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Background: Venous thrombosis is a common life-threatening disorder and is a significant source of morbidity and mortality in hospitalized patients. This study aims to evaluate soluble P-selectin (sP-Sel) and to correlate with D-dimer and C-reactive protein (CRP) in venous thrombosis patients. Subjects and Methods: This cross-sectional study includes 144 subjects, with cases (100) as duplex scan positive, Control A (22) includes age matched with no signs of inflammation, and Control B (22) with age matched with signs of inflammation and duplex scan negative. The severity of venous thrombosis is assessed by Well’s score. The statistical analysis was performed using Microsoft Excel, GraphPad Prism version 9.4.1 (681), and MedCalC 20.114. Normality for all the variables in controls and cases was checked. The data were expressed as the median (interquartile range). Comparison between groups was made using the Kruskal–Wallis test. Post hoc analysis was conducted using Dunn’s multiple comparison tests. Quantitative correlation of data was done using Spearman rho test. Receiver operating characteristics curves were constructed to assess the diagnostic performance of sP-Sel, and cutoff value was established. Linear and logistic regression analyses were also performed to predict the disease outcome. Results: In the study, controls have more females, but cases turned out to be more in males may be due to additional risk factors such as smoking and alcohol associated with diabetes mellitus and hypertension. The D-dimer (ng/mL) levels were compared in Control A, B, and cases, and the values were 67.5 (36–107), 135 (101–264), and 1309 (750–2390) ng/mL, respectively, and were statistically significant (P < 0.0001). The sP-Sel (ng/mL) were compared in Control A, B, and cases; the values were 7.59 (7.150–10.64), 7.84 (7.0–11.87), and 19.64 (12.95–33.29), respectively, and were statistically significant (P < 0.0001). Based on the Well’s score, the cases were categorized into having low disease probability, moderate probability, and high probability, and the sP-Sel is high in cases with high probability and is statistically significant. Based on CRP (mg/L) positive (>6 mg/L) or negative (14.29 (ng/mL) showed a sensitivity of 70% and specificity of 81.8% positively predicting the diagnosis of venous thrombosis and D-dimer at a cutoff of >367 ng/mL with a sensitivity of 91% and specificity of 95.45% is positively predicting the diagnosis of venous thrombosis. When multilinear regression analysis was performed D-dimer (ng/mL) and Well’s score were positively associated with sP-Sel (ng/mL) in cases of venous thrombosis. Logistic regression analysis is applied sP-Sel (ng/mL), D-dimer (ng/mL), Well’s score, and smoking came out as the positive predictor for the occurrence of venous thrombosis. Conclusion: D-dimer and Well’s scores are positively associated with sP-Sel and help to diagnose venous thrombosis. more...

BackgroundAssociations between childhood trauma, neurodevelopment, alcohol use disorder (AUD), and posttraumatic stress disorder (PTSD) are understudied during adolescence.MethodsUsing 1652 participants (51.75% female, baseline Mage = 14.3) from the Collaborative Study of the Genetics of Alcoholism, we employed latent growth curve models to (1) examine associations of childhood physical, sexual, and non-assaultive trauma (CPAT, CSAT, and CNAT) with repeated measures of alpha band EEG coherence (EEGc), and (2) assess whether EEGc trajectories were associated with AUD and PTSD symptoms. Sex-specific models accommodated sex differences in trauma exposure, AUD prevalence, and neural development.ResultsIn females, CSAT was associated with higher mean levels of EEGc in left frontocentral (LFC, ß = 0.13, p = 0.01) and interhemispheric prefrontal (PFI, ß = 0.16, p < 0.01) regions, but diminished growth in LFC (ß = -0.07, p = 0.02) and PFI (ß = -0.07, p = 0.02). In males, CPAT was associated with lower mean levels (ß = -0.17, p = 0.01) and increased growth (ß = 0.11, p = 0.01) of LFC EEGc. Slope of LFC EEGc was inversely associated with AUD symptoms in females (ß = -1.81, p = 0.01). Intercept of right frontocentral and PFI EEGc were associated with AUD symptoms in males, but in opposite directions. Significant associations between EEGc and PTSD symptoms were also observed in trauma-exposed individuals.ConclusionsChildhood assaultive trauma is associated with changes in frontal alpha EEGc and subsequent AUD and PTSD symptoms, though patterns differ by sex and trauma type. EEGc findings may inform emerging treatments for PTSD and AUD. more...

Abstract Objective To understand the impact of both frailty and chronologic age on outcomes of weaning from invasive mechanical ventilation (MV). Methods The study population consisted of patients enrolled in the ‘WorldwidE. AssessmeNt of Separation of pAtients From ventilatory assistancE (WEAN SAFE) study. We defined 4 non-overlapping groups, namely: ‘frail’ (clinical frailty scale [CFS] score > 4; age 4; age ≥ 80 years), and a ‘not frail or elderly’ population. The primary outcome was the impact of frailty and older age on delayed weaning and failed weaning from invasive MV. Secondary outcomes included the impact of frailty and age on ICU and hospital survival. Results In the study population, 760 (17%) were frail, while 360 (8%) were elderly, 197 (4%) were frail and elderly, while 3,176 (70%) were not frail or elderly. The frail and elderly cohorts were more likely to be female, had hypoxemic/hypercapnic respiratory failure or sepsis, and had more comorbidities. The proportion of delayed weaning and of failed weaning from invasive MV was significantly higher in the frail (28 and 23%), the elderly (25 and 19%), and the frail and elderly groups (22% and 25%), compared to the not frail or elderly population (12% and 13%, P more...

Background: People with intellectual disabilities are living longer and are increasingly diverse, with health and care needs that are varied and complex. Without changes to funding, services have found it difficult to respond to needs and wishes. Method: A descriptive mixed methods design study, data were collected through questionnaire, focus groups and individual interviews from intellectual disability service managers, direct care staff and older people with intellectual disabilities and family members. Results: Continued reticence on the part of some community healthcare providers to treat people with intellectual disability was noted. Although some service innovations were noted, housing, staffing levels, staff mix and the timely provision of equipment were all reported to impact the ability of services to respond to changing needs. Current per-capita funding practices were reported as unresponsive to growing age-related complexity and fundamentally unsustainable. Conclusions: The health inequalities experienced by people with intellectual disabilities are compounded as they age with complex age-related health needs. There is an urgent need for revision of the service model in Ireland and instigation of flexible and responsive approaches to funding. more...

Background: Spirituality and spiritual support for older people with intellectual disability are deemed important, however little is known about their specific needs. This paper reports for the first time on the religious and spiritual practices of older adults with intellectual disability. Methods: A national longitudinal study examined the prevalence of spiritual practices among older people with intellectual disability in the Republic of Ireland. Results: Older people with intellectual disability seek and receive solace from religious and spiritual practices, especially if they are lonely, in poor health, distressed or bereaved. There is likely a social benefit to spiritual and religious aspects of life that would be beneficial to explore further. Conclusions: Globally more research is required and efforts should be made to ensure greater opportunities for inclusion in societal spiritual and religious activities and to more clearly determine the spiritual needs of this population. more...

Purpose: Set within the context of International Financial Services (IFS), this research aims to considers the demographic profile of IFS apprenticeship candidates in relation to gender equality and social mobility in Ireland. This study also offers valuable insights as to the gendered nature of these "new" apprenticeships and examine whether these programmes provide opportunities for social mobility. Design/methodology/approach: Implementing a quantitative approach, underpinned by a positivist stance, this study analyses Irish national apprenticeship data relating to IFS programmes (n = 1118). Non-parametric tests were applied in the analysis of the gender dimension, while to analyse social mobility, the socio-economic status and spatial profile of candidates were compiled and analysed using the Pobal HP Deprivation Index (SA). Findings: The findings revealed more women are undertaking non-traditional apprenticeship programmes as compared with traditional craft apprenticeships. Within the IFS context, while female participation was seen to be growing, gender divergence was observed in terms of programme level, with a greater number of men, as compared with women, engaging in higher-level degree apprenticeship programmes. The findings also show that IFS apprentices are primarily from socio-economic areas that are above average. This trend indicates a distinctive candidate who is more aligned with the sectoral profile of IFS than that of traditional apprenticeship programmes. Such findings reveal that the "widening participation" aim of IFS apprenticeships is not yet fully realised with issues of gender inequality and social mobility persistent within the wider IFS sector. Originality/value: This study provides an important dimension to both academic and practitioner literature concerning apprenticeships. To date, there has been a proliferation of publications concerning the beneficial impact of skills and vocational-led apprenticeships. However, limited attention has been directed to non-traditional apprenticeships and even less still within the setting of IFS. This research initiates the process of addressing that gap within an Irish context. This study also adds to the existing apprenticeship discourse regarding issues of gender and social mobility by examining the gendered nature of IFS apprenticeships and well as assessing whether these apprenticeships aid social mobility. more...

Objective: Alcohol consumption patterns during the COVID-19 pandemic have varied notably. Participants: We examined the acute impact of the pandemic on alcohol use disorder (AUD) in a generalizable sample of college students who were surveyed pre-pandemic and re-surveyed in May 2020. Method: Items assessed pre-pandemic included DSM-5 AUD and mental health symptoms. A COVID-19 impacts questionnaire was administered, and alcohol and mental health items re-assessed. Results: AUD symptoms decreased from pre-pandemic to during the pandemic, demonstrating a change in trajectory compared to prior cohorts. Students with persistent AUD reported greater concurrent symptoms of PTSD, depression, and alcohol consumption than those with remitted AUD (ps [less than or equal to] 0.02), but not increased COVID-19 impact. Persistent AUD status was predicted by higher sensation seeking and alcohol consumption. Conclusions: Students with concurrent mental health problems are at continued risk for persistent AUD. Findings highlight the impact of the college environment and social context for drinking on AUD. more...

Background: Children involved in the child welfare system, especially those in out-of-home care, experience high rates of mental health symptoms. Mental health symptoms have been linked to worse permanency outcomes in this population. Objective: The present study aimed to evaluate whether children who received a trauma-focused evaluation, compared to children who received usual care, experienced differential permanency outcomes, as well as other court-related outcomes (e.g., legal system involvement). Participants and setting: One-hundred and twenty-five children (58% female, Mage = 10.61) from a family court in the Northeastern United States participated in a trauma-focused evaluation program. Methods: Data for the current study were collected via a retrospective chart. Participants were recruited at a family court of a Northeastern state. Between-groups differences on court-related outcomes were assessed using logistic regression and Kaplan Meier estimates. Findings: There were no significant differences between children who received the trauma-focused evaluation program versus usual care in the likelihood for guardianship changes, termination of parental rights, new child welfare petitions or new juvenile legal petitions. The groups significantly differed in the likelihood of case closure; children who received the trauma-focused evaluation program were more likely to experience case closure compared to children who received usual care. Additionally, on average, children who received the trauma-focused evaluation program achieved case closure almost 8 months sooner. Conclusions: The findings suggest that initiatives aimed at identifying mental health concerns and linking children placed in out-of-home to relevant mental health services care can have a significant and positive impact on permanency outcomes. more...