The treatment, outcomes and management of hand, wrist, finger, and thumb injuries in the professional/amateur contact sport athletes: A scoping review.

INTRODUCTION: Amateur and professional participation in sport and physical activity worldwide is increasing in popularity, which in turn is increasing the volume and types of injuries sustained by athletes. Ensuring these injuries are treated appropriately and efficiently is paramount for athletes' recovery and return to sport in a timely and safe manner. METHODS: A scoping review to map the evidence regarding the treatment, outcomes and management of hand, wrist, finger, and thumb injuries in the professional/amateur athlete from contact sports. A search of seven electronic databases; SPORTdiscus, CINAHL, Medline, Scopus, Web of Science, Embase and Cochrane Library and grey literature was conducted in January 2024. The reporting of the review is in line with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews Checklist. Inductive content analysis was used to examine the data and the Critical Appraisal Skills Programme was used to appraise the quality of the included studies. RESULTS: Eight papers met the inclusion criteria and three themes emerged addressing the return to play/sport, surgical and conservative treatment and the most common/reoccurring injuries sustained from contact sports. CONCLUSION: Managing hand, wrist, finger, and thumb injuries in athletes requires a varied approach depending on the type of injury, treatment options, and external pressures. While conservative treatment is common and effective, surgical intervention may be necessary in certain cases to improve recovery and facilitate a faster return to sport. Preventive measures in high-risk sports settings could help reduce the incidence of these injuries.

Older adults' perceptions of ageism, discrimination, and racism.

Older adults often experience different forms of discrimination, whether it be on the basis of their age, gender, race, or ethnicity (Rochon et al. 2021). Many older adults have stated they have experienced the health care system differently because of their race or ethnicity . Understanding older adults' experiences and their perceptions of ageism and racism can guide future work. This observational cross-sectional study captured community-dwelling older adults' perceptions about their experiences with ageism and racism. A few opened-ended questions were included in the cross-sectional survey. While results did not yield differences with respect to perceptions of ageism by race; there were statistically significant results in regard to perceived racism, with higher scores on the racism scales for individuals who self-identified as Black. Discussion and implications for practice, policy and research are explored.

Comparing Harmful Behaviors Among Dancers According to Sexual Orientation and Gender Identity Utilizing the RISQ.

INTRODUCTION: There is a dearth of information about whether lesbian, gay, bisexual, transgender, queer/questioning (LGBTQ+) dancers, who often experience increased psychosocial risk factors, are at increased risk of engaging in harmful behaviors compared to their heterosexual cisgender counterparts. This study explores harmful behaviors dancers engage in according to their self-reported sexual orientation and gender identity (SOGI), utilizing the validated Risky, Impulsive, and Self-Destructive Behavior Questionnaire (RISQ). METHODS: Three hundred sixty-four dancers from 7 elite dance entities in New York were contacted by e-mail to participate in the study. Sixty-six participants completed the study through a virtual questionnaire. Chi-square, ANOVA and independent t-test were utilized to assess statistical differences among RISQ outcomes in 4 SOGI groups: Cisgender Heterosexual Female (n = 20); Cisgender Heterosexual Male (n = 7); LGBTQ+ Female (n = 19); and LGBTQ+ Male (n = 20). RESULTS: Chi-square comparing SOGI group frequency of participation within each of the RISQ behaviors revealed statistically significant difference with: difficulty stopping eating (P = .05); gambling illegally (P = .036); betting on sports, horses, or other animals (P = .036); buying expensive items that cannot be afforded at the spur of the moment (P = .019); and drinking 5 or more alcoholic drinks in 3 hours or less (P = .013). Between-group frequency comparison through ANOVA and independent t-test revealed: the LGBTQ+ Male group were 92% more likely to have unprotected sex with someone they just met or did not know well (P < .001) and 83% more likely to use hallucinogens, LSD, or mushrooms (P = .018); the LGBTQ+ Female and LGBTQ+ Male groups were 4.4 times more likely to buy drugs (P = .01) and 4.88 times more likely to think about killing themselves (P = .023); and both male groups were 12.8 times more likely to steal money (P = .006). CONCLUSIONS: This study found significant difference in RISQ scores based on a dancer's SOGI. Harmful behaviors should be taken into consideration when working to improve dancer patient outcomes and quality of life.

The invisible gap: Older adults' communication with health care providers about concomitant use of alcohol and medications.

The purpose of this study was to assess the impact of a new educational intervention, Communicating with your Health Care Providers, which was designed to assist older adults in communicating with their physicians and other health care providers and improving their knowledge about concomitant alcohol and medication risks. A randomized control trial was conducted in older adult centers in an urban community. Participants were assigned to either the intervention group or a control group that received traditional services. The intervention group received educational material about health, physical and other aging changes, medication use and possible adverse interactions between alcohol and medications, as well as strategies to initiate communication with physicians and other health care providers. The outcomes measured were: (1) interest in communicating with physicians and health care providers; (2) perception of the importance of communication; and (3) knowledge about concomitant alcohol and medication use. MANCOVA tests indicated that the intervention group had greater knowledge about the risks of combining alcohol with prescription medications than the control group, as well as greater interest in having health care discussions with their physicians and other health care providers. These findings may be translated into future educational programming for community centers.

2022 ISFM/AAFP Cat Friendly Veterinary Environment Guidelines.

PRACTICAL RELEVANCE: The '2022 ISFM/AAFP Cat Friendly Veterinary Environment Guidelines' (hereafter the 'Cat Friendly Veterinary Environment Guidelines') describe how the veterinary clinic environment can be manipulated to minimise feline patient distress. Many components of a veterinary clinic visit or stay may result in negative experiences for cats. However, much can be done to improve a cat's experience by making the veterinary clinic more cat friendly. Exposure to other cats and other species can be reduced, and adjustments made with consideration of the feline senses and species-specific behaviour. Caregivers can prepare cats for a clinic visit with appropriate advice. Waiting rooms, examination rooms, hospital wards and other clinic areas can be designed and altered to reduce stress and hence encourage positive emotions. Changes need not be structural or expensive in order to be effective and make a difference to the cats and, in turn, to cat caregivers and the veterinary team. Moreover, by improving the all-round experience at the veterinary clinic, there are positive effects on preventive healthcare, identification of and recovery from illness, and compliance with treatment. CLINICAL CHALLENGES: Good feline healthcare necessitates visiting the veterinary clinic, which, simply by being outside of a cat's territory and familiar surroundings, may lead to negative experiences. Such experiences can trigger negative (protective) emotions and associated physiological stress, which can result in misleading clinical findings, patient distress, prolonged recovery from illness, further difficulties with handling at subsequent visits and potential veterinary personnel injury. There may be a mistaken belief that veterinary clinics must undergo significant renovation or building work to become cat friendly, and that, if species cannot be separated, then clinics cannot improve their care of cats. These Guidelines aim to dispel any such misconceptions and provide detailed practical advice. EVIDENCE BASE: These Guidelines have been created by a Task Force of experts convened by the International Society of Feline Medicine and American Association of Feline Practitioners, based on an extensive literature review and, where evidence is lacking, the authors' experience. Endorsements: These Guidelines have been endorsed by a number of groups and organisations, as detailed on page 1161 and at icatcare.org/cat-friendly-guidelines and catvets.com/environment.

2022 ISFM Consensus Guidelines on Management of the Inappetent Hospitalised Cat.

PRACTICAL RELEVANCE: Inappetence may have many origins and, as a presenting sign or observation in the hospitalised patient, is common in feline practice. Nutritional assessment of every patient is encouraged, to identify the need for, and appropriate type of, intervention indicated. The impact of malnutrition may be significant on the feline patient, perpetuating illness, delaying recovery, slowing wound healing and negatively impacting gut health and immunity. Delayed intervention may result in the cat's deterioration; hence prompt control of contributing factors such as the underlying illness, pain, nausea, ileus and stress is vital to optimise voluntary food intake. Management is multimodal, comprising reduction of stress, medications and assisted nutrition in the form of tube feeding or parenteral nutrition. Use of antiemetic, analgesic, prokinetic and appetite stimulant medications may restore appetite, but placement of feeding tubes should not be delayed. Feeding tubes are generally well tolerated and allow provision of food, water and medication with minimal stress, although clinicians must be aware of complications such as stoma site infections and refeeding syndrome. CLINICAL CHALLENGES: Cats are vulnerable to malnutrition owing to their unique metabolism and specific nutritional requirements. Moreover, their nature as a species means they are susceptible to stress in the hospital environment, which may result in reduced food intake; previous negative experiences may compound the problem. In particular, an inappropriate clinic environment and/or handling may cause or exacerbate inappetence in hospitalised patients, with negative impacts on recovery. Postponing interventions such as feeding tube placement to await improvement, owing to clinician or caregiver apprehension, may hinder recovery and worsen nutritional deficits. EVIDENCE BASE: The 2022 ISFM Consensus Guidelines on Management of the Inappetent Hospitalised Cat have been created by a panel of experts brought together by the International Society of Feline Medicine (ISFM). Information is based on the available literature, expert opinion and the panel members' experience.

Accessing community dementia care services in Ireland: Emotional barriers for caregivers.

Despite the benefits of utilising community-based care services (CBS) for people with dementia and their caregiver being well established, people with dementia and caregivers use fewer services in comparison to other people in need of care. While societal, cultural and logistical factors effecting caregiver use of CBS are frequently studied, research of internal emotional barriers, mental limitations created by one's own self that prevents open communication of thoughts and feelings, and their effect on CBS use is limited. This paper explores internal emotional barriers on caregivers' use of CBS within the Irish Healthcare System. Professional Healthcare Providers were also interviewed as a preliminary indicator of their awareness of these internal emotional barriers and their impact on caregivers' use of CBS. Using interpretive description methodology, interviews with 20 caregivers and fourteen dementia professional healthcare providers were transcribed and a thematic analysis methodology applied to illuminate themes/patterns within participants' subjective perceptions of caregivers emotional barriers to using CBS. Four themes emerge: reluctance to question general practitioner (GP) authority; embarrassment during level of care requirement reviews; sense of obligation to provide all care; and fear of stigma. Caregivers interviewed were reluctant to communicate concerns with professional healthcare providers (PHPs), thereby reducing the PHP's awareness of these barriers and delaying/preventing use of CBS. As key gatekeepers within the care pathway, GPs should address the uneven power dynamic with the caregiver through user-centred models of care, which actively encourage open dialogue, and receive training to identify the indicative behaviours of internal emotional barriers and empower the caregiver to communicate their feelings/concerns directly.

Interprofessional practice: Social work students' perspectives on collaboration.

As the value of interprofessional practice becomes increasingly recognized, it is critical to educate social work students so that they understand the importance of interprofessional practice, and the role that social workers play. The objective of this research was to understand social work students' experiences, attitudes, and perspectives toward interprofessional practice. A cross-sectional, non-probability convenience sample was used (N = 125), with data collected from students in a large school of social work in New York State in order to understand their experiences in the field and classroom. Results of a linear regression showed that overall, students had positive perspectives on interprofessional collaboration, with one of the strongest predictors being students' positive attitudes toward interprofessional practice. The results also point to students having limited experience in working in interprofessional teams and exposure to training, either on the job or in the classroom. To help students gain more experience and training, fieldwork opportunities in interprofessional practice can be expanded, and more courses can be offered, particularly collaborating with other academic disciplines.

Will Patients Perceive a Numbing Spray to Be an Effective Method of Anesthetizing an Intravenous Site?

PURPOSE: The purpose of this study was to determine if patients would perceive a numbing spray to be an effective method of anesthetizing an intravenous (IV) site. DESIGN: A quasi-experimental design was used. METHODS: The first 50 patients were given no pain management strategy before their IV insertion, and the next 50 patients were given a numbing spray. FINDINGS: The hypothesis that pain scores reported from the numbing spray group would be less than pain scores reported from the non-numbing spray group was not supported. CONCLUSION: The numbing spray is an effective method of anesthetizing an IV site based on both groups' responses to the other research questions. Both groups indicated they would try a numbing spray with future IV insertions, would prefer a numbing spray over a numbing injection, and were satisfied with their IV insertion. Patients wanted a less intrusive method than intradermal lidocaine.

Work Factors of Importance to Adjunct Nursing Faculty.

BACKGROUND: The use of adjunct faculty has increased exponentially in the past decade. It is essential that resources to retain adjuncts are identified and made available to adjunct faculty. To identify the appropriate factors, it is essential to discover what nursing adjunct instructors perceive to be the factors of importance to their work role. The purpose of the article was to determine the perceived factors of importance and availability of work role needs of adjunct faculty. METHOD: A quantitative, exploratory design was developed, using an anonymous online Adjunct Instructor Likert Scale Survey. The sample included participating adjunct instructors from a possible total of 91 midsized, midwestern baccalaureate nursing programs. RESULTS: Fourteen of 18 pairs were significantly different (p < .05) in adjunct perception. CONCLUSION: Using these data, colleges of nursing may be able to identify adjunct work factors in that can be improved to increase adjunct faculty recruitment, satisfaction, and retention. [J Nurs Educ. 2016;55(5):245-251.].

Decreased Stress Levels in Nurses: A Benefit of Quiet Time.

BACKGROUND: The benefits of quiet time, a therapeutic method of improving the health care environment, have been evaluated in patients, but only a few studies have examined the effects of quiet time on intensive care nurses. OBJECTIVE: To evaluate the effects of implementing quiet time in a medical-surgical intensive care unit on levels of light, noise, and nurses' stress. METHODS: Quiet time consisted of turning down the unit lights for a designated time. Levels of light, noise, and nurses' stress were measured. Nurses' stress levels were measured by using a 100-point visual analog scale; unit noise, by using a digital sound level meter (model 407736, Extech Instruments); and unit light, by using an illumination light meter (model 615, Huygen Corporation). Measurements were obtained 30 minutes before and 30 minutes, 1 hour, and 2 hours after implementation of quiet time. RESULTS: Analysis of variance and comparisons of means indicated that both light levels and nurses' stress levels were significantly decreased after quiet time (both P < .001). Noise levels were also decreased after quiet time, but the decrease was not significant (P = .08). CONCLUSIONS: Use of quiet time resulted in decreased light levels and decreased stress levels among nurses. Quiet time is an easily performed energy-saving intervention to promote a healthy work environment.

Application of magnetic resonance imaging in developmental neurotoxicity testing: a pilot study.

In a pilot developmental neurotoxicity study, a protocol was designed to utilize three-dimensional magnetic resonance (MR) images for linear and volumetric measurements of the developing rat brain. MR imaging, because of its non-destructive nature, provides a complement to traditional optical microscopy. Sprague-Dawley dams received 0, 1.25, 4.0 or 7.5mg/kg methylazoxymethanol acetate (MAM) by intraperitoneal injection during gestation days 13-15. At postnatal days (PND) 23 and 60, brains from representative male and female rats from two dams in each dose group were fixed with 10% neutral buffered formalin by transcardial perfusion for in situ MR imaging. A 7T small animal magnet system was used to obtain isotropic images at 100 microm resolution for PND 23 and 150 microm resolution for PND 60. Data from a rapid screening method based on midpoint MR slices of whole brain, cerebrum, cerebellum, and hippocampus showed a dose-related decreased volume of whole brain, cerebrum, and hippocampus in treated rats. Subsequent volumetric estimates using the Cavalieri method confirmed these findings. The brains were subsequently removed and processed for conventional histologic examination of hematoxylin and eosin-stained sections. It is concluded that MR imaging in rat developmental neurotoxicity studies offers the advantages of in situ volumetric measurements of brain structures while preserving the samples for conventional optical microscopy.

New insights into functional aspects of liver morphology.

The liver is structurally and functionally complex and has been considered second only to brain in its complexity. Many mysteries still exist in this heterogeneous tissue whose functional unit of the lobule has continued to stump morphologists for over 300 years. The primary lobule, proposed by Matsumoto in 1979, has been gaining acceptance as the functional unit of the liver over other conceptual views because it's based on vessel architecture and includes the classic lobule as a secondary feature. Although hepatocytes comprise almost 80% of the liver, there are at least another dozen cell types, many of which provide "cross-talk" and play important functional roles in the normal and diseased liver. The distribution and functional roles of all cells in the liver must be carefully considered in both the analysis and interpretation of research data, particularly data in the area of genomics and "phenotypic anchoring" of gene expression results. Discoveries regarding the functional heterogeneity of the various liver cell types, including hepatocytes, hepatic stellate cells, sinusoidal endothelia, and Kupffer cells, are providing new insights into our understanding of the development, prevention and treatment of liver disease. For example, functional differences along zonal patterns (centrilobular or periportal) have been demonstrated for sinusoidal endothelium, Kupffer cells, and hepatocytes and can explain the gradients and manifestations of disease observed within lobules. Intralobular gradients of bile uptake, glycogen depletion, glutamine synthetase, and carboxylesterase by hepatocytes; widened fenestrations in centrilobular sinusoidal lining cells; and differences in the components of centrilobular extracellular matrix or function of Kupffer cells have been demonstrated. Awareness of the complexities and heterogeneity of the liver will add to a greater understanding of liver function and disease processes that lead to toxicity, cancer, and other diseases.