Primary Care Nurse Attitudes, Beliefs and Confidence Levels Regarding Alcohol Abuse and Its Treatment: Impact of Educational Intervention.

Alcohol abuse has been a major burden on the society. In the fight against it a key issue the education of the primary care nurses has been ignored. This study evaluates the effect of education program on the attitudes, beliefs, and confidence levels of primary care nurses regarding alcohol abuse and its treatment. Data from the Project Mainstream educational intervention were used with permission from the investigators. Two hundred one students and faculty of nursing at Vanderbilt University participated in the intervention, which was designed to train primary care providers in the Brief Negotiated Intervention technique for early detection and treatment of alcohol problems. Participants completed questionnaires before and after the educational intervention. Analysis of the data using paired samples t-test and one way analysis of variance showed statistically significant positive change in the nurses\u27 attitudes, beliefs, and confidence levels regarding alcohol abuse and its treatment after the educational intervention. This study has shown the importance of educational intervention in dealing with alcohol abuse

Intestinal Strongyloidiasis and Hyperinfection Syndrome

In spite of recent advances with experiments on animal models, strongyloidiasis, an infection caused by the nematode parasite Strongyloides stercoralis, has still been an elusive disease. Though endemic in some developing countries, strongyloidiasis still poses a threat to the developed world. Due to the peculiar but characteristic features of autoinfection, hyperinfection syndrome involving only pulmonary and gastrointestinal systems, and disseminated infection with involvement of other organs, strongyloidiasis needs special attention by the physician, especially one serving patients in areas endemic for strongyloidiasis. Strongyloidiasis can occur without any symptoms, or as a potentially fatal hyperinfection or disseminated infection. Th2 cell-mediated immunity, humoral immunity and mucosal immunity have been shown to have protective effects against this parasitic infection especially in animal models. Any factors that suppress these mechanisms (such as intercurrent immune suppression or glucocorticoid therapy) could potentially trigger hyperinfection or disseminated infection which could be fatal. Even with the recent advances in laboratory tests, strongyloidiasis is still difficult to diagnose. But once diagnosed, the disease can be treated effectively with antihelminthic drugs like Ivermectin. This review article summarizes a case of strongyloidiasis and various aspects of strongyloidiasis, with emphasis on epidemiology, life cycle of Strongyloides stercoralis, clinical manifestations of the disease, corticosteroids and strongyloidiasis, diagnostic aspects of the disease, various host defense pathways against strongyloidiasis, and available treatment options

Intestinal strongyloidiasis and hyperinfection syndrome

In spite of recent advances with experiments on animal models, strongyloidiasis, an infection caused by the nematode parasite Strongyloides stercoralis, has still been an elusive disease. Though endemic in some developing countries, strongyloidiasis still poses a threat to the developed world. Due to the peculiar but characteristic features of autoinfection, hyperinfection syndrome involving only pulmonary and gastrointestinal systems, and disseminated infection with involvement of other organs, strongyloidiasis needs special attention by the physician, especially one serving patients in areas endemic for strongyloidiasis. Strongyloidiasis can occur without any symptoms, or as a potentially fatal hyperinfection or disseminated infection. Th(2 )cell-mediated immunity, humoral immunity and mucosal immunity have been shown to have protective effects against this parasitic infection especially in animal models. Any factors that suppress these mechanisms (such as intercurrent immune suppression or glucocorticoid therapy) could potentially trigger hyperinfection or disseminated infection which could be fatal. Even with the recent advances in laboratory tests, strongyloidiasis is still difficult to diagnose. But once diagnosed, the disease can be treated effectively with antihelminthic drugs like Ivermectin. This review article summarizes a case of strongyloidiasis and various aspects of strongyloidiasis, with emphasis on epidemiology, life cycle of Strongyloides stercoralis, clinical manifestations of the disease, corticosteroids and strongyloidiasis, diagnostic aspects of the disease, various host defense pathways against strongyloidiasis, and available treatment options

Numerical Simulation of Departure from Nucleate Boiling in Rod Bundles under High-Pressure Conditions

In subcooled boiling flows beyond a certain heat flux, heat transfer is hampered due to a phenomenon known as Departure from Nucleate Boiling (DNB). Conducting DNB experiments at one-to-one nuclear reactor operating conditions is highly challenging and expensive. Another alternative approach is to use Look-up table data. However, its applicability is limited due to its dependence on rod bundle correction factors. In the present investigation, a state-of-the-art Eulerian-Eulerian two-fluid model coupled with an extended heat flux partitioning model is used to predict DNB in tubes and rod bundles with square and hexagonal lattices (relevant to Pressurized Water Reactors). In this approach, bubble departure characteristics are modeled using semi-mechanistic models based on force balance analysis. The predicted DNB values are compared with experimental and Look-up table data and found out to be within 1.8% to 20%

Numerical Simulation of Departure from Nucleate Boiling in Rod Bundles under High-Pressure Conditions

In subcooled boiling flows beyond a certain heat flux, heat transfer is hampered due to a phenomenon known as Departure from Nucleate Boiling (DNB). Conducting DNB experiments at one-to-one nuclear reactor operating conditions is highly challenging and expensive. Another alternative approach is to use Look-up table data. However, its applicability is limited due to its dependence on rod bundle correction factors. In the present investigation, a state-of-the-art Eulerian-Eulerian two-fluid model coupled with an extended heat flux partitioning model is used to predict DNB in tubes and rod bundles with square and hexagonal lattices (relevant to Pressurized Water Reactors). In this approach, bubble departure characteristics are modeled using semi-mechanistic models based on force balance analysis. The predicted DNB values are compared with experimental and Look-up table data and found out to be within 1.8% to 20%

Interaction Between Warfarin and Levofloxacin: Case Series

Warfarin is the most widely used oral anticoagulant and is indicated for many clinical conditions. Levofloxacin, a fluoroquinolone, is one of the most commonly prescribed antibiotics in clinical practice and is effective against Gram-positive, Gram-negative, and atypical bacteria. While small prospective studies have not revealed any significant drug-drug interaction between warfarin and levofloxacin, several case reports have indicated that levofloxacin may significantly potentiate the anticoagulation effect of warfarin. We report 3 cases of serious bleeding complications that appear to be the result of the interaction between warfarin and levofloxacin. Physicians should be aware of this potential interaction and use caution when prescribing levofloxacin to patients taking warfarin

Nurses\u27 Attitudes, Beliefs and Confidence Levels Regarding Care for Those Who Abuse Alcohol: Impact of Educational Intervention

Alcohol abuse is a worldwide public health concern. Nurses, representing the largest body of health care providers, are a potential resource to provide screening and brief intervention for patients with alcohol problems. This study evaluates the effect of an educational intervention on the attitudes, beliefs, and confidence levels of nurses regarding screening and brief intervention for alcohol problems. One hundred eighty-one students at Vanderbilt University School of Nursing participated in a four-hour educational intervention to train providers in brief negotiated intervention (BNI) for screening, early detection and brief treatment of alcohol problems. Participants completed questionnaires before and after this training. Analysis of the data using paired t-test and one-way analysis of variance showed statistically significant positive change in the nurses\u27 attitudes, beliefs, and confidence levels regarding alcohol abuse and its treatment after the educational intervention. For example, the percentage of nurses who reported always having confidence in assessing patients\u27 readiness to change their behavior increased from 8.3% to 23.5% after training. In conclusion, the BNI educational intervention can be effective in promoting positive changes among nurses in attitudes, beliefs, and confidence levels regarding alcohol abuse and its treatment