Alternative Food Practices as Pathways to Cope with Climate Distress.

Experiences of distress and challenging emotions in response to the climate crisis are increasingly common, particularly among young adults. These experiences can include challenging emotions caused by the harmful environmental impacts of conventional food systems, as their contributions to greenhouse gas emissions have become more widely known. While recent studies have examined various experiences of climate distress, the interaction between climate distress and food practice remains poorly understood.

Frequency of and Risk Factors Associated With Hospital Readmission After Sepsis.

Objectives: Although children who survive sepsis are at risk for readmission, identification of patient-level variables associated with readmission has been limited by administrative datasets. We determined frequency and cause of readmission within 90 days of discharge and identified patient-level variables associated with readmission using a large, electronic health record-based registry.

Methods: This retrospective observational study included 3464 patients treated for sepsis or septic shock between January 2011 and December 2018 who survived to discharge at a single academic children's hospital.

Investigating Racial and Socioeconomic Characteristics in Pediatric Sepsis Using Electronic Health Data.

Background And Objectives: Racial/ethnic and socioeconomic disparities are reported in sepsis, with increased mortality for minority and low socioeconomic status groups; however, these studies rely on billing codes that are imprecise in identifying sepsis. Using a previously validated algorithm to detect pediatric sepsis using electronic clinical data, we hypothesized that racial/ethnic and socioeconomic status disparities would be evident in this group.

Methods: We performed a retrospective study from a large, quaternary academic center, including sepsis episodes from January 20, 2011, to May 20, 2021, identified by an algorithm indicative of bacterial infection with organ dysfunction (cardiac, respiratory, renal, or hematologic).

Validation of a Computational Phenotype to Identify Acute Brain Dysfunction in Pediatric Sepsis.

Objectives: To validate a computational phenotype that identifies acute brain dysfunction (ABD) based on clinician concern for neurologic or behavioral changes in pediatric sepsis.

Design: Retrospective observational study.

Setting: Single academic children's hospital.

The Association of Physical Function Measures With Frailty, Falls History, and Metabolic Syndrome in a Population With Complex Obesity.

Frailty, falls and metabolic syndrome are known to be associated with poorer physical function. This study builds on available research by further investigating the relationship between physical function measures, including those comprising frailty, with metabolic syndrome (MetS) and falls, in the context of complex obesity. Participants were recruited from the national Level 3 weight management service in Ireland.

Mental Illness Disclosure in the Workplace: An Opportunity for Improvement.

Background: The Americans with Disabilities Act (ADA) prohibits discrimination based on physical or mental disabilities and requires that employers provide reasonable accommodations to workers with disabilities who can perform their essential job functions. However, the ADA also states that an employer is not required to hire or keep an individual with a psychiatric disability if it poses a direct threat to his or her safety or the safety of others.

Objectives: To identify employers' disclosure requirements for mental illness diagnosis or treatment during the job application process and/or as a condition of ongoing employment, to determine disclosure requirements of state and federal licensing bodies, and to evaluate the legality of disclosure of mental health status.

Responding to a Behavioral Health Crisis: Applying a New Care Model in the Emergency Department.

Objectives: Emergency department (ED) visits for behavioral health (BH) emergencies continue to rise, and institutions across the country encounter barriers and struggle to put BH processes in place to address their needs. After learning of an unanticipated closure of a local psychiatric crisis response center (CRC), our ED implemented quality improvement interventions to respond to an acute surge of BH patients.

Methods: Interventions included an enhanced BH database, the role of social workers as extenders, shared electronic health record documentation, increased staffing, clinical pathway updates, and processes to improve communication.

Temperature Trajectory Sub-phenotypes and the Immuno-Inflammatory Response in Pediatric Sepsis.

Objective: Heterogeneity has hampered sepsis trials, and sub-phenotyping may assist with enrichment strategies. However, biomarker-based strategies are difficult to operationalize. Four sub-phenotypes defined by distinct temperature trajectories in the first 72 h have been reported in adult sepsis.

Prevalence of and Associations With Avascular Necrosis After Pediatric Sepsis: A Single-Center Retrospective Study.

Objectives: Avascular necrosis (AVN) is a rare, but serious, complication after sepsis in adults. We sought to determine if sepsis is associated with postillness diagnosis of AVN, as well as potential-associated risk factors for AVN in children with sepsis.

Design: Retrospective observational study.

PRagMatic Pediatric Trial of Balanced vs nOrmaL Saline FlUid in Sepsis: study protocol for the PRoMPT BOLUS randomized interventional trial.

Background/aims: Despite evidence that preferential use of balanced/buffered fluids may improve outcomes compared with chloride-rich 0.9% saline, saline remains the most commonly used fluid for children with septic shock. We aim to determine if resuscitation with balanced/buffered fluids as part of usual care will improve outcomes, in part through reduced kidney injury and without an increase in adverse effects, compared to 0.

Extreme Weather and Climate Change: Population Health and Health System Implications.

Extreme weather and climate events, such as heat waves, cyclones, and floods, are an expression of climate variability. These events and events influenced by climate change, such as wildfires, continue to cause significant human morbidity and mortality and adversely affect mental health and well-being. Although adverse health impacts from extreme events declined over the past few decades, climate change and more people moving into harm's way could alter this trend.

Patient Case Report: Gabapentin-Induced Hypoglycemia.

Purpose: Gabapentin is an analog of gamma-aminobutyric acid (GABA), but its complete mechanism is not well understood. Common adverse effects from gabapentin include somnolence, sedation, and dizziness. Hyperglycemia is listed as a possible adverse drug reaction in the labeling.

Psychosocial adaptation to climate change in High River, Alberta: implications for policy and practice.

Objectives: Psychosocial adaptation to climate change-related events remains understudied. We sought to assess how the psychosocial consequences of a major event were addressed via public health responses (e.g.

Acetaminophen (Paracetamol) Metabolites Induce Vasodilation and Hypotension by Activating Kv7 Potassium Channels Directly and Indirectly.

Objective: Intravenous acetaminophen/paracetamol (APAP) is well documented to cause hypotension. Since the patients receiving intravenous APAP are usually critically ill, any severe hemodynamic changes, as with those associated with APAP, can be life-threatening. The mechanism underlying this dangerous iatrogenic effect of APAP was unknown.

Effects, uptake, and translocation of aluminum oxide nanoparticles in lettuce: A comparison study to phytotoxic aluminum ions.

The widespread use of aluminum oxide nanoparticles (AlO NPs) unavoidably causes the release of NPs into the environment, potentially having unforeseen consequences for biological processes. Due to the well-known issue of Al phytoxicity, plant interactions with AlO NPs are cause for concern, but these interactions remain poorly understood. This study investigated the effects of AlO NPs on lettuce (Lactuca sativa L.

Gene Expression Profiles in Children With Suspected Sepsis.

Study Objective: Sepsis recognition is a clinical challenge in children. We aim to determine whether peripheral blood gene expression profiles are associated with pathogen type and sepsis severity in children with suspected sepsis.

Methods: This was a prospective pilot observational study in a tertiary pediatric emergency department with a convenience sample of children enrolled.

Sepsis in Complex Patients in the Emergency Department: Time to Recognition and Therapy in Pediatric Patients With High-Risk Conditions.

Objectives: To compare timeliness of sepsis recognition and initial treatment in patients with and without high-risk comorbid conditions.

Methods: This was a retrospective cohort study of patients presenting to a pediatric emergency department (ED) who triggered a vital sign-based electronic sepsis alert resulting in bedside "huddle" assessment per institutional practice. A positive sepsis alert was defined as age-specific tachycardia or hypotension, concern for infection, and at least 1 of the following: abnormal capillary refill, abnormal mental status, or a high-risk condition.

Racial Differences in Sepsis Recognition in the Emergency Department.

Objectives: We assessed racial differences in sepsis recognition in a pediatric emergency department (ED) with an established electronic sepsis alert system.

Methods: Quality-improvement data from June 1, 2016 to May 31, 2017 was used in this retrospective cohort study. All ED visits were included for non-Hispanic black (NHB) and non-Hispanic white (NHW) patients.

Factors Influencing the Mental Health Consequences of Climate Change in Canada.

Climate change is increasing risks to the mental health of Canadians. Impacts from a changing climate may outstrip the ability of Canadians and their health-sustaining institutions to adapt effectively and could increase poor mental health outcomes, particularly amongst those most marginalized in society. A scoping review of literature published during 2000-2017 explored risks, impacts, and vulnerabilities related to climate change and mental health.

Trends in Emergent Head Computed Tomography Utilization for Minor Head Trauma After Implementation of a Clinical Pathway.

Objective: The aims of this study were to evaluate trends over time in computed tomography (CT) scan utilization after implementation of a clinical pathway in a tertiary care children's hospital emergency department (ED), to determine how ED throughput differs by CT utilization, and to determine provider reasoning for obtaining head CT in low-risk patients.

Methods: This was a retrospective cohort study of patients 21 years or younger discharged from our ED with head trauma (Glasgow Coma Scale score ≥13 and a head trauma International Classification of Diseases code) over a 5-year period, starting 1 year after pathway implementation (January 2012 to December 2016). A manual chart review of 10% of patients who received a CT was performed to determine reasoning for CT utilization and guideline compliance.

Stress Testing the Capacity of Health Systems to Manage Climate Change-Related Shocks and Stresses.

Vulnerability and adaptation assessments can provide valuable input to foster climate-resilient health systems. However, these assessments often do not explore the potential health risks of climate change far outside the range of recent experience with extreme weather events and other climate-related hazards. Climate and health stress tests are designed to increase the capacity of health systems and related sectors to manage potentially disruptive climate-related shocks and stresses.

Improving efficiency of pediatric emergency asthma treatment by using metered dose inhaler.

: Evidence suggests using metered dose inhaler (MDI) to treat acute asthma in the Emergency Department reduces length of stay, though methods of implementation are lacking. We modified a treatment pathway to recommend use of MDI for mild-moderate asthma in a pediatric ED. : A baseline review assessed discharged patients >2 years with an asthma diagnosis and non-emergent Emergency Severity Index triage assessment (3/4).

Addressing Mental Health in a Changing Climate: Incorporating Mental Health Indicators into Climate Change and Health Vulnerability and Adaptation Assessments.

A growing number of health authorities around the world are conducting climate change and health vulnerability and adaptation assessments; however, few explore impacts and adaptations related to mental health. We argue for an expanded conceptualization of health that includes both the physiological and psychological aspects of climate change and health. Through a review of the global literature on mental health and climate change, this analytical review explores how mental health can be integrated into climate change and health vulnerability assessments and concludes with recommendations for integrating mental health within climate change and health vulnerability and adaptation assessments.