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Objective: The aim of this study was to investigate how the experience of caring for COVID-19 patients, nurses' moral distress, and the current practice environment impact nurses' intention to leave., Background: Caring for COVID-19 patients has been associated with an increase in nurses' moral distress and an increase in nurses' turnover. To date, research has focused on nurses' moral distress, the practice environment, and intentions to leave during the pandemic's peak. The current workplace climate, including those who stayed in their positions, has not been adequately assessed., Methods: This cross-sectional correlational study was conducted in a Magnet® hospital., Results: Moral distress related to team/system (B = 0.64, t = 3.86, P < 0.001), nurses' participation in hospital affairs (B = -2.21, t = -3.52, P < 0.001), and staffing (B = -1.91, t = -5.48, P < 0.001) are strongest predictors for nurses' intention to leave postpandemic., Conclusions: Nurses in practice still report experiencing COVID-related moral distress; however; issues related to resources and staffing have the most substantial impact on intention to leave among the current nursing workforce., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Child sexual abuse (CSA) is a pervasive public health problem. If left undetected, CSA can result in immediate and long-term health problems, which can be mitigated through early identification. Schools are an ideal environment to implement screening measures, and school nurses (SN) are uniquely poised to intervene and respond early. The aim of this review was to systematically examine and synthesize the international evidence related to screening for early identification of CSA in schools. Themes emerging from the analysis were SN behaviors relative to screening, potential instruments or approaches for screening, and SN and school professionals' beliefs about CSA screening practices. This review found little evidence that CSA screening is occurring in schools. However, SNs are aware that screening falls within their scope of practice and many SNs feel they should be screening for it. A constant proactive approach by SNs is necessary to improve early identification and subsequent intervention., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

We aimed to collect parallel perspectives from pharmacists and pharmacy students on their use, knowledge, attitudes, and perceptions about herbal supplements/natural products. Two cross-sectional descriptive survey questionnaires-one focusing on pharmacists and the other focusing on pharmacy students-were administered from March to June 2021 via Qualtrics. The surveys were sent out to preceptor pharmacists and pharmacy students currently enrolled at a single U.S. school of pharmacy. The questionnaires were composed of five main sections, including (1) demographics; (2) attitudes/perceptions; (3) educational experience; (4) resource availability; and (5) objective knowledge of herbal supplements/natural products. Data analysis primarily utilized descriptive statistics with relevant comparisons across domains. A total of 73 pharmacists and 92 pharmacy students participated, with response rates of 8.8% and 19.3%, respectively. A total of 59.2% of pharmacists and 50% of pharmacy students stated they personally used herbal supplements/natural products. Most respondents (>95% for both groups) considered vitamins/minerals safe, although a lower percentage agreed on this for herbal supplements/natural products (60% and 79.3% for pharmacists and pharmacy students, respectively). Patient inquiries in the pharmacy setting were most seen for vitamin D, zinc, cannabidiol, and omega-3. A total of 34.2% of pharmacists reported having training in herbal supplements/natural products as a required part of their Pharm.D. training, and 89.1% of pharmacy students desired to learn more. The median score on the objective knowledge quiz was 50% for pharmacists and 45% for pharmacy students. Ultimately, herbal supplements/natural products are recognized by pharmacists/pharmacy students as a consistent and embedded part of pharmacy practice, although there is a need to enhance knowledge and skills in this area.

Background: No Arabic translation exists for the medication management patient satisfaction survey (MMPSS), a 10-item psychometrically valid patient satisfaction survey tool developed to assess patient satisfaction for comprehensive medication management. The objective of this study is to translate the medication management patient satisfaction survey into Lebanese Arabic while culturally adapting and assessing the psychometric properties of the translated survey in the outpatient setting. Methods: Guidelines for translation, adaptation, and validation of instruments for cross-cultural healthcare research were followed. The process included forward translation, expert panel review, back-translation, pretesting, and cognitive interviewing. Participants were approached after picking up their medications from the pharmacy at a primary care facility. The medication management patient satisfaction survey was administered verbally by two trained data collectors. Instrument psychometric analyses included testing both for reliability using Cronbach's alpha (α) and McDonald's omega (ω) and for construct validity using exploratory factor analysis (EFA). Pearson correlations between items were calculated. Results: During the translation process, the term "clinical pharmacist" was changed to "pharmacist today" for improved understanding. Four items were adapted through minor linguistic modifications. Data were collected from 143 patients. The mean age of participants was 72 years. Participants were mostly females (69%) and had an average of four comorbidities and eight daily medications. Findings from Cronbach's α and McDonald's ω indicated that the internal consistency among items from one to nine was very strong ( α = 0.90; ω = 0.90). Exploratory factor analysis indicated that all items are strongly influenced by one factor, except for item six, "My clinical pharmacist is working as a team member with my other healthcare providers" which was the least influenced (loading = 0.44) with the highest uniqueness (0.81). The latent factor captured over 50% of the variance originally observed between variables. Items four and five "My clinical pharmacist helped me find easier ways to take my medicines" and "My clinical pharmacist helped me understand the best ways to take my medicines", had the strongest correlation (0.77), while the weakest correlation was seen between item six "My clinical pharmacist is working as a team member with my other healthcare providers" and other items. Conclusion: The Lebanese Arabic version of the medication management patient satisfaction survey was produced as a brief tool to serve as a valid and reliable instrument for measuring patient satisfaction with comprehensive medication management services., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Alaa Eddine, Schreiber and Amin.)

Background: Nurses obtaining higher levels of education has been recommended nationally for more than a decade to support improved patient outcomes., Local Problem: Organizational strategies were implemented to achieve a highly educated workforce at the project site over 14 years. However, there was no evaluation of relationship with increasing education levels and pediatric patient outcomes., Methods: A quality improvement project explored the relationship of Bachelor of Science in Nursing (BSN) or higher prepared nurses with 9 different nurse-sensitive indicators (NSIs). Educational preparation and NSI data were retrieved retrospectively from hospital databases from up to 14 years., Results: Moderate to moderately strong correlations were noted between the proportion of BSN or higher prepared nurses and 2 NSIs (central line-associated bloodstream infections, r = -0.55 and surgical site infections, r = -0.71). Four of the 9 indicators were approaching moderate correlation., Conclusions: Increasing the proportion of highly educated nurses at the project site correlated with improvements in select NSI outcomes., Competing Interests: The authors declare no conflicts of interest or source of funding., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

This two-part series describes how to test hypotheses on molecular mechanisms that underlie biological phenomena, using preclinical drug testing as a simplified example. While pursuing drug testing in preclinical research, students will need to understand the limitations of descriptive as well as mechanistic studies. The former does not identify any causal links between two or more variables; it identifies the presence or absence of correlations. Parts I and II of this educational series encourage the student to 1) ensure the sensitivity and specificity of their measurements, 2) establish or optimize an appropriate disease model, 3) find pharmaceutical drug doses/concentrations that interfere with experimental disease processes, 4) leverage the literature and exploratory datasets to craft a mechanism-oriented hypothesis on drug binding and downstream effects, 5) and design a full-factorial experiment to test the hypothesis after sketching potential outcomes and imagining their interpretations. These creative goals facilitate the choice of the appropriate positive and negative controls to avoid false data interpretations. Here, Part II describes in detail how to test for a causal link between drug-induced activation of biological targets and therapeutic outcomes. Upon completion of this two-part series, the new student will have some of the tools in hand to design mechanistic studies, interpret the outcomes of their research, and avoid technical and theoretical pitfalls, which can otherwise decelerate scientific progress and squander human and financial resources., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Leak and Schreiber.)

Background: The nursing shortage has been deemed a public health crisis as the turnover rate of newly licensed graduate nurses (NLGNs) continues to grow. One of five NLGNs are leaving the profession due to work dissatisfaction and feelings of inadequacy, risking patient safety., Method: A prospective, randomized controlled trial evaluated the impact of a 6-week digital intervention (text messaging) on NLGNs' self-reported stress, resiliency, sense of support, and intention to leave their jobs, organization, and profession. Messages to the experimental group ( n = 10) conveyed emotional, esteem, and networking support, and messages to the control group ( n = 11) were medical facts., Results: The digital intervention in the form of medical facts increased the control group's sense of social support. Stress, resilience, and intention to leave their jobs, organizations, or profession did not change for either the control or experimental group., Conclusion: A digital intervention, such as text messaging, potentially can increase NLGNs' sense of support during their first year of hire. [ J Contin Educ Nurs . 2021;52(8):367-374.] .

This commentary provides a brief mathematical review of exploratory factor analysis, the common factor model, and principal components analysis. Details and recommendations related to the goals, measurement scales, estimation technique, factor retention, item retention, and rotation of factors. For researchers interested in attempting to identify latent factors, exploratory factor analysis, the common factor model, is the appropriate analysis. For surveys with Likert-type scales weighted least squares with robust standard errors is recommended along with oblique rotation. Alternative techniques for analyzing the data, e.g., item response theory and machine learning, are briefly discussed. Finally, a basic check list for researchers and reviewers is provided., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Background: Competency based education (CBE) has been suggested for nurse practitioner (NP) education reform. For this to occur, competencies should reflect the knowledge, skills, and attitudes that NPs need for independent practice., Purpose: This integrative review examined the general practice activities of NPs across all population foci to determine the extent to which these activities are reflected in current NP competencies., Method: Using the Whittemore and Knafl (2005) integrative review method, 17 studies that focused on NP practice between 2008 and 2018 were retrieved from three electronic databases. These studies were evaluated, analyzed and synthesized for themes. Afterwards the themes were compared with seven sets of current NP core competencies., Results: The themes for NP practice activities were direct and indirect patient care activities with a majority of NP time spent performing direct patient care activities. However, only 14% of the NP core competencies reflected these direct care activities., Conclusion: In order to successfully implement CBE, a need exists for the NP core competencies to reflect current NP practice., (Copyright © 2019 Elsevier Inc. All rights reserved.)

This commentary discusses the new American Statistical Association forty-three article issue in The American Statistician. I cover some history of p-values, misunderstandings, along with NHST and the Neyman-Pearson model. Special focus is placed on Student [W. Gosset] and Fisher's work. Finally, a list of recommendations is provided., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Objective: The aim of this study was to describe the complex relationships among patient safety culture, nurse demographics, advocacy, and patient outcomes., Background: Why has healthcare lagged behind other industries in improving quality? Little nursing research exists that explores the multifactorial relationships that impact quality., Methods: A convenience sample of 1045 nurses from 40 medical/surgical units was analyzed using a correlational cross-sectional design with secondary data analysis. Data sources included survey results for patient safety culture, nurse perceptions of patient advocacy, and patient experience and fall and pressure ulcer rates., Results: Significant findings included a positive correlation between patient safety culture and advocacy and a negative correlation between safety culture, advocacy, and years of experience as a nurse. No significant correlations were found between safety culture and patient outcomes or advocacy and patient outcomes., Conclusions: Newer nurses were more positive about safety culture and advocacy, whereas experienced nurses were overall less positive.

Background: Competency-based education (CBE) has been recommended for nurse practitioner (NP) education. To implement CBE, existing NP core competencies need to be reduced in number and refined., Purpose: This study refined and reduced redundancy in the National Organization of Nurse Practitioner Faculties (NONPF) and the American Association of Colleges of Nursing (AACN) NP core competencies through the consensus of experts in NP practice. This study used the current NP Core Competencies (NONPF, 2017), the Essentials of Doctoral Education for Advanced Nursing Practice (AACN, 2006), and the Common Advanced Practice Registered Nurse Doctoral-Level Competencies (AACN, 2017a) because these documents are the competencies-accredited NP programs commonly used in curriculum development. The primary aim of this study was to refine and reduce redundancy of these competencies; a secondary aim was to ensure that the final competencies were clear and measurable., Methods: A Delphi approach was used to reach consensus among an expert panel who reviewed the core competencies via an online questionnaire. Descriptive statistics were used to calculate median and interquartile ranges; content analysis was conducted with qualitative data., Results: Consensus was reached after 3 rounds and resulted in 49 final core competencies., Implications for Practice: This study provides the NP community with a manageable list of relevant, clear, and measurable competencies that faculty members can use to implement CBE in their programs.

Providing care for people with dementia is difficult when resistive behaviors displayed by people impede caregiving efforts., Purpose: To examined the frequency of resistive behaviors during informal caregiver-assisted activities of daily living and the impact of these occurrences., Design: A cross sectional design was used to recruit 17 caregivers from Alzheimer's support group meetings in 2010., Method: Self-report surveys were used to obtain participants' report of resistive behaviors., Findings: A positive correlation was found between caregivers reported frequency of bathing behaviors and their reported upset with dressing behaviors. Gender differences emerged in caregiver reported frequencies of the resistive behaviors. Caregivers reported behaviors occurring between two and six times per week but rated the not frequent behaviors as somewhat to very upsetting when they occurred., Conclusions: When informal caregivers provide assisted care, resistive behaviors occur. Future research is needed to identify interventions to help caregivers manage their upset when resistiveness occurs., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Background: Electronic cognitive assessment tools present potential benefits for clinical practice; however, they warrant examination before use with clinical populations such as people with traumatic brain injury (TBI)., Objective: The primary study purpose was to compare results from a tablet-based, electronic cognitive assessment to two paper cognitive assessments when administered to adults with TBI. We also explored the effect of iPad comfort on performance., Methods: We employed a quasi-experimental, correlational study design. Forty adults between 18 to 615 months post TBI completed the Standardized Touchscreen Assessment of Cognition (STAC), the Montreal Cognitive Assessment (MoCA), and the Cognitive Linguistic Quick Test (CLQT) in a systematically, counterbalanced order. We compared participants' performance on these tools and examined the effect of iPad comfort., Results: Three STAC subtests had a good relationship with CLQT subtests: orientation, generative naming category, and generative naming first letter. A good relationship was also identified between two STAC and two MoCA subtests: orientation and generative naming first letter. People who were very comfortable using the iPad performed statistically better on the STAC first letter fluency item than participants who were not comfortable., Conclusions: Moderate correlations suggest validity for some STAC items; however, modifications and further testing are needed.

Objective: The purpose of this paper is to provide a brief non-mathematical introduction to Latent Class Analysis (LCA) and a demonstration for researchers new to the analysis technique in pharmacy and pharmacy administration. LCA is a mathematical technique for examining relationships among observed variables when there may be collections of unobserved categorical variables. Traditionally, LCA focused on polytomous observed variables, but recent work has extended the types of data that can be utilized. Included in this introduction are basic guidelines for the information that should be part of a manuscript submitted for review. For the analysis, LatentGold is used, but I also include basic R code for running LCA and LC Regressions with the poLCA package., (Copyright © 2016 Elsevier Inc. All rights reserved.)

This paper is a technical update to "Core Reporting Practices in Structural Equation Modeling." 1 As such, the content covered in this paper includes, sample size, missing data, specification and identification of models, estimation method choices, fit and residual concerns, nested, alternative, and equivalent models, and unique issues within the SEM family of techniques., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Background: Portable electronic devices are increasingly being used for clinical assessment of individuals with cognitive deficits. Prior to implementation of tablet-based assessments, comparison with other standard measures is needed., Objective: The study purpose was to compare an iPad administered cognitive assessment known as the Standardized Touchscreen Assessment of Cognition (STAC) to the Cognitive Linguistic Quick Test (CLQT) and the Cognitive Assessment of Minnesota (CAM)., Methods: Eighty-eight neurotypical participants completed the STAC, CAM, and CLQT in a randomized order. The researchers compared the participants' responses across similar subtests. Performance across iPad comfort levels was also explored., Results: Findings revealed moderate correlations in some areas of assessment: generative naming and immediate visual memory. The correlations varied across age groups within each area of assessment with no consistent pattern. Additionally, people with comfort using an iPad performed significantly better on three areas of STAC assessment (generative naming category and first letter, and auditory working memory) compared to people who reported no iPad comfort., Conclusions: Initial testing of the STAC in a neurotypical population identified moderate correlations with standard measures in some subtests; however, additional testing of the STAC is needed to determine the clinical utility and validity of assessing populations with cognitive impairments.

A wealth of research demonstrates the importance of early parent-child interactions on children's social functioning. However, less is known about the interrelations between child and parent characteristics and parent-child interactions in early childhood. Moreover, few studies have broadly examined the longitudinal relations between these constructs and social competence. This study is an examination of the relations between parent responsiveness, negativity, and emotional supportiveness, attachment security, and child temperament, and their impact on children's social competence from infancy to kindergarten entry. The sample was derived from the Early Childhood Longitudinal Study--Birth Cohort and included 6850 parent-child dyads. Observational and rating scale data were used. The proposed model was nearly fully supported by path analysis, and it provides insight into the complex relations between early parenting behaviors, child characteristics, and parent-child interactions in the development of social competence., (Copyright © 2013 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.)

Background: Structural equation modeling (SEM) is a popular analysis technique because of the wide range of questions that it can help answer. There are several pieces of information specific to SEM that should be reported when this technique is used., Objectives: To demonstrate a basic framework for reporting SEM analyses, to provide definitions of key terms readers will encounter, and to illustrate 2 examples for reporting SEM results., Methods: Data from 650 participants who completed 3 self-report surveys were used to test a confirmatory factor analysis and a structural model as examples of information to be reported., Results: The results displayed are requisite information for any SEM analysis., Conclusions: It is important for investigators to provide this information so that readers can properly evaluate the results and conclusions based on the analyses.

The Brief Symptom Inventory-18 (BSI-18: Derogatis, 2000) is an abbreviated version of the nine dimension, 53-item BSI (Derogatis, 1993) which is a shortened form of the 90-item Symptom Checklist-90-Revised (SCL-90-R: Derogatis, 1994). Criticism focused on factor structure (cf. Boulet & Boss, 1991; Ruipérez, Ibáñez, Lorente, Moro, & Ortet, 2001) and the two older versions' poor discriminant validity suggest the scales' usefulness is limited to global scores only. Using principal component analysis, the authors explore the three-dimension factor structure of the BSI - 18 with the understudied population of Central American immigrants to the U.S. (N = 100). Results suggest one underlying factor best used in aggregate as a general screening for overall levels of psychological distress. Cultural differences are discussed.

Background: Stress and social support influence adolescents' coping strategies. Adolescents need to acquire a large repertoire of coping strategies in light of a rapidly changing socio-economic and political situation., Aim: This study reports on the coping strategies of Zimbabwean adolescents and highlights some major stressors they face. The interplay among stress, social support and the coping strategies of Zimbabwean adolescents are also reported., Sample: A sample of 101 Zimbabwean students (ages 17-19) participated in this study., Method: Participants completed three instruments: the Perceived Stress Scale, the Social Provision Scale and the Ways of Coping Scale., Results: Zimbabwean adolescents experienced slight stress as measured by the Perceived Stress Scale. Major stressors included schoolwork, relationships, social life and financial hardship. Females reported a higher level of perceived stress than males. Zimbabwean adolescents reported having fewer social provisions than the norm group. Results from the Ways of Coping Scale indicated that Zimbabwean adolescents use emotion-focused strategies more frequently than problem-solving strategies., Conclusion: The implications of the study are that Zimbabwean adolescents may need to acquire a larger repertoire of coping skills adding to what they may already have. Problem-solving skills need to be employed in face of today's challenging situations.

The relative effects of developmental level and domain-specific knowledge on children's ability to identify and make similarity decisions about object concepts based only on haptic (touch) information were investigated. Children aged 4-9 years with varying levels of dinosaur knowledge completed a cross-comparison task in which they haptically explored pairs of familiar (dinosaur) and unfamiliar (sea creature) models that varied in terms of their degree of differentiability. Older children explored models more exhaustively, found more differentiating features and consequently made fewer errors than younger children did. High knowledge enabled children to identify models correctly, but was also associated with the use of a hypothesis testing strategy, which led children to make greater numbers of "miss" errors on the cross-comparison task. Performance in the control domain illustrated that the hypothesis testing strategy was specific to the high knowledge domain. Potential explanations for the role of knowledge and development in haptic exploration are considered.

A previously healthy 22-yr-old woman was found to have chronic pancreatitis restricted to the ventral pancreas in association with pancreas divisum. When conservative treatment failed, sphincteroplasty of both papillae was performed with good results. This well-documented case represents a clear exception to the commonly held concept that obstruction of the dorsal duct is the essential pathogenic factor in the development of pancreatitis associated with pancreas divisum. The importance of visualizing both the dorsal and ventral pancreatic ducts to direct therapy for patients with idiopathic pancreatitis is discussed. Theories of the pathogenesis of concomitant pancreatitis and pancreas divisum are reviewed.

The subcellular distribution of the enzyme catalysing the conversion of retinyl phosphate and GDP-[14C]mannose into [14C]mannosyl retinyl phosphate was determined by using subcellular fractions of rat liver. Purity of fractions, as determined by marker enzymes, was 80% or better. The amount of mannosyl retinyl phosphate formed (pmol/min per mg of protein) for each fraction was: rough endoplasmic reticulum 0.48 +/- 0.09 (mean +/- S.D.); smooth membranes (consisting of 60% smooth endoplasmic reticulum and 40% Golgi apparatus), 0.18 +/- 0.03; Golgi apparatus, 0.13 +/- 0.03; and plasma membrane 0.02.

A study was conducted to determine whether mannosyl retinyl phosphate occurred in rat liver and intestine in vivo, and, if so, to partially purify it and investigate its properties. After injection of [(3)H]retinol and [(14)C]mannose, a chloroform-methanol 2:1 extract of rat liver and small intestinal mucosa yielded two (3)H/(14)C-labeled peaks on DEAE-cellulose column chromatography: peak I eluted with 10 mM and peak II eluted with 29 mM ammonium acetate. Peak II, subjected to silicic acid column chromatography, gave principally two (3)H/(14)C-labeled fractions, one eluted with chloroform-methanol 2:1 and the other with chloroform-methanol 1:1. The latter showed, on thin-layer chromatography in a chloroform-methanol-water 60:25:4 system, an R(f) of 0.25 (with coincidence of the (3)H and (14)C radioactivity), which is identical to the R(f) of authentic mannosyl retinyl phosphate. The chloroform-methanol 1:1 peak, on mild acid hydrolysis, yielded [(3)H]retinol (identified by two thin-layer chromatography systems), [(14)C]mannose, and [(14)C]-mannose phosphate (identified by paper chromatography). On mild alkali hydrolysis, the peak yielded [(3)H]retinol and [(14)C]mannose phosphate. The substance eluted in the chloroform-methanol 1:1 peak from silicic acid was therefore concluded to be mannosyl retinyl phosphate. When chromatographed on silicic acid, peak I from the DEAE-cellulose column primarily showed a fraction eluted with chloroform-methanol 2:1. When chromatographed on thin-layer plates in the above solvent, this fraction showed an R(f) of 0.3, with coincidence of (3)H and (14)C radioactivity; it was resistant to mild acid hydrolysis, mild and strong alkali hydrolysis, and glucuronidase action. Mannosyl retinyl phosphate occurs, therefore, in vivo in liver and intestinal mucosa, and it is accompanied by a closely similar, though slightly less polar, compound that remains unidentified.

Recent evidence supports the concept that vitamin A plays some role in glycoprotein synthesis in a large-variety of tissues examined. Its involvement may be through participation of a retinol-linked sugar, mannosyl retinyl phosphate (MRP). Upon injection of [3H]retinol and [14C]mannose into rats, [14C, 3H]MRP could be isolated from liver and intestinal mucosa, and identified by chromatographic and hydrolytic experiments. The enzyme system that forms MRP from GDP-mannose and retinyl phosphate was located primarily in rough endoplasmic reticulum of fractionated liver cells, with some activity also in smooth membranes and Golgi apparatus. Vitamin A deficiency resulted in depressed synthesis of the rat serum glycoprotein alpha 1-macroglubin (alpha 1-MG), as shown by a decline in labeling. Analysis of the labeled alpha 1-MG from serum of normal and vitamin A-deficient rats showed this to be the result of a defect in glycosylation. The specific activity ratio (deficient:normal) of the alpha 1-MG of serum declined progressively with development of the deficiency, as a result of underglycosylation. Complete carbohydrate analysis of the alpha 1-MG of normal and deficient serum revealed a sugar loss in this glycoprotein as a result of vitamin A deficiency.

A case of idiopathic central serous chorioretinopathy with bullous retinal detachment occurring in a patient with Crohn's disease is described. This rare eye condition (36 reported cases in the world's literature) has previously been seen in association with ulcerative colitis, and its occurrence in a patient with Crohn's disease suggests that it may represent another ophthalmologic complication of inflammatory bowel disease.

Results of animal studies and human clinical trials assessing the efficacy of newer agents in the treatment of stress-related mucosal damage have been reviewed. Currently available data suggest that prostaglandin treatment is as effective in preventing and treating stress-induced mucosal injury as more established therapeutic modalities, but that the proposed efficacy of somatostatin infusion and tranexamic acid administration is highly suspect. Promising agents yet to be evaluated include omeprazole, allopurinol, and epidermal growth factor.