Notes

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d other practice and personal factors among PICU nurses. Nurses with high depersonalization experienced significantly higher distress in relationship satisfaction, and nurses who reported high personal satisfaction had significantly higher distress in relationship consensus.
Older adults occupy one third of acute care hospital beds, and the regular duties of many nurses include caring for older patients. A working knowledge of geriatric care competencies is necessary for nurses to provide high-quality care to older patients and their families. It is unclear how nurses who work in acute care hospitals self-evaluate their geriatric care competencies and how these self-evaluated abilities differ from the objective abilities of these nurses.

This study was designed to explore the geriatric care competencies of nurses in hospitals and to identify the factors associated with these competencies.

This was a cross-sectional study. Nurses who were employed and directly caring for patients aged 65 years and older in any of the adult wards of a medical center located in southern Taiwan were recruited as participants. A structured questionnaire was developed based on a review of the relevant literature and validated using expert consensus. This questionnaire included a demographic datascare competencies of nurses working in hospitals and to oversee the implementation of effective educational methods in Taiwan.
A significant gap was found between the self-perceived and actual competencies of nurses in terms of providing geriatric care. HDAC inhibitor are necessary to improve the geriatric care competencies of nurses working in hospitals and to oversee the implementation of effective educational methods in Taiwan.
To identify medication therapy issues and resolutions, and assess their relationship to antiretroviral therapy (ART) adherence among participants of the Patient-centered HIV Care Model (PCHCM) demonstration project.

Adult persons with HIV (PWH) in the United States were enrolled in the PCHCM from August 2014 to September 2016. Pharmacists conducted regular medication therapy reviews and documented ART and non-ART issues and suggested resolutions. Adherence to ART was calculated using proportion of days covered (PDC) and mean PDC by number of ART issues was compared using a generalized linear model with linear trend estimation.

The most common ART issue was adherence (57%). Adherence ART issues were resolved by adherence management (48%) or patient education (36%). Participants had a mean of 4.2 ART issues and 6.4 non-ART issues. #link# PDC was 89% for those with 0 ART issues and 73% for those with ≥ 3 ART issues. Persons with 0 ART issues had an increase in adherence (+8%) in the post period, while those with ≥ 3 ART issues had a decrease in adherence (-6%) (P = .02) in the post period.

Identifying therapy issues could help pharmacists improve care for PWH. Because PWH are an aging population with increased risk of comorbidities and polypharmacy, pharmacists and providers should collaborate to provide holistic, primary care solutions to address both the number and nature of therapy issues.
Identifying therapy issues could help pharmacists improve care for PWH. Because PWH are an aging population with increased risk of comorbidities and polypharmacy, pharmacists and providers should collaborate to provide holistic, primary care solutions to address both the number and nature of therapy issues.
HIV-exposed uninfected (HEU) individuals are predisposed to adverse health outcomes, which in part may stem from the influence of an altered intrauterine milieu on fetal programming. The placenta serves as a readout for the effects of the maternal environment on the developing fetus and may itself contribute to the pathogenesis of disease.

U.S. academic health system.

We leveraged a previously established registry-based cohort of HEU adolescents and young adults to identify 26 subjects for whom placental histopathology was available. We further obtained placental tissue from 29 HIV-unexposed pregnancies for comparison. We examined differences in placental histopathology between groups, and related villous vascularity in the HEU group to prenatal maternal characteristics and long-term health outcomes.

Placentas from HEU pregnancies demonstrated a higher blood vessel count per villus as compared to controls (5.9 ± 1.0 vs. 5.4 ± 0.8, P = 0.05), which was independent of maternal prenatal age, race, BMI, smoking status, hemoglobin, and gestational age. Furthermore, within the HEU group, lower CD4+ T cell count during pregnancy was associated with greater placental vascularity (r = -0.44, P = 0.03). No significant relationships were observed between placental blood vessel count per villus and BMI z-score or reactive airway disease among HEU individuals later in life.

Placentas from HEU pregnancies demonstrated increased villous vascularity compared to HIV-unexposed controls in proportion to the severity of maternal immune dysfunction. Further studies are needed to examine intrauterine exposure to hypoxia as a potential mechanism of fetal programming in HIV.
Placentas from HEU pregnancies demonstrated increased villous vascularity compared to HIV-unexposed controls in proportion to the severity of maternal immune dysfunction. Further studies are needed to examine intrauterine exposure to hypoxia as a potential mechanism of fetal programming in HIV.
Critical illness is characterized by increased serum cortisol concentrations and bioavailability resulting from the activation of the hypothalamic-pituitary-adrenal axis, which constitutes an essential part of the stress response. The actions of glucocorticoids are mediated by a ubiquitous intracellular receptor protein, the glucocorticoid receptor. So far, data on coronavirus disease 2019 and glucocorticoid receptor alpha expression are lacking.

Prospective observational study.

One academic multidisciplinary ICU.

Twenty-six adult coronavirus disease 2019 patients; 33 adult noncoronavirus disease 2019 patients, matched for age, sex, and disease severity, constituted the control group. All patients were steroid-free.

None.

Glucocorticoid receptor alpha, glucocorticoid-inducible leucine zipper expression, and serum cortisol were measured on ICU admission. In coronavirus disease 2019 patients, glucocorticoid receptor alpha and glucocorticoid-inducible leucine zipper messenger RNA expression were upregulated (4.
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