Predictors of Food Insecurity and Food Assistance Program Usage Among Puerto Ricans Before and During the COVID-19 Pandemic in Holyoke, Massachusetts.

Background/objectives: Puerto Rican households often face elevated rates of food insecurity. Frequently, households experiencing food insecurity turn to federal and emergency nutrition assistance for urgent or prolonged aid. This study analyzes factors influencing food insecurity and food assistance program involvement among Puerto Ricans in Holyoke, Massachusetts, amidst the COVID-19 pandemic.

Applying athletic principles to medical rounds to improve teaching and patient care.

Problem: Teaching hospital multidisciplinary work rounds are often inefficient, delaying the completion of patient care tasks and detracting from teaching. Participants often act as working groups rather than interdependent teams. Athletic principles were used to train multidisciplinary rounding teams to adopt the systems used by manufacturing to improve the efficiency and quality of patient care, as well as teamwork and didactic teaching.

The Lin28b-let-7-Hmga2 axis determines the higher self-renewal potential of fetal haematopoietic stem cells.

Mouse haematopoietic stem cells (HSCs) undergo a postnatal transition in several properties, including a marked reduction in their self-renewal activity. We now show that the developmentally timed change in this key function of HSCs is associated with their decreased expression of Lin28b and an accompanying increase in their let-7 microRNA levels. Lentivirus-mediated overexpression of Lin28 in adult HSCs elevates their self-renewal activity in transplanted irradiated hosts, as does overexpression of Hmga2, a well-established let-7 target that is upregulated in fetal HSCs.

Caught in the tapestry of tobacco: why I smoke.

Faced with the knowledge that smoking is dangerous, women continue to smoke cigarettes, and the number is growing. In contrast, breast cancer is being diagnosed earlier, and women are listening to the call for mammograms and examination screenings. Why then, are women not listening to the call to never start or stop smoking? In nursing today it has become necessary to put forth a greater effort to call attention to the toll of lung cancer and other smoking related diseases.

Hematopoietic stem cell subtypes expand differentially during development and display distinct lymphopoietic programs.

Adult hematopoietic stem cells (HSCs) with serially transplantable activity comprise two subtypes. One shows a balanced output of mature lymphoid and myeloid cells; the other appears selectively lymphoid deficient. We now show that both of these HSC subtypes are present in the fetal liver (at a 1:10 ratio) with the rarer, lymphoid-deficient HSCs immediately gaining an increased representation in the fetal bone marrow, suggesting that the marrow niche plays a key role in regulating their ensuing preferential amplification.

On-site and distance education of emergency medicine personnel with a human patient simulator.

Background: Infrequent use of emergency medical skills eventually leads to skill degradation. Even during residency training, certain skills may be infrequently encountered. The use of human patient simulators (HPS) is one means by which these skills may be practiced with sufficient numbers to learn and maintain emergency skills.

Education of Out-of-Hospital Emergency Medical Personnel in Pediatrics: Report of a National Task Force.

The Pediatric Education Task Force has developed a list of major topics and skills for inclusion in pediatric curricula for EMS providers. Areas of controversy in the management of pediatric patients in the prehospital setting are outlined, and helpful learning tools are identified. [Gausche M, Henderson DB, Brownstein D, Foltin GL, for the Pediatric Education Task Force: Education of out-of-hospital emergency medical personnel in pediatrics: Report of a National Task Force.

Mucormycosis in diabetes.

Mucormycosis is a rare opportunistic infection caused by ubiquitous fungi typically found in soil, spoiled foods, bread, and dust. The acute infection most commonly is rhinocerebral and is associated with metabolic acidosis. Mucormycosis spreads quickly and can progress from the paranasal area to the brain in a few days.

Gut dysfunction in critically ill patients: a review of the literature.

Background: Critically ill patients are susceptible to injury of the intestinal mucosa, changes in gut permeability, and failure of intestinal defense mechanisms. These conditions put the patients at risk for infection and multiple organ dysfunction syndrome. Specific therapies are needed to prevent gut failure during critical illness.

Angulation of the pediatric cervical spine with and without cervical collar.

Study Objective: To determine whether semirigid cervical collars eliminate cervical spine (CS) flexion in children on back boards.

Design: Prospective clinical study.

Setting: An urban pediatric emergency department.

Who dispenses pharmaceuticals to children at school?

Use of both prescription and non-prescription pharmaceuticals has increased among children. Many of these drugs are taken during school hours and dispensed by school personnel who are not health professionals. They know little or nothing about the drugs themselves or the medical conditions requiring their use.

Use of a clinical assessment tool for orally intubated patients.

Background: Although oral hygiene is difficult to perform in orally intubated, critically ill patients, oropharyngeal status may be related to acquisition of nosocomial organisms and should therefore be addressed.

Objective: To develop a clinical tool for assessment of the mouth in orally intubated patients.

Methods: Sixteen orally intubated patients from one surgical and one medical intensive care unit were subjects.

Interruption of enteral feedings in head injured patients.

This study was undertaken to determine differences between caloric intake and requirements of critically ill, enterally fed, neurosurgical and neurotrauma patients and to determine the nature and frequency of interruptions in enteral feedings in this same population. This descriptive, prospective study was conducted in a surgical intensive care unit (ICU) in a university teaching hospital. The sample consisted of 52 mechanically ventilated, critically ill patients with a mean age of 48.

The effect of nonnutritive sucking on oxygenation in healthy, crying full-term infants.

Crying in healthy, recently born infants has been associated with decreased oxygenation, which may prolong adjustment to extrauterine life. This research investigated the use of nonnutritive sucking (NNS) as an intervention to reduce crying and prevent any decreases in oxygenation that may occur in crying healthy term infants between 9 and 72 hours of life. Twenty-nine experimental group infants, who received a pacifier (NNS) immediately after crying was induced by a heelstick, had statistically significantly higher transcutaneous oxygen tensions (tcPO2S) compared with baseline values than 30 control (ONNS) infants who did not.

Neutral cervical spine positioning in children.

Study Objectives: To determine the height of back elevation required to place the cervical spine of children less than 8 years old in neutral position and whether agreement on the height required for neutral position could be reached by two independent observers.

Study Design: Prospective.

Setting: Pediatric emergency department and outpatient clinics.

Death in the city. An American childhood tragedy.

Objective: To look at trends in mortality and homicide rates in a specific metropolitan area, comparing the urban and suburban mortality trends.

Design: Descriptive study of mortality rates. Linear regression determined whether changes in mortality rates over time represented significant trends.

The effect of familiar and unfamiliar voice treatments on intracranial pressure in head-injured patients.

Limited research has been conducted exploring the relationship between verbal stimulation and intracranial pressure (ICP). The purpose of this study was to investigate effects of verbal stimulation on ICP in head-injured patients. The sample consisted of 12 head-injured patients with a mean age of 31.

Use of emergency services by unaccompanied minors.

Study Objective: The objective of the study was to describe the use of emergency services by minors who are unaccompanied by their parents or guardians and how they are managed in emergency departments.

Design: Self-administered survey.

Type Of Participants: The ED directors of 71 emergency medicine training programs, 82 Michigan community EDs, and 56 pediatric EDs.

Comparison of rectal, axillary, and tympanic membrane temperatures in infants and young children.

Study Objective: To evaluate the reliability of a tympanic membrane thermometer in detecting fever in young children presenting to the emergency department.

Setting: Pediatric emergency department in an urban teaching hospital, DESIGN/MEASUREMENT/PARTICIPANTS: Temperature measurements were obtained sequentially at three body sites in children less than 3 years old presenting to the pediatric ED. Axillary and rectal temperatures were obtained with an electronic thermistor probe (Diatek 500), and tympanic membrane temperatures were obtained with a noncontact, infrared sensing device (First TEMP).

Acute pulmonary edema after near strangulation.

We report a case of acute, noncardiogenic pulmonary edema in an 11-year-old boy who suffered strangulation during an altercation. The clinical presentation was characterized by moderate respiratory distress and hemoptysis. Both the radiographic and clinical findings resolved during the three day admission which followed.