Search

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]

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]

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]