ASD Symptoms, Social Skills, and Comorbidity: Predictors of Bullying Perpetration.

Children with ASD are more likely to be involved in bullying compared to typically developing peers; however, studies rarely examine bullying perpetration and the contributing factors among this population. The primary aim of this study was to examine the extent to which parent-reported ASD symptoms, social skills, and comorbid externalizing and internalizing symptoms predicted bullying perpetration in a sample of 390 children with ASD without intellectual disability. Findings from hierarchical regression analyses indicated that social skill deficits, externalizing symptoms (i.

Identifying low-risk chest pain in the emergency department without troponin testing: a validation study of the HE-MACS and HEAR risk scores.

Introduction: Patients presenting to EDs with chest pain of possible cardiac origin represent a substantial and challenging cohort to risk stratify. Scores such as HE-MACS (History and Electrocardiogram-only Manchester Acute Coronary Syndromes decision aid) and HEAR (History, ECG, Age, Risk factors) have been developed to stratify risk without the need for troponin testing. Validation of these scores remains limited.

Generation and transmission of interlineage recombinants in the SARS-CoV-2 pandemic.

We present evidence for multiple independent origins of recombinant SARS-CoV-2 viruses sampled from late 2020 and early 2021 in the United Kingdom. Their genomes carry single-nucleotide polymorphisms and deletions that are characteristic of the B.1.

Does venous thromboembolism prophylaxis affect the risk of venous thromboembolism and adverse events following primary hip and knee replacement? A retrospective cohort study.

Background: The optimum chemical venous thromboembolism (VTE) prophylactic agents following total hip and knee replacement (THR and TKR) remain unknown. NICE recommends multiple agents, including direct oral anticoagulants (DOACs), low-molecular weight heparin (LMWH), and aspirin. We assessed whether VTE prophylaxis affected the risk of VTE and adverse events following primary THR and TKR.

Rates of Bile Acid Diarrhoea After Cholecystectomy: A Multicentre Audit.

Introduction: Bile acid diarrhoea (BAD) can occur due to disruption to the enterohepatic circulation, e.g. following cholecystectomy.

Impact of COVID-19 on inpatient referral of acute heart failure: a single-centre experience from the south-west of the UK.

Aims: Healthcare services worldwide have been significantly impacted by the COVID-19 pandemic. Recent reports have shown a decline in hospitalization for emergency cardiac conditions. The impact of the COVID-19 pandemic on hospitalization and particularly mortality due to acute heart failure has not been thoroughly described.

A patient-specific lower extremity biomechanical analysis of a knee orthotic during a deep squat movement.

Although knee orthotics have become the preferred treatment method for rehabilitation and injury prevention, their biomechanical influence has not yet been quantified. A new type of knee joint orthosis (KJO) using a non-linear spring-loaded (NLSL) component was recently introduced to help prevent the growing number of knee injuries and aid during rehabilitation. The purpose of this case study is to quantify the lower extremity biomechanical effects and evaluate functional benefits of a new KJO as a precision treatment option.

Can We Use Routinely Collected Healthcare Data for a Nationwide Trial on Venous Thromboembolism Prophylaxis Following Primary Joint Replacement? A Feasibility Study.

Background: UK hospitals nationally report venous thromboembolism (VTE) within 90 days of hospital admission, with hospital-acquired thrombosis (HAT) registers at each center used for this. We assessed the accuracy of our HAT register in identifying VTE following primary total hip arthroplasty (THA) and total knee arthroplasty (TKA).

Methods: We assessed 982 elective admissions for primary THA and TKA at a large tertiary center during 2018.

Sharing simulation-based training courses between institutions: opportunities and challenges.

Background: Sharing simulation-based training (SBT) courses between institutions could reduce time to develop new content but also presents challenges. We evaluate the process of sharing SBT courses across institutions in a mixed method study estimating the time required and identifying barriers and potential solutions.

Methods: Two US academic medical institutions explored instructor experiences with the process of sharing four courses (two at each site) using personal interviews and a written survey and estimated the time needed to develop new content vs implement existing SBT courses.

Postgraduate Alcohol and Other Drug Practitioner Training in New Zealand: Significant Influences.

Objective: The purpose of this article is to present a case study of the evolution of postgraduate-level training programs for alcohol and other drug (AOD) practitioners provided by two universities in New Zealand.

Method: The case study compiles details on relevant treatment contexts and systems in New Zealand and key milestones and significant developments in postgraduate AOD practitioner programs in two locations over a 30-year period. The details were compiled by the authors, all of whom were closely involved with the development of the training programs.

Drug use and addiction: evolutionary perspective.

Drug use creates a significant amount of harm in modern societies. From an evolutionary perspective, the pervasive use of drugs and the ongoing risk of drug addiction can be explained in terms of the action of drugs on evolved motivational-emotional systems. Addiction arises through interaction of these evolutionarily ancient systems, designed to promote the pursuit of natural rewards, and contemporary environments where purified and potent forms of drugs are readily available.

Coexisting psychiatric disorders in a New Zealand outpatient alcohol and other drug clinical population.

Objective: To describe the extent of psychiatric disorder and mental health service utilization in a representative outpatient alcohol and other drug (AOD) treatment sample in New Zealand.

Method: A total of 105 patients were randomly recruited from two outpatient AOD treatment services in New Zealand and completed a diagnostic interview within the first 2 months of treatment. Axis I psychiatric diagnoses were made using the computerized Composite International Diagnostic Interview (CIDI-Auto), and were supplemented by the South Oaks Gambling Scale (SOGS) and the conduct disorder and antisocial personality disorder section of the Diagnostic Interview for Genetic Studies (DIGS).

To lead or not to lead? Prospective controlled study of emergency nurses' provision of advanced life support team leadership.

Background And Objectives: In many emergency departments advanced life support (ALS) trained nurses do not assume a lead role in advanced resuscitation. This study investigated whether emergency nurses with previous ALS training provided good team leadership in a simulated cardiac arrest situation.

Methods: A prospective study was conducted at five emergency departments and one nurses' association meeting.

A case report and review of the locked metacarpophalangeal joint.

A 59-year-old female with metacarpal joint locking is presented. The successful closed manipulation is described with a review of the literature.

Barriers to optimal care for patients with coexisting substance use and mental health disorders.

Objective: This paper describes qualitative research that was carried out as part of a project aimed at drawing up a series of guidelines for the assessment and management for people with coexisting substance use and mental health disorders, or dual diagnosis.

Method: A core consultation team of 14 experts with experience in the areas of both substance use and mental health in New Zealand was established to advise on the development of eight clinical scenarios. The clinical scenarios were selected to highlight a range of real life issues in the treatment of people with coexisting substance use and mental health disorders and were presented at 12 focus groups around New Zealand.

Clinician beliefs and practices related to increasing responsivity to the needs of Măori with alcohol and drug problems.

Culturally responsive treatments are often cited as essential for successfully addressing substance use-associated problems in indigenous and other ethnic groups. However, there has been little investigation of the support for this assertion among alcohol and drug-user treatment workers, or how it might translate into clinical practice. The current paper reports on the results of a survey of the New Zealand alcohol and drug-user treatment field, which canvassed these issues.

Bupropion overdose: a potential problem with the new 'miracle' anti-smoking drug.

Bupropion (Zyban) has recently been launched in the UK as an aid to smoking cessation. As a result of the considerable publicity, there has been unprecedented demand for this new drug in primary care. Within a few weeks of its launch, four patients presented to our A&E department having taken bupropion as an intentional overdose.

A profile of alcohol and drug clients in New Zealand: results from the 1998 national telephone survey.

Aims: To describe the profile of clients seen across the broad spectrum of dedicated alcohol and drug treatment services in New Zealand.

Methods: 217 randomly selected alcohol and drug treatment workers in New Zealand were interviewed by telephone, yielding a randomly selected sample of 291 clients. Workers were asked to identify the age, gender, ethnicity, main substance use problem and geographical location of clients.

Snap without crackle or pop: a rude awakening. A case history of penile fracture.

Penile fracture is a rare but worrying condition. The presentation to accident and emergency or primary care should not present difficulty in diagnosis but may cause concern with regard to initial treatment and definitive management. Emergency admission to a urologist is mandatory.

Toxicity of field bindweed (Convolvulus arvensis) to mice.

The effects of feeding high and low doses of field bindweed (Convolvulus arvensis) to mice were investigated. Bindweed contains several alkaloids, including pseudotropine, and lesser amounts of tropine, tropinone, and meso-cuscohygrine. Mice fed bindweed exclusively died or were euthanized after 4-7 d and had severe hepatic necrosis and gastritis with ulceration or erosions.