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Over the past 10 years, there has been a rapid expansion of legal and legislative changes in abortion care provision for advanced practice clinicians (APCs), including nurse practitioners, midwives, and physician associates (formerly physician assistants), with most of that expansion occurring in the last several years. This expansion has occurred via several routes (eg, legislative, popular vote, court decision, attorney general opinion), and the patchwork of legal statuses nationally creates confusion for clinicians who are unclear on current regulations. This review explores the historical context of abortion practice for APCs, as well as the primary philosophical and legal concepts relevant to this role development. Since 2012, the number of states permitting abortion practice by APCs has more than quintupled, and the changes to abortion law in the United States in the wake of the 2022 Supreme Court decision in the case of Dobbs v. Jackson Women's Center creates a new imperative to understand the role of APCs in accessing abortion care. Additionally, although the research on abortion safety for APC abortion providers is well‐established, the physician‐centered paradigm of abortion care has limited the ability of APCs to develop expertise in this essential public and clinical health service. [ABSTRACT FROM AUTHOR]

Aim: To examine the barriers and facilitators nurses experience in addressing social needs in the United States and the associated outcomes of addressing these needs in adults in the ambulatory care setting. Design: A systematic review with inductive thematic and narrative synthesis. Data Sources: PubMed, CINAHL, Web of Science, and Embase from 2010 through 2021. Review Methods: Cochrane Handbook of Systematic Reviews; Risk of Bias‐CASP and the JBI checklist; Certainty of evidence‐GRADE‐CERQual assessment. Results: After duplicates were removed, 1331 titles and abstracts were screened, and a full‐text review was performed on 189 studies. Twenty‐two studies met inclusion criteria. The most frequently cited barriers to addressing social needs were lack of resources, workload burden, and lack of education in social needs. The most cited facilitators were engaging the person and family in decision‐making, a well‐integrated standardized data tracking and referral documentation system, clear communication within the clinic and with community partners, and specialized education and training. Seven studies measured the nurse's impact of screening for and addressing social needs, and outcomes improved in most of these studies. Conclusion: Barriers and facilitators specific to nurses in the ambulatory setting and associated outcomes were synthesized. Limited evidence suggests that screening for social needs by nurses may impact outcomes by decreasing hospitalizations, decreasing emergency department utilization, and improving self‐efficacy towards medical and social services navigation. Impact: These findings inform practice and facilitate changes within nursing towards care that accounts for a person's individual social needs in ambulatory care settings and are most directly applicable to nurses and administrators in the United States. Reporting Method: PRISMA guidelines, supplemented by the ENTREQ and SWiM guidelines. No Patient or Public Contribution: This systematic review is the result of work performed by the four authors exclusively. [ABSTRACT FROM AUTHOR]

The production of green gasoline, jet, and diesel biofuels from waste greases was achieved using a novel hydrothermal, continuous‐flow catalytic process operating under supercritical water conditions, with recycled water the only added chemical. Thermally and chemically stable catalysts were explored to optimize yields of liquid biofuels and to minimize production of gases and acidic compounds. A 50:50 mixture of brown and yellow waste greases converted into 76.6 wt% liquid biocrude (BC); the remainder converted to water and gases. Less than 0.2% of the feedstock (FS) formed carbon char (mainly amongst catalyst particles). Various tubular reactors (Inconel, Hastelloy, titanium, stainless) showed no interior defects, erosion, or mass loss after runs. The titanium catalyst was fully recovered and regenerated back to its original potency. The BC was further refined into 28%, 48%, 20%, and 4 wt%, respectively for green gasoline, jet, diesel, and bunker. Biofuels were analyzed for compound class compositions and reaction mechanisms were proposed. Hundreds of identified fuel products (C3‐C35) from processing oleic acid as a pure model compound were identified. The neat green gasoline and diesel biofuels, along with a 50% green jet blend (with petroleum Jet A), were tested in appropriate spark ignition, turbine, and diesel engines at the University of Minnesota Engine Labs. The biofuels achieved 107.7%, 97.2%, and 101.3% engine power performance levels relative to petroleum fuels (91‐Octane, Jet A, #2 Diesel) along with lower CO and pollutant emissions. The biofuels complied with American Society for Testing and Materials (ASTM) fuel specifications (D4814, D7566, D975) including mandated corrosion and low sulfur limits of all three biofuels. © 2021 Society of Chemical Industry and John Wiley & Sons, Ltd [ABSTRACT FROM AUTHOR]

Purpose: To determine what is known about climate change health effects for gender diverse (GD) populations, and identify gaps in research, practice, education, and policy. Design/Methods: A scoping review was conducted. Findings: Twenty‐seven information sources met inclusion criteria. Natural disasters and inadequate disaster relief responses were identified as an overarching health threat for GD populations. Within this theme, four sub‐themes emerged. No other climate‐related health impacts for GD populations were mentioned in the sources reviewed. Conclusions: There are major gaps in knowledge about health implications of climate change for GD populations. Gender‐sensitive data must be collected in order to better understand these threats and detect disparities. Currently most practice and policy recommendations focus on disaster relief. More research on the broad effects of climate change on GD populations is urgently needed to inform practice and policy. Clinical relevance: Climate change amplifies existing risks of adverse health outcomes. Because of discrimination, stigma, and violence, gender diverse individuals are particularly vulnerable. [ABSTRACT FROM AUTHOR]

Interest in self‐management approaches to abortion with pills in the United States preceded the coronavirus disease 2019 (COVID‐19) pandemic and has accelerated during this global health crisis. Coupled with the unclear future of legal abortion in the United States, clinical care providers need to be aware of the range of self‐managed abortion approaches and of the varying levels of engagement with the formal health care system they entail. This article is intended to serve as a resource to inform providers of the current landscape of abortion with pills in the United States, while also describing possible shifts in the future that may result due to the ongoing pandemic and the continuing erosion of access to abortion care and services. [ABSTRACT FROM AUTHOR]

In practice, nutrition recommendations vary widely for inpatient and discharge management of acute, uncomplicated diverticulitis. This systematic review aims to review the evidence and develop recommendations for dietary fibre modifications, either alone or alongside probiotics or antibiotics, versus any comparator in adults in any setting with or recently recovered from acute, uncomplicated diverticulitis. Intervention and observational studies in any language were located using four databases until March 2017. The Cochrane Risk of Bias tool and GRADE were used to evaluate the overall quality of the evidence and to develop recommendations. Eight studies were included. There was "very low" quality evidence for comparing a liberalised and restricted fibre diet for inpatient management to improve hospital length of stay, recovery, gastrointestinal symptoms and reoccurrence. There was "very low" quality of evidence for using a high dietary fibre diet as opposed to a standard or low dietary fibre diet following resolution of an acute episode, to improve reoccurrence and gastrointestinal symptoms. The results of this systematic review and GRADE assessment conditionally recommend the use of liberalised diets as opposed to dietary restrictions for adults with acute, uncomplicated diverticulitis. It also strongly recommends a high dietary fibre diet aligning with dietary guidelines, with or without dietary fibre supplementation, after the acute episode has resolved. [ABSTRACT FROM AUTHOR]

This article examines the ritual specialists and initiates of the three Adzima shrines in the southeastern Volta Region of Ghana and their criticism of Christianity, particularly Neo-Pentecostalist discourse that encourages adherents to sever lineage-based ties to deities and ancestors. The influence of Christianity is an issue that the Adzima shrine ritual specialists deal with on a regular basis since different types of people are drawn into hierarchical relationships with the Adzima deities through the fiasidiwo initiates. The Adzima ritual specialists have to manage shifting perspectives on the appropriate relationship between persons embedded in lineage structures and with deities, which could undermine the meanings attributed to the fiasidiwo and potentially threaten the initiates’ livelihoods. [ABSTRACT FROM AUTHOR]

Background: Abdominal aortic aneurysms can be either treated by an open abdominal aortic aneurysm repair or an endovascular repair. Comparing clinical predictors of outcomes and those which influence survival rates in the long term is important in determining the choice of treatment offered and the decision-making process with patients. Aims: To determine the influence of pre-existing clinical predictors and perioperative determinants on late survival of elective open abdominal aortic aneurysm repair and endovascular repair at a tertiary hospital. Methods: Consecutive patients undergoing elective abdominal aortic aneurysm repair from 1990 to 2013 were included. Data were collected from a prospectively acquired database and death data were gathered from the Queensland state death registry. Pre-existing risks and perioperative factors were assessed independently. Kaplan-Meier and Cox regression modeling were performed. Results: During the study period, 1340 abdominal aortic aneurysms were repaired electively, of which 982 were open abdominal aortic aneurysm repair. The average age was 72.4 years old and 81.7% were males. The cumulative percentage survival rates for open abdominal aortic aneurysms repair at 5, 10, 15 and 20 years were 79, 49, 31 and 22, respectively. The corresponding 5-, 10- and 15-year survival rates for endovascular repair were not significantly different at 75, 49 and 33%, respectively (P = 0.75). Predictors of reduced survival were advanced age, American Society of Anaesthesiology scores, chronic obstructive pulmonary disease, renal impairment, bifurcated grafts, peripheral vascular disease and congestive heart failure. Conclusions: Open repair offers a good long-term treatment option for patients with an abdominal aortic aneurysm and in our experience there is no significant difference in late survival between open abdominal aortic aneurysms repair and endovascular repair. Consideration of the factors identified in this study that predict reduced long-term survival for open abdominal aortic aneurysms repair and endovascular repair should be considered when deciding repair of abdominal aortic aneurysm. [ABSTRACT FROM AUTHOR]

Objectives Carpal tunnel syndrome ( CTS) is a common entrapment neuropathy of the median nerve at the wrist that is characterized by pain, paresthesias, weakness, and loss of dexterity. This pilot study was conducted to evaluate the heated lidocaine/tetracaine patch ( HLT patch) as a conservative treatment for pain of CTS. Methods Twenty adult patients (mean age = 44 ± 12 years) with pain secondary to unilateral CTS and electrodiagnostic evidence of mild-to-moderate CTS enrolled in this open-label study. Patients were treated with a single HLT patch placed over the junction of forearm and wrist on the palmar aspect of the wrist twice daily (morning and evening at 12-hour intervals) for 2 hours. At baseline and during the 2-week study, patients graded their pain intensity with an 11-point numerical rating scale (0 = no pain, 10 = worst imaginable pain). Pain interference with general activity, work, and sleep was evaluated with a similar 0-to-10-point scale. Results Fifteen patients completed the 14-day treatment period. Mean average pain intensity score decreased from 5.1 ± 1.5 at baseline to 2.5 ± 1.6 at end of study in the per-protocol population ( P < 0.001). Two-thirds of the patients demonstrated clinically meaningful pain relief (≥ 30% reduction in average pain score), with 40% of the patients reaching this threshold by the third treatment day. Similar improvements were observed for pain interference scores. The HLT patch was generally well tolerated. Conclusion The HLT patch resulted in clinically meaningful reduction in pain intensity in the majority of patients with mild-to-moderate CTS and may represent a targeted nonsurgical treatment for pain associated with CTS. [ABSTRACT FROM AUTHOR]

Presents a study which examined lactobacillus growth and membrane composition in the presence of linoleic or conjugated linoleic acid (CLA). Background on conjugated linoleic acid; Growth of lactobacillus species in MRS broth and milk with linoleic acid or CLA; Cell membrane fatty acid analysis after growth with linoleic acid or CLA.

Hospital-acquired malnutrition is a significant issue with complex aetiology, hence nutrition interventions must be multifaceted and context-specific. This paper describes the development, implementation and process evaluation of a complex intervention for improving nutrition among medical patients in an Australian hospital. An integrated knowledge translation (iKT) approach was used for intervention development, informed by previous research. Intervention strategies targeted patients (via a nutrition intake monitoring system); staff (discipline-specific training targeting identified barriers); and the organisation (foodservice system changes). A process evaluation was conducted parallel to implementation assessing reach, dose, fidelity and staff responses to the intervention using a mixed-methods design (quantitative and qualitative approaches). Staff-level interventions had high fidelity and broad reach (61% nurses, 93% foodservice staff and all medical staff received training). Patient and organisation interventions were implemented effectively, but due to staffing issues, only reached around 60% of patients. Staff found all intervention strategies acceptable with benefits to practice. This study found an iKT approach useful for designing a nutrition intervention that was context-specific, feasible and acceptable to staff. This was likely due to engagement of multiple disciplines, identifying and targeting specific areas in need of improvement, and giving staff frequent opportunities to contribute to intervention development/implementation. [ABSTRACT FROM AUTHOR]

Malnutrition is a common and complex problem in hospitals. This study used an integrated knowledge translation approach to develop, implement, and evaluate a multifaceted, tailored intervention to improve nutrition care, delivery, and intake among acute medical inpatients. This observational, pre-post study was conducted in a medical ward at a public hospital in Australia. The intervention was co-developed with key stakeholders and targeted three levels: individuals (nutrition intake magnets at patient bedsides), the ward (multidisciplinary hospital staff training), and the organisation (foodservice system changes). Observational data were collected pre- and post-intervention on patient demographics, food intakes, and the mealtime environment. Data were entered into SPSS and analysed using descriptive and inferential statistics. Ethical approval was gained through the hospital and university ethics committees. A total of 207 patients were observed; 116 pre- and 91 post-intervention. After intervention implementation, patients' mean energy and protein intakes (in proportion to their estimated requirements) were significantly higher and the number of patients eating adequately doubled (p < 0.05). In summary, a multifaceted, pragmatic intervention, tailored to the study context and developed and implemented alongside hospital staff and patients, seemed to be effective in improving nutrition practices and patient nutrition intakes on an acute medical ward. [ABSTRACT FROM AUTHOR]