The In-Hospital Suicide: A Psychological Autopsy of a System Involving Borderline Dynamics

This manuscript reviews principles of hospital management in the care of severe borderline patients with concomitant affective syndromes. The case presented highlights a process of experiential learning in a novice clinician (a beginning psychiatric resident) and illustrates several critical areas of concern with these patients. The following four facets of clinical management are discussed: 1) Failed attempts to understand borderline dynamics and subsequent countertransference reactions; 2) Staff resistance to consistent, honest and open acknowledgement of suicide potential; 3) Special risks when borderline dynamics are combined with affective syndromes; and 4) Possible suicide preventive measures and their relative effectiveness

Response to rapidly changing healthcare information regarding COVID-19 with virtual journal club

Virtual twice weekly COVID-19 journal club (JC) created to optimize residency and faculty education regarding COVID-19 management, critical appraisal of new literature, and improve departmental collaboration and connection

Factors Associated with 5-Year Glaucomatous Progression in Glaucoma Suspect Eyes

Background: The US Preventive Services Task Force found that treatment of early asymptomatic primary open-angle glaucoma reduces visual field defects. However, it remains unclear which factors are associated with glaucomatous progression and which patients are at higher risk. The purpose of this study was to assess demographic factors, medical comorbidities, Humphrey visual field (VF) results, and Cirrus optical coherence tomography variables that could be predictive for 5-year glaucoma progression. Methods: A retrospective longitudinal study was conducted with the following inclusion criteria: glaucoma suspect eyes (defined as an asymmetric cup to disc ratio or an intraocular pressure \u3e21mmHg), best-corrected visual acuity 20/100 or better, spherical equivalent better than −8 diopters and astigmatism less than 3 diopters. Two consecutive abnormal VF tests during a 5-year follow-up was considered glaucomatous progression. Results: A total of 365 eyes (288 patients) were included in the study, of which 55 (15%) converted to glaucoma after 5 years. Logistic regression analysis showed that baseline mean deviation (MD), pattern standard deviation (PSD), VF index, and retinal nerve fiber layer (RNFL) colors were statistically significant in predicting 5-year glaucomatous progression. Though there were differences in glaucoma progression rates when analyzing sex, age, hypertension, diabetes mellitus, family history of glaucoma, and baseline intraocular pressure, these factors were not statistically significant. Conclusions: The study found that VF test results (MD and PSD) and RNFL colors can strongly predict which patients are at an increased risk of glaucoma progression. Clinicians can consider these factors when initiating, or continuing, prophylactic treatment for patients with glaucoma suspect eyes

5 Analytics Imperatives for 21st Century Population Health

Dr. Graham Hughes is the Chief Medical Officer within SAS Institute’s Center for Health Analytics & Insights. He is responsible for identifying and developing opportunities to create novel analytics solutions that help health and life science organizations improve care quality, clinical operations and patient outcomes. This forum presentation describes the difference between traditional healthcare business intelligence and a more comprehensive view of the spectrum of analytics. It discusses the importance of having an appreciation for how other industries leverage advanced analytics and how the same techniques can rapidly be applied to healthcare. Lastly, it identifies the 5 key analytic areas the healthcare organizations need to consider in the Population Health management initiatives. Presentation: 52 minutes PowerPoint slides at bottom of page

A standardised sampling protocol for robust assessment of reach-scale fish community diversity in wadeable New Zealand streams

The New Zealand fish fauna contains species that are affected not only by river system connectivity, but also by catchment and local-scale changes in landcover, water quality and habitat quality. Consequently, native fish have potential as multi-scale bioindicators of human pressure on stream ecosystems, yet no standardised, repeatable and scientifically defensible methods currently exist for effectively quantifying their abundance or diversity in New Zealand stream reaches. Here we report on the testing of a back-pack electrofishing method, modified from that used by the United States Environmental Protection Agency, on a wide variety of wadeable stream reaches throughout New Zealand. Seventy-three first- to third-order stream reaches were fished with a single pass over 150-345 m length. Time taken to sample a reach using single-pass electrofishing ranged from 1-8 h. Species accumulation curves indicated that, irrespective of location, continuous sampling of 150 stream metres is required to accurately describe reach-scale fish species richness using this approach. Additional species detection beyond 150 m was rare (<10%) with a single additional species detected at only two out of the 17 reaches sampled beyond this distance. A positive relationship was also evident between species detection and area fished, although stream length rather than area appeared to be the better predictor. The method tested provides a standardised and repeatable approach for regional and/or national reporting on the state of New Zealand's freshwater fish communities and trends in richness and abundance over time

Triethyl­ammonium bis­(2-oxido-2,2-diphenyl­acetato-κ2 O 1,O 2)anti­monate(III)

The coordination around the Sb atom in the title compound, (C6H16N)[Sb(C14H10O3)2], is fourfold in a pseudo-trigonal-bipyramidal pattern in which one of the equatorial sites is occupied by the stereoactive lone pair of electrons. The four ligating atoms comprise the hydoxylate and carboxyl­ate O atoms from two independent benzilate ligands, each of which forms a five-membered chelating ring, spanning an axial and an equatorial site about the Sb atom. The hydroxy­late atoms occupy the two equatorial sites, and the carboxyl­ate atoms are in the pseudo-axial sites; the O—Sb—O angle is 147.72 (5)°. One carboxyl­ate group shows quite different bond lengths from those of the other group; one O atom is clearly the carbonyl atom and the other O atom the hydroxy­late atom. In the other ligand, there is less distinction in the C—O bonds. This is presumably related to the carbonyl O atom being the acceptor atom of a strong N—H⋯O hydrogen bond, which links the ammonium cation to the Sb complex anion

Brain MRI in a patient with classical galactosemia: acute event of unilateral hemispheric cerebral edema

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Fake news on Facebook and their impact on supply chain disruption during COVID-19

Social media (SM) fake news has become a serious concern especially during COVID-19. In this study, we develop a research model to investigate to what extent SM fake news contributes to supply chain disruption (SCD), and what are the different SM affordances that contribute to SM fake news. To test the derived hypotheses with survey data, we have applied partial least square based structural equation modelling (PLS-SEM) technique. Further, to identify how different configurations of SC resilience (SCR) capabilities reduce SCD, we have used fuzzy set qualitative comparative analysis (fsQCA). The results show that SM affordances lead to fake news, which increases consumer panic buying (CPB); CPB in turn increases SCD. In addition, SM fake news directly increases SCD. The moderation test suggests that, SCR capability, as a higher-order construct, decreases the effect of CPB on SCD; however, neither of the capabilities individually moderates. Complimentarily, the fsQCA results suggest that no single capability but their three specific configurations reduce SCD. This work offers a new theoretical perspective to study SCD through SM fake news. Our research advances the knowledge of SCR from a configurational lens by adopting an equifinal means towards mitigating disruption. This research will also assist the operations and SC managers to strategize and understand which combination of resilience capabilities is the most effective in tackling disruptions during a crisis e.g., COVID-19. In addition, by identifying the relative role of different SM affordances, this study provides pragmatic insights into SM affordance measures that combat fake news on SM.publishedVersionPaid Open Acces

Cervical Radiculopathy: A Review

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