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Background: Venous thromboembolism (VTE) is a leading cause of preventable morbidity and mortality, with total hip arthroplasty (THA) and total knee arthroplasty (TKA) at the highest risk. Safe and appropriate thromboprophylaxis is essential. However, investigations into prescribing practices have been limited. Aim: To describe current VTE prophylaxis regimens in Australian patients following an elective THA/TKA and compare these regimens to an international standard. Method: A retrospective multisite case series of patients admitted for a THA/TKA in six tertiary hospitals in Queensland, Australia, was conducted over 12 months (1 October 2017–30 September 2018). Patient and medication data were collected following surgery and for 60 days after discharge to determine changes to the patients' thromboprophylaxis regimen. Results were summarised and compared to National Institute for Health and Care Excellence (NICE) guidelines. Ethical approval was granted by the Metro South Human Research Ethics Committee (Reference no: HREC/2018/QMD/46757) and the study conforms to the National Statement on Ethical Conduct in Human Research. Results: The study included 1011 patients (43.1% THA, 56.9% TKA), and thromboprophylaxis was used in 98.1% of inpatients and in 94.3% of discharge patients for 5.2 (±5.2) and 29.2 (±15.9) days (±standard deviation) respectively. Low‐molecular‐weight heparins (LMWHs) were the primary drugs for inpatients (71.2%) and aspirin 150 mg for discharge (42.0%), most commonly for 6 weeks (31.8%). Aspirin was used for significantly longer duration than rivaroxaban and LMWH (p < 0.001). A two‐staged prophylaxis regimen was implemented, most commonly any anticoagulant as an inpatient; followed by rivaroxaban on discharge (32.7%) or an anticoagulant as an inpatient with aspirin on discharge (26.4%). Overall, adherence to NICE guidelines was low; THA: 8.7%, TKA: 5.9%. Conclusion: VTE prophylaxis regimens varied considerably, and consequently, adherence to international guidelines was low. There is a need for local, peer‐led guidelines to ensure consistent, safe, and effective prophylaxis. [ABSTRACT FROM AUTHOR]

Understanding how basic safety practices can affect the daily work of operators can reduce the chance of harm to personnel and infrastructure. [ABSTRACT FROM AUTHOR]

Purpose: To improve health equity, dental and medical students must have a firm grasp of the proper use of race as a social construct. The purpose of this study was to determine the degree to which an innovative learning event affected students' understanding of race as a social construct. It also sought to examine the effects that personally experienced and/or witnessed racism and previous education had on students' responses to the learning event. Methods: In 2022, all incoming first‐year dental (N = 48) and medical (N = 114) students completed an online pre‐matriculation assignment about the use of race in healthcare. Students initially completed an anonymous 14‐item pre‐survey and then read assigned publications, followed by answering questions about a real‐life vignette concerning the topic of race as a social construct. Students finished the assignment by completing an anonymous seven‐item post‐survey. Data from the pre‐ and post‐surveys were collected and analyzed to assess if differences existed among students and between the two surveys. Results: Dental and medical students were significantly more likely to endorse race as a social construct after the learning experience (p < 0.001). Students who had experienced discrimination or obtained training were more likely to define race as a social construct before and after the learning event. Conclusion: Dental and medical schools can increase students' understanding of race as a social construct, rather than a biological construct, with educational interventions. [ABSTRACT FROM AUTHOR]

Copyright of Journal: American Water Works Association is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: We investigated environmental variables associated with spawning migration behavior for a dual‐spawning population of endangered Atlantic Sturgeon Acipenser oxyrinchus oxyrinchus in the Great Pee Dee River, South Carolina. Methods: From 2016 to 2021, 147 Atlantic Sturgeon were captured, implanted with acoustic transmitters, and monitored using a stationary array of 40 receivers located every 5–20 km along a 302‐km section of the Great Pee Dee River from the river mouth at Winyah Bay to the first movement barrier at Blewett Falls Dam, North Carolina. Result: We observed 47 Atlantic Sturgeon attempting 74 spring migrations and 39 Atlantic Sturgeon attempting 76 fall migrations across 4 years of telemetry observations (2018–2021). Mixed‐effects models indicated that discharge interacted with water temperature to affect both migration initiation and upriver movement, and these interactions differed between the spring and fall runs. Spring runs were cued by rising temperatures and high river discharge, whereas fall runs were cued by falling temperatures and low discharge. Within migrations, spring‐run fish migrated further upriver when discharge was falling, and fall‐run fish moved further upriver when discharge was rising. Overall, fall‐run sturgeon migrated significantly further upriver than spring‐run sturgeon. Conclusion: Differences in migratory behavior between the two runs suggest potentially unique adaptations to ambient river conditions during the respective spawning seasons. Identifying the environmental factors that drive—and thereby limit—Atlantic Sturgeon migrations in the Great Pee Dee River informs regional recovery efforts and highlights the importance of studying and managing this species at the population level. Impact statementSome populations of Atlantic Sturgeon have uniquely adapted to spawn in both spring and fall. Each seasonal spawning run is cued differently by the interplay between river temperature and flow. Because they are present in rivers for a longer period of time, dual‐spawning sturgeon may be more susceptible to a wider range of threats. [ABSTRACT FROM AUTHOR]

Key Takeaways: The environmental laboratory workforce is aging out and needs creative solutions to recruit and retain skilled staff to perform physical, microbial, chemical, and radiological tests. There are immediate needs for chemists to work in radiochemistry and to conduct analyses for per‐ and polyfluoroalkyl substances and other contaminants of emerging concern. Promoting the water and wastewater industry and developing the industry workforce require education through public outreach, internships, fellowships, and citizen science. [ABSTRACT FROM AUTHOR]

Purpose/Objective: Due to the coronavirus pandemic, virtual interviews became a mainstay of graduate dental and medical education selection processes. To gain a handle on how to navigate lingering uncertainties about how interviews should be conducted in the future, this study examined the benefits and pitfalls of the virtual interview process (VIP) and assessed program plans to implement in the next interview cycle. Methods: An anonymous online survey, for completion by one program representative (director or associate director), was sent to graduate medical education (GME) and advanced dental education programs at West Virginia University (N = 74). Results: Fifty‐two (52) of the programs (70%) completed the survey. Zoom was the most frequently used interview platform (78.8%). Approximately two thirds (65.4%) of the interviewers thought VIP allowed the program to promote the university, the school, and their program and also reported experiencing video‐conferencing fatigue. About six in 10 perceive VIP can introduce bias in selecting applicants (59.6%) and potentially disadvantage some applicants (67.3%). Compared to the previous in‐person cycle, 67.4% of programs invited more applicants, and 73.1% interviewed more applicants. Regarding the 2021–2022 interview cycle, 55.8% of programs plan to offer either an in‐person or VIP, while 7.7% plan to keep their process completely virtual. Conclusion: Graduate programs in this study demonstrated the indispensability of technology in transitioning from in‐person to virtual interviews during COVID‐19 pandemic. VIP has several advantages and disadvantages; this style of interview is forecasted to have a presence in applicant selection in the future. [ABSTRACT FROM AUTHOR]

Background: The elderly is the fastest growing kidney transplant recipient group; however, they are more likely to die from immunosuppressant side effects than graft failure. Aim: The aim of this study was to explore immunosuppressant prescribing practices in elderly kidney transplant recipients. Method: We conducted a retrospective audit of registry data from the Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry between 2000 and 2015, to determine the actual prescribing trends of immunosuppressant drugs in elderly recipients (≥65 years). Drug choice and doses, prescribed initially and at 1‐year, were examined, with a survival analysis conducted to determine if drug regimen influenced graft survival. Results: Six hundred and one elderly recipients were included in the analysis. Elderly patients were less likely to be prescribed tacrolimus at 1 year than younger patients, and median doses (149.3 vs 155.6 micrograms/kg; p < 0.05) were significantly lower in elderly patients across the timeframe (initially and at 1‐year post‐transplant). We also observed that elderly recipients prescribed dual immunosuppressant therapy (compared to triple therapy) had an increased risk of graft loss (p < 0.05). Conclusion: By examining Registry data across a 15‐year span, we observed differences in both immunosuppressant usage and drug dosing trends in elderly recipients. The implications of these findings may suggest that guidelines need adjustment to reflect this. [ABSTRACT FROM AUTHOR]

Objective: To investigate whether integrating pharmacists into general practices reduces the number of unplanned re-admissions of patients recently discharged from hospital.Design, Setting: Stepped wedge, cluster randomised trial in 14 general practices in southeast Queensland.Participants: Adults discharged from one of seven study hospitals during the seven days preceding recruitment (22 May 2017 - 14 March 2018) and prescribed five or more long term medicines, or having a primary discharge diagnosis of congestive heart failure or exacerbation of chronic obstructive pulmonary disease.Intervention: Comprehensive face-to-face medicine management consultation with an integrated practice pharmacist within seven days of discharge, followed by a consultation with their general practitioner and further pharmacist consultations as needed.Major Outcomes: Rates of unplanned, all-cause hospital re-admissions and emergency department (ED) presentations 12 months after hospital discharge; incremental net difference in overall costs.Results: By 12 months, there had been 282 re-admissions among 177 control patients (incidence rate [IR], 1.65 per person-year) and 136 among 129 intervention patients (IR, 1.09 per person-year; fully adjusted IR ratio [IRR], 0.79; 95% CI, 0.52-1.18). ED presentation incidence (fully adjusted IRR, 0.46; 95% CI, 0.22-0.94) and combined re-admission and ED presentation incidence (fully adjusted IRR, 0.69; 95% CI, 0.48-0.99) were significantly lower for intervention patients. The estimated incremental net cost benefit of the intervention was $5072 per patient, with a benefit-cost ratio of 31:1.Conclusion: A collaborative pharmacist-GP model of post-hospital discharge medicines management can reduce the incidence of hospital re-admissions and ED presentations, achieving substantial cost savings to the health system.Trial Registration: Australian New Zealand Clinical Trials Registry, ACTRN12616001627448 (prospective). [ABSTRACT FROM AUTHOR]

Background: Australian data suggest that one‐fifth of emergency department (ED) presentations are re‐presentations within 28 days of discharge, with early re‐presentations common. The contribution of medication misadventure to re‐presentations has been poorly defined to date, but has been reported previously as medication‐related readmission rates of 23%, of which 90% are considered preventable. Aims: This study identified and categorised medication‐related 28‐day ED re‐presentations after discharge, associated medication‐related problems (MRPs) and differences in demographics between medication‐related and ‐unrelated ED re‐presentations. Methods: A retrospective medical record review was conducted for every third adult 28‐day ED re‐presentation between 1 July and 31 December 2016. Re‐presentations were examined for potential medication‐related causes. The MRPs identified were categorised using causality, contribution and preventability criteria. Results: Of 631 eligible re‐presentations, 196 were sampled. Re‐presentations were potentially medication related in 41 (21%) cases; in 24 (59%) re‐presentations, preventable MRPs were considered the main cause of re‐presentation. Early medication‐related re‐presentations were common: 49% occurred within 7 days of discharge, and 20% on Day 1. Patients re‐presenting with an MRP were, on average, 10.3 years older and prescribed 3.4 more medications on the index discharge than those re‐presenting with a non‐MRP. Cardiovascular medications (n = 14) were most commonly implicated in MRPs, with toxicity or adverse reaction (n = 16) and undertreated (n = 15) the most common MRP categories. Conclusions: One‐fifth of the 28‐day ED re‐presentations observed were considered potentially medication related, with 59% of these associated with MRPs considered preventable. MRPs most frequently involved cardiovascular medications, adverse reactions and undertreatment. Early individualised pharmaceutical review after discharge may help reduce the MRPs observed. [ABSTRACT FROM AUTHOR]

Due to recent outbreaks of native bark beetles, forest ecosystems have experienced substantial changes in landscape structure and function, which also affect nearby human populations. As a result, land managers have been tasked with sustaining ecosystem services in impacted areas by considering the best available science, public perceptions, and monitoring data to develop strategies to suppress bark beetle epidemics, and in some cases to restore affected lands and ecosystem services. The effects of bark beetle outbreaks are often detrimental to the provision of ecosystem services, including degraded landscape aesthetics and diminished air and water quality. However, there have been instances where bark beetle outbreaks have benefited communities by, for example, improving habitat for grazing animals and enhancing real‐estate values. As a consequence of the interaction of a warming climate and susceptible forest stand conditions, the frequency, severity, and extent of bark beetle outbreaks are expected to increase and therefore will continue to challenge many social–ecological systems. We synthesize experiences from recent outbreaks to encourage knowledge transfer from previously impacted communities to potentially vulnerable locations that may be at risk from future bark beetle epidemics. [ABSTRACT FROM AUTHOR]

Background Evolution in Australian community pharmacy and general practice environments has seen the emergence of a new opportunity for pharmacist practice, distinct from the conventional community and hospital settings, in which the pharmacist is integrated into the general practice setting to provide professional services. Aim To characterise pharmacists practising in the Australian general practice setting. Method An electronic questionnaire. Results Twenty-six practice pharmacists completed the questionnaire. Practice pharmacists were more likely to be female, aged between 30 and 49 years, have postgraduate qualifications and also work in other pharmacy sectors. The general practice settings more frequently had multiple general practitioners and also housed multiple allied health professionals. The most commonly conducted services provided by the practice pharmacists were Home Medicine Reviews, responding to clinical enquiries from general practitioners and responding to enquiries from other health professionals. Most practice pharmacists worked as independent contractors for services provided. The practice pharmacists provided some services in the absence of remuneration. The majority of practice pharmacists agreed or strongly agreed that a set of competencies should be developed and a credentialing process required with experience of the pharmacist being regarded highly. Conclusion The results of this study have described the variety of professional roles, remuneration and characteristics in a small sample of pharmacists practising in a general practice setting in Australia. For this model of pharmacist practice to expand an appropriate method of remuneration is required. [ABSTRACT FROM AUTHOR]

Background: Statin use has been associated with muscle toxicity and clinically significant muscle symptoms. Aim: To investigate if high-dose statin users have a greater incidence of myalgia than low-to-moderate dose statin users. Method: A questionnaire-based interview of participants at a hospital and community pharmacy in Brisbane. Data were gathered on the history of statin use, presence of myalgia, analgesic use and self-reported adherence. Participants were excluded if they had a chronic degenerative musculoskeletal condition, such as rheumatoid arthritis or osteoarthritis. Results: 192 participants were included in the study - 65 (34%) in the low-to-moderate dose group and 127 (66%) in the high-dose group. Excluding participants with a pre-existing painful condition (n = 72), myalgia was reported by 24 (37%) patients in the low-to-moderate dose group and 42 (33%) in the high-dose group (p = 0.22). 8 (12%) patients in the low-tomoderate dose group used analgesics compared to 24 (19%) in the high-dose group (p = 0.34). Adherence in both groups was the same when assessed using the Morisky scale. Conclusion: There was no significant difference in myalgia between the high and low-to-moderate dose statin groups. The incidence of myalgia in statin users was higher than reported in previous studies. [ABSTRACT FROM AUTHOR]

The article presents abstracts on medical topics which include the use of prasugrel in treating patients with ST segment elevation myocardial infarction (STEMI), the inability of valsartan to prevent the recurrence of atrial fibrillation (AF) and the inapplicable of adding clopidogrel to aspirin in treating patients with FA for it increases the risk of major haemorrhage.

Objective: Proximal peripheral nerve conduction studies can provide useful information to the clinician. The difficulty of measuring the length of the proximal nerve as well as a frequent inability to stimulate at 2 points along the nerve adds a challenge to the use of electrodiagnosis for this purpose. The purpose of this article is to present normal values for the suprascapular, axillary, and musculocutaneous nerves using surface electrodes while accounting for side-to-side variability. Design: Prospective, observational study. Setting: Patients were evaluated in outpatient, private practices affiliated with tertiary care systems in the United States and Malaysia. Participants: One hundred volunteers were recruited and completed bilateral testing. Exclusion criteria included age younger than 18 years; previous shoulder surgery/atrophy; symptoms of numbness, tingling, or abnormal sensations in the upper extremity; peripheral neuropathy; or presence of a cardiac pacemaker. Methods: Nerve conduction studies to bilateral supraspinatus, infraspinatus, deltoid, and biceps brachii muscles were performed with documented technique. Distal latency, amplitude, and area were recorded. Side-to-side comparisons were made. A mixed linear model was fit to the independent variables of gender, race, body mass index, height, and age with each recorded value. Main Outcome Measurements: Distal latency, amplitude, area, and side-to-side variability of nerve conduction studies of the suprascapular, axillary, and musculocutaneous nerves with correlation to significant independent variables. Results: Data are presented showing normal distal latency, amplitude, and area values subcategorized by clinically significant variables, as well as acceptable side-to-side variability. Increased height correlated with increased distal latency in all the nerves tested. Amplitudes were larger in the infraspinatus recordings from women, while the amplitudes from the biceps and deltoid were greater in men. A larger body mass index was associated with a smaller amplitude in the deltoid in men. No correlations were seen with age or race. Conclusion: Normative values for distal latency, amplitude, duration, and area were developed for proximal nerve conductions to the axillary, musculocutaneous, and suprascapular nerves. Simple surface electrode placement allows for easy reproduction of the authors'' techniques. This is a useful standard to facilitate evaluation of these proximal peripheral nerves. [Copyright &y& Elsevier]

The article focuses the national survey that study the health risk of vaginal douching among women in the U.S. Medical practitioners said douching can affect the normal colonization of bacteria in the vagina that causes health problems such as the incidence of bacterial vaginosis and other vaginal infections. With this regard, nurses plays a crucial role in informing women of the dangers associated with douching.

This article presents a study on social characteristics of narcotic patients admitted to hospitals in Lexington, Kentucky in 1965. The U.S. Public Health Service maintains two psychiatric hospitals for the treatment of narcotic patients. The Lexington hospital was opened in 1935 and the Fort Worth hospital in Texas opened in 1938. There have been 90,645 admissions of some 50,400 addict patients from 1935 through 1965. The patients include both voluntary admissions and federal prisoners. Thus, the two institutions serve both as hospitals and as prisons. In 1965, 79 percent of the patients admitted were voluntary and 21 percent were federal prisoners. It has been estimated that there are 60,000 to 100,000 narcotic addicts in the U.S. at present. The estimate is based on the belief that most addicts become known to police or hospital authorities during the course of their addiction, due either to their illegal acts or their desire for medical treatment. A principal reason for considering narcotic drug addiction a social problem in the U.S. is the association between addiction and criminality. Related to this is the fact that most addicts are unable or unwilling to seek and maintain steady legitimate employment. Of 1,693 consecutive addict admissions to the Lexington hospital in 1965, 1,426 patients admitted to one or more arrests. The median age at time of first arrest was 18.4 years for the males and 20.8 years for the females. Commonly, arrest preceded first use of opiates. The median age at onset of opiate use among the 1,693 addicts was 20.0 years for the males and 22.6 years for the females. Of even greater significance than the sequence of arrest and opiate use found in the high delinquency slum areas from which addicts come is the means of livelihood addicts pursue. Thus, the association of narcotic addiction and criminality is such that many addicts are unable to secure legitimate work or are not interested in such employment.

One drinking water utility found a comprehensive, cost‐effective strategy for monitoring toxin‐producing cyanobacteria that can harm water quality. [ABSTRACT FROM AUTHOR]

The article discusses the time it takes for hospital governance, or administration, and ethics review for approval of medical care research in Australia.

A letter to the editor is presented in response to the article "Integration of a consultant pharmacist into a general practice: development of a collaborative care model," by M. Angley, A. Kellie, and G. Barrow in the 2015 issue.

The article presents several abstracts related to cardiovascular issues including one on the dosage of the drug warfarin, one on heart failure and the drugs candesartan and losartan and one on cognitive behavioral therapy and cardiovascular events.

The article discusses several technical reports regarding cardiovascular drug research including one on a comparative study investigating the effects of mean INR control on patient receiving the drugs warfarin versus dabigatran, one on a review of the Diabetes Audit and Research in Tayside Scotland database regarding the role of the drug metformin in heart failure, and one on a clinical trial, called OASIS-7, comparing high and standard doses of clopidogrel with aspirin.

The article presents summary information on cardiovascular drug therapies from international medical literature. Topics include antiplatelet therapy using aspirin and/or clopidogrel in patients with drug-eluting stents, the effectiveness of antihypertensive drugs in reducing blood pressure and stroke, and the role of patient attitudes on adherence to drug therapies.

The article presents abstracts on cardiovascular research topics which include thienopyridine therapy after stent placement, selective endothelin-receptor antagonist for blood pressure reduction and the link between platelet reactivity and glycemic control in diabetics.

An abstract of the article "Defining an evidence-based cut-point for medication adherence in heart failure" is presented.

Discusses the abstract of the study 'Knowledge and Attitudes of Modern Orthodox Jewish High School Students Toward Carrier Screening,' presented at the 21st Annual Education Conference of the National Society of Genetic Counselors held in Phoenix, Arizona in November 2002.

The article presents information on the meetings held by the Committee on Research on Marriage and the Family during the National Conference on Family Relations in New York City on December 29-31, 1941. Since so few committee members were present, it was decided not to devote time to the prepared memoranda published in the October issue of Marriage and Family Living. Members presented lines of inquiry that are suggested for persons interested in marriage and family research under present war conditions. These include: that material be assembled and made available to research workers on the impact of war on family relations in contemporary Europe; that special attention be given to adjustment in families where the father is removed for military or industrial reasons; that the adjustment that men make to military service be studied in relation to the attitudes of members of their family; and that the basic personality characteristics associated with good adjustment to democratic relationships be studied, as well as the family relationships which encourage and discourage their development.

An abstract of the article "brain natriuretic peptide (BNP)-guided vs. symptom-guided heart failure therapy" is presented.

An abstract of the article "Genetic determinants of response to clopidogrel and cardiovascular events" is presented.

An abstract of the article "Effect of dronedarone on cardiovascular events in atrial fibrillation" is presented.

This article provides information on a 1940 report of the Committee on Marriage and Family Research. The report, which sought to focus on a proposal to work toward the development of a comprehensive statement of what representative research workers regard as fairly well established knowledge about marriage and family relations and a proposal to outline what representative research workers regard as the most important research problems needing attention for the next decade. These are ambitious projects, and thus far the committee has been unable to get very far toward the achievement of its aims. The general plan is for members representing different research fields such as psychology, psychiatry, sociology and economics of the household to submit memoranda on one or both of the projects. These memoranda are to serve as a basis for discussion out of which a final report is to be drafted. Members of the National Conference are invited to read them and to send the chairman their criticisms and suggestions. Members are also invited to participate in the open meetings of the committee at the annual meeting where the following memoranda and others are to be discussed. It should be kept in mind that these memoranda are not final reports but preliminary formulations designed to serve as bases for discussion.

This article reports on the memoranda being prepared to what members of the Committee on Marriage and Family Research regard as established knowledge about marriage and family relations in the U.S. as of May 1941. The following topics have been assigned to individual committee members: family economics, sociology, social psychology, parent-child relations, psychopathology and psychiatry. A second group of Committee members is preparing memoranda on problems in the field of marriage and the family, the memoranda to be the basis of committee recommendations for research for the next several years. Fields included are psychology, social anthropology and sociology.