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Neoadjuvant teriparatide therapy individuals osteoporotic spinal column: affect of supervision period in the outlook during bone fragments histomorphometry.
INTRODUCTION Health professionals worldwide are required to maintain their knowledge and skills through continuing education. However, there is limited evidence that the accumulation of hours of educational activity enhances practice. The aim of this study was to review evidence of the impact of continuing professional development (CPD), best educational practice and new models of CPD requirements. METHODS We conducted a rapid evidence synthesis, reviewing literature and websites on continuing education for healthcare and non-healthcare professionals. RESULTS We extracted data from 184 publications. Evidence of changed practice and improved patient care is uncommon in studies of CPD. What evidence there is suggests that activities are more likely to have impact if a combination of methods is used and if they are aligned with learning needs. Impact is also affected by the learner and their work environment. In terms of CPD requirements, we identified three models input-based; outcomes-based and mixed models. We found a clear shift from quantitative, time-serving, input-models to outcomes-focused models which emphasise the identification of learning needs, selection of educational activity relevant to practice and reflection on practice improvement. Across a range of professions, recently updated CPD regulations no longer require registrants to accumulate CPD hours/points/credits. CONCLUSION Outcomes-based models support registrants' engagement in relevant, meaningful CPD which holds greater potential to positively impact on practice and strengthen patient safety. In funding this study, the UK General Dental Council exemplifies its commitment to reviewing its CPD requirments. © 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.The crosslink-enhanced emission effect was first proposed to explore the strong luminescence of non-conjugated polymer dots only possessing either non- or weakly-emissive sub-luminophores. Interesting phenomena in recent research indicate such enhancement caused by extensive crosslinking appears in diverse luminescent polymers with sub-luminophores (electron-rich hetero-atomic moieties) or luminophores (conjugated π domains). This enhancement can promote the emission from non-luminous to luminous, weakly-luminous to strongly-luminous and even converting the pathway of radiative transitions. The concept of the crosslink-enhanced emission effect should be updated and extended to an in-depth spatial effect, such as electron overlap and energy splitting in confined domains by effective crosslinking, more than initial immobilization. This minireview outlines the development of the crosslink-enhanced emission effect from the perspective of the detailed classification, inherent mechanism and applicable systems. An outlook on the further exploration and application of this theory are also proposed. © 2020 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.PURPOSE Opioids are commonly prescribed for acute pain after surgery. However, it is unclear whether these prescriptions are usually modified to account for patient age and, in particular, opioid-related risks among older adults. We therefore sought to describe postoperative opioid prescriptions filled by opioid-naïve adults undergoing four common surgical procedures. METHODS This retrospective cohort study used individually linked surgery and prescription opioid dispensing data from Ontario, Canada to create a population-based sample of 135 659 opioid-naïve adults who underwent one of four surgical procedures (laparoscopic cholecystectomy, laparoscopic appendectomy, knee meniscectomy, or breast excision) between 2013 and 2017. Patient age, in years, was categorized as 18 to 64, 65 to 69, 70 to 74, and 75 and over. Postoperative opioid prescriptions were identified as those filled on or within 6 days of surgical discharge date. For those who filled a prescription, we assessed the total morphine milligram equivalent (MME) dose, types of opioids, and any subsequent opioid prescriptions filled within 30 days of surgical discharge date. Results were presented stratified by surgical procedure. RESULTS For three of the four surgical procedures we assessed, the proportion of patients who filled a postoperative opioid prescription decreased with age (P  less then  0.001 for trend), and there was a small shift in the type of opioid (more codeine or tramadol and less oxycodone; P  less then  0.001 for trend). However, the total MME dose of the initial prescription(s) filled showed minimal age-related trends. CONCLUSIONS The proportion of opioid-naïve patients filling postoperative opioid prescriptions decreases with age. However, postoperative opioid prescription dosage is not typically different in older adults. © 2020 John Wiley & Sons Ltd.INTRODUCTION AND AIMS Large for-profit firms supply the majority of US state-legal cannabis stores and some firms have attempted to shape cannabis-related policies. Understanding firms' motivations for participation in the cannabis space is critical, given firms' possible links to cannabis usage patterns. Epoxomicin supplier Key decision-makers (KDM) in the cannabis space may have information unavailable to lower ranking staff, and may influence firm decision-making and consequently US cannabis usage practises. We present the findings of a qualitative study investigating the views of KDMs in the cannabis market, on large cannabis firms' motivations for participation in the space. DESIGN AND METHODS Data were collected through 37 semi-structured interviews with a convenience sample of KDMs in the US cannabis space, representing both for-profit and non-profit organisations. Thematic analysis, with an inductive approach, was used to analyse the data. RESULTS KDMs reported three non-exclusive motivations for large cannabis firms' participation in the space; to seek profit, to mitigate social inequity and to provide cannabis as medicine. Within the theme relating to profit, findings suggest that for-profit and non-profit organisations in the space may be cognisant of the other's goals, representing a symbiotic relationship. DISCUSSION AND CONCLUSIONS We suggest that firms may have reasons to enter the space not necessarily centred on increasing use. Although non-profits and for-profits have different agendas, the bottom line for both groups is to expand access. Policy-makers should be aware of that fact, and set policies which consider the two groups as a unified whole. © 2020 Australasian Professional Society on Alcohol and other Drugs.
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