Interventions to improve the psychological well-being of healthcare workers in disasters, pandemics, and mass casualty events.

Objectives: This information paper will describe the current research and recommendations for improving healthcare worker's (HCW) mental health. Individual and organizational goals will be outlined with items broken up into the time frames of predisaster, during a disaster, and post-disaster.

Methods: A team of subject matter experts reviewed the current literature utilizing a search of PubMed, Google Scholar, relevant article reference lists, and subject matter interviews.

On the incorporation of nano TiOto inhibit concrete deterioration in the marine environment.

To develop high deterioration resistance concrete for marine infrastructures, two types of nano TiO(NT) including anatase phase NT and silica surface-treated rutile phase NT were incorporated into concrete. The fabricated NT modified concrete was then put into the marine environment for 21 months in this study. The effects and mechanisms of two types of NT on the deterioration of concrete in the marine environment were investigated from three aspects, including seawater physical and biological as well as chemical actions on concrete with NT.

Home Modifications for Rural Veterans With Disabilities.

Background: Appropriate home modifications (HMs) can make the home environment accessible and relatively safe by reducing the risk of falls. Of special concern are individuals living alone, living in rural communities, and/or living in substandard housing. The Home Improvements and Structural Alterations (HISA) is a Veterans Health Administration (VHA) benefit program providing HMs for veterans with disabilities.

Weight status of rural school youth in Poland: secular change 1986-2016.

The objective of this study was to evaluate secular changes in the Body Mass Index (BMI) and weight status of rural children and adolescents in west-central Poland across decennial surveys spanning 1986 and 2016. Participants were 8,677 boys and girls 7-15 years attending schools in 10 rural communities in 1986, 1996, 2006, and 2016. Heights and weights were measured; BMIs were calculated.

Abnormal levels of mitochondrial proteins in plasma neuronal extracellular vesicles in major depressive disorder.

To characterize neuronal mitochondrial abnormalities in major depressive disorder (MDD), functional mitochondrial proteins (MPs) extracted from enriched plasma neuron-derived extracellular vesicles (NDEVs) of MDD participants (n = 20) were quantified before and after eight weeks of treatment with a selective serotonin reuptake inhibitor (SSRI). Pretreatment baseline NDEV levels of the transcriptional type 2 nuclear respiratory factor (NRF2) which controls mitochondrial biogenesis and many anti-oxidant gene responses, regulators of diverse neuronal mitochondrial functions cyclophilin D (CYPD) and mitofusin-2 (MFN2), leucine zipper EF-hand containing transmembrane 1 protein (LETM1) component of a calcium channel/calcium channel enhancer, mitochondrial tethering proteins syntaphilin (SNPH) and myosin VI (MY06), inner membrane electron transport complexes I (subunit 6) and III (subunit 10), the penultimate enzyme of nicotinamide adenine dinucleotide (NAD) generation nicotinamide mononucleotide adenylytransferase 2 (NMNAT2), and neuronal mitochondrial metabolic regulatory and protective factors humanin and mitochondrial open-reading frame of the 12S rRNA-c (MOTS-c) all were significantly lower than those of NDEVs from matched controls (n = 10), whereas those of pro-neurodegenerative NADase Sterile Alpha and TIR motif-containing protein 1 (SARM1) were higher. The baseline NDEV levels of transcription factor A mitochondrial (TFAM) and the transcriptional master-regulator of mitochondrial biogenesis PPAR γ coactivator-1α (PGC-1α) showed no differences between MDD participants and controls.

Clinical Instructions for Using Silver Diamine Fluoride (SDF) in Dental Caries Management.

Unlabelled: Manufacturer instructions for 38% silver diamine fluoride (SDF) are limited to current FDA clearance for tooth desensitization. There is a need for instructions to provide best-practice recommendations for off-label use of SDF for caries prevention and arrest.

Methods: The authors considered existing clinical approaches to the use of 38% SDF at pH 10 for the prevention and arrest of active dental caries, in light of the best current evidence.

Antidepressant side effects and their impact on treatment outcome in people with major depressive disorder: an iSPOT-D report.

Side effects to antidepressant medications are common and can impact the prognosis of successful treatment outcome in people with major depressive disorder (MDD). However, few studies have investigated the severity of side effects over the course of treatment and their association with treatment outcome. Here we assessed the severity of side effects and the impact of treatment type and anxiety symptoms over the course of treatment, as well as whether side effects were associated with treatment outcome.

Clinically Significant Changes in the 17- and 6-Item Hamilton Rating Scales for Depression: A STAR*D Report.

Objective: To develop clinically meaningful improvement thresholds in both the 17-item and the 6-item Hamilton Rating Scale for Depression (HRSD) total scores in depressed outpatients.

Methods: The post-hoc analysis included all adult outpatients with non-psychotic major depressive disorder in the STAR*D trial who entered and exited the first treatment step (up to 14 weeks of citalopram) with a complete set of study measures at baseline and exit and at least one post-baseline measure. Within-patient change and linear regression anchor-based analyses were conducted to define meaningful and substantial changes in the HRSD and HRSD using three patient-reported outcomes [Work and Social Adjustment Scale (WSAS), Quality of Life Enjoyment and Satisfaction-Short Form (Q-LES-Q-SF); Mini-Q-LES-Q] obtained at baseline and exit from the first treatment step in STAR*D.

National Study of Nursing Faculty and Administrators' Perceptions of Professional Identity in Nursing.

Background: Establishing a professional identity in nursing is integral to professional development, yet this area of inquiry remains understudied.

Purpose: This segment of a multiphased national study measured nursing faculty's perceived level of importance regarding key components of professional identity in nursing using the newly developed Professional Identity in Nursing Survey (PINS).

Methods: Fifty subject matter experts from nursing education, practice, and regulation utilized the DeVellis scale development process to develop the PINS over the course of 2 years.

Managing Incidental Findings on Thoracic CT: Lung Findings. A White Paper of the ACR Incidental Findings Committee.

The ACR Incidental Findings Committee presents recommendations for managing incidentally detected lung findings on thoracic CT. The Chest Subcommittee is composed of thoracic radiologists who endorsed and developed the provided guidance. These recommendations represent a combination of current published evidence and expert opinion and were finalized by informal iterative consensus.

How Health Consciousness and Health Literacy Influence Evaluative Responses to Nutrient-Content Claimed Messaging for an Unhealthy Food.

Guided by the theoretical frameworks of the "health halo effect" and consumer expertise, this research was undertaken to determine how two individual factors, health consciousness and health literacy, differentially influence evaluations of nutrient-content claimed messaging for an unhealthy food (i.e., chocolate) and whether such evaluations are moderated by the reading of the food's Nutrition Facts Label displaying different serving sizes.

Ira Remsen, Osler, the Flexner Report, and the full-time plan.

A famous letter from Sir William Osler to Ira Remsen, dated September 1, 1911, concerns Osler's objections to the full-time plan, whereby clinical professors should focus on research and abstain from private practice. Previous accounts of this well-known episode make little or no mention of the recipient other than his being president of the Johns Hopkins University. Remsen, in retrospect, was uniquely positioned to champion ideas advanced by Abraham Flexner, the General Education Board of the Rockefeller Foundation, and some of Osler's former colleagues at Johns Hopkins, notably William H.

Continued Supervision for the Common Pediatric Subspecialty Entrustable Professional Activities May Be Needed Following Fellowship Graduation.

Purpose: Entrustable professional activities (EPAs) are one approach to competency-based medical education (CBME), and 7 EPAs have been developed that address content relevant for all pediatric subspecialties. However, it is not known what level of supervision fellowship program directors (FPDs) deem necessary for graduation. The Subspecialty Pediatrics Investigator Network (SPIN) investigated FPD perceptions of the minimum level of supervision required for a trainee to successfully graduate.

Development of a Patient-Centered Software System to Facilitate Effective Management of Bipolar Disorder.

Objective: Self-management of bipolar disorder (BD) is an important component of treatment.

Methods: We developed a patient-centered computational software system based on concepts from nonlinear systems (chaos) theory with mobile access to assist in managing BD known as KIOS. KIOS tracks interacting symptoms to determine theprecise state of a BD patient.

Sex Representation Among Principal Investigators in Cardiac Surgery Clinical Trials in the United States: The Glass Ceiling and Room for Improvement.

Objective: The aim of this study was to determine the sex representation among principal investigators (PIs) in US cardiac surgery clinical trials.

Summary Background Data: Being a principal investigator in a US clinical trial confers national recognition among peers. Sex representation among principal investigators (PIs) in US cardiac surgery clinical trials has not been evaluated.

Living with COVID-19: Voices from the grassroots.

COVID-19 has had a significant impact on the lives of nurses. To capture these experiences, the AANP history committee sponsored a writing contest. The stories, essays, and poems were heartfelt and ranged from personal experiences to future implications.

Gastrointestinal Factors Associated With Hospitalization in Infants With Cystic Fibrosis: Results From the Baby Observational and Nutrition Study.

Objectives: To identify factors that increase the risk of gastrointestinal-related (GI-related) hospitalization of infants with cystic fibrosis (CF) during the first year of life.

Methods: The Baby Observational and Nutrition Study was a longitudinal, observational cohort of 231 infants diagnosed with CF by newborn screening. We performed a post-hoc assessment of the frequency and indications for GI-related admissions during the first year of life.