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Transfusion Jul 2024Less discriminatory donor selection policies for men who have sex with men (MSM) may impact transfusion safety in terms of higher residual risks for known...
BACKGROUND
Less discriminatory donor selection policies for men who have sex with men (MSM) may impact transfusion safety in terms of higher residual risks for known transfusion-transmitted infections (TTIs), increased vulnerability toward new TTIs that are also transmitted via sex, and HIV infections masked by pre-exposure prophylaxis (PrEP).
STUDY DESIGN AND METHODS
TTI trends in Dutch donors were studied over a 13-year period (2011-2023), characterized by successive relaxations of MSM deferral criteria. Structured posttest counseling was performed to determine risk factors in TTI-positive donors. PrEP drug levels were measured in 9977 donations from male donors living in urban areas and in 67 donors with active or resolved syphilis.
RESULTS
HIV incidence (from 5.8 to 1.5 per 1,000,000 donor years (DY)) and HBV incidence (from 12.4 to 4.5 per 1,000,000 DY) in Dutch donors decreased with less stringent MSM deferral criteria, while syphilis prevalence (from 26.4 to 44.1 per 100,000 new donors) and syphilis incidence (from 18.3 to 46.3 per 1,000,000 DY) increased over time. The proportion of MSM-related syphilis rose from 2% to 32% in new donors and from 12% to 27% in repeat donors. PrEP was detected in 2 of 9977 (0.02%) donations from male donors living in urban areas, and in 1 of 39 (2.6%) male donors with syphilis.
DISCUSSION
To date, phasing out donor deferral for MSM had no significant impact on transfusion safety in the Netherlands. However, rising syphilis rates and (recent) PrEP use in the blood donor population, albeit rare, suggest an influx of donors with higher sexual risk profiles and requires intensified TTI surveillance in donors.
PubMed: 38963400
DOI: 10.1111/trf.17941 -
Medical Teacher Jul 2024Since 1991, there have been significant changes in medical education in Georgia. Key changes include adapting national legislation toward international standards,...
Since 1991, there have been significant changes in medical education in Georgia. Key changes include adapting national legislation toward international standards, establishing the National Center for Education Quality Enhancement (NCEQE), which was recognized in 2018 by the World Federation for Medical Education (WFME) as an accrediting agency and opening the Association for Medical Education in Europe (AMEE) International Networking Center in 2019. Undergraduate medical education, regulated by the Ministry of Education, Science and Youth of Georgia, spans six years. MD graduates then have options for further career paths, including working as junior doctors, residency, and/or pursuing PhD research.The main challenges the country presently faces are:the need to reduce the increasing number of (mainly) private medical schools. Recent updates to the national standards for undergraduate medical education have imposed stricter accreditation requirements for MD programs, resulting in the closure of schools that fail to meet these standards;postgraduate medical education is governed by the Ministry of Internally Displaced Persons from the Occupied Territories, Labor, Health and Social Affairs of Georgia (MOH) and needs further reform due to limited and paid residency positions;continuous professional development (CPD) was optional until recently, which led to an increase in professional inaccuracy and malpractice cases. To address this, regulatory bodies, including the MOH and professional associations, are preparing the legal basis for introducing compulsory CPD.
PubMed: 38963305
DOI: 10.1080/0142159X.2024.2370899 -
British Journal of Community Nursing Jul 2024Collaboration is a key factor influencing the quality and safety in patients transition between sectors. However, specific collaborative practices may give rise to...
BACKGROUND
Collaboration is a key factor influencing the quality and safety in patients transition between sectors. However, specific collaborative practices may give rise to conflict between hospital nurses and community nurses.
AIMS
To gain a deeper understanding of collaborative practices which have the potential to fuel tension in collaboration between hospital nurses and community nurses during discharge of older patients from hospital to homecare.
METHODS
A meta-ethnography approach was used in this study and a systematic literature search was conducted in 2022.
RESULTS
Five themes were identified in the analysis. These themes revealed how uncertainty, limited confidence in information and personal attitude in communication may fuel tension between hospital nurses and community nurses. Tensions arising from a negative loop emerged because of uncertainty, causing a growing rift between hospital nurses and community nurses, leaving them as opponents rather than collaborators. The authors suggest that policy makers and managers can break this loop by underpinning shared policies and awareness of common objectives.
Topics: Humans; Patient Discharge; Home Care Services; Aged; Cooperative Behavior; Nursing Staff, Hospital; Community Health Nursing; Anthropology, Cultural; Attitude of Health Personnel
PubMed: 38963274
DOI: 10.12968/bjcn.2023.0069 -
British Journal of Community Nursing Jul 2024Consent is an essential part of healthcare practice, allowing patients to make autonomous decisions. However, this changes when a patient has mental incapacity or is...
Consent is an essential part of healthcare practice, allowing patients to make autonomous decisions. However, this changes when a patient has mental incapacity or is unable to make decisions for themselves for a duration of time. This month's Policy column looks at some of the key principles of the Mental Capacity Act 2005, and how this can be applied in community nursing practice.
Topics: Humans; Mental Competency; Informed Consent; United Kingdom; Community Health Nursing
PubMed: 38963268
DOI: 10.12968/bjcn.2024.0068 -
Journal of Law and Medicine Jun 2024AI technologies can pose a major national security concern. AI programs could be used to develop chemical and biological agents which circumvent existing protective...
AI technologies can pose a major national security concern. AI programs could be used to develop chemical and biological agents which circumvent existing protective measures or medical treatments, or to design pathogens with capabilities they do not naturally possess (gain-of-function research). Although Australia has a strong legislative framework relating to research into genetically modified organisms, the framework requires the interaction of more than 10 different government departments, universities and funding agencies. Further, there are few guidelines about the responsible use of AI in biological research where existing laws and policies do not apply to research that is conducted "virtually", even where that research may have national security implications. This article explores these under-scrutinised concepts in Australia's biological security frameworks.
Topics: Synthetic Biology; Australia; Humans; Security Measures; Artificial Intelligence
PubMed: 38963250
DOI: No ID Found -
Veterinary Medicine and Science Jul 2024H. Noruzi and F. Aziz-Aliabadi, "Garlic (Allium Sativum) and Mushroom (Agaricus Bisporus) Powder: Investigation of Performance, Immune Organs and Humoural and Cellular...
Expression of Concern: Garlic (Allium sativum) and mushroom (Agaricus bisporus) powder: Investigation of performance, immune organs and humoural and cellular immune response in broilers.
H. Noruzi and F. Aziz-Aliabadi, "Garlic (Allium Sativum) and Mushroom (Agaricus Bisporus) Powder: Investigation of Performance, Immune Organs and Humoural and Cellular Immune Response in Broilers," Veterinary Medicine and Science 10, no. 2 (2024): e31367, https://doi.org/10.1002/vms3.1367. This Expression of Concern is for the above article, published online on 15 February 2024 in Wiley Online Library (wileyonlinelibrary.com), and has been published by agreement between the journal Editor-in-Chief, Gayle Hallowell and John Wiley & Sons Ltd. The Expression of Concern has been agreed due to concerns raised by a third party regarding the availability of an ethical approval. The authors have received Higher Degree by Research (HDR) committee approval and a bioethical course certificate. The authors and their institute confirmed that this was equivalent to an ethical approval from the Ferdowsi University of Mashhad at the time when the research was conducted but could not provide the HDR committee approval documentation. Since this does not fully comply with the ethics policy of the journal, as noted on the journal's author guidelines page, the journal has decided to issue an Expression of Concern to inform and alert the readers.
Topics: Agaricus; Animals; Chickens; Garlic; Immunity, Cellular; Animal Feed; Powders; Diet; Dietary Supplements
PubMed: 38963192
DOI: 10.1002/vms3.1541 -
Current Opinion in Pulmonary Medicine Jul 2024Updated clinical practice guidelines for pulmonary fibrosis recommend early integrated palliative care using a primary palliative approach. Clinicians need to be aware...
PURPOSE OF REVIEW
Updated clinical practice guidelines for pulmonary fibrosis recommend early integrated palliative care using a primary palliative approach. Clinicians need to be aware of the various palliative interventions in order to implement guidelines' recommendations. This review provides an update on evidence-based palliative therapies.
RECENT FINDINGS
Literature review indicates early integration of palliative care in pulmonary fibrosis is feasible and meets patient needs. Key components of a primary palliative approach include comprehensive symptoms and needs screening, systematic symptom management using nonpharmacologic interventions, supplemental oxygen and opioids for dyspnea and cough. Patient-centered communication is essential for successful integration of palliative care. Early, iterative advance care planning in clinic to understand patient goals, values and preferences for current and future care, improves patient care and satisfaction. Prioritizing caregiver inclusion in clinics can address their needs. Collaborating with a multidisciplinary allied team facilitates integration of palliative care and supports patients throughout the disease course. Different models of palliative care delivery exist and can be adapted for local use. The use of artificial intelligence algorithms and tools may improve care and continuity.
SUMMARY
Clinicians must develop competency in palliative care. Organizational and policy support is essential to enable seamless integration of palliative care throughout the care continuum.
PubMed: 38963163
DOI: 10.1097/MCP.0000000000001093 -
Personalized Medicine Jul 2024In the transformative landscape of healthcare, personalized medicine emerges as a pivotal shift, harnessing genetic, environmental and lifestyle data to tailor medical...
In the transformative landscape of healthcare, personalized medicine emerges as a pivotal shift, harnessing genetic, environmental and lifestyle data to tailor medical treatments for enhanced outcomes and cost efficiency. Central to its success is public engagement and consent to share health data amidst rising data privacy concerns. To investigate European public opinion on this paradigm, we executed a comprehensive cross-sectional survey to capture the general public's views on personalized medicine and data-sharing modalities, including digital tools and electronic records. The survey was distributed in eight major European Union countries and the results aim at guiding future policymaking and trust-building measures for secure health data exchange. This article delineates our methodological approach, whereby survey findings will be expounded in subsequent publications.
PubMed: 38963136
DOI: 10.1080/17410541.2024.2342770 -
Substance Use & Misuse Jul 2024To examine use and frequency patterns across e-cigarettes, cigarettes, and little cigars, cigars, and cigarillos (LCCs) over time and determine whether patterns differ...
OBJECTIVE
To examine use and frequency patterns across e-cigarettes, cigarettes, and little cigars, cigars, and cigarillos (LCCs) over time and determine whether patterns differ by race and ethnicity.
METHODS
Data was obtained from the Truth Longitudinal Cohort of youth and young adults between September 2020 and June 2022. Latent class and transition analyses were used to classify participants ( = 4448) into subgroups, based on frequency of tobacco product use in the past 30 days, and to estimate the probability of use pattern transitions by race and ethnicity, adjusted for the effects of gender, financial situation, parental education, household tobacco use, and sensation seeking.
RESULTS
Four latent classes were identified: former/noncurrent users, predominantly frequent to daily (FTD) e-cigarette users, predominantly FTD e-cigarette and LCC users, and predominantly FTD cigarette with polytobacco users. Use trajectories differed by race and ethnicity. A lower proportion of those who identified as non-Hispanic Black (60.0%) remained e-cigarette and LCC users, relative to those who identified as non-Hispanic White (86.0%), Hispanic or Latino (86.0%), and another race and ethnicity (79.0%). A lower proportion of those who identified as Hispanic or Latino (54.0%) and another race and ethnicity (59.9%) remained cigarette with polytobacco users, relative to those who identified as non-Hispanic White (76.0%) and non-Hispanic Black (72.0%). A greater proportion of non-Hispanic Black respondents transitioned from e-cigarette and LCC user to former/noncurrent user (40.0%) and polytobacco user to e-cigarette and LCC user (11.0%), relative to other racial/ethnic groups.
CONCLUSION
More research is needed to determine why tobacco use trajectories differ by race and ethnicity. Such research will be important in informing comprehensive approaches that promote evidence-based prevention policies and programs.
PubMed: 38963130
DOI: 10.1080/10826084.2024.2374974 -
Reviews on Environmental Health Jul 2024Solid fuel use is increasingly linked to low birth weight (LBW), but conclusions were inconsistent. We aimed to summarize the association between solid fuel use and LBW.... (Review)
Review
Solid fuel use is increasingly linked to low birth weight (LBW), but conclusions were inconsistent. We aimed to summarize the association between solid fuel use and LBW. Twenty-one studies that met the inclusion criteria were identified through PubMed, Qvid Medline, and Web of Science databases. The final search occurred on March 20, 2024. Summary relative effect and 95 % confidence intervals were estimated with a random-effects model. Subgroup analyses and sensitivity analyses were performed to investigate possible sources of heterogeneity and to test the stability of the results. Nineteen studies evaluated the association between solid fuel use in pregnant woman and LBW (1.188 for solid fuels: 1.055 to 1.322). No significant heterogeneity was identified among the included studies (p=0.010, Tau=0.02, I=48.1 %). Subgroup analysis found positive correlations for Asia, data years prior to 2014, and rural studies (1.245 for Asia: 1.077 to 1.412; Tau=0.03, I=56.0 %; 1.243 for data years prior to 2014: 1.062 to 1.424; Tau=0.04, I=60.98 %; 1.514 for rural: 1.258 to 1.771; Tau=0.00, I=0.0 %). Our meta-analysis showed that solid fuel use in pregnant women had an impact on LBW. Measures and policies are also needed to promote energy conversion and to limit and reduce the use of solid fuels.
PubMed: 38963124
DOI: 10.1515/reveh-2024-0055