Sleep disturbance and cognitive functioning among firefighters.

Firefighters are at risk for chronic sleep disruption due to their rotating 24-hour on and 48-hour off work schedule and hazardous work conditions. Forty-five firefighters were assessed to determine the impact of their shift schedule on sleep duration, sleep quality, processing speed, sustained attention, vigilance, and mental health. Assessments were conducted at the start and end of shift.

Potential uses of naltrexone in emergency department patients with opioid use disorder.

Despite widespread recognition of the opioid crisis, opioid overdose remains a common reason for Emergency Department (ED) utilization. Treatment for these patients after stabilization often involves the provision of information for outpatient treatment options. Ideally, an ED visit for overdose would present an opportunity to start treatment for opioid use disorder (OUD) immediately.

Quality of Life Enhancement Research Program: Lessons Learned.

The attempted Quality of Life Enhancement program appeared to be a novel method for creating a symbiotic and sustainable relationship between a large Southeastern university and local nursing home and assisted living facilities (ALF), through which ALF residents would attend university arts and sporting events. During implementation, it was discovered that this project was unsustainable, undesired, unneeded by many care centers, difficult to implement, and required a dedicated and specialized staff. After attempting to enroll 14 local care facilities, only 2 were interested in becoming involved and produced 5 eligible participants.

The relationship between moderate alcohol consumption, depressive symptomatology, and C-reactive protein: the Health and Retirement Study.

Objective: Moderate alcohol use has been broadly associated with health benefits among older adults, including improved mood. Aims of this study were to evaluate the relationship of moderate alcohol use and depressive symptomatology over a period of eight years, and to examine inflammation, indicated by C-reactive protein (CRP), as one mechanism by which this relationship functions.

Methods: The study included 3177 community-dwelling participants over the age of 65 in 2008 drawn from the Health and Retirement Study.

Socioeconomic status and hippocampal volume in children and young adults.

An individual's socioeconomic status (SES) is often viewed as a proxy for a host of environmental influences. SES disparities have been linked to variance in brain structures particularly the hippocampus, a neural substrate of learning and memory. However, it is unclear whether the association between SES and hippocampal volume is similar in children and adults.

Code-based Diagnostic Algorithms for Idiopathic Pulmonary Fibrosis. Case Validation and Improvement.

Rationale: Population-based studies of idiopathic pulmonary fibrosis (IPF) in the United States have been limited by reliance on diagnostic code-based algorithms that lack clinical validation.

Objectives: To validate a well-accepted International Classification of Diseases, Ninth Revision, code-based algorithm for IPF using patient-level information and to develop a modified algorithm for IPF with enhanced predictive value.

Methods: The traditional IPF algorithm was used to identify potential cases of IPF in the Kaiser Permanente Northern California adult population from 2000 to 2014.

Recommendations to limit life support: a national survey of critical care physicians.

Rationale: There is debate about whether physicians should routinely provide patient surrogates with recommendations about limiting life support.

Objectives: To explore physicians' self-reported practices and attitudes.

Methods: A cross-sectional, stratified survey of 1,000 randomly selected US critical care physicians was mailed.

Critical care physicians' approaches to negotiating with surrogate decision makers: a qualitative study.

Objective: To describe how critical care physicians manage conflicts with surrogates about withdrawing or withholding patients' life support.

Design: Qualitative analysis of key informant interviews with critical care physicians during 2010. We transcribed interviews verbatim and used grounded theory to code and revise a taxonomy of themes and to identify illustrative quotes.

Sedation and analgesia for the mechanically ventilated patient.

Mechanically ventilated patients in the intensive care unit routinely require sedative and analgesic medications to manage pain and anxiety. These medications may have unpredictable effects with long-term use. Strategies that may help to improve patient outcomes include thoughtful selection of medications, use of objective sedation and pain scales, and implementation of protocolized sedation.

The relationship between service learning and medical student academic and professional outcomes.

Background: Little is known about the relationship between medical student participation in service and performance outcomes.

Purpose: To examine relationships between involvement in required service learning and measures of academic and professional achievement and specialty choice.

Methods: Using preexisting, self-reported data for Tulane University School of Medicine's class of 2004, we categorized students as low, moderate, or high on commitment and involvement in service learning (CISL) and compared to multiple outcomes: class rank; election to the Alpha Omega Alpha (AOA) Honor Society; election to the Gold Humanism in Medicine Honor Society; total percent scores on 2 multistation, structured, clinical examinations; and specialty choice per 2004 residency match results.