Employment Protection and Domestic Violence: Addressing Abuse in the Labor Grievance Process

The effects of domestic violence are not limited to the home environment. Its effects are felt in employment when abused employees are absent from work and when violent incidents erupt in the workplace. For example, a bruised employee might be too injured and embarrassed to attend work, or an estranged spouse might stalk and harass a victim on the job. Another issue arises in that employers often discipline victims of domestic violence for absenteeism and incidents of violence that occur in the workplace. Discipline of union members is governed by collective bargaining agreements and subject to the labor grievance process. These grievances often end in arbitration, where the union represents the battered employee. Because of this occurrence, employers, unions, and arbitrators must be educated about domestic violence to ensure victims of abuse receive adequate job protection

Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial

SummaryBackground Azithromycin has been proposed as a treatment for COVID-19 on the basis of its immunomodulatoryactions. We aimed to evaluate the safety and efficacy of azithromycin in patients admitted to hospital with COVID-19.Methods In this randomised, controlled, open-label, adaptive platform trial (Randomised Evaluation of COVID-19Therapy [RECOVERY]), several possible treatments were compared with usual care in patients admitted to hospitalwith COVID-19 in the UK. The trial is underway at 176 hospitals in the UK. Eligible and consenting patients wererandomly allocated to either usual standard of care alone or usual standard of care plus azithromycin 500 mg once perday by mouth or intravenously for 10 days or until discharge (or allocation to one of the other RECOVERY treatmentgroups). Patients were assigned via web-based simple (unstratified) randomisation with allocation concealment andwere twice as likely to be randomly assigned to usual care than to any of the active treatment groups. Participants andlocal study staff were not masked to the allocated treatment, but all others involved in the trial were masked to theoutcome data during the trial. The primary outcome was 28-day all-cause mortality, assessed in the intention-to-treatpopulation. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936.Findings Between April 7 and Nov 27, 2020, of 16 442 patients enrolled in the RECOVERY trial, 9433 (57%) wereeligible and 7763 were included in the assessment of azithromycin. The mean age of these study participants was65·3 years (SD 15·7) and approximately a third were women (2944 [38%] of 7763). 2582 patients were randomlyallocated to receive azithromycin and 5181 patients were randomly allocated to usual care alone. Overall,561 (22%) patients allocated to azithromycin and 1162 (22%) patients allocated to usual care died within 28 days(rate ratio 0·97, 95% CI 0·87–1·07; p=0·50). No significant difference was seen in duration of hospital stay (median10 days [IQR 5 to >28] vs 11 days [5 to >28]) or the proportion of patients discharged from hospital alive within 28 days(rate ratio 1·04, 95% CI 0·98–1·10; p=0·19). Among those not on invasive mechanical ventilation at baseline, nosignificant difference was seen in the proportion meeting the composite endpoint of invasive mechanical ventilationor death (risk ratio 0·95, 95% CI 0·87–1·03; p=0·24).Interpretation In patients admitted to hospital with COVID-19, azithromycin did not improve survival or otherprespecified clinical outcomes. Azithromycin use in patients admitted to hospital with COVID-19 should be restrictedto patients in whom there is a clear antimicrobial indication

The effect of attitudinal and behavioral nutrition bulletins on adolescents' nutrition knowledge, attitudes, and fat intake behavior

Includes bibliographical references (pages [26]-29)The purpose of this study was to investigate the effect of nutrition bulletins containing cognitive, behavioral, and attitudinal components on nutrition knowledge, food/nutrition attitudes, and fat intake behavior of senior high school students. One hundred and six students were surveyed using a pretest-posttest, treatment-control group design. The treatment groups received the nutrition bulletins in their health or home economics class, with the control groups receiving general health bulletins. The survey used consisted of three instruments: a fat intake scale, a food/nutrition attitude instrument, and a nutrition knowledge test. Student t-tests and chi square analyses comparing treatment and control groups' knowledge, attitude, and behavior scores at baseline revealed no significant differences between the groups. Results of stepwise multiple linear regressions indicate that the experimental group had significantly improved knowledge scores. No significant changes were observed in nutrition attitudes or fat intake behavior. Among demographic variables examined, results indicate younger students showed more positive knowledge gains than older students. Also, age and family history of heart disease were significant predictors of both fat intake behavior and selected nutrition attitudes. The attitude scale entitled Caring About Nutrition was also found to be a significant predictor of fat intake behavior.M.S. (Master of Science

Evidence for P2Y(1), P2Y(2), P2Y(6) and atypical UTP-sensitive receptors coupled to rises in intracellular calcium in mouse cultured superior cervical ganglion neurons and glia

1. P2Y receptors are expressed in the nervous system and are involved in calcium signalling in neurons and glia. In the superior cervical ganglion (SCG), RT–PCR analysis indicated the presence of P2Y(1,2&6) receptors. Rises in intracellular calcium in response to P2Y receptor stimulation were determined from adult mouse cultured SCG neurons and glia. 2. ADP evoked suramin (100 μM)- and pyridoxalphosphate-6-azophenyl-2′,4′-disulphonic acid (PPADS, 30 μM)-sensitive rises in intracellular calcium in ∼80% of SCG neurons (EC(50)∼20 μM). ADP-evoked responses were abolished in neurons from P2Y(1) receptor-deficient mice (responses to UTP were unaffected). 3. The pyrimidines UTP (EC(50)∼85 μM) and UDP (EC(50)>90 μM) evoked PPADS- and suramin-sensitive responses in ∼70 and ∼20% of SCG neurons, respectively. 4. In SCG glial cells, ADP (EC(50)∼30 μM) evoked calcium responses in ∼50% of glia. These were suramin and PPADS sensitive and essentially abolished in SCG glial cells cultured from adult P2Y(1) receptor-deficient mice. 5. UTP (EC(50)∼25 μM) and UDP (EC(50)>200 μM) evoked suramin- and pyridoxalphosphate-6-azophenyl-2′,5′-disulphonate-sensitive rises in calcium in ∼60 and 20% SCG glial cells, respectively. 6. These results indicate the presence of several P2Y receptors coupled to an increase in intracellular calcium in the SCG: ADP-sensitive P2Y(1) receptors and UDP-sensitive P2Y(6) receptors in SCG neurons and glial cells, a novel UTP-sensitive P2Y receptor in SCG neurons and UTP- and ATP-sensitive P2Y(2) receptors in SCG glia

Postoperative continuous positive airway pressure to prevent pneumonia, re-intubation, and death after major abdominal surgery (PRISM): a multicentre, open-label, randomised, phase 3 trial

Background: Respiratory complications are an important cause of postoperative morbidity. We aimed to investigate whether continuous positive airway pressure (CPAP) administered immediately after major abdominal surgery could prevent postoperative morbidity. Methods: PRISM was an open-label, randomised, phase 3 trial done at 70 hospitals across six countries. Patients aged 50 years or older who were undergoing elective major open abdominal surgery were randomly assigned (1:1) to receive CPAP within 4 h of the end of surgery or usual postoperative care. Patients were randomly assigned using a computer-generated minimisation algorithm with inbuilt concealment. The primary outcome was a composite of pneumonia, endotracheal re-intubation, or death within 30 days after randomisation, assessed in the intention-to-treat population. Safety was assessed in all patients who received CPAP. The trial is registered with the ISRCTN registry, ISRCTN56012545. Findings: Between Feb 8, 2016, and Nov 11, 2019, 4806 patients were randomly assigned (2405 to the CPAP group and 2401 to the usual care group), of whom 4793 were included in the primary analysis (2396 in the CPAP group and 2397 in the usual care group). 195 (8\ub71%) of 2396 patients in the CPAP group and 197 (8\ub72%) of 2397 patients in the usual care group met the composite primary outcome (adjusted odds ratio 1\ub701 [95% CI 0\ub781-1\ub724]; p=0\ub795). 200 (8\ub79%) of 2241 patients in the CPAP group had adverse events. The most common adverse events were claustrophobia (78 [3\ub75%] of 2241 patients), oronasal dryness (43 [1\ub79%]), excessive air leak (36 [1\ub76%]), vomiting (26 [1\ub72%]), and pain (24 [1\ub71%]). There were two serious adverse events: one patient had significant hearing loss and one patient had obstruction of their venous catheter caused by a CPAP hood, which resulted in transient haemodynamic instability. Interpretation: In this large clinical effectiveness trial, CPAP did not reduce the incidence of pneumonia, endotracheal re-intubation, or death after major abdominal surgery. Although CPAP has an important role in the treatment of respiratory failure after surgery, routine use of prophylactic post-operative CPAP is not recommended