The costs of non-training in chronic wounds : estimates through practice simulation

The high prevalence and incidence rates of chronic wounds represent high financial costs for patients, families, health services, and for society in general. Therefore, the proper training of health professionals engaged in the diagnosis and treatment of these wounds can have a very positive impact on the reduction of costs. As technology advances rapidly, the knowledge acquired at school soon becomes outdated, and only through lifelong learning can skills be constantly updated. Information and Communication Technologies play a decisive role in this field. We have prepared a cost estimate model of Non-Training, using a Simulator (Web Based System – e-fer) for the diagnosis and treatment of chronic wounds. The preliminary results show that the costs involved in the diagnosis and treatment of chronic wounds are markedly higher in health professionals with less specialized training

Pressure injury in Australian public hospitals: a cost-of-illness study

Objective: Pressure injuries (PI) are largely preventable and can be viewed as an adverse outcome of a healthcare admission, yet they affect millions of people and consume billions of dollars in healthcare spending. The existing literature in Australia presents a patchy picture of the economic burden of PI on society and the health system. The aim of the present study was to provide a more comprehensive and updated picture of PI by state and severity using publicly available data. Methods: A cost-of-illness analysis was conducted using a prevalence approach and a 1-year time horizon based on data from the existing literature extrapolated using simulation methods to estimate the costs by PI severity and state subgroups. Results: The treatment cost across all states and severity in 2012–13 was estimated to be A$983 million per annum, representing approximately 1.9$820 million per annum. These estimates were associated with a total number of 121 645 PI cases in 2012–13 and a total number of 524 661 bed days lost. Conclusions: The costs estimated in the present study highlight the economic waste for the Australian health system associated with a largely avoidable injury. Wastage can also be reduced by preventing moderate injuries (Stage I and II) from developing into severe cases (Stage III and IV), because the severe cases, accounting for 12% of cases, mounted to 30% of the total cost

Survey of registered nurses’ selection of compression systems for the treatment of venous leg ulcers in the UK

Background: Venous leg ulceration is common in older adults in the United Kingdom. The gold-standard treatment is compression therapy. There are several compression bandage and hosiery systems that can be prescribed or purchased, but it was unclear what types of compression systems are currently being used to treat venous leg ulceration within the UK. This online scoping survey of registered nurses sought to (1) to identify what compression systems are available across the UK, (2) how frequently these are in use and (3) if there are any restrictions on their use. Results: The results showed that registered nurses who treat patients with venous leg ulceration use a wide range of compression systems. The most frequently used systems are the ‘less bulky’ two-layer elastic and inelastic compression bandaging systems whilst two-layer hosiery was used less frequently and four-layer bandaging used infrequently. Nurses report that certain compression systems are less accessible through the usual procurement routes but this appears to be related to concerns about competency in application techniques. Conclusions: The data in this survey provides some important insights into the issues around the use of compression therapy for venous leg ulceration in the UK. Limiting access to certain types of compression may promote patient safety but limit patient choice. There may be underuse of the types of compression that promote patient independence, such as hosiery, and over-use of potentially sub-therapeutic therapy such as ‘reduced compression’. Overall, this study suggests that further consideration is needed about the provision of compression therapy to UK patients with venous leg ulceration to optimise care and patient choice

Effect of androgen treatment during foetal and/or neonatal life on ovarian function in prepubertal and adult rats

We investigated the effects of different windows of testosterone propionate (TP) treatment during foetal and neonatal life in female rats to determine whether and when excess androgen exposure would cause disruption of adult reproductive function. Animals were killed prepubertally at d25 and as adults at d90. Plasma samples were taken for hormone analysis and ovaries serial sectioned for morphometric analyses. In prepubertal animals, only foetal+postnatal and late postnatal TP resulted in increased body weights, and an increase in transitory, but reduced antral follicle numbers without affecting total follicle populations. Treatment with TP during both foetal+postnatal life resulted in the development of streak ovaries with activated follicles containing oocytes that only progressed to a small antral (smA) stage and inactive uteri. TP exposure during foetal or late postnatal life had no effect upon adult reproductive function or the total follicle population, although there was a reduction in the primordial follicle pool. In contrast, TP treatment during full postnatal life (d1-25) resulted in anovulation in adults (d90). These animals were heavier, had a greater ovarian stromal compartment, no differences in follicle thecal cell area, but reduced numbers of anti-Mullerian hormone-positive smA follicles when compared with controls. Significantly reduced uterine weights lead reduced follicle oestradiol production. These results support the concept that androgen programming of adult female reproductive function occurs only during specific time windows in foetal and neonatal life with implications for the development of polycystic ovary syndrome in women

Historical review of efforts to reduce noise‐induced hearing loss in the United States

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/137565/1/ajim22627.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/137565/2/ajim22627_am.pd

Author Correction: Genome-wide association study of self-reported walking pace suggests beneficial effects of brisk walking on health and survival.

A Correction to this paper has been published: https://doi.org/10.1038/s42003-020-01447-6

Near real-time vaccine safety surveillance using electronic health records-a systematic review of the application of statistical methods.

PURPOSE: Pre-licensure studies have limited ability to detect rare adverse events (AEs) to vaccines, requiring timely post-licensure studies. With the increasing availability of electronic health records (EHR) near real-time vaccine safety surveillance using these data has emerged as an option. We reviewed methods currently used to inform development of similar systems for countries considering their introduction. METHODS: Medline, EMBASE and Web of Science were searched, with additional searches of conference abstract books. Questionnaires were sent to organizations worldwide to ascertain unpublished studies. Eligible studies used EHR and regularly assessed pre-specified AE to vaccine(s). Key features of studies were compared descriptively. RESULTS: From 2779 studies, 31 were included from the USA (23), UK (6), and Taiwan and New Zealand (1 each). These were published/conducted between May 2005 and April 2015. Thirty-eight different vaccines were studied, focusing mainly on influenza (47.4%), especially 2009 H1N1 vaccines. Forty-six analytic approaches were used, reflecting frequency of EHR updates and the AE studied. Poisson-based maximized sequential probability ratio test was the most common (43.5%), followed by its binomial (23.9%) and conditional versions (10.9%). Thirty-seven of 49 analyses (75.5%) mentioned control for confounding, using an adjusted expected rate (51.4% of those adjusting), stratification (16.2%) or a combination of a self-controlled design and stratification (13.5%). Guillain-Barré syndrome (11.9%), meningitis/encephalitis/myelitis (11.9%) and seizures (10.8%) were studied most often. CONCLUSIONS: Near real-time vaccine safety surveillance using EHR has developed over the past decade but is not yet widely used. As more countries have access to EHR, it will be important that appropriate methods are selected, considering the data available and AE of interest

Hypogammaglobulinemia with Facial Edema

Knight and colleagues discuss the diagnosis and management of a 35-year-old man with a past history of recurrent cellulitis and otitis media and a two-year history of facial swelling

Mesoscale physical–biological–biogeochemical linkages in the open ocean : an introduction to the results of the E-Flux and EDDIES programs

Author Posting. © Elsevier B.V., 2008. This is the author's version of the work. It is posted here by permission of Elsevier B.V. for personal use, not for redistribution. The definitive version was published in Deep Sea Research Part II: Topical Studies in Oceanography 55 (2008): 1133-1138, doi:10.1016/j.dsr2.2008.03.001.Mesoscale currents, fronts, and eddies are ubiquitous and energetic features of ocean circulation. These phenomena, sometimes referred to as the “internal weather of the sea,” accommodate a diverse set of physical, chemical, and biological interactions that influence marine biogeochemistry on a wide range of timescales. These biogeochemical processes include the “biological pump”, i.e. the transfer or flux of biologically produced organic matter and associated elements from the surface ocean to depth (Ducklow et al., 2001; Volk and Hoffert, 1985). Within ~ 80% of the world’s oceans, the productivity and species composition of the autotrophic organisms that contribute to the biological pump are typically limited by major nutrients (e.g. nitrogen, phosphorus, and silica), or trace metals (e.g. iron). Primary production in such oligotrophic regions therefore depends mostly on intense recycling of nutrients within the surface sunlit waters, with only a small fraction supported by that entering from the atmosphere, or from the physical transport of nutrients from nutrient-rich deep waters below. Evidence that mesoscale and submesoscale phenomena play a role in the latter process dates back more than two decades (Angel and Fasham, 1983; Franks et al., 1986; Ring Group, 1981; Tranter et al., 1980; Venrick, 1990; Woods, 1988).E-Flux and EDDIES were supported by the National Science Foundation Chemical, Biological, and Physical Oceanography Programs. Additional support for the EDDIES project was provided by NASA

Menthol Suppresses Nicotinic Acetylcholine Receptor Functioning in Sensory Neurons via Allosteric Modulation

In this study, we have investigated how the function of native and recombinant nicotinic acetylcholine receptors (nAChRs) is modulated by the monoterpenoid alcohol from peppermint (−) menthol. In trigeminal neurons (TG), we found that nicotine (75 μM)-activated whole-cell currents through nAChRs were reversibly reduced by menthol in a concentration-dependent manner with an IC50 of 111 μM. To analyze the mechanism underlying menthol's action in more detail, we used single channel and whole-cell recordings from recombinant human α4β2 nAChR expressed in HEK tsA201 cells. Here, we found a shortening of channel open time and a prolongation of channel closed time, and an increase in single channel amplitude leading in summary to a reduction in single channel current. Furthermore, menthol did not affect nicotine's EC50 value for currents through recombinant human α4β2 nAChRs but caused a significant reduction in nicotine's efficacy. Taken together, these findings indicate that menthol is a negative allosteric modulator of nAChRs