Articles: ninos.
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Modern general practice is characterised by increased demand and growing multidisciplinarity, including ring-fenced funding for additional non-clinical roles. For practice receptionists, however, training has remained unchanged for decades despite primary care being under greater pressure than ever, with receptionists becoming a growing focal point for abuse and unprecedented numbers leaving the role. ⋯ Although confident performing administrative tasks, receptionists described uncertainty and anxiety when providing clinically oriented support or managing patients when their requests for appointments could not be met. More appropriate training or professionalisation might improve staff retainment.
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Clinical guidance recommends promoting physical activity during general practice consultations. The frequency and content of physical activity discussions in UK general practice are poorly understood. ⋯ Physical activity advice, following national guidance, was potentially relevant to more than half of GP consultations; GPs delivered advice of varying depth in a third of these consultations. Future work should explore ways of delivering physical activity advice effectively, efficiently, and equitably within the constraints of general practice.
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Vaccine-induced immune thrombocytopenia and thrombosis (VITT) is associated with antibodies that target platelet factor 4 (PF4) and are heparin-independent. VITT antibodies are implicated in acute, transient prothrombotic disorders that are triggered by adenoviral vector vaccines against coronavirus disease 2019 or by adenovirus infection. ⋯ The antibody clonotype profiles and binding epitopes on PF4 were different from those observed with the acute disorders occurring after vaccination or viral infection, features that reflect distinct immunopathogenesis. Treatment strategies besides anticoagulation alone are needed for the chronic disorders, referred to as VITT-like monoclonal gammopathy of thrombotic significance. (Funded by the Canadian Institutes of Health Research and others.).
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Enhanced recovery after surgery (ERAS) protocols incorporating multimodal analgesia (MMA) have become increasingly popular for breast cancer surgery. Our study evaluated an ERAS approach that combined nonintubated general anesthesia with thoracic paravertebral block (TPVB) as part of the MMA and compared it to traditional general anesthesia (GA). Postoperative outcomes were assessed using numerical rating scale (NRS) pain scores, total analgesic consumption, and nausea and vomiting (PONV). ⋯ Nonintubated general anesthesia with TIVA and MMA using TPVB is a viable and safe alternative for breast cancer surgery. It results in reduced pain scores and analgesic needs compared with conventional GA, with PONV outcomes comparable to those managed with standard intravenous medications.
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The manufacturing industry, one of the largest employers of migrant workers in Taiwan, reports a high incidence of musculoskeletal disorders, particularly low back pain (LBP), among its workforce overall. Understanding the prevalence and risk factors of LBP among Indonesian migrant workers, who make up a substantial portion of this workforce, is essential for developing effective preventive programs. ⋯ Trunk flexion, lifting, and whole-body vibration consistently emerged as significant determinants of LBP disability. More detailed assessments of these factors are necessary to clarify their associations.