Traumatic Brain Injury as an Independent Predictor of Futility in the Early Resuscitation of Patients in Hemorrhagic Shock.

This review explores the concept of futility timeouts and the use of traumatic brain injury (TBI) as an independent predictor of the futility of resuscitation efforts in severely bleeding trauma patients. The national blood supply shortage has been exacerbated by the lingering influence of the COVID-19 pandemic on the number of blood donors available, as well as by the adoption of balanced hemostatic resuscitation protocols (such as the increasing use of 1:1:1 packed red blood cells, plasma, and platelets) with and without early whole blood resuscitation. This has underscored the urgent need for reliable predictors of futile resuscitation (FR).

A County-Level Analysis of Socioeconomic and Clinical Predictors of COVID-19 Incidence and Case-Fatality Rates in Georgia, March-September 2020.

Objectives: The global COVID-19 pandemic has affected various populations differently. We investigated the relationship between socioeconomic determinants of health obtained from the Robert Wood Johnson Foundation County Health Rankings and COVID-19 incidence and mortality at the county level in Georgia.

Methods: We analyzed data on COVID-19 incidence and case-fatality rates (CFRs) from the Georgia Department of Public Health from March 1 through August 31, 2020.

Cystic fibrosis improves COVID-19 survival and provides clues for treatment of SARS-CoV-2.

Systemic pools of ATP are elevated in individuals homozygous for cystic fibrosis (CF) as evidenced by elevated blood and plasma ATP levels. This elevated ATP level seems to provide benefit in the presence of advanced solid tumors (Abraham et al., Nature Medicine 2(5):593-596, 1996).

Pleasant Emotions Widen Thought-Action Repertoires, Develop Long-Term Resources, and Improve Reaction Time Performance: A Multistudy Examination of the Broaden-and-Build Theory Among Athletes.

The authors investigated relationships between emotions, coping, and resilience across two studies. In Study 1a, 319 athletes completed dispositional questionnaires relating to the aforementioned constructs. In Study 1b, 126 athletes from Study 1a repeated the same questionnaires 6 months later.

Transitions from healthcare to self-care: a qualitative study of falls service practitioners' views on self-management.

Purpose: The aim of this study was to understand the views of falls service practitioners regarding: their role in supporting self-management of falls prevention; and a transition pathway from National Health Service (NHS) exercise-based falls interventions to community-run exercise programmes.

Method: Semi-structured interviews were conducted with physiotherapists, nurses, and rehabilitation assistants ( = 8) who worked in an NHS falls service. Data were analysed using thematic analysis.

The Susceptibles, Chancers, Pragmatists, and Fair Players: An Examination of the Sport Drug Control Model for Adolescent Athletes, Cluster Effects, and Norm Values Among Adolescent Athletes.

Although there are few high-profile cases of adolescent athletes being caught doping, up to a third of young athletes may dope. In order to generate a more accurate understanding of why adolescent athletes dope, it is important to validate models that help to explain this behavior. The aims of this study were 3-fold: firstly, to test the Sport Drug Control Model for Adolescent Athletes (SDCM-AA); secondly, to generate athlete profiles that would help quantify the proportion of athletes who are at risk of doping; and thirdly, to create norm values for the Adolescent Sport Doping Inventory (ASDI), which would allow national doping organizations, sporting organizations, and clubs to benchmark the scores of their athletes for key psycho-social variables linked to doping.

Socioeconomic determinants of health and county-level variation in cardiovascular disease mortality: An exploratory analysis of Georgia during 2014-2016.

Since cardiovascular disease (CVD) represents the leading cause of death in the state of Georgia, we sought to describe the relationship between socioeconomic determinants of health (SDH) and CVD-related mortality in Georgia using publicly available population health and economic data. A multivariate regression model was estimated to examine physical inactivity, median household income, health insurance status, urban-rural status, and air quality on CVD mortality in Georgia between 2014 and 2016. We find that the median household income and annual average ambient concentrations of PM2.

The effects of the iPlayClean education programme on doping attitudes and susceptibility to use banned substances among high-level adolescent athletes from the UK: A cluster-randomised controlled trial.

Background This study examined the effects of the iPlayClean anti-doping intervention on attitudes towards doping and susceptibility, and whether delivery mode affected the results. Methods A total of 1081 high-level UK athletes (14-18 years old, 904 males, 177 females) were cluster-randomised to the control (11 teams/organisations/schools, 314 athletes), face-to-face group presentation (8 teams/organisations/schools, 254 athletes), online (11 teams/organisations/schools, 251 athletes), or face-to-face presentation with online access (5 teams/organisations/schools, 262 athletes). Results Compared to the control group, all modes of the iPlayClean anti-doping education programme reduced favourable attitudes towards doping immediately after the intervention, which was sustained across all intervention groups 8 weeks later.

The development and validation of the Adolescent Sport Drug Inventory (ASDI) among athletes from four continents.

A significant barrier to understanding the psychosocial antecedents of doping use among adolescent athletes is the lack of valid measures. In order to address this issue, the first aim of this paper was to develop and validate the Adolescent Sport Drug Inventory (ASDI) among adolescent athletes from Asia, Europe, North America, and Oceania. The second aim was to assess the construct validity of the ASDI.

Children's First Experience of Taking Anabolic-Androgenic Steroids can Occur before Their 10th Birthday: A Systematic Review Identifying 9 Factors That Predicted Doping among Young People.

Taking performance-enhancing drugs (PEDs) can cause serious and irreversible health consequences, which can ultimately lead to premature death. Some young people may take PEDs without fully understanding the ramifications of their actions or based on the advice from others. The purpose of this systematic review was to identify the main factors that predicted doping among young people.

Being Mindful in Your Practice.

As physician practices function to deliver safe and low-risk patient care, they often are susceptible to unexpected events for which the consequences can be high. By acting mindfully, physicians can focus on better managing unexpected events as well as decreasing the risk of such an event. There are five main components of mindfulness that can be implemented within your practice to gain a deeper understanding of your own systems in order to become a safer practice: sensitivity to operations; reluctance to simplify; preoccupation with failure; deference to expertise; and commitment to resilience.

Mandatory insurance coverage and hospital productivity in Massachusetts: bending the curve?

Objective: The aim of this study was to examine whether universal insurance coverage mandates lead to a more productive use of hospital resources.

Data Sources: The American Hospital Association's Annual Survey and the Centers for Medicare and Medicaid Services' case mix index for fiscal years 2005 through 2008 were used.

Study Design: A Malmquist approach was used to assess hospitals' productivity in the United States and Massachusetts over the sample period.

Health information technology vendor selection strategies and total factor productivity.

Objective: The aim of this study was to compare health information technology (HIT) adoption strategies' relative performance on hospital-level productivity measures.

Data Sources: The American Hospital Association's Annual Survey and Healthcare Information and Management Systems Society Analytics for fiscal years 2002 through 2007 were used for this study.

Study Design: A two-stage approach is employed.

Price trends in single- and multispecialty physician practices.

Effective provision of physician services and the financial performance of physician practices depend on both cost and price. While there has been much discussion and research on the differences among physician organizations, particularly pertaining to cost and efficiency, little attention has been paid to how prices received for services have changed over time. In order to address this void in the literature, we focus on the trends in prices paid for services rendered by two different organizational structures, namely single- and multispecialty physician groups.

Reassessing nurse aide job satisfaction in a Texas nursing home.

This article reports a study that replicates and extends Castle's 2007 study by examining factors related to satisfaction of nurse aides at Carillon House, a 120-bed nonprofit skilled nursing facility in Lubbock, Texas. The Nursing Home Nurse Aide Job Satisfaction Questionnaire was adapted to allow for the collection of qualitative responses and administered to the nursing staff. The results suggest that satisfaction among nurse aides is related to rewards, workload, and the team environment created among coworkers.

The impact of accelerating electronic prescribing on hospitals' productivity levels: can health information technology bend the curve?

This paper examines how different strategies for implementing computerized prescriber order entry (CPOE) impact hospitals' productivity. We used the American Hospital Association's Annual Survey to construct hospital-level measures for 1,812 facilities and analyzed the productivity indices against CPOE use rates. The relationship between CPOE use rates and indices for "technical efficiency change" and "total factor productivity" was significant.

Induced hypothermia prior to left ventricular assist device.

Induced hypothermia, a therapy that recently gained the attention of a broad spectrum of US and international medical authorities for its neuroprotective benefits in post-cardiac arrest patients, may represent an underexplored therapeutic option in patients with severe cardiac failure by optimizing hemodynamics and augmenting cardiac contractility. The authors present the first case report, to their knowledge, of a patient with severe congestive heart failure who underwent cooling prior to successful left ventricular assist device implantation.

A cost-benefit analysis of bariatric surgery on the South Plains region of Texas.

The regional economic burdens of obesity have not been fully quantified. This study incorporated bariatric surgery demographics collected from a large university hospital with regional economic and employment data to evaluate the cost of obesity for the South Plains region of Texas. Data were collected from patients who underwent laparoscopic gastric bypass and laparoscopic banding between September 2003 and September 2005 at Texas Tech University Health Sciences Center.

Posttransplant pacemaker placement: case series and review.

Introduction: Sinus node dysfunction (SND) following orthotopic heart transplantation may lead to bradycardia, atrioventricular block, sick sinus syndrome, syncope, and death, with 6%-23% of patients requiring pacemakers.

Methods: Permanent pacemakers were placed in 5% of orthotopic heart transplants conducted at our institution from January 2002 to October 2008.

Results: THREE DIFFERENT IMPLANT TECHNIQUES WERE USED OVER THIS TIME: (1) dual-chamber pacing in the donor atrium and ventricle (A(D)-V(D)) (62.

Pulmonary hypertension for primary care providers.

Pulmonary hypertension is a constellation of diseases that shares signs and symptoms of dyspnea, fatigue, chest pain, palpitations, and syncope. Research advances made over the past decade have significantly changed the natural history of this disease. Therapies initially designed to specifically target the molecular causes of increased pulmonary vascular resistance are now used in all types of patients with pulmonary hypertension.

Participant's perception of negative cognition in low back pain: a pilot study.

Objective: It has been theorized that low back pain contributes to the development of negative cognition (negative thinking) which may predispose a person towards chronicity. The objective of this paper is to examine the role of negative cognition in non-depressed participants who have previously experienced low back pain.

Methods: Ten students enrolled in a course at the University of Kansas were involved in a 4 week educational project.

Adolescent idiopathic scoliosis screening for school, community, and clinical health promotion practice utilizing the PRECEDE-PROCEED model.

Background: Screening for adolescent idiopathic scoliosis (AIS) is a commonly performed procedure for school children during the high risk years. The PRECEDE-PROCEDE (PP) model is a health promotion planning model that has not been utilized for the clinical diagnosis of AIS. The purpose of this research is to study AIS in the school age population using the PP model and its relevance for community, school, and clinical health promotion.

Endurance exercise training improves endothelium-dependent relaxation in brachial arteries from hypercholesterolemic male pigs.

We tested the hypothesis that exercise (Ex) training attenuates hypercholesterolemia-induced impairment of endothelium-dependent relaxation (EDR) in brachial (Br) arteries of adult male pigs by enhancing nitric oxide (NO)-mediated EDR. Adult male pigs were fed a normal-fat (NF) or high-fat/cholesterol (HF) diet for 20 wk. Four weeks after the diet was initiated, pigs were trained or remained sedentary (Sed) for 16 wk, yielding four groups: 1) NF-Sed, 2) NF-Ex, 3) HF-Sed, and 4) HF-Ex.

Exercise preserves endothelium-dependent relaxation in coronary arteries of hypercholesterolemic male pigs.

We tested the hypothesis that exercise training (Ex) attenuates hypercholesterolemia-induced impairment of endothelium-dependent relaxation (EDR) in male porcine coronary arteries [left anterior descending coronary arteries (LAD)] by increasing nitric oxide (NO) release [due to increased endothelial NO synthase (NOS) expression] and/or increased bioactivity of NO. Adult male pigs were fed a normal-fat (NF) or high-fat (HF) diet for 20-24 wk. Pigs were Ex or remained sedentary (Sed) for 16-20 wk, beginning after 4 wk on diet.