Perceptions of Advocacy in High School Students: A Pilot Study.

Assessing perceptions and attitudes of advocacy in adolescent populations is an important area of research. Previous studies have shown that advocacy programs in high schools are well-received and help promote health advocacy. This pilot study took place at the University of Central Florida College of Medicine Health Leaders Summer Academy hosted by medical students of the Student National Medical Association.

Health Equity in Medicine.

Description Healthcare disparities exist when, due to racial, ethnic, or gender identity differences linked to social, economic or environmental factors, certain populations lack equitable access to quality healthcare and insurance coverage. Such disparities across history carry profound future implications that we have only begun to contemplate as a profession. This special issue of the HCA Healthcare Journal of Medicine examines the critical issue of health equity in medicine and how the medical community can advance health equity through inclusive behavior and interactions in clinical and educational settings, and our communities.

Racial disparities in patients hospitalized for COVID-19.

Background: The COVID-19 pandemic has demonstrated the significance of health disparities across populations with older adults and minoritized groups being disproportionately affected. Data during the COVID-19 pandemic demonstrated higher infection rates, hospitalization rates, morbidity, and potentially greater mortality in Black, Hispanic, and Native Americans compared to Whites.

Methods: This is a retrospective cohort study of de-identified patient data from 178 hospitals across the United States.

Disparities in the Use of Chemical and Physical Restraints in the Emergency Department by Race/Ethnicity.

Background: Restraints are often utilized in the emergency department (ED) to prevent patients from injuring themselves or others while managing their agitation in order to deliver appropriate medical care. Chemical and physical restraints are ordered at the discretion of the medical provider and typically employed after reasonable verbal de-escalation has been attempted. While health inequities and racial bias in medicine and healthcare have been well-established, information on the differences in the selection and use of restraints by race and ethnicity are scarce.

A Simulated Scenario to Improve Resident Efficiency in an Emergency Department.

Introduction Multitasking is a core competency in emergency medicine. Simulation has been shown to be an effective method of education, which allows learners to prepare for real-world challenges in a controlled environment. Methods In this study, trainees were given a scenario that simulated the experience of managing two patient encounters within a time metric while addressing interruptions that take place in a typical ED.

Apnea and Diffuse Alveolar Hemorrhage Caused by Cocaine and Heroin Use: A Case Report.

Introduction: Drug overdose represents a growing reason for emergency department visits and hospitalizations in the United States. Co-ingestion of multiple substances is also on the rise, and toxidromes can be seen from any of multiple drugs in a single patient.

Case Report: We present a case of diffuse alveolar hemorrhage secondary to cocaine abuse in a patient who was apneic and unresponsive after heroin overdose.

Hyperkalemic Emergency: When You Have Taken a Few Too Many KCl Tablets.

Hyperkalemia is a common clinical problem that varies significantly in severity and indications for treatment. Hyperkalemic emergency exists when there are clinical signs or symptoms, including cardiac conduction abnormalities. The combination of nebulized albuterol and insulin with glucose is most effective for managing clinically significant hyperkalemia.

Disparities in Opioid Pain Management for Long Bone Fractures.

An expanding body of evidence has established that racial disparities exist in the US healthcare system, manifesting in poorer health outcomes for members of the non-white population. This study examines whether disparities exist in the type of analgesia ordered for long bone fractures and the time to medication administration in a community teaching hospital serving a large Hispanic population. We reviewed de-identified data of 115 patients from the emergency department of a community Level II Trauma Center in central Florida with diagnosed long bone fractures and examined the clinical and demographic variables associated with the type of analgesic administered and factors associated with delays in medication administration.

Ocular Thermal Burn Injury in the Emergency Department.

We present a case of an ocular thermal burn from a cooking accident where vegetable oil splashed into the patient's face. The emergency department evaluation and management of ocular thermal burns is discussed. Prompt evaluation, copious irrigation, and consultation with ophthalmology are recommended.

Assembly Line Education: A Novel Educational Technique for Today's Learners.

Background Education is undergoing a transformation. The traditional passive lectures are failing to capture and inspire the new generation of learners who value more active and collaborative learning techniques. Objective We sought to create a novel educational technique to integrate into our curriculum that would be more personalized, employ more active learning and collaboration, and allow for an effective assessment of resident strengths and weaknesses.

Medical students and metrics: seven techniques for a win-win situation.

Background: The authors present seven winning strategies for maintaining a rich academic environment for learners while working in a busy emergency department with expected productivity metrics.

Methods: This is a descriptive paper based on existing literature and on the authors' experience.

Results: Winning strategies to improve ED throughput while also supporting the mission of medical education and improving the learning environment for students include the following: (1) attending first, (2) provider in triage, (3) mobile workstations, (4) patient education, (5) bedside patient presentations, (6) dedicated teaching resident, and (7) thoughtful scheduling.

Emergency Management of Spontaneous Bacterial Peritonitis - A Clinical Review.

Spontaneous bacterial peritonitis (SBP) has a high mortality rate; early antimicrobial therapy is essential for improving patient outcomes. Given that cirrhotic patients are often coagulopathic, the perceived risk of bleeding may prevent providers from performing a paracentesis and ruling out this potentially deadly disease. We examine the pathophysiology and risk factors for SBP, and current guidelines for its diagnosis and treatment.

Living with an indwelling urethral catheter in a community setting: Exploring triggers for unscheduled community nurse "out-of-hours" visits.

Aims And Objective: To explore the experiences of community patients living with a urethral catheter and those caring for them.

Background: Living at home with an indwelling urethral catheter often results in consequences that create a double-edged burden: first, on patients and their relative carers and second, in terms of unscheduled community nurse service "out-of-hours" provision.

Design: One-to-one interviews were conducted with patients living at home, their relative carers, qualified community nurses, augmented home carers and healthcare assistant.

The link lecturer role; inconsistent and incongruent realities.

Background: The United Kingdom (UK) Nursing and Midwifery Council (NMC) suggest that the link lecturer role which is intended to support student nurse practice-based learning should account for 20% of the university-based nurse lecturer's remit. Meantime, a long-standing academic discussion indicates that this role lacks clarity.

Objective: Nurse lecturer (provider) and final year undergraduate student nurse (intended beneficiary) experiences and perceptions of the link lecturer role were explored and compared.

Socially-assigned race, healthcare discrimination and preventive healthcare services.

Background: Race and ethnicity, typically defined as how individuals self-identify, are complex social constructs. Self-identified racial/ethnic minorities are less likely to receive preventive care and more likely to report healthcare discrimination than self-identified non-Hispanic whites. However, beyond self-identification, these outcomes may vary depending on whether racial/ethnic minorities are perceived by others as being minority or white; this perception is referred to as socially-assigned race.

Ethical considerations for clinical photography in the global South.

Clinical photography is an important tool for teaching practitioners and field workers about the clinical manifestations of famine and undernutrition, particularly with respect to the Global South. Current international guidelines for clinical photography are not consistently applied or enforced, which has led to violations of privacy and rights, particularly for patients and victims of disaster in the Global South. Combining existing clinical photography guidelines from the North with ongoing clinical ethics debates in the South, this paper explores approaches to establishing photography guidelines throughout the world that will be sensitive to the privacy and dignities of all patients and victims of emergencies.

Late gestation increase in 11beta-hydroxysteroid dehydrogenase 1 expression in human fetal membranes: a novel intrauterine source of cortisol.

Late human gestation is associated with an increase in the concentration of cortisol (F) in the fetal circulation and amniotic fluid. It had been assumed that most of the F measured in the amniotic fluid came from the fetal adrenal gland. However, local production of F can also occur in human intrauterine tissues from inactive cortisone under the influence of the enzyme 11beta-hydroxysteroid dehydrogenase (11beta-HSD) type 1.

There is differential loss of pyramidal cells from the human hippocampus with survival after blunt head injury.

The experimental literature has shown that neurons within sub-fields of the hippocampus possess differential sensitivities to cell loss after different types of insult to the brain. In humans, after blunt head injury, differential neuronal responses between sub-fields of the hippocampus up to 72 hours after injury have been documented. But, in only a small part of the literature have data for alterations in real numbers of neurons been provided.

Generation and characterization of mouse monoclonal antibodies to the myelin-associated glycoprotein (MAG).

A panel of mouse monoclonal antibodies to rat and human myelin-associated glycoprotein (MAG) was developed. Normal mice were unresponsive to rat MAG, and successful immunization with rat MAG was only achieved in autoimmune NZB mice. By contrast, all strains of mice were responsive to human MAG.

IgM in a human neuropathy related to paraproteinemia binds to a carbohydrate determinant in the myelin-associated glycoprotein and to a ganglioside.

The IgM in three patients with paraproteinemia and peripheral neuropathy was shown to bind to human myelin-associated glycoprotein (MAG) that had been purified to homogeneity by gel filtration on Sepharose CL-6B. The antigenic determinant reacting with the IgM from all three patients was in the carbohydrate part of the MAG molecule. In addition, the IgM from the same three patients bound to a single ganglioside of human sciatic nerve.

P2 protein in oligodendrocytes and myelin of the rabbit central nervous system.

P2 protein, a myelin-specific protein, was detected immunocytochemically and biochemically in rabbit central nervous system (CNS) myelin. P2 protein was synthesized by rabbit oligodendrocytes and was present in varying amounts throughout the rabbit CNS. Comparison of P2 and myelin basic protein (MBP) stained sections revealed that P2 antiserum did not stain all myelin sheaths within the rabbit CNS.