Ageist Attitudes Among Radiologic Science Professionals.

Purpose: To measure radiologic science professionals' current attitudes toward older adults.

Methods: The Geriatrics Attitude Scale (GAS) paper survey was distributed to radiology and radiation oncology personnel in a large, single teaching hospital system. The GAS provides a global measure of ageist attitudes using 14 questions and 4 subscales.

How Should Responsibility for Proper Medication Disposal Be Shared?

Pharmaceutical companies' capital, influence, and labor force well equip them to assume responsibility for public medication disposal programs. Government- and industry-funded campaigns for medication disposal do work, but responsibility often falls on local health care organizations to provide education and services. Lack of public awareness about how to dispose of medications and the ramifications of contaminating our natural resources and ecosystems with pharmaceuticals suggest a need for collaboration among pharmaceutical companies, government officials, clinicians, and patients.

Nurse-led implementation of awake prone positioning.

This article discusses the pathophysiology of COVID-19 acute respiratory distress syndrome (ARDS), the evidence supporting the use of awake prone positioning (APP) for adult patients with COVID-19 ARDS cared for in acute care medical units, and a quality improvement initiative to support a standardized APP process on a COVID-19 medical unit.

Flash Forward.

A flash back: Graduates of nurse anesthesia programs have an average of 9,369 hours of clinical experience, including 733 hours during their baccalaureate nursing program, 6,032 hours as a critical care registered nurse, and 2,604 hours during their nurse anesthesia program.

Epithelial Wntless regulates postnatal alveologenesis.

Alveologenesis requires the coordinated modulation of the epithelial and mesenchymal compartments to generate mature alveolar saccules for efficient gas exchange. However, the molecular mechanisms underlying the epithelial-mesenchymal interaction during alveologenesis are poorly understood. Here, we report that Wnts produced by epithelial cells are crucial for neonatal alveologenesis.

Perioperative Goal-Directed Fluid Therapy: A Prime Component of Enhanced Recovery After Surgery.

Perioperative goal-directed fluid therapy (GDFT) is a prime component of the Enhanced Recovery After Surgery (ERAS) protocol. Multiple studies have demonstrated a relationship between GDFT and positive patient outcomes, including shorter hospital stays, decreased ileus formation, reduced gastrointestinal-related issues, decreased nausea, and hemodynamic stability. Electrolyte disturbances following a positive fluid balance may occur, and GDFT is aimed at euvolemia to avoid a hypervolemic state.

Harnessing the Endocannabinoid System: What It Means for the Anesthesia Provider.

The desire to limit narcotic use, coupled with a desire for efficacious pain relief with few side effects, has led researchers and providers alike to focus on the possibilities inherent in the exploitation of the endocannabinoid system. In particular, fatty acid amide hydrolase (FAAH) inhibitors and monoamine glycerol lipase (MAGL) inhibitors hold great potential to become some of the next new classifications of pharmaceuticals formulated for not only pain relief, but a host of other conditions as well. This course is designed to introduce the reader to the endocannabinoid system, its components and mechanism of action, and examine how its effects are currently employed in anesthesia.

Current State of Pain Treatment: Does Dexmedetomidine Have a Role to Play?

Opioids are a mainstay in the modern practice of anesthesia and perioperative pain management. However, due to the crisis surrounding opioid use and abuse, as well as the undesirable side effects that occur with normal use, anesthesia providers are searching for ways to curtail perioperative opioid use. The advent of various analgesic adjuncts such as dexmedetomidine has opened new avenues for multimodal analgesic approaches to perioperative pain management.

Brain State Monitoring: Current Research and Future Possibilities.

Processed electroencephalography (pEEG) devices have been used as depth of anesthesia monitors for over two decades to monitor anesthetic depth and reduce the incidence of awareness with recall (AWR). Each device has unique strengths and weaknesses. A growing body of evidence questions the ability of a pEEG-derived numerical indices to consistently, rapidly, and reliably quantify consciousness and prevent AWR in patients under general anesthesia.

Ten-Year Outcomes of a Systems-Based Approach to Longitudinal Amputation Care in the US Department of Veteran Affairs.

Background: The goal of the US Department of Veterans Affairs (VA) Amputation System of Care (ASoC) is to enhance the quality and consistency of amputation rehabilitation care for veterans with limb loss.

Objective: The ASoC provides specialized expertise in amputation rehabilitation incorporating the latest practices in medical management, rehabilitation, and artificial limbs in order to minimize disability and to enable the highest level of social, vocational, and recreational success for veterans with amputation.

Discussion: The ASoC serves veterans with limb amputation from any etiology.

Adiposis Dolorosa Pain Management.

While current approaches to treatment focus on surgery, opiates, and other medications, health care providers may also consider ketamine infusion, electrostimulation, and perineural injections.

Testicular Swelling as an Initial Presentation of a Patient With Metastatic Gastric Cancer.

While signet-ring cell morphology in the testes might represent metastatic spread from an extragonadal adenocarcinoma, a rare variant of primary testicular neoplasms should be considered in a differential diagnoses as was seen in this rare occurrence of a testicular swelling as an initial presentation for a patient with metastatic gastric cancer.

Population Management of Nonalcoholic Fatty Liver Disease.

With the enormous burden of NAFLD on the rise, quality care for patients warrants resource-adaptive population health management strategies.

Comorbidities and Nonalcoholic Fatty Liver Disease: The Chicken, the Egg, or Both?

Improvement in NAFLD may lead to improvement of metabolic syndrome, cardiovascular disease, and malignancy and vice versa.

AANA Journal Course-Residual Neuromuscular Blockade: Evidence-Based Recommendations to Improve Patient Outcomes.

Neuromuscular blocking drugs are administered to facilitate endotracheal intubation and induce paralysis to allow surgeons access to their anatomical target. Traditionally, qualitative measures; such as tactile observation of fade by a peripheral nerve stimulator, are used to assess the extent of the patient's recovery after receiving the neuromuscular blocking agent. Use of these qualitative measures; however, can contribute to high rates of residual neuromuscular blockade (RNMB), placing patients at risk of serious postoperative adverse events.

Understanding the role of violence as a social determinant of preterm birth.

Background: Preterm birth is one of the leading causes of infant morbidity and mortality. Although major strides have been made in identifying risk factors for preterm birth, the complexities between social and individual risk factors are not well understood.

Objective: This study examines the association between neighborhood youth violence and preterm birth.

The VA/DoD Chronic Effects of Neurotrauma Consortium: An Overview at Year 1.

This federally funded program identifies gaps in research and provides support services for scientific, clinical, and translational research projects focused on the long-term effects of mild traumatic brain injury in veterans and active-duty service members.

Perceptions of Distress in Women with Ovarian Cancer.

Purpose/objectives: To explore women's experience of distress by asking "What do women with ovarian cancer want their spouse or significant other, family, friends, and healthcare providers to know about their experience of distress during diagnosis and treatment?"

Research Approach: Modified Glaserian grounded theory.

Setting: An urban setting in the Mid-Atlantic region of the United States.

Participants: 12 women, aged 21-71 years, diagnosed with and treated for ovarian cancer.

Symptoms, Cytokines, and Quality of Life in Patients Diagnosed with Chronic Graft-Versus-Host Disease Following Allogeneic Hematopoietic Stem Cell Transplantation.

Purpose/objectives: To describe associations among symptoms, cytokines, and quality of life (QOL) of patients with chronic graft-versus-host disease (cGVHD).

Design: Prospective, cross-sectional, cohort.

Setting: The bone marrow transplantation unit at a National Cancer Institute-designated cancer center in Virginia.

Reevaluating the neutropenic diet: time to change.

The neutropenic diet historically has been a mainstay in oncology practice, with many providers continuing to adhere tightly to the diet for patients with neutropenia. However, clinically sound evidence remains limited and weak and does not support the diet as a foundation for policy and practice. Therefore, two questions remain: Does evidence exist to support the effectiveness of the neutropenic diet in reducing infection rates in the neutropenic oncology population? Based on limited evidence supporting the neutropenic diet in this population, what clinically sound diet strategies are best for these patients?