life of elderly diabetic patients.

This study was conducted in 2018. The statistical population in this cross-sectional study consisted of elderly people referred to the health centers of Kermanshah province in western Iran, who were divided via available sampling into two groups with diabetes and without diabetes. Data gathering tools were a couple of LIPAD Quality of Life and Shrink Emotional Intelligence standard questionnaires. The Data was analysed using software SPSS, 23 th version. Tests were used (T-test, Chi-square, Anova and regression).

Most of them were male (52.72%) and the mean age of the patients was 65.01(±6.08) years old and married. The quality of life score in diabetics and non-diabetics was respectively 51.9 and 50.37 with a standard deviation of 17.73 and 20.54. The mean total score of emotional intelligence in the elderly with diabetes was 99.42 with a standard deviation of 10.37 and non-diabetic subjects were 97.18 with a standard deviation of 18.4.

There was no significant difference between the mean scores of quality of life (0.652) and emotional intelligence (0.421) in diabetic and non-diabetic individuals. But, the emotional intelligence has an effect on the quality of life of the elderly people.
There was no significant difference between the mean scores of quality of life (0.652) and emotional intelligence (0.421) in diabetic and non-diabetic individuals. But, the emotional intelligence has an effect on the quality of life of the elderly people.Background Post deinstitutionalisation, mental health mainstreaming has led to substantial increases in presentations to Emergency Departments (EDs). The assessment process requires the ED triage nurse to undertake a rapid client assessment, assign a clinically appropriate triage score, and then refer the client to a mental health clinician. The initial assessment is important, and a number of factors influence the process of triage, referral and response including an understanding of mental health presentation acuity. Aim To understand the factors that influence the ED triage assessment, referral and clinical response of clients with a mental illness. Methods An ethnographic methodology underpinned the research design. ED triage nurses and mental health triage nurses who worked in a regional hospital provided insights through interviews and observations. The study was also informed by institutional policies and procedures regarding triage. Transcribed in-depth interviews, field notes and memos were analysed using an inductive thematic process. Findings Mental health triage nurses and ED triage nurses concur that triage is an important part of the assessing process for a person who presents to the ED with a mental health problem. Timely and clinically accurate assessment, followed by referral and response is strongly influenced by the user knowledge of the mental health triage scale, and comprehension of mental health acuity. The conflicting understandings between the two professional nursing groups, called professionally cultured orientations, further impact this process. Conclusion Professionally cultured orientation to mental health triage and acuity comprehension influence the process of emergency mental health triage and therefore may affect optimal client outcomes. Further research into ED triage design, ED triage education, and a shared understanding of acuity is called for.
A community-based research project,
sought to provide evidence to respond to the community-identified need to more fully understand the parameters of the social and risk profiles of youth in Ottawa who smoked crack.
In this article we examine engagement in HIV and HCV risk-related smoking practices, and experiences accessing safer inhalation supplies with the objective of identifying potential intervention points and associated harm reduction interventions to initiate and support safer inhalation practices.
The study comprised four sequential components - formation and facilitation of a Youth Project team, qualitative interviews, and member checking workshops - each component building on the preceding and all contributing to the final and fourth component of the interviewer-administered quantitative survey from which data for this article are drawn. Eligibility criteria capable of informed consent; aged between 16 and 25 years; had ever injected drugs
had ever tried crack
had used two or moreough gender neutral, youth-specific enhanced programming and resource distribution.Often, individuals share private information on social media, being unaware of online dangers. You, a popular psychological thriller series on Netflix, raises issues of stalking behaviors through social media as part of a pattern of dating violence. Using a qualitative content analysis approach, this study examined how social media is used for erotic stalking, dating violence, and cyber safety awareness (or lack thereof) in You. The researchers analyzed all 10 episodes of the first season of You independently, taking notes. A combined in-depth analysis included discussions of messages and meanings resulting in three overarching themes obsessive online and in-person erotic stalking, controlling behaviors in the context of the dating relationship, and an apparent indifference about cyber safety with oversharing of personal information on social media, which was exploited by the lead protagonist. You raises important concerns including inappropriate dating behaviors such as stalking, coercive control, violence, and questionable masculine attitudes, which are interwoven with an apparent lack of knowledge and understanding in relation to cyber safety. We concluded that raising awareness of the importance of online safety and security in the context of a dating relationship is imperative and that You can be used as an educational tool.Herd immunity is a form of indirect protection that is offered to the community when a large proportion of individuals contained in the community are immune to a certain infection. This immunity can be due to vaccination or to the recovery post-disease. Effective herd immunity in SARS-CoV-2 infection has several hurdles upon achievement. Herd immunity cannot be obtained concomitantly in many geographical areas because the areas have different population density and the societal measures to contain the spreading are different. A proportion of 50-66% of the population needs to be immunized naturally or artificially in this SARS-Cov2 pandemic and this percentage is not easily achievable. The duration of herd immunity is another issue while information on the long-term immune response against SARS-CoV2 is yet scarce. Epitope stability, another issue to be solved when achieving herd immunity, is important. Mutation in the viral structure will call upon other sets of neutralizing antibodies and hence for other herd immunity type installment. The societal tactics to achieve the much-needed herd immunity should be developed keeping in mind the welfare of the population. Without being exhaustive, throughout our paper we will elaborate on each of the hurdles encountered in developing herd immunity to SARS-Cov2 infection.Background The red blood cell (RBC) storage lesion is a series of morphological, functional, and metabolic changes that RBCs undergo following collection, processing, and refrigerated storage for clinical use. Since the biochemical attributes of the RBC unit shifts with time, transfusion of older blood products may contribute to cardiac complications, including hyperkalemia and cardiac arrest. We measured the direct effect of storage age on cardiac electrophysiology and compared it with hyperkalemia, a prominent biomarker of storage lesion severity. Methods and Results Donor RBCs were processed using standard blood-banking techniques. The supernatant was collected from RBC units, 7 to 50 days after donor collection, for evaluation using Langendorff-heart preparations (rat) or human induced pluripotent stem cell-derived cardiomyocytes. Cardiac parameters remained stable following exposure to "fresh" supernatant from red blood cell units (day 7 5.8±0.2 mM K+), but older blood products (day 40 9.3±0.3 mM K+) caused bradycardia (baseline 279±5 versus day 40 216±18 beats per minute), delayed sinus node recovery (baseline 243±8 versus day 40 354±23 ms), and increased the effective refractory period of the atrioventricular node (baseline 77±2 versus day 40 93±7 ms) and ventricle (baseline 50±3 versus day 40 98±10 ms) in perfused hearts.
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