Exploring the relationship between volunteering and hospice sustainability in the UK:A theoretical model

Aim: To explore the relationship between volunteering and the sustainability of UK voluntary hospices.Methods: A narrative literature review was conducted to inform the development of a theoretical model. Eight databases were searched: CINAHL (EBSCO), British Nursing Index, Intute: Health and Life Sciences, ERIC, SCOPUS, ASSIA (CSA), Cochrane Library and Google Scholar.Results: A total of 90 documents were analysed. Emerging themes included the importance of volunteering to the hospice economy and workforce, the quality of services, and public and community support. Findings suggest that hospice sustainability is dependent on volunteers; however, the supply and retention of volunteers is affected by internal and external factors.Conclusions: A theoretical model was developed to illustrate the relationship between volunteering and hospice sustainability. It demonstrates the factors necessary for hospice sustainability and the reciprocal impact that these factors and volunteering have on each other. The model has a practical application as an assessment framework and strategic planning tool

An evaluation of membrane properties and process characteristics of a scaled-up pressure retarded osmosis (PRO) process

YesThis work presents a systematic evaluation of the membrane and process characteristics of a scaled-up pressure retarded osmosis (PRO). In order to meet pre-defined membrane economic viability ( ≥ 5 W/m2), different operating conditions and design parameters are studied with respect to the increase of the process scale, including the initial flow rates of the draw and feed solution, operating pressure, membrane permeability-selectivity, structural parameter, and the efficiency of the high-pressure pump (HP), energy recovery device (ERD) and hydro-turbine (HT). The numerical results indicate that the performance of the scaled-up PRO process is significantly dependent on the dimensionless flow rate. Furthermore, with the increase of the specific membrane scale, the accumulated solute leakage becomes important. The membrane to achieve the optimal performance moves to the low permeability in order to mitigate the reverse solute permeation. Additionally, the counter-current flow scheme is capable to increase the process performance with a higher permeable and less selectable membrane compared to the co-current flow scheme. Finally, the inefficiencies of the process components move the optimal APD occurring at a higher dimensionless flow rate to reduce the energy losses in the pressurization and at a higher specific membrane scale to increase energy generation

Differential Analysis of Ovarian and Endometrial Cancers Identifies a Methylator Phenotype

Despite improved outcomes in the past 30 years, less than half of all women diagnosed with epithelial ovarian cancer live five years beyond their diagnosis. Although typically treated as a single disease, epithelial ovarian cancer includes several distinct histological subtypes, such as papillary serous and endometrioid carcinomas. To address whether the morphological differences seen in these carcinomas represent distinct characteristics at the molecular level we analyzed DNA methylation patterns in 11 papillary serous tumors, 9 endometrioid ovarian tumors, 4 normal fallopian tube samples and 6 normal endometrial tissues, plus 8 normal fallopian tube and 4 serous samples from TCGA. For comparison within the endometrioid subtype we added 6 primary uterine endometrioid tumors and 5 endometrioid metastases from uterus to ovary. Data was obtained from 27,578 CpG dinucleotides occurring in or near promoter regions of 14,495 genes. We identified 36 locations with significant increases or decreases in methylation in comparisons of serous tumors and normal fallopian tube samples. Moreover, unsupervised clustering techniques applied to all samples showed three major profiles comprising mostly normal samples, serous tumors, and endometrioid tumors including ovarian, uterine and metastatic origins. The clustering analysis identified 60 differentially methylated sites between the serous group and the normal group. An unrelated set of 25 serous tumors validated the reproducibility of the methylation patterns. In contrast, >1,000 genes were differentially methylated between endometrioid tumors and normal samples. This finding is consistent with a generalized regulatory disruption caused by a methylator phenotype. Through DNA methylation analyses we have identified genes with known roles in ovarian carcinoma etiology, whereas pathway analyses provided biological insight to the role of novel genes. Our finding of differences between serous and endometrioid ovarian tumors indicates that intervention strategies could be developed to specifically address subtypes of epithelial ovarian cancer

Potty Politics: The Biopolitical and Bioeconomic Implications of Sanitation Infrastructure Mega-Projects in Cairo, Mumbai, and Shanghai

In the last decade, Egypt, India, and China have all declared national sanitation for all campaigns, building large-scale sanitation systems and millions of toilets as a solution to the persistent crisis of controlling surplus human waste. Scholars and journalists have heralded these initiatives as major modernization projects. At its core, the conception of sanitation as a marker of modernization has been centered around the need to contain the stench and surplus of human waste, and in public health fears about excreta related infectious diseases that would render bodies unproductive. Across Trip Advisor ratings to policy making discourses, stench and fear are always at the center of concern around who and what is excessive or out of place, and how they are to be controlled. “Potty Politics,” is an interdisciplinary transnational examination of sanitation projects as sites of biopolitical and bioeconomic state regulation in three global mega-cities: Cairo, Mumbai, and Shanghai. All three cities are sites of vast inequality, with 40-60% of the population living in informal settlements which are sites of poor sanitation, as well as intense surveillance, in increasingly authoritarian nationalist states. “Potty Politics” centers the experiences of stigmatized and overlooked populations in both the colonial and contemporary moment who work on the street, such as fruit vendors in Cairo, third-gender hijras in Mumbai, and militarized sex-workers in British colonial cantonments, as they navigate sanitary landscapes that criminalize poverty and inflict bodily violence. I illustrate how the threat or symbolic inclusion of these neglected populations is used by the state to pursue social and urban cleansing, clearing the way for capitalist urban development and nationalist fervor. Control over who or what is excessive has led to justifications for invasive new measures embedded in sanitation projects, such as toilets that automate fecal analysis in the bowl, YouTube channels exposing public urinators, #NoLooNoIDo social media campaigns, and facial recognition cameras in public toilets. Taken together, these examples of state and community regulation and enforcement mechanisms reveal that sanitation for all projects are not ultimately about providing public works provisions for the public good. I use interdisciplinary methods including interviews, discourse analysis, participant observation, and toilet mapping to demonstrate how logics of modernization, morality, and risk are used to extend state control over bodies and public spaces through these sanitation and hygiene campaigns. Through extensive multi-sited fieldwork conducted in four countries, I explore how these projects impact community socialities, while also capturing human feces as a source of capital and biodata. I contend that the collection of human waste facilitates state participation in emerging speculative and existing material bioeconomies of excrement, and incorporates wastewater surveillance within an expanding security architecture. In addition to exploring sanitary projects in the contemporary moment, “Potty Politics” also offers an alternative history of the biopolitics of sanitation in the colonial period in Cairo, Mumbai, and Shanghai

Capacitance analysis for volume reduction based on integrated buck and buck-boost LED driver

This work was supported in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES/PROEX) - Finance Code 001, PRPG/UFSM, INCT-GD, CAPES proc 23038.000776/2017-54, CNPQ proc 465640/2014-1 and FAPERGS proc 17/2551-0000517-1 and in part by the Spanish government under grants PID2019-105568RB-I00 and TED2021-129372B-I00

A qualitative study exploring perceptions and attitudes of community pharmacists about extended pharmacy services in Lahore, Pakistan

Background In recent decades, community pharmacies reported a change of business model, whereby a shift from traditional services to the provision of extended roles was observed. However, such delivery of extended pharmacy services (EPS) is reported from the developed world, and there is scarcity of information from the developing nations. Within this context, the present study was aimed to explore knowledge, perception and attitude of community pharmacists (CPs) about EPS and their readiness and acceptance for practice change in the city of Lahore, Pakistan. Methods A qualitative approach was used to gain an in-depth knowledge of the issues. By using a semi-structured interview guide, 12 CPs practicing in the city of Lahore, Pakistan were conveniently selected. All interviews were audio-taped, transcribed verbatim, and were then analyzed for thematic contents by the standard content analysis framework. Results Thematic content analysis yielded five major themes. (1) Familiarity with EPS, (2) current practice of EPS, (3) training needed to provide EPS, (4) acceptance of EPS and (5) barriers toward EPS. Majority of the CPs were unaware of EPS and only a handful had the concept of extended services. Although majority of our study respondents were unaware of pharmaceutical care, they were ready to accept practice change if provided with the required skills and training. Lack of personal knowledge, poor public awareness, inadequate physician-pharmacist collaboration and deprived salary structures were reported as barriers towards the provision of EPS at the practice settings. Conclusion Although the study reported poor awareness towards EPS, the findings indicated a number of key themes that can be used in establishing the concept of EPS in Pakistan. Over all, CPs reported a positive attitude toward practice change provided to the support and facilitation of health and community based agencies in Pakistan

Commentary on: Attafi IM, Albeishy MY, Oraiby ME, Khardali IA, Shaikhain GA, Fageeh MM. Postmortem Distribution of Cathinone and Cathine in Human Biological Specimens in a Case of Death Associated wit

The interpretation of post-mortem human tissue toxicology levels may be affected by the sampling site chosen. It is important to bear this in mind when looking at the psychoactive constituents of khat (Catha edulis Forsk) that have been consumed and have contributed to or caused death.The post-mortem levels of cathine, cathinone and norephedrine/ norpseudoephedrine are very rarely reported, thereby making it impossible for toxicologists, pathologists and others investigating khat-related fatalities to decide if a level is toxic or fatal. This paper presents all the published data that exists to help start documenting this neglected area. Such information should be collected and reported on a systematic basis to facilitate correct interpretations in the future

Pharmacovigilance Signals of the Opioid Epidemic over 10 Years: Data Mining Methods in the Analysis of Pharmacovigilance Datasets Collecting Adverse Drug Reactions (ADRs) Reported to EudraVigilance (EV) and the FDA Adverse Event Reporting System (FAERS)

© 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).In the past twenty years, the consumption of opioid medications has reached significant proportions, leading to a rise in drug misuse and abuse and increased opioid dependence and related fatalities. Thus, the purpose of this study was to determine whether there are pharmacovigilance signals of abuse, misuse, and dependence and their nature for the following prescription opioids: codeine, dihydrocodeine, fentanyl, oxycodone, pentazocine, and tramadol. Both the pharmacovigilance datasets EudraVigilance (EV) and the FDA Adverse Events Reporting System (FAERS) were analyzed to identify and describe possible misuse-/abuse-/dependence-related issues. A descriptive analysis of the selected Adverse Drug Reactions (ADRs) was performed, and pharmacovigilance signal measures (i.e., reporting odds ratio, proportional reporting ratio, information component, and empirical Bayesian geometric mean) were computed for preferred terms (PTs) of abuse, misuse, dependence, and withdrawal, as well as PTs eventually related to them (e.g., aggression). From 2003 to 2018, there was an increase in ADR reports for the selected opioids in both datasets. Overall, 16,506 and 130,293 individual ADRs for the selected opioids were submitted to EV and FAERS, respectively. Compared with other opioids, abuse concerns were mostly recorded in relation to fentanyl and oxycodone, while tramadol and oxycodone were more strongly associated with drug dependence and withdrawal. Benzodiazepines, antidepressants, other opioids, antihistamines, recreational drugs (e.g., cocaine and alcohol), and several new psychoactive substances, including mitragynine and cathinones, were the most commonly reported concomitant drugs. ADRs reports in pharmacovigilance databases confirmed the availability of data on the abuse and dependence of prescription opioids and should be considered a resource for monitoring and preventing such issues. Psychiatrists and clinicians prescribing opioids should be aware of their misuse and dependence liability and effects that may accompany their use, especially together with concomitant drugs.Peer reviewedFinal Published versio

Focus on Over-the-Counter Drugs' Misuse: A Systematic Review on Antihistamines, Cough Medicines, and Decongestants

Background: Over the past 20 years or so, the drug misuse scenario has seen the emergence of both prescription-only and over-the-counter (OTC) medications being reported as ingested for recreational purposes. OTC drugs such as antihistamines, cough/cold medications, and decongestants are reportedly the most popular in being diverted and misused. Objective: While the current related knowledge is limited, the aim here was to examine the published clinical data on OTC misuse, focusing on antihistamines (e.g., diphenhydramine, promethazine, chlorpheniramine, and dimenhydrinate), dextromethorphan (DXM)- and codeine-based cough medicines, and the nasal decongestant pseudoephedrine. Methods: A systematic literature review was carried out with the help of Scopus, Web of Science databases, and the related gray literature. For data gathering purposes, both the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and PROSPERO guidelines were followed (PROSPERO identification code CRD42020209261). Results: After completion of the selection, eligibility, and screening phases, some 92 articles were here taken into consideration; case reports, surveys, and retrospective case series analyses were included. Findings were organized according to the specific OTC recorded. Most articles focused here on DXM (n = 54) and diphenhydramine (n = 12). When specified, dosages, route(s) of administration, toxicity symptoms (including both physical and psychiatric ones), and outcomes were here reported. Conclusion: Results from the systematic review showed that the OTC misusing issues are both widespread worldwide and popular; vulnerable categories include adolescents and young adults, although real prevalence figures remain unknown, due to a lack of appropriate monitoring systems. Considering the potential, and at times serious, adverse effects associated with OTC misusing issues, healthcare professionals should be vigilant, and ad hoc preventative actions should be designed and implemented

New psychoactive substances and suicidality: A systematic review of the current literature

Background and Objectives: Over the past twenty years a large number of new psychoactive substances (NPS) have entered and modified the recreational drug scene. Their intake has been associated with health-related risks, especially so for vulnerable populations such as people with severe mental illness, who might be at higher risk of suicidality or self-injurious behavior. This paper aims at providing an overview of NPS abuse and the effects on mental health and suicidality issues, by performing a literature review of the current related knowledge, thereby identifying those substances that, more than others, are linked to suicidal behaviors. Materials and Methods: A comprehensive and updated overview of the literature regarding suicidality and NPS categories has been undertaken. An electronic search was performed, including all papers published up to March 2021, using the following keywords "NPS" OR "new psychoactive substances" OR "novel psychoactive substances" OR "synthetic cannabinoids" OR "phenethylamines" OR "synthetic cathinones" OR "tryptamines" OR "piperazines" OR "new synthetic opioids" OR "designer benzodiazepines" AND ("suicide" OR "suicidality") NOT review NOT animal on the PubMed, Cochrane Library, and Web of Science online databases. Results: Suicidality and self-injurious behavior appear to be frequently associated with some NPS such as cathinones, synthetic cannabinoids, and new synthetic opioids. The results are organized according to the substances recorded. Conclusion: The growing use of NPS has become a significant clinical issue, causing increasing concern and challenges for clinicians working in both mental health and emergency departments. Thus, considering the associations between NPS and suicidality or self-injurious behaviors, areas where suicide-prevention efforts and strategies might be focused are the early detection, monitoring, and restriction of NPS