The nature of the pandemic: Exploring the negative impacts of the COVID-19 pandemic upon recreation visitor behaviors and experiences in parks and protected areas.

Unlabelled: The COVID-19 pandemic dramatically affected parks and protected areas and overall recreation visitation across the United States. While outdoor recreation has been demonstrated to be beneficial, especially during a pandemic, the resulting increase in recreation visitation raises concerns regarding the broader influence of social, situational, ecological, and behavioral factors upon overall visitor experiences. This study investigated the extent to which recreation visitors' behaviors and experiences have been impacted by the COVID-19 pandemic within the White Mountain National Forest (WMNF).

Best Practices in Pharmacotherapy for Acute Coronary Syndromes.

Numerous advances have been made in the therapy of acute coronary syndromes. Despite these advances, acute coronary syndromes still cause significant morbidity and mortality. Decisions as to the best therapy vary depending on other patient factors, such as age, need for chronic anticoagulation, tolerability of medications, and the degree of myocardial damage.

COVID-19 pandemic: Challenges and solutions from the cardiology pharmacist's perspective.

The recent coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) challenges pharmacists worldwide. Alongside other specialized pharmacists, we re-evaluated daily processes and therapies used to treat COVID-19 patients within our institutions from a cardiovascular perspective and share what we have learned. To develop a collaborative approach for cardiology issues and concerns in the care of confirmed or suspected COVID-19 patients by drawing on the experiences of cardiology pharmacists across the country.

Protamine sulfate for the reversal of enoxaparin associated hemorrhage beyond 12 h.

Clinical practice guidelines recommend protamine sulfate for reversal of enoxaparin associated bleeds dependent on the time from last administration and dose of enoxaparin. We present a case of a hemodynamically unstable patient with an enoxaparin induced abdominal wall hematoma/hemorrhage and the previous enoxaparin administration 21.5 h prior to presentation with a therapeutic anti-Xa assay (0.

The Role of Nonvitamin K Antagonist Oral Anticoagulants (NOACs) in Stroke Prevention in Patients with Atrial Fibrillation.

Anticoagulation is important in stroke prevention in patients with atrial fibrillation. Until recently, heparins and vitamin K antagonists were the only available therapy for stroke reduction in atrial fibrillation (AF) patients. Non-vitamin K antagonist oral anticoagulants (NOACs) including direct thrombin inhibitor (dabigatran) and direct factor Xa inhibitors (rivaroxaban, apixaban and edoxaban) are now available and offer new options for stroke prevention.

A competency-based approach to preparing staff as recreation and youth development leaders.

Youth development professionals and parks and recreation professionals often are charged with providing services to youth. However, the approach of each can be quite different as recreation is a primary focus for recreation professionals and part of many services offered by youth development specialists. Despite the differences, these two groups of professionals can learn a great deal from each other.

Back to the future: The potential relationship between leisure and education.

There is a long, documented history of the relationships among leisure, recreation, and education dating back to Greek philosophy.Originally there was little differentiation among the terms as they were presented as a unified process for youth and human development. Over time, each of these fields has developed, and their definitions have been shaped and reshaped.

Eptifibatide-associated acute, profound thrombocytopenia.

Objective: To describe 3 cases of eptifibatide-associated acute, profound thrombocytopenia.

Case Summaries: A 40-year-old black female received eptifibatide 180-microg/kg double bolus followed by a continuous infusion of 2 microg/kg/min for percutaneous coronary intervention (PCI). The platelet count decreased from 308 x 10(3)/mm3 to 2 x10(3)/mm3 4 hours after initiation of eptifibatide.

Dobutamine-induced eosinophilia.

A man with dilated cardiomyopathy presented with decompensated heart failure and marked eosinophilia. After extensive clinical and laboratory evaluation for hypereosinophilic syndrome, including a myocardial biopsy, it was determined by means of rechallenge (second dobutamine infusion) that the patient was afflicted with dobutamine-induced eosinophilia. This report is important because of the high utilization rate of this drug in a sick population.