scholarly journals Addressing Challenges in Humanistic Communication During COVID-19 Through Medical Education

2021 ◽  
Vol 6 ◽  
Author(s):  
Shefali Amin ◽  
Justin Chin ◽  
Mark A. Terrell ◽  
Christine M. Lomiguen
Keyword(s):  
Medical Education ◽  
Human Interaction ◽  
Mitigation Measures ◽  
Healthcare Facilities ◽  
Patient Interaction ◽  
Global Pandemic ◽  
Life Saving ◽  
Short And Long Term ◽  
Insight Into

The current global pandemic due to COVID-19 has resulted in widespread lockdowns, social distancing, and other protective guidelines; these infectious control and mitigation measures challenge the medical system and create anxiety among all populations. In hospitals and healthcare facilities, patient interaction and shared decision making are sacrificed for fear of COVID-19 nosocomial spread. The intangible effects of human interaction with COVID-19 patients, whether of a physician or a patient’s family, are replaced with isolation amid ventilators. Medical professionals must find a way to practice life-saving medical care while maintaining humanistic and professional interactions. This article provides insight into the necessity and challenges of humanistic communication during COVID-19 across various institutions and offers both short- and long-term solutions and reforms through medical education.

scholarly journals Behavioral medicine challenges in the shadow of a global pandemic

2020 ◽  
Author(s):  
Alyssa T Brooks ◽  
Hannah K Allen ◽  
Louise Thornton ◽  
Tracy Trevorrow
Keyword(s):  
Environmental Factors ◽  
Health Behavior ◽  
Health Behaviors ◽  
Natural Experiment ◽  
Direct Effects ◽  
Global Pandemic ◽  
Wide Range ◽  
Future Data ◽  
Short And Long Term

Abstract Health behavior researchers should refocus and retool as it becomes increasingly clear that the challenges of the COVID-19 pandemic surpass the direct effects of COVID-19 and include unique, drastic, and ubiquitous consequences for health behavior. The circumstances of the pandemic have created a natural experiment, allowing researchers focusing on a wide range of health behaviors and populations with the opportunity to use previously collected and future data to study: (a) changes in health behavior prepandemic and postpandemic, (b) health behavior prevalence and needs amidst the pandemic, and (c) the effects of the pandemic on short- and long-term health behavior. Our field is particularly challenged as we attempt to consider biopsychosocial, political, and environmental factors that affect health and health behavior. These realities, while daunting, should call us to action to refocus and retool our research, prevention, and intervention efforts

scholarly journals What Caused Record Water Level Rise in the Great Lakes?

Eos ◽  
2016 ◽  
Vol 97 ◽  
Author(s):  
Terri Cook
Keyword(s):  
Great Lakes ◽  
Water Level ◽  
Water Levels ◽  
Climate Trends ◽  
Modeling Framework ◽  
Water Level Rise ◽  
Short And Long Term ◽  
Insight Into

A new modeling framework offers insight into how specific lakes' water levels respond to short- and long-term climate trends.

scholarly journals Variation, Variegation and Heritable Gene Repression in S. cerevisiae

2021 ◽  
Vol 12 ◽  
Author(s):  
Kholoud Shaban ◽  
Safia Mahabub Sauty ◽  
Krassimir Yankulov
Keyword(s):  
Gene Expression ◽  
Current Knowledge ◽  
Regulatory Circuits ◽  
Epigenetic Diversity ◽  
Short And Long Term ◽  
Unstructured Proteins ◽  
Gene Regulatory ◽  
Gene Regulatory Circuits ◽  
Insight Into

Phenotypic heterogeneity provides growth advantages for a population upon changes of the environment. In S. cerevisiae, such heterogeneity has been observed as “on/off” states in the expression of individual genes in individual cells. These variations can persist for a limited or extended number of mitotic divisions. Such traits are known to be mediated by heritable chromatin structures, by the mitotic transmission of transcription factors involved in gene regulatory circuits or by the cytoplasmic partition of prions or other unstructured proteins. The significance of such epigenetic diversity is obvious, however, we have limited insight into the mechanisms that generate it. In this review, we summarize the current knowledge of epigenetically maintained heterogeneity of gene expression and point out similarities and converging points between different mechanisms. We discuss how the sharing of limiting repression or activation factors can contribute to cell-to-cell variations in gene expression and to the coordination between short- and long- term epigenetic strategies. Finally, we discuss the implications of such variations and strategies in adaptation and aging.

Rethinking Sedation in the ICU

2014 ◽  
Author(s):  
Sinead Galvin ◽  
Lisa Burry ◽  
Sangeeta Mehta
Keyword(s):  
Mechanical Ventilation ◽  
Patient Outcomes ◽  
Critically Ill Patients ◽  
Randomized Trials ◽  
Drug Exposure ◽  
Pain Anxiety ◽  
Patient Interaction ◽  
Monitoring Strategies ◽  
Short And Long Term

Analgesic and sedative medications are commonly given to manage pain, anxiety, and delirium in critically ill patients; such agents are also used to facilitate painful procedures and to promote greater tolerance of mechanical ventilation. The manner in which we administer, titrate, and monitor analgesia and sedation in the ICU can have an impact on both short- and long-term patient outcomes. The benefit of sedation strategies that limit drug exposure and promote greater wakefulness and patient interaction has been demonstrated in several randomized trials. The overall objective of sedation in the ICU has changed, such that a calm, comfortable, awake, and interactive patient is the goal. This can be achieved using an individualized, restrictive, goal-directed, and protocolized approach to analgo-sedation. This chapter discusses specific medications for analgo-sedation, administration, and monitoring strategies, and how these strategies relate to delirium in the ICU.

Insight into the short- and long-term effects of Cu(II) on denitrifying biogranules

2016 ◽  
Vol 304 ◽  
pp. 448-456 ◽  
Author(s):  
Hui Chen ◽  
Qian-Qian Chen ◽  
Xiao-Yan Jiang ◽  
Hai-Yan Hu ◽  
Man-Ling Shi ◽  
...  
Keyword(s):  
Long Term Effects ◽  
Short And Long Term ◽  
Insight Into

scholarly journals Corrosion at the carbon steel-clay compact interface at 90°C: Insight into short- and long-term corrosion aspects

2019 ◽  
Vol 152 ◽  
pp. 31-44 ◽  
Author(s):  
M.L. Schlegel ◽  
F. Martin ◽  
M. Fenart ◽  
C. Blanc ◽  
J. Varlet ◽  
...  
Keyword(s):  
Carbon Steel ◽  
Short And Long Term ◽  
Insight Into

scholarly journals High-altitude champions: birds that live and migrate at altitude

2017 ◽  
Vol 123 (4) ◽  
pp. 942-950 ◽  
Author(s):  
Sabine L. Laguë
Keyword(s):  
High Altitude ◽  
Oxygen Transport ◽  
Physiological Responses ◽  
The Andes ◽  
Trade Offs ◽  
Short And Long Term ◽  
Anser Indicus ◽  
Insight Into ◽  
Cardiac Stroke Volume

High altitude is physiologically challenging for vertebrate life for many reasons, including hypoxia (low environmental oxygen); yet, many birds thrive at altitude. Compared with mammals, birds have additional enhancements to their oxygen transport cascade, the conceptual series of steps responsible for acquiring oxygen from the environment and transporting it to the mitochondria. These adaptations have allowed them to inhabit a number of high-altitude regions. Waterfowl are a taxon prolific at altitude. This minireview explores the physiological responses of high-altitude waterfowl (geese and ducks), comparing the strategies of lifelong high-altitude residents to those of transient high-altitude performers, providing insight into how birds champion high-altitude life. In particular, this review highlights and contrasts the physiological hypoxia responses of bar-headed geese ( Anser indicus), birds that migrate biannually through the Himalayas (4,500–6,500 m), and Andean geese ( Chloephaga melanoptera), lifelong residents of the Andes (4,000–5,500 m). These two species exhibit markedly different ventilatory and cardiovascular strategies for coping with hypoxia: bar-headed geese robustly increase convective oxygen transport elements (i.e., heart rate and total ventilation) whereas Andean geese rely predominantly on enhancements that are likely morphological in origin (i.e., increases in lung oxygen diffusion and cardiac stroke volume). The minireview compares the short- and long-term cardiovascular and ventilatory trade-offs of these different physiological strategies and offers hypotheses surrounding their origins. It also draws parallels to high-altitude human physiology and research, and identifies a number of areas of further research. The field of high-altitude avian physiology offers a unique and broadly applicable insight into physiological enhancements in hypoxia.

scholarly journals Quantifying transmissibility of SARS-CoV-2 and impact of intervention within long-term healthcare facilities

2022 ◽  
Vol 9 (1) ◽  
Author(s):  
Jessica E. Stockdale ◽  
Sean C. Anderson ◽  
Andrew M. Edwards ◽  
Sarafa A. Iyaniwura ◽  
Nicola Mulberry ◽  
...  
Keyword(s):  
Population Level ◽  
Credible Interval ◽  
Total Size ◽  
Bayesian Hierarchical ◽  
Healthcare Facilities ◽  
Standard Methods ◽  
Risk Environments ◽  
Global Pandemic ◽  
Level Model

Estimates of the basic reproduction number ( R 0 ) for COVID-19 are particularly variable in the context of transmission within locations such as long-term healthcare (LTHC) facilities. We sought to characterize the heterogeneity of R 0 across known outbreaks within these facilities. We used a unique comprehensive dataset of all outbreaks that occurred within LTHC facilities in British Columbia, Canada as of 21 September 2020. We estimated R 0 in 18 LTHC outbreaks with a novel Bayesian hierarchical dynamic model of susceptible, exposed, infected and recovered individuals, incorporating heterogeneity of R 0 between facilities. We further compared these estimates to those obtained with standard methods that use the exponential growth rate and maximum likelihood. The total size of outbreaks varied dramatically, with range of attack rates 2%–86%. The Bayesian analysis provided an overall estimate of R 0 = 2.51 (90% credible interval 0.47–9.0), with individual facility estimates ranging between 0.56 and 9.17. Uncertainty in these estimates was more constrained than standard methods, particularly for smaller outbreaks informed by the population-level model. We further estimated that intervention led to 61% (52%–69%) of all potential cases being averted within the LTHC facilities, or 75% (68%–79%) when using a model with multi-level intervention effect. Understanding of transmission risks and impact of intervention are essential in planning during the ongoing global pandemic, particularly in high-risk environments such as LTHC facilities.

scholarly journals The Extravascular Implantable Cardioverter-Defibrillator: The Pivotal Study Plan

2021 ◽  
Author(s):  
Ian Crozier ◽  
David O'Donnell ◽  
Lucas V.A. Boersma ◽  
Francis Murgatroyd ◽  
Jaimie Manlucu ◽  
...  
Keyword(s):  
Electrical Performance ◽  
Antitachycardia Pacing ◽  
Pivotal Study ◽  
Life Saving ◽  
Safety Endpoint ◽  
Short And Long Term ◽  
Human Use ◽  
Novel Design ◽  
Study Plan

Background: Transvenous implantable cardiac defibrillators (TV ICD) provide life-saving therapy for millions of patients worldwide. However, they are susceptible to several potential short- and long- term complications including cardiac perforation and pneumothorax, lead dislodgement, venous obstruction, and infection. The extravascular ICD (EV ICD) system’s novel design and substernal implant approach avoids the risks associated with TV ICDs while still providing pacing features and similar generator size to TV ICDs. Study Design: The EV ICD pivotal study is a prospective, multi-center, single-arm, non-randomized, pre-market clinical study designed to examine the safety and acute efficacy of the system. This study will enroll up to 400 patients with a Class I or IIa indication for implantation of an ICD. Implanted subjects will be followed up to approximately 3.5 years, depending on when the patient is enrolled. Objective: The clinical trial is designed to demonstrate safety and effectiveness of the EV ICD system in human use. The safety endpoint is freedom from major complications, while the efficacy endpoint is defibrillation success. Both endpoints will be assessed against prespecified criteria. Additionally, this study will evaluate antitachycardia pacing (ATP) performance, electrical performance, extracardiac pacing sensation, asystole pacing, appropriate and inappropriate shocks, as well as a summary of adverse events. Conclusion: The EV ICD pivotal study is designed to provide clear evidence addressing the safety and efficacy performance of the EV ICD System.

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