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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.

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]

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