Articles: health.
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Pol. Arch. Med. Wewn. · Dec 2024
ReviewNovel factors affecting fibrin clot formation and their clinical implications.
Fibrin formation is pivotal in hemostasis, serving as a temporary barrier to blood loss following vascular injury, while in thrombosis this process is involved in thrombus progression, stability, and recurrence. Growing evidence shows exceptional complexity of processes that determine fibrin clot structure and function, especially lysability, both in health and disease, which might be relevant in the pathogenesis of arterial and venous thromboembolic diseases. ⋯ These factors have been shown to be not only associated with ischemic stroke, myocardial infarction, pulmonary embolism, and cardiovascular death, but also with unfavorably altered fibrin clot characteristics, which underscores clinical relevance of fibrin clot properties. Given preclinical or ongoing studies aimed at modifying some of these factors, in particular FXI/FXIa inhibitors, recent findings might expand our knowledge on fibrin‑related mechanisms of emerging therapeutic agents tested and stimulate further research into new targets for future therapeutic interventions to prevent thromboembolic events.
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Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States and is associated with the development of genital warts, precancerous lesions, and cancers of the oropharynx, anus, penis, vulva, vagina, and cervix. HPV-associated diseases are preventable through vaccination. An Australian nationwide vaccination program will effectively eliminate cervical cancer as a public health concern by the year 2035. ⋯ Providers should use every opportunity to recommend HPV vaccination, including recommending HPV vaccines for individuals who do not have a record of HPV vaccination. The electronic health record can be utilized to generate prompts for vaccine reminders, and clinics should stock HPV vaccines to allow for easy administration. Additionally, adoption of an opt-out policy for HPV vaccines rather than mandatory vaccination may be an acceptable alternative to increase HPV vaccination while allowing active duty service members to retain autonomy.
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Survivors of acute respiratory failure (ARF) have complex healthcare needs postdischarge, frequently resulting in unmet needs. This prospective multicenter study explores the association between COVID-19 status and unmet healthcare needs in survivors of ARF following hospital discharge. We analyzed patient characteristics and unmet healthcare needs by COVID-19 status using a multivariable regression model with propensity weights. ⋯ The median (IQR) percentage of unmet healthcare needs was 26% (17%-36%), with follow-up appointments accounting for most unmet needs. Unmet medication needs were found to be very low at 6%. Despite the challenges in healthcare delivery during the COVID-19 pandemic, our data suggest COVID status had no observable effect on unmet healthcare needs for ARF survivors, after controlling for patient baseline and clinical status.
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Leadership development is of the utmost importance as the Army Medical Department prepares for future conflicts. All Army Medical Department leaders, including nurses, need to be prepared to lead in a high-tempo, complex environment. Nurse leader effectiveness is paramount to military readiness as well as for recruitment and retention within the Army Nurse Corps (ANC). Both Army talent management and Defense Health Agency documents recognize the importance of Emotional Intelligence principles for successful leadership. Resonant Leadership (RL) is informed by Emotional Intelligence principles and is well-studied within nursing literature. Additionally, the body of evidence examining RL demonstrates a positive impact on the nurse work environment. The purpose of this concept analysis is to define RL within the context of Army nursing, to clarify how this concept relates to Army leadership doctrine, and to propose innovative application(s) of RL within the ANC. ⋯ Resonant Leadership bridges the gap between frontline nursing leadership development, the Army leadership model, and the DHA's Joint Professional Practice Model for nurses. By focusing on developing resonance, Army nurse leaders can simultaneously demonstrate many of the attributes and competencies the Army describes within its leadership doctrine. Although further research is needed to determine the prevalence of RL within Army nursing, RL has applicability to practice and military education. RL is one tool at the disposal of ANC senior to leaders to promote healthy work environments while preparing competent leaders for the complexities of future combat operations.
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Background General practice has a key role in reducing inequity in access to sexual and reproductive health (SRH). Unplanned pregnancy, abortion and STIs are increasing and disproportionately affects deprived communities and ethnic minority groups. The candidacy framework offers a practical, theoretical framework for understanding the complex interactional processes of access to SRH in general practice. ⋯ There are multiple barriers, which include the behaviours of healthcare professionals who have a crucial role in recognising an individual's SRH need. Conclusions General practice offers a cradle-to-grave healthcare service, which should have SRH as a priority area of provision. Further understanding is needed of the impact of historic harms by medicine and healthcare on racialised individuals and gender minorities.