Development of a Delirium Educational Program for Hospital Medicine Providers

Hospital medicine providers were surveyed to evaluate baseline delirium attitudes and behaviors. An educational program was then shared, and a follow up survey was given to determine if their delirium attitudes and practices were impacted by the educational intervention. Follow up survey results indicated that providers perceived more of a change in their attitudes than practices, and overall found the education to be useful and felt more confident in treating delirium as a result

Politics and Policy of the Falling Birth Rate in Italy: Predictions and Concerns

The birth rate in Italy had been a topic of concern for the past couple decades, making it a source of conversation and debate among political parties and candidates in Italy. With the election of a new Italian government and the prediction of Giorgia Meloni being Italy’s new prime minister, how Meloni and her party have spoken of and plan to tackle the falling birth rate is a discussion occurring around the world. The falling birth rate was concerning to country leaders prior to the start of the COVID-19 pandemic, but statistics show that the Italian birth rate has fallen even more since the virus first struck the country. The most recent calendar year of 2021 was marked by another decline in birth rate with only 399,431 births, which is the lowest yearly rate seen since the unification of the country in 1861. Because of this continued decline, population growth in large Italian cities, as well as in small towns and villages has been a major goal for the Italian government in recent years. This post was originally published on the Cardozo International & Comparative Law Review on January 19, 2023. The original post can be accessed via the Archived Link button above

To Spain and Back: Changing Roles and Identities of Ecuadorian Female Migrants

In the late 1990s and early 2000s, Ecuadorian migration to Spain expanded due to economic and political push and pull factors between the two countries. Through the feminization of migration, women came to represent approximately half of all Ecuadorian migrants in Spain. During the migration process, women who lived in Spain experienced reconfigured identities with respect to their roles as migrants, employees, wives, and mothers. Beginning in 2008, the economic crisis and rampant unemployment in Spain forced many Ecuadorian migrants to return to their native country. As women came home to Ecuador, they reconciled the migration experience with their transition back to Ecuador. This paper focuses on the migration and return processes for Ecuadorian women and examines the challenges and opportunities that females confront with respect to identity reconfiguration when they are abroad and when they come home to Ecuador. Additionally, this paper highlights to what extent public and private organizations in Ecuador provide opportunities for support for Ecuadorian women when they return from Spain. Analysis is based on qualitative research stemming from 24 interviews: eight conducted via internet with Ecuadorian migrant women living in Spain, ten with Ecuadorian migrant women returned from Spain and living in Quito, and six with representatives from Ecuadorian government offices and NGOs offering programs for returned migrants. This research emphasizes the need for readjustment support for returned migrant women to facilitate sustained empowerment throughout their return to Ecuador

Does hypercoagulopathy testing benefit patients with DVT?

There is no evidence to suggest that testing for hypercoagulopathy benefits most patients with deep venous thrombosis (DVT). Nor has research established that thrombophilia test results improve the ability to predict recurrence better than clinical risk assessment alone (strength of recommendation [SOR]: B, multiple cohort studies)

A Social-Ecological systems perspective on water management in South Africa

Conventional approaches to water management have traditionally treated social systems and ecosystems as distinct, and to a large degree have failed to achieve outcomes that are simultanously efficient, equitable, and sustainable. Perhaps nowhere has the need to reform the way water is managed and even conceived been more apparent than in South Africa in the last decade, where a tremendous opportunity for change has been created in the form of the National Water Act of 1998. In this thesis I propose that water management in South Africa – which encompasses its water resources, ecosystems and their services, people they support, and institutions that govern them – is a social-ecological system: a coupled, inseparable system of human beings and nature. Using a combination of approaches, I demonstrate that a social-ecological systems perspective is needed to understand the true nature of these challenges. First, drawing from the experience of the Southern African Millennium Ecosystem Assessment (SAfMA), I construct and apply a framework for evaluating past water management responses. Second, I review a scenario planning exercise as an approach for identifying robust decisions amid high levels of uncertainty about future ecosystem services. Third, I use an agent-based model to explore the evolution of decision-making and learning by water managers under alternative paradigms. Lastly, I compare the ability of two existing frameworks to increase understanding of resilience as it applies to South African water management. Results of this work indicate that: congruence of impacts, awareness, and power is key to achieving effective water management in South Africa; future water management planning needs to take account of cross-scale trade-offs; decentralisation holds most promise when supported by a national policy framework but which allows for local learning; learning may be constrained by temporal variability, water stress, access to learning networks, and use of inappropriate indicators; and the concept of resilience may provide a mechanism for uniting social and ecological research on water management. As most past water management failures have resulted from a misunderstanding of social-ecological system dynamics, work of this kind can make a significant contribution at this pivotal point in South Africa’s water management history. Copyright 2006, University of Pretoria. All rights reserved. The copyright in this work vests in the University of Pretoria. No part of this work may be reproduced or transmitted in any form or by any means, without the prior written permission of the University of Pretoria. Please cite as follows: Bohensky, EL 2006, A Social-Ecological systems perspective on water management in South Africa, PhD thesis, University of Pretoria, Pretoria, viewed yymmdd Thesis (PhD (Environmental Studies))--University of Pretoria, 2006.Zoology and Entomologyunrestricte

Corticosterone secretion in tuatara (Sphenodon punctatus): Influential factors and conservation applications

Animals are regularly exposed to environmental, social and physiological challenges. In reaction to these challenges, individuals adjust their physiology and behaviour to maintain essential processes and optimise fitness. The most widely used indicators of physiological stress in vertebrates are glucocorticoid hormones (corticosterone (CORT) or cortisol), which are commonly referred to as ‘stress hormones’. The use of CORT as a tool to understand how individuals respond to natural or human-caused challenges is central to stress physiology research. Here, I investigated intrinsic and extrinsic factors associated with CORT secretion, CORT secretion as an indicator of physiological response to challenges/stressors, and the value of CORT secretion as conservation tool in an iconic protected reptile (the tuatara, Sphenodon punctatus). A capture-restraint time series revealed a significant CORT response over a 24 h period in male and female (non-gravid and gravid) tuatara. Baseline CORT and the CORT response to capture and restraint (i.e. a standardised capture-stress protocol) were similar between sexes; however, female reproductive condition was correlated with CORT secretion in that higher baseline CORT and a lower CORT response were observed in gravid females. An observational study incorporating data across a wide range of ambient temperatures (from four island sites) confirmed that body temperature (Tb) is positively correlated with baseline CORT in gravid females only, and revealed a positive correlation between the CORT response and higher Tb in all adults. A supporting experimental study showed that acute ambient temperature increase (in which mean Tb reached 21.4±0.4°C) elicits a significant CORT response to capture-restraint in gravid females. These results confirmed that gravid females are not secreting CORT maximally during nesting, but actively modulate secretion. An inter-island comparison of CORT secretion (for four populations) revealed that baseline CORT secretion was similar among populations during the non-breeding and breeding seasons; however, the CORT response to capture-restraint varied significantly among populations. Inter-population variation in testosterone (T) was observed in males (but not females) and was positively linked with increased baseline CORT from the non-breeding season to the breeding season, suggesting male reproductive activity may drive seasonal change of baseline CORT. Significant correlations were observed between the CORT response to capture-restraint (but not baseline CORT) and habitat elements of latitude, tuatara density and seabird abundance and 2) demogenetic factors of sex ratio and genetic diversity. The measurement of CORT as a physiological monitoring tool indicated that short- and long- term dynamics of CORT secretion in tuatara are not altered through translocation to a new island, as the acute CORT response remained stable throughout exposure to cumulative stressors and long-term dynamics of CORT secretion in translocated populations simultaneously mirrored those in source populations. These findings deliver the most detailed study of CORT secretion patterns in tuatara to date. Moreover, as the first study to apply CORT secretion data as an conservation physiology monitoring tool in tuatara, these results serve as a baseline reference for future research and monitoring of conservation efforts

Caught in the act: the stage as a backdrop for defining crime in early modern England

Due to the character of the original source materials and the nature of batch digitization, quality control issues may be present in this document. Please report any quality issues you encounter to [email protected], referencing the URI of the item.Includes bibliographical references (leaves 62-64).This study seeks to explicate the complex relationship between crime and drama in early modern England. In a historical context of social, political, and religious upheaval, defining criminality becomes an essential component of maintaining social control when class conflicts often color the administration of justice. Several social stages, including the ceremony of the church, the pomp of the royal court, and the spectacle of criminal punishment, provide a setting in which criminals can be compared to actors. With old power structures reluctantly crumbling in response to economic change, the theater itself emerges as a forum for discussion where themes of corruption in the church and government are introduced. Shakespeare's Measure for Measure, John Webster's The Duchess of Malfi, and Ben Jonson's Bartholomew Fair offer examples of the relative nature of criminality and the unique role of the stage in conglomerating all of the societal stages to comment on their transgressions and shortcomings before an audience comprised of varying social classes

Epidemiology of Injuries in Collegiate Male Cheerleaders in the United States

Injuries in cheerleading have been identified as a significant problem in recent years, however, very little information has been collected about male cheer injuries. The purpose of this study was to describe the epidemiology of cheerleading injuries of collegiate male cheerleaders. This study identifies the most common injuries, mechanism of injuries, and the body part injured. The sample consisted of 89 male collegiate cheerleaders from the United States. Subjects recruited via email or Facebook. Participants voluntarily completed an online questionnaire regarding their cheerleading injury history. Statistical analyses included calculations of 2 tests and Pearson correlations. Frequencies were calculated for the categorical variables. An alpha level of p < 0.05 was used to assess statistical significance. Just over half (48) of the participants reported an injury occurring within the last year. Lower extremity injuries accounted for 40% of the injuries and upper extremity injuries were 36% of the injuriesSchool of Teaching and Curriculum Leadershi

The Contribution of the Descending Pain Modulatory Pathway in Opioid Tolerance

Opioids remain among the most effective pain-relieving therapeutics. However, their long-term use is limited due to the development of tolerance and potential for addiction. For many years, researchers have explored the underlying mechanisms that lead to this decreased effectiveness of opioids after repeated use, and numerous theories have been proposed to explain these changes. The most widely studied theories involve alterations in receptor trafficking and intracellular signaling. Other possible mechanisms include the recruitment of new structural neuronal and microglia networks. While many of these theories have been developed using molecular and cellular techniques, more recent behavioral data also supports these findings. In this review, we focus on the mechanisms that underlie tolerance within the descending pain modulatory pathway, including alterations in intracellular signaling, neural-glial interactions, and neurotransmission following opioid exposure. Developing a better understanding of the relationship between these various mechanisms, within different parts of this pathway, is vital for the identification of more efficacious, novel therapeutics to treat chronic pain