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State laws governing recreational and medicinal cannabis use are trending toward legalization, which has implications for school social workers and the students, families, and communities they serve. The patchwork of policies and conflicting public opinion sends mixed messages to youth and families who may lack sufficient information regarding risks of adolescent cannabis use. This article will explore topics relevant to legalization of cannabis including medical versus recreational use, racial overtones in marijuana policy, effects on student cognitive development and mental health, child welfare involvement, disparities in school discipline, criminal record expungement, and school-based cannabis prevention programs. The article will conclude with a summary of recommendations for schools. This article is a product of the research conducted by the Health Education and Leadership Scholars planning team at the University of Illinois for a policy-practice conference that was cancelled due to COVID-19.

Mobile integrated health-community paramedicine (MIH-CP) uses patient-centered, mobile resources in the out-of-hospital environment to increase access to care and reduce unnecessary emergency department (ED) usage. The objective of this systematic review is to characterize the outcomes and methodologies used by MIH-CP programs around the world and assess the validity of the ways programs evaluate their effectiveness. The PubMed, Embase, CINAHL, and Scopus databases were searched for peer-reviewed literature related to MIH-CP programs. We included all full-length studies whose programs met the National Association of Emergency Medical Technicians definition, had MIH-CP–related interventions, and measured outcomes. We excluded all non-English papers, abstract-only, and incomplete studies. Our initial literature review identified 6434 titles. We screened 178 full-text studies to assess for eligibility and identified 33 studies to include in this review. These 33 include four randomized controlled trials, 17 cohort studies, eight 8 case series, and four 4 cross-sectional studies. Of the 29 non-randomized trials, five used matched controls, 13 used pre-post, and 11 used no controls. Outcomes measured were hospital usage (24 studies), ED visits (15), EMS usage (23), patient satisfaction (8), health-related outcomes (8), and cost (9). Studies that evaluated hospital usage reported one of several outcome measures: hospital admissions (11), ED length of stay (3), and hospital readmission rate (2). EMS usage was measured by ambulance transports (12) and EMS calls (10). Cost outcomes observed were ambulance transport savings (7), ED visit savings (4), hospital admission savings (3), and cost per quality-adjusted life year (2). Most studies assessing MIH-CP programs reported success of their interventions. However, significant heterogeneity of outcome measures and varying quality of study methodologies exist among studies. Future studies designed with adequately matched controls and applying uniform core metrics for cost savings and health care usage are needed to better evaluate the effectiveness of MIH-CP programs. [ABSTRACT FROM AUTHOR]

Mobile Integrated Health Community Paramedicine (MIH-CP) programs are designed to increase access to care and reduce Emergency Department (ED) and Emergency Medical Services (EMS) usage. Previous MIH-CP systematic reviews reported varied interventions, effect sizes, and a high prevalence of biased methods. We aimed to perform a meta-analysis on MIH-CP effect on ED visits, and to evaluate study designs' effect on reported effect sizes. We hypothesized biased methods would produce larger reported effect sizes. We searched Pubmed, Embase, CINAHL, and Scopus databases for peer-reviewed MIH-CP literature from January 1, 2000, to July 24, 2021. We included all full-text English studies whose program met the National Associations of Emergency Medical Technicians definition, reported ED visits, and had an MIH-CP related intervention and outcome. We established risk ratios for each included study through interpreting the reported data. We performed a random-effects and cumulative meta-analysis of ED visit data, tests of heterogeneity, and a moderator analysis to assess for factors influencing the magnitude of observed effect. We identified 16 studies that reported ED visit data and included 12 in our meta-analysis. All studies were observational; 3 used matched controls, 6 pre-post controls, and 3 without controls. 7 studies' intervention were diversion/triage while 5 studies intervened with health education/home primary care services. Pooled risk ratio for our data set was 0.56 (95% confidence interval 0.42–0.74). Cumulative meta-analysis revealed that as of 2018 MIH-CP programs began to show consistent reductions in ED visits. Significant heterogeneity was seen among studies, with I-squared >90%. Moderator analysis showed reduced heterogeneity for matched-control studies. Our data revealed MIH-CP programs were associated with a reduced risk of ED visits. Study design did not have a statistically significant influence on effect size, though it did influence heterogeneity. We would recommend future studies continue to use high levels of control to produce reliable data with lower heterogeneity. [ABSTRACT FROM AUTHOR]

Greater understanding of clinical decision thresholds may improve inappropriate testing and treatment of urinary tract infection (UTI). We used a survey of clinicians to examine UTI decision thresholds. Although overestimates of UTI occurred, testing and treatment thresholds were generally rational, were lower than previously reported, and differed by type of clinician. [ABSTRACT FROM AUTHOR]

Summary Nurses have a key role in ensuring that patients receive the right blood at the right time. This article discusses the importance of giving irradiated blood components to certain [...]

Cardiovascular disease is the leading cause of morbidity and mortality in the Western world. Monocyte-macrophages are crucial cells in atherogenesis. Several lines of evidence suggest that antioxidants, especially [alpha]-tocopherol, have beneficial effects with regard to cardiovascular disease. [alpha]-Tocopherol has beneficial effects on cell functions that are pivotal in atherogenesis. [alpha]-Tocopherol inhibits platelet aggregation and proinflammatory activity of monocytes. In vitro data also support an effect of [alpha]-tocopherol on smooth muscle cell proliferation and endothelial function. Finally, recent data support an effect of [alpha]-tocopherol on macrophage function. The mounting evidence from in vitro and in vivo studies provides a sound scientific basis for [alpha]-tocopherol supplementation. Further clinical trials are required, however, before a definitive recommendation can be made for primary and secondary prevention of heart disease. Key Words: cardiovascular disease, antioxidants, platelet aggregation, [alpha]-tocopherol

Virginia Woolf mapped a feminine terrain where language attempted to reproduce sensual impressions in her novel 'The Waves.' The book's characters discover language prevents their ability to acquire direct sensory experience, and come to understand that objects exist essentially when they are experienced rather than described. Woolf felt naming objects falsified them, and she wanted to live in a world where every thing and every person existed without artificiality.

Djuna Barnes' novel 'Nightwood' is the story of Dr. Matthew O'Conner, an unlicensed quack and a man of dubious sexual preferences. He is a transvestite who makes use of his position as a sexologist to study cases of lesbians and women of deviant sexual behavior. This he does to appease his own desire to be a woman. He tries to theorize that gender is neither completely masculine nor wholly feminine but a mixture of the two in varying proportions.

State laws governing recreational and medicinal cannabis use are trending toward legalization, which has implications for school social workers and the students, families, and communities they serve. The patchwork of policies and conflicting public opinion sends mixed messages to youth and families who may lack sufficient information regarding risks of adolescent cannabis use. This article will explore topics relevant to legalization of cannabis including medical versus recreational use, racial overtones in marijuana policy, effects on student cognitive development and mental health, child welfare involvement, disparities in school discipline, criminal record expungement, and school-based cannabis prevention programs. The article will conclude with a summary of recommendations for schools. This article is a product of the research conducted by the Health Education and Leadership Scholars planning team at the University of Illinois for a policy-practice conference that was cancelled due to COVID-19. [ABSTRACT FROM AUTHOR]

The 3-factor prothrombin complex concentrate (3FPCC) may be used off-label to treat refractory bleeding during cardiac surgery in children. This retrospective study examined the rate of clinical complications following the use of 3FPCC. Patients treated with 3FPCC were matched to controls for age, gender, prematurity, weight, cardiopulmonary bypass times, and cross-clamp times. Fifty-nine cases were individually matched to 59 controls based on propensity scores. 3FPCC was not associated with an increased risk of thromboembolic events, mortality, or need for postoperative extracorporeal membrane oxygenator support. These results suggest the safety of 3FPCC when used for refractory bleeding after cardiopulmonary bypass in children undergoing congenital heart surgery. [ABSTRACT FROM AUTHOR]

The Advisory Committee on the Safety of Blood, Tissues and Organs (SaBTO) decided that its 2011 recommendations on consent for blood transfusion needed to be reviewed and revised due to evidence of poor compliance and recent legal guidance on consent. The recommendations are to ensure that patients are informed about and understand the purpose, benefits and potential risks of transfusion, and have an opportunity to discuss their treatment options. They should be incorporated into local practices for all patients. [ABSTRACT FROM AUTHOR]

The article highlights role of nurses in Great Britain's National Health Service Blood and Transplant. It mentions that the centre has constant working environment than the mobile teams as their equipment do not need to be transported to a different venue; the role of national nursing and care quality team to manage new projects and induction training; and the Joint UK Blood Transfusion and Tissue Transplantation Services Professional Advisory Committee that provides donor selection guidelines.

Background: AABB surveyed AABB institutional members about their 2013 blood collection, transfusion, and patient blood management (PBM) programs. Results were compared with previous US national surveys.Study Design and Methods: The 2013 AABB Blood Collection, Utilization, and Patient Blood Management Survey was distributed to AABB blood centers (79) and hospitals (1068). Statistical procedures were used to estimate blood collection and transfusion.Results: Estimated whole blood (WB) and red blood cell (RBC) collections in 2013 totaled 13.6 million units, a 12.1% decrease from 15.5 million units in 2011 (p < 0.0001). Transfusions of WB and RBC units by AABB hospitals totaled 6.1 million units, 7.3% fewer compared to 2011 (p = 0.036). There was no change in overall platelet (PLT) distributions by blood collectors but WB-derived (WBD) PLT distributions increased significantly (27.1%, p < 0.0001). Transfusion of PLTs increased 15.4% totaling 1.3 million units (p = 0.0423), including increases in apheresis PLT (12.2%) and WBD PLT transfusions (30.7%). Distribution of plasma for transfusion declined 22.4% (p < 0.0001), while transfused plasma decreased only 9.9% (p = 0.036). Hospitals reduced outdated WB, RBC, and PLT components by 14.9% to 26.1% and wasted plasma components by 19.0%. PBM programs were reported by 37.8% of AABB hospitals.Conclusions: Compared to 2011, WB and RBC collections declined significantly in 2013 and disproportionately to the significant reductions in WB and RBC transfusions. Distributions of PLTs and plasma for transfusion declined in 2013, as did transfusions of plasma, while transfusion of PLTs increased significantly. Decreases in outdated and wasted components by hospitals suggest improvements in product and inventory management. Ongoing national surveys allow for trend analysis and are important for future planning. [ABSTRACT FROM AUTHOR]

Social rhythms, also known as daily routines (e.g. exercise, of school or work, recreation, social activities), have been identified as potential time cues to help to regulate the biological clock. Past research has shown links between regularity and healthy sleep. This study examined the regularity and frequency of daytime activities in a clinical insomnia population and a good sleeper comparison group. Participants ( N = 69) prospectively monitored their sleep and daily activities for a 2-week period. Although participants with insomnia and good sleepers had similar levels of activity, relative to good sleepers, those with insomnia were less regular in their activities. Findings from this study add to the growing number of studies that highlight the relative importance of the regularity of daytime activities on sleep. Accordingly, future research should test treatment components that focus on regulating daytime activities, which would likely improve treatment outcomes. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Oncology Nursing Journal is the property of Pappin Communications and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

As many as 90% of women who have undergone mastectomy or lumpectomy for breast cancer surgery will choose to wear a breast prosthesis. To date, there has been little systematic exploration of experiences and preferences related to wearing external breast pros- theses, especially with new products. For this qualitative descriptive study, 24 women were interviewed regarding their perspectives about the conventional breast prosthesis and 19 about their perspectives regarding a newly available custom-designed breast prosthesis. Women spoke about difficulties obtaining information regarding available breast prostheses options; the awkwardness of being measured and fitted for a prosthesis, especially with seemingly untrained staff; challenges in wearing an external prosthesis; and how a prosthesis can foster increased confidence, enhanced body image and self-esteem, and a sense of normalcy. All recommended that women must make an individual decision about wearing a breast prosthesis and emphasized how important it is to have information about options early in the cancer journey. The study findings can guide oncology nurses in educating women about breast prostheses. [ABSTRACT FROM AUTHOR]

The article presents information on the 19th century Italian American ballerina and dancer Giuseppina Morlacchi. It mentions that the Morlacchi Ballet toured the U.S. performing romantic and post-romantic dances. It includes information regarding the drama "The Scouts of the Prairie, And, Red Deviltry As It Is!," where Morlacchi appeared as the American Indian princess Dove Eye.

The extent to which humor and negative affect each predict different components of physical health was examined by having 105 participants complete measures of four distinct humor styles, negative affect, and three indices of physical health. An increased number of physical symptoms and more negative attitudes about illness were associated with higher levels of negative affect, but were unrelated to the humor styles. Conversely, three of the humor styles significantly predicted coping strategies for physical ailments and complaints, whereas negative affect did not. Adaptive self-enhancing humor was associated with facilitative coping strategies such as changing perspective, planning, and the effective use of humor. Maladaptive aggressive humor was linked to a more dysfunctional coping pattern that included greater denial and a reduction in the ability to change perspective. These findings reinforce the need to consider more complex models of humor that explicitly address the effects of both adaptive and maladaptive humor styles across a broad range of physical health measures while also considering effects that may be attributable to other highly-relevant attributes, such as negative affect. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Psychiatry is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The article offers information on the challenges faced by National Health Service Blood and Transport in blood donation and role of nurses in overcoming challenges including donor attendance, staff availability, venue accessibility and suitability, transport and communication. It mentions that need of up to 5000 people to donate blood to fulfill hospitals' demands to meet patients' needs.

The article overviews on nursing in National Health Service blood and transplantation (NHSBT) service. Topics discussed include information on NHSBT which aims to encouraging people to donate organs, blood, stem cells and tissues; information on therapeutic apheresis services (TAS) that provide life-saving and life-enhancing treatments using specialist technology; and role of NHSBT staff and donors to support donation and transplantation.

Cardiovascular disease is the leading cause of morbidity and mortality in the Western world. Monocyte-macrophages are crucial cells in atherogenesis. Several lines of evidence suggest that antiooxidants, especially α-tocopherol, have beneficial effects with regard to cardiovascular disease. α-Tocopherol has beneficial effects on cell functions that are pivotal in atherogenesis. α-Tocopherol inhibits platelet aggregation and proinflammatory activity of monocytes. In vitro data also support an effect of α-tocopherol on smooth muscle cell proliferation and endothelial fucntion. Finally, recent data support an effect of α-tocopherol on macrophage function. The mounting evidence from in vitro and in vivo studies provides a sound scientific basis for α-tocopherol supplementation. Further clinical trials are required, however, before a definitive recommenadtion can be made for primary and secondary prevention of heart disease. [ABSTRACT FROM AUTHOR]

Influenza hemagglutinin (HA) is considered a major protective antigen of seasonal influenza vaccine but antigenic drift of HA necessitates annual immunizations using new circulating HA versions. Low variation found within conserved non-HA influenza virus (INFV) antigens may maintain protection with less frequent immunizations. Conserved antigens of influenza A virus (INFV A) that can generate cross protection against multiple INFV strains were evaluated in BALB/c mice using modified Vaccinia virus Ankara (MVA)-vectored vaccines that expressed INFV A antigens hemagglutinin (HA), matrix protein 1 (M1), nucleoprotein (NP), matrix protein 2 (M2), repeats of the external portion of M2 (M2e) or as tandem repeats (METR), and M2e with transmembrane region and cytoplasmic loop (M2eTML). Protection by combinations of non-HA antigens was equivalent to that of subtype-matched HA. Combinations of NP and forms of M2e generated serum antibody responses and protected mice against lethal INFV A challenge using PR8, pandemic H1N1 A/Mexico/4108/2009 (pH1N1) or H5N1 A/Vietnam/1203/2004 (H5N1) viruses, as demonstrated by reduced lung viral burden and protection against weight loss. The highest levels of protection were obtained with NP and M2e antigens delivered as MVA inserts, resulting in broadly protective immunity in mice and enhancement of previous natural immunity to INFV A. [ABSTRACT FROM AUTHOR]

A 7.5 kb Kpnl-generated fragment, from within the rfb cluster of Salmonella typhimurium LT2 that encodes abequose synthase (the rfbJ gene) which is necessary for 04 antigen synthesis, and flanking sequences, was inserted into a suicide vector. Using allelic exchange techniques, these rfb sequences of S. typhimurium were integrated into the rfb clusters of wild-type Salmonella typhi Vi-positive strain ISP 1820 (i.e. serotype O9, 12; Vi+; H-d), S. typhi Vi-negative strain H400 (i.e. serotype O9, 12; Vi-; H-d), and a double aro mutant of S. typhi ISP 1820, strain CVD 906, resulting in the isolation of strains H325, H404 and CVD 906-04, respectively. Immunoblot analysis of lipopolysaccharide (LPS) purified from H325, H404 and CVD 906-04 demonstrated that these strains express the 04 antigen (an abequose residue) in place of the 09 antigen (a tyvelose residue) in the LPS molecule. Hence, the serotype of H325 is O4, 12; Vi+; H-d and the serotype of H404 is 04, 12; Vi-; H-d. DNA hybridization analysis of chromosomal DNA from H325, H404 and CVD 906-04 confirmed that a precise recombination event within sequences flanking rfbSE of S. typhi (which encodes the enzymes necessary for cytidine diphosphate-tyvelose synthesis) resulted in replacement of rfbSE with rfbJ (which encodes abequose synthase and is necessary for 04 synthesis) of S. typhimurium in strains H325, H404 and CVD 906-O4. The resistance of each strain to the bactericidal effects of guinea-pig serum (GPC) was assessed. Whereas ISP 1820, H325 and H404 exhibit similar resistance patterns in GPC, strain H400 is sensitive to the bactericidal effects of GPC. The results suggest that the development of the 0-antigen serotype diversity of Salmonella is probably the result of both sequence divergence and recombination betwe... [ABSTRACT FROM AUTHOR]

• TLR agonists in mice predominantly are stimulatory regardless of formulation (Alhydrogel or squalene) • Functional (toxin-neutralizing) antigen-specific antibodies are a functional subset of IgG antigen-specific serum antibodies. • Ratios for antigen-specific IgG1:IgG2a redirection in mice were established using quantitative ELISA achieving 1:1 for profound redirection effect, 10:1 for partial redirection and 40:1 for an Alhydrogel vaccine with no redirection. • Overall, an accelerated immunization regimen (2 immunizations 7 days apart) had less negative effect upon vaccines that contained CPG 7909. Toll-like receptor (TLR) agonists can act as immune stimulants alone or as part of alum or oil formulations. Humoral and cellular immune responses were utilized to assess quantitative and qualitative immune response enhancement by TLR agonists using recombinant protective antigen (rPA) of B. anthracis as a model antigen. To rPA, combined with aluminum hydroxide (Alhydrogel; Al(OH)3) or squalene (AddaVax™), was added one of 7 TLR agonists: TLR2 agonist Pam3CysSK4 (PamS), TLR3 agonist double stranded polyinosinic:polycytidylic acid (PolyIC), TLR4 agonists Monophosphoryl lipid A (MPLA) or glucopyranosyl lipid A (GLA), TLR7-8 agonists 3M−052 or Resiquimod (Resiq), or TLR9 agonist CPG 7909 (CPG). CD-1 or BALB/c mice received two intraperitoneal or intramuscular immunizations 14 days apart, followed by serum or spleen sampling 14 days later. All TLR agonists except PamS induced high levels of B. anthracis lethal toxin-neutralizing antibodies and immunoglobulin G (IgG) anti-PA. Some responses were >100-fold higher than those without a TLR agonist, and IP delivery (0.5 mL) induced higher TLR-mediated antibody response increases compared to IM delivery (0.05 mL). TLR7-8 and TLR9 agonists induced profound shifts of IgG anti-PA response to IgG2a or IgG2b. Compared to the 14-day immunization schedule, use of a shortened immunization schedule of only 7 days between prime and boost found that TLR9 agonist CPG in a squalene formulation maintained higher interferon-γ-positive cells than TLR4 agonist GLA. Variability in antibody responses was lower in BALB/c mice than CD-1 mice but antibody responses were higher in CD-1 mice. Lower serum 50% effective concentration (EC50) values were found for rPA-agonist formulations and squalene formulations compared to Al(OH)3 formulations. Lower EC50 values also were associated with low frequency detection of linear peptide epitopes. In summary, TLR agonists elicited cellular immune responses and markedly boosted humoral responses. [ABSTRACT FROM AUTHOR]