Notes

Bitemporal hemianopsia supplementary for you to ischemic chiasmopathy following mechanical thrombectomy.
managed within an integrated health and social care response.
In response to the opioid crisis, states and health systems are encouraging clinicians to use risk mitigation strategies aimed at assessing a patient's risk for opioid misuse or abuse opioid agreements, prescription drug monitoring programs (PDMPs), and urine drug tests (UDT).
The objective of this qualitative study was to understand how clinicians perceived and used risk mitigation strategies for opioid abuse/misuse and identify barriers to implementation.
We interviewed clinicians who prescribe opioid medications in the outpatient setting from 2016-2018 and analyzed the data using Constructivist Grounded Theory methodology.
We interviewed 21 primary care clinicians and 12 specialists. Nearly all clinicians reported using the PDMP. Some clinicians (adopters) found the opioid agreement and UDTs to be valuable, but most (non-adopters) did not. Adopters found the agreements and UDTs helpful in treating patients equitably, setting limits, and having objective evidence of misuse; protocols and workflows in certain settings have found effective ways to implement and use the PDMP, opioid agreements, and UDT but that other clinicians are less comfortable with their use. Administrators and policymakers should ensure that the strategies are designed in a way that strengthens the clinician-patient relationship while maximizing safety for patients and that clinicians are adequately trained and supported when introducing the strategies.The COVID-19 pandemic has exposed a paradox in historical models of medical education organizations responsible for applying consistent standards for progression have needed to adapt to training environments marked by inconsistency and change. Although some institutions have maintained their traditional requirements, others have accelerated their programs to rush nearly graduated trainees to the front lines. One interpretation of the unplanned shortening of the duration of training programs during a crisis is that standards have been lowered. But it is also possible that these trainees were examined according to the same standards as usual and were judged to have already met them. This paper discusses the impacts of the COVID-19 pandemic on the current workforce, provides an analysis of how competency-based medical education (CBME) in the context of the pandemic might have mitigated wide-scale disruption, and identifies structural barriers to achieving an ideal state. The paper further calls upon universities, health centres, governments, certifying bodies, regulatory authorities, and health care professionals to work collectively on a truly time-variable model of CBME. The pandemic has made clear that time variability in medical education already exists and should be adopted widely and formally. If our systems today had used a framework of outcome competencies, sequenced progression, tailored learning, focused instruction, and programmatic assessment, we may have been even more nimble in changing our systems to care for our patients with COVID-19.
Adolescent alcohol use was a major social and public health concern given its negative impacts. Previous studies indicated gender role attitudes (GRA) were associated with alcohol use; however, few studies focused on early adolescents (10 to 14
years) and similar researches were not found in China.
This study sought to explore the association between GRA and alcohol use among early adolescents.
A cross-sectional study was conducted among students in grades six to eight across three public secondary schools in Shanghai, China. Data were collected by Computer-Assisted Self-Interview (CASI) questionnaire on mobile tablets. Alcohol use was measured by self-report, and six items with 5-point Likert-type options assessed the attitude toward traditional gender roles. The logistic regression model was adopted to examine the associations between GAR and alcohol use.
Totally 1,631 adolescents aged 10 to 14
years with 50.33% of boys included in this study. The mean score of GRA in drinkers was significantlyR = 0.96, 95%CI 0.74-1.24). Conclusions Traditional GRA may increase the risk of alcohol use among early adolescent boys, suggesting that altering traditional GRA among this population group may help to prevent alcohol use.Purpose There are currently no available aids for authors when selecting ophthalmology journals to submit their manuscripts. We aim to provide comprehensive data on the duration from submission to various stages of the publication process and assess factors influencing time to publication in ophthalmology journals.Methods A list of ophthalmology journals was obtained from the 2019 Web of Science Journal Citation Report. Journal characteristics, such as five-year impact factor, number of authors per article, journal type, and number of multi-institutional articles, were collected. The dates of submission, acceptance, electronic and print publication for all articles published in an ophthalmology journal in 2019 were determined.Results In total, 56 journals and 8835 research articles were included. selleck Of these articles, 3591 (40.6%) were open access and 4837 (54.7%) were multi-institutional. In 2019, most publications came from the United States of America (n = 1973), China (n = 1069) and Germany (n = 602). Significant associations were found between various predictors and a reduced mean number of days from submission to electronic publication increased journal five-year impact factor (p = .026), more authors (p = .028), publishing in a hybrid journal (both open-access and subscription articles) versus an open-access journal (p = .021), and a reduced proportion of multi-institutional articles in a journal (p = .030).Conclusions There is a wide variation in the time to acceptance and publication in ophthalmology journals. Authors can expect a shorter time to publication when publishing in high-impact journals.Dengue virus (DENV) infection is responsible for the development of dengue illness, which can be either asymptomatic, present mild manifestations or evolve to severe dengue. Thrombocytopenia is an important characteristic during DENV infection, being observed both in mild and severe dengue, although the lowest platelet counts are encountered during severe cases. This review gathers information regarding several mechanisms that have been related to alterations in platelet number and function, leading to thrombocytopenia but also platelet-mediated immune and inflammatory response. On this regard, we highlight that the decrease in platelet counts may be due to bone marrow suppression or consumption of platelets at the periphery. We discuss the infection of hematopoietic progenitors and stromal cells as mechanisms involved in bone marrow suppression. Concerning peripheral consumption of platelets, we addressed the direct infection of platelets by DENV, adhesion of platelets to leukocytes and vascular endothelium and platelet clearance mediated by anti-platelet antibodies.
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