The Impact Of Hospital Nursing Resources On Postsurgical Outcomes For Patients With Opioid Use Disorder

Opioid use disorder (OUD) is common, with the rate of opioid-related hospitalizations doubling from 2006 to 2016. Surgical patients with OUD are at significantly higher risk of prolonged length of stay, in-hospital mortality, and readmission. Postoperative care for patients with OUD is particularly challenging for nurses whose responsibilities include pain and withdrawal management, care team coordination, patient assessment, and patient teaching. A large body of evidence suggests better outcomes for surgical patients when they are cared for in hospitals with strong nursing resources. This study sought to determine whether variations in nursing resources (i.e., education, staffing, and work environment) were associated with postsurgical outcomes (i.e., length of stay, in-hospital 30-day mortality, and 7, 30, 60, and 90-day readmission) for patients with and without OUD (Aim 1). This cross-sectional analysis leveraged 2015-2016 data of nurse survey responses, patient discharge abstracts, and hospital characteristics. The final sample included 919,601 patients across 448 hospitals in California, Florida, New Jersey, and Pennsylvania. Logistic and zero truncated negative binomial regression models were used to estimate the relationships between nursing resources and surgical patient outcomes. After adjustments, we found that each 10% increase in the proportion of bachelors-educated nurses was associated with lower odds of readmission at 7 (OR 0.95, p-value = 0.001), 30 OR 0.95, p-value \u3c0.001), 60 (OR 0.95, p-value \u3c0.001), and 90 (OR 0.95, p-value \u3c0.001) days for all surgical patients, and that this effect was even stronger for surgical patients with OUD (i.e., 15% lower odds for 7-day readmission; 16% for 30-day readmission; 14% for 60-day readmission; and 14% for 90-day readmission). In adjusted models, we also found that each additional patient-per-nurse was associated with higher odds of readmission for surgical patients with OUD (i.e., 13% higher odds for 7-day readmission and 10% for 30-day readmission). A substantial proportion of surgical patients with OUD are readmitted, and the odds of readmission are lessened when these patients are cared for in hospitals with better nurse education and staffing. Findings from this study can inform organizational strategies to reduce readmissions following needed surgical care for people already suffering from OUD

Prevalence and correlates of cryptococcal antigen positivity among AIDS patients--United States, 1986-2012.

Cryptococcal meningitis (CM) is one of the leading opportunistic infections associated with human immunodeficiency virus (HIV) infection. The worldwide burden of CM among persons living with HIV/acquired immunodeficiency syndrome (AIDS) was estimated in 2009 to be 957,900 cases, with approximately 624,700 deaths annually. The high burden of CM globally comes despite the fact that cryptococcal antigen (CrAg) is detectable weeks before the onset of symptoms, allowing screening for cryptococcal infection and early treatment to prevent CM and CM-related mortality (2). However, few studies have been conducted in the United States to assess the prevalence of cryptococcal infection. To quantify the prevalence of undiagnosed cryptococcal infection in HIV-infected persons in the United States during 1986-2012, stored sera from 1,872 participants in the Multicenter AIDS Cohort Study and the Women's Interagency HIV Study with CD4 T-cell counts <100 cells/µL were screened for CrAg, using the CrAg Lateral Flow Assay (LFA) (Immy, Inc.). This report describes the results of that analysis, which indicated the overall prevalence of CrAg positivity in this population to be 2.9% (95% confidence interval [CI] = 2.2%-3.7%)

Heat shock-induced phosphorylation of TAR DNA-binding protein 43 (TDP-43) by MAPK/ERK kinase regulates TDP-43 function

TAR DNA-binding protein (TDP-43) is a highly conserved and essential DNA- and RNA-binding protein that controls gene expression through RNA processing, in particular, regulation of splicing. Intracellular aggregation of TDP-43 is a hallmark of amyotrophic lateral sclerosis and ubiquitin-positive frontotemporal lobar degeneration. This TDP-43 pathology is also present in other types of neurodegeneration including Alzheimer's disease. We report here that TDP-43 is a substrate of MEK, a central kinase in the MAPK/ERK signaling pathway. TDP-43 dual phosphorylation by MEK, at threonine 153 and tyrosine 155 (p-T153/Y155), was dramatically increased by the heat shock response (HSR) in human cells. HSR promotes cell survival under proteotoxic conditions by maintaining protein homeostasis and preventing protein misfolding. MEK is activated by HSR and contributes to the regulation of proteome stability. Phosphorylated TDP-43 was not associated with TDP-43 aggregation, and p-T153/Y155 remained soluble under conditions that promote protein misfolding. We found that active MEK significantly alters TDP-43-regulated splicing and that phosphomimetic substitutions at these two residues reduce binding to GU-rich RNA. Cellular imaging using a phospho-specific p-T153/Y155 antibody showed that phosphorylated TDP-43 was specifically recruited to the nucleoli, suggesting that p-T153/Y155 regulates a previously unappreciated function of TDP-43 in the processing of nucleolar-associated RNA. These findings highlight a new mechanism that regulates TDP-43 function and homeostasis through phosphorylation and, therefore, may contribute to the development of strategies to prevent TDP-43 aggregation and to uncover previously unexplored roles of TDP-43 in cell metabolism

Psychological aspects of the alien contact experience

Previous research has shown that people reporting contact with aliens, known as “experiencers”, appear to have a different psychological profile compared to control participants. They show higher levels of dissociativity, absorption, paranormal belief and experience, and possibly fantasy proneness. They also appear to show greater susceptibility to false memories as assessed using the Deese/Roediger-McDermott technique. The present study reports an attempt to replicate these previous findings as well as assessing tendency to hallucinate and self-reported incidence of sleep paralysis in a sample of 19 UK-based experiencers and a control sample matched on age and gender. Experiencers were found to show higher levels of dissociativity, absorption, paranormal belief, paranormal experience, self-reported psychic ability, fantasy proneness, tendency to hallucinate, and self-reported incidence of sleep paralysis. No significant differences were found between the groups in terms of susceptibility to false memories. Implications of the results are discussed and suggestions are made for future avenues of research. Santomauroa, Hamiltona, Rachel Foxa, Thalbourne

Faculty Recital Series: Sonneries Woodwind Quintet: Kim Risinger, Flute; Jillian Kouzel, Oboe; David Gresham, Clarinet; Rachel Hockenberry, French Horn; Midori Samson, Bassoon; February 13, 2023

Kemp Recital HallFebruary 13, 2023Monday Evening7:00 p.m

Preventing type 2 diabetes:A research agenda for behavioural science

Aims The aim of this narrative review was to identify important knowledge gaps in behavioural science relating to type 2 diabetes prevention, to inform future research in the field. Methods Seven researchers who have published behaviour science research applied to type 2 diabetes prevention independently identified several important gaps in knowledge. They met to discuss these and to generate recommendations to advance research in behavioural science of type 2 diabetes prevention. Results A total of 21 overlapping recommendations for a research agenda were identified. These covered issues within the following broad categories: (a) evidencing the impact of whole population approaches to type 2 diabetes prevention, (b) understanding the utility of disease-specific approaches to type 2 diabetes prevention such as Diabetes Prevention Programmes (DPPs) compared to generic weight loss programmes, (c) identifying how best to increase reach and engagement of DPPs, whilst avoiding exacerbating inequalities, (d) the need to understand mechanism of DPPs, (e) the need to understand how to increase maintenance of changes as part of or following DPPs, (f) the need to assess the feasibility and effectiveness of alternative approaches to the typical self-regulation approaches that are most commonly used, and (g) the need to address emotional aspects of DPPs, to promote effectiveness and avoid harms. Conclusions There is a clear role for behavioural science in informing interventions to prevent people from developing type 2 diabetes, based on strong evidence of reach, effectiveness and cost-effectiveness. This review identifies key priorities for research needed to improve existing interventions

Chronic Hospital Nurse Understaffing Meets COVID-19

A study of hospitals in New York and Illinois at the start of the COVID-19 pandemic found that most did not meet benchmark patient-to-nurse staffing ratios for medical-surgical or intensive care units. New York City hospitals had especially low staffing ratios. Understaffed hospitals were associated with less job satisfaction among nurses, unfavorable grades for patient safety and quality of care, and hesitance by nurses and patients to recommend their hospitals

The Grizzly, April 23, 2015

Mayday Concert Returning • Not on My Campus Campaign Launches • Student Art Show to Open on CoSA Day • Elections Results • Holocaust Survivor to Share Her Story to Campus • CoSA Spurs Second Annual Creative Exchange in Myrin • CoSA to Celebrate Wide Variety of Student Work • Opinion: Crigler Beneficial But Needs Improvements; What Makes Crigler Worthwhile for Students? • Sibling Stickhandlers Stayed Side by Side • UCWR Sticks it to Gender Normshttps://digitalcommons.ursinus.edu/grizzlynews/1932/thumbnail.jp