Terrestrial Isopods Generate Microplastics from Low-Density Polyethylene Without Effects on Survival.

With concern growing regarding the impact of microplastics (MPs) on terrestrial ecosystems, it is important to assess the role invertebrates may play in the fate of MPs within these ecosystems. Commonly, MPs enter these environments through improperly discarded waste or the application of treated biosolids and/or wastewater on agricultural soils. The present study investigated whether three species of terrestrial isopod (Porcellio scaber, Porcellio laevis, and Porcellionides pruinosus) ingest plastic debris and generate MPs during exposures varying from 24 h to 14 days and whether this may have an adverse effect on their health. Test vessels were designed to expose isopods to plastic fragments in the form of polyethylene plastic foam. Isopods were exposed to plastic that was either (1) pristine, or (2) weathered in a soil and water solution prior to incorporation in test vessels. When exposed to weathered polyethylene, all three species generated MPs (minimum-maximum size values for all durations inclusive: P. laevis = 114-1673 µm, P. scaber = 99-1635 µm, P. pruinosus = 85-1113 µm) through the consumption of macroplastic fragments with no observed impact on their health. In the shorter-duration exposures, the number of MPs generated by the isopod species in the present study was highly variable between experimental vessels (minimum-maximum generated MPs for 14-day exposure: P. laevis = 25-420, P. scaber = 50-583, P. pruinosus = 48-311). However, as the exposure durations increased, there was a clear trend of increasing MP generation, indicating that the isopods continued to consume the plastic fragments as long as the surface was weathered. A significant difference in the size of generated MPs was observed as well, with smaller isopod species generating smaller MP fragments on average. The results of the present study confirm that certain species of isopod can contribute to the generation of MPs, which constitutes an additional pathway of MP exposure to soil ecosystems. Environ Toxicol Chem 2024;43:784-792. © 2023 The Authors. Environmental Toxicology and Chemistry published by Wiley Periodicals LLC on behalf of SETAC.

Improving transplant patient safety through pharmacist discharge medication reconciliation.

Greater than 50% of medication errors are estimated to occur during transitions of care, and solid-organ transplant recipients are at an increased risk for errors due to significant changes in their medication regimen following transplantation. This prospective, observational study with a historical control group was conducted to evaluate the discharge process for transplant recipients and determine if transplant pharmacist involvement would improve safety. During the prospective period, a total of 191 errors were made on discharge medication reconciliations (n = 64, mean rate 3.0 per patient); however, pharmacists prevented 119 of these errors (1.9 errors per patient). In the retrospective period, none of the 430 errors identified were prevented at the time of discharge (n = 128, p < 0.0001). The 72 errors not prevented at the time of discharge in the prospective cohort were identified by the pharmacist at the patient's first clinic visit (1.1 errors per patient). In the historical cohort, all 430 errors made at discharge persisted until at least the time of the first clinic visit (3.4 errors per patient, p < 0.0001). This study demonstrates that transplant recipients are at a high risk for medication errors and that transplant pharmacist involvement leads to improved safety through the significant reduction of medication errors.

Israeli oncology and nononcology nurses' attitudes toward physician-assisted dying: a comparison study.

PURPOSE/OBJECTIVES: To compare the attitudes of Israeli oncology and nononcology nurses toward physician-assisted dying (PAD) and its legalization and to determine the factors that may be related to their attitudes. DESIGN: Nonrandomized, correlational study. SETTING: A teaching hospital in Jerusalem, Israel. SAMPLE: 71 oncology nurses and 52 nurses working in the maternity and nursery departments. RESULTS: The majority of nurses supported PAD and its legalization, with the greatest support being given when a suffering patient was involved. In the vignettes dealing with the nurse-patient relationship, oncology nurses were significantly less likely than nononcology nurses to agree with PAD but more likely to stay with their patients while the lethal drug was being given. Nononcology nurses were more supportive of legalization than oncology nurses. Religious nurses and nurses who observed religious traditions were significantly less likely to support PAD or vote for its legalization. CONCLUSION: Israeli nurses generally are supportive of PAD. However, oncology nurses were less likely to support its practice. In addition, the more religious nurses considered themselves, the less likely they were to support the practice. IMPLICATIONS FOR NURSING PRACTICE: Israeli nurses need to be made aware of the ethical, social, and legal implications of PAD and its legalization for the Israeli nursing profession. In addition, more cross-cultural research on attitudes toward PAD needs to be conducted.

Use of quantum methods for a consistent approach to combustion modelling: hydrocarbon bond dissociation energies.

An attempt has been made to use modern quantum methods to codify the data base concerning bond dissociation energies in hydrocarbons. Calculations have been performed using two hybrid DFT methods, the well-known B3LYP formalism and a newly developed alternative named KMLYP. CBS-Q has also been employed where possible. The combination of experimental uncertainty and theoretical limitations is less than completely satisfactory. However, within uncertainties that translate to a factor of two at 1500 K, many transferable quantities are elucidated. A hybrid method has been developed for the correction of DFT calculations using group additivity. Given that the philosophy behind this work is the understanding that all data bases must be optimised for specific applications, so that avoidance of large errors is more important than absolute precision, the results appear to be quite useful. We are particularly encouraged by the performance of the KMLYP method, given its ease of application to molecules of practical interest.

An exploratory pilot study of nurse-midwives' attitudes toward active euthanasia and abortion.

Over the past three decades, active euthanasia and abortion have received increasing international attention. Since both these practices are relevant to the role of the nurse-midwife, it is important to know what influences their attitudes towards them. Therefore, the purpose of this study was: 1, to survey the attitudes of nurse-midwives' to active euthanasia and its legalization; 2, to determine the relationship between nurse-midwives' attitudes toward active euthanasia and its legalization, and attitudes toward abortion, self-reported religiosity and religious affiliation. The study setting was an international midwifery conference and the sample consisted of 139 nurse-midwives attending the conference. The majority of nurse-midwives displayed a positive attitude toward active euthanasia and its legalization. In addition, there was a positive relationship between their attitude to abortion and active euthanasia. Self-reported religiosity and religious affiliation were significantly related to attitudes toward active euthanasia and its legalization. An interesting positive relationship between country of practice and attitudes to euthanasia was also found. Nurse-midwives practicing in countries with more liberal euthanasia and assisted suicide legislation were more supportive of active euthanasia. With the increasing acceptance of active euthanasia's legalization, the results of this study pose some ethical questions that nurse-midwives internationally will have to consider.

Active euthanasia and assisted suicide: a perspective from an American abortion and Dutch euthanasia scenario.

PURPOSE/OBJECTIVES: To discuss the critical issues involved in the legalization of active euthanasia and physician-assisted suicide. DATA SOURCES: Nursing, medical, legal, and ethics literature; newspaper articles; book chapters. DATA SYNTHESIS: The major terms employed in the discussion of active euthanasia and physician-assisted suicide are defined. The implications of the recent Supreme Court decision on these practices are outlined. The Dutch euthanasia and the American abortion scenarios are used as models for the interpretation of the effects of future legislation on such practices. CONCLUSIONS: Oncology nurses need to be cognizant of the crucial issues involved in the practices of active euthanasia and physician-assisted suicide and determine their philosophical stance regarding the practices. IMPLICATIONS FOR NURSING PRACTICE: If active euthanasia and physician-assisted suicide practices are legalized, oncology nurses will have to make decisions about their desired degree of involvement in acts that will end their patients' lives.

A preceptorship program in an Israeli bone marrow transplantation unit.

Bone marrow transplantation (BMT) departments are unique in character. This is due largely to the following factors: the diseases treated, long-term hospitalization, strong family involvement in the care of patients, and the use of experimental treatment. Because of these factors, clinical experiences in a BMT unit may be a threatening experience for both nursing students and nurses. The BMT unit at Hadassah Hospital has, therefore, developed and implemented a preceptorship program for nursing students and nurses involved in advanced courses. The program includes three aspects: (a) a comprehensive medical knowledge base, (b) instruction in special nursing skills aimed at meeting both the physical and psychologic needs of BMT patients and their families, and (c) supervised involvement in patient and family education and counseling. Our goal is to enable students to care for patients throughout the BMT experience, from admission to post-BMT follow-up. Feedback elicited from students who have undergone the program was positive. They said that the program helped them overcome their fears and encouraged them to apply for nursing jobs in the unit.

An oncology clinical experience in an Israeli baccalaureate nursing program.

Cancer is a serious health hazard in Israel. There is, therefore, a need to appropriately prepare nurses to administer quality care to oncology patients. Hadassah-Hebrew University School of Nursing has designed and implemented a routine clinical oncology experience for third- and fourth-year students in their baccalaureate nursing program. The clinical experience includes a special orientation day, exposure to treatment modalities, rotations through several oncology settings, post-conference sessions devoted to cancer pain control, and the spiritual needs of cancer patients. Although the experience does not make the students oncology experts, it gives them a greater awareness of the multifaceted nature of oncology nursing.

Intravenous hydration for terminal patients: what are the attitudes of Israeli terminal patients, their families, and their health professionals?

Dehydration in terminally ill patients is a common condition and its treatment in an active oncology unit often involves intravenous (IV) hydration programs. The decision to use IV hydration is only partly determined by an objective assessment of the clinical data. The other component is the attitudes of those involved in the decision-making process. This pilot study surveyed the attitudes of patients, family members/friends, nurses and doctors toward IV hydration in this patient population. Although the majority of the conscious patients (95%), family members/friends (81%), and nurses (64%) were not involved in the decision-making process, the expressed attitudes were generally positive. The three most commonly stated reasons for IV therapy were "medication," "giving fluids" and "giving morphine." Interestingly, among the reasons expressed, the amelioration of thirst was never explicitly cited.

Pain assessment: a pilot study in an Israeli bone marrow transplant unit.

The incidence and quality of pain experienced by nine patients during the first phase of the bone marrow transplant (BMT) was assessed in an Israeli BMT Unit. Reports of 215 separate episodes of pain were collected, which included the quality, intensity, and different locations of pain reported by the patient and medical staff. It was found that patients experienced on an average five anatomically identifiable pains daily for a period of > 11 days. In addition, although nurses recorded these episodes of pain more frequently than physicians did (47 versus 33%), there was still a discrepancy between the nurses' and the patients' reporting. This pilot study highlights the need for a larger study to be conducted in the area.

The sensation of thirst in dying patients receiving i.v. hydration.

Cancer patients in the terminal phase of their disease often experience fluid deficits. This is mainly due to their inability to ingest adequate amounts of oral fluids to meet the body's physiological demands. In order to correct this deficit, intravenous (i.v.) fluid programs are often instituted. This pilot study was conducted on a group of terminal patients hospitalized in an oncology unit who died while receiving i.v. fluids. It sought to assess the effects of these fluids on their level of thirst. Data were collected on 30 patients in the last 24 hours of life. However, of the 30 patients only 19 were sufficiently alert to be able to verbally evaluate their thirst intensity. Of the 19 patients, six experienced mild thirst, eight moderate thirst, and four severe thirst. This was in spite of IAV hydration regimens which ranged from 500 mL to 3000 mL. Little relationships was found between level of thirst and the amount of i.v. fluids received, blood urea nitrogen (BUN), or sodium blood levels. In addition, although 70% of the patients had fluid retention signs, there was little correlation between these signs and the amount of fluids received. Since the pilot study's sample was small, definitive conclusions could not be drawn. However, our results highlight the need for future research in this area.

Breast cancer prevention education at a shopping center in Israel: a student nurse community health project.

Community health nursing at the baccalaureate level emphasizes health prevention education. With this focus in view, fourth-year students at a nursing school in Israel were required to organize, present, and evaluate a health fair. One of the subjects presented was breast cancer prevention and early detection. To implement their project, students employed health marketing, educational, and communicational skills. The breast cancer booth, located at a shopping center, served 200 women and 7 men with information on prevention and early detection over a period of about 3 hr. The health fair design, execution, and evaluation successfully met the course goals. In addition, a large public was reached, much interest was displayed, and positive feedback was received.

Acute postoperative pain: the cause and the care.

Although pain is one of the most difficult phenomena to measure, in recent decades giant steps have been taken in its effective control. A lack of knowledge in the area of pain and inordinate fear of the side effects of analgesic drugs used to treat pain limit the advances in control of postoperative pain. To address this deficiency, this article highlights the important determinants in the control of postoperative pain. Some of the factors that influence an individual's perception of pain will be described. A review of the more commonly used routes and modes of drug administration in such treatment will be presented, followed by a discussion of the side effects, both positive and negative, of the opioids that can be used. Finally, some of these opioid drugs will be described.

Terminal dehydration. To give or not to give intravenous fluids?

The question of whether or not to give intravenous fluids to cancer patients who are in the last stages of their illness is one that has become problematic to health professionals, particularly those working in terminal-care settings. This article attempts to give a better understanding of the subject by unraveling some of the issues involved. The different types of dehydration and the signs and symptoms that may be experienced by dying patients who are dehydrated are defined. Some of the beneficial effects, as well as the ill effects, that such dehydration may cause are delineated. An analysis is made of health professionals' attitudes to dehydration in dying cancer patients and the special ethical problems associated with the question. There is then a practical synthesis of these facts into the formation of guidelines to facilitate the decision-making process related to the initiation of parenteral fluids in dying patients, and a discussion on the law as it pertains to the treatment of dehydration in such patients.

Stockroom layout methodology.

A chronic problem with the layout of our stockroom inspired us to develop decision-making guidelines for effective space utilization and to completely reorganize our stockroom area. Using basic information about our inventory, we determined the necessary amount fo storage space, and the needed number, size and location of the storage bins. We grouped like-use stock items into "families" and assigned them to stockroom location based upon the frequency of the items' use, the cubic volume of space required for their storage, and staffing and equipment considerations. This paper describes the procedure used to reorganize the storage area of our stockroom and contains proven guidelines and practical suggestions for stockroom space utilization.