The purpose of this study was to investigate whether nurses provide different amounts of narcotic analgesics to male and female patients, and different amounts to white and ethnic minority patients. A retrospective survey was conducted with the medical records of 101 male and 79 female uncomplicated adult appendectomy patients, 40 of whom were ethnic minority members. Narcotic analgesic doses for the entire postoperative period were converted to equianalgesic doses comparable to intramuscular morphine. Male patients received significantly larger initial doses than female patients. There was no gender difference in the total dose received postoperatively. White patients received significantly more total postoperative narcotic analgesics than ethnic minority patients. The gender difference provides modest external validation for prior experimental results. The ethnic difference suggests that irrelevant cues may be used in nurses' medication decisions.
Critical illness in COVID-19 is an extreme and clinically homogeneous disease phenotype that we have previously shown1 to be highly efficient for discovery of genetic associations2. Despite the advanced stage of illness at presentation, we have shown that host genetics in patients who are critically ill with COVID-19 can identify immunomodulatory therapies with strong beneficial effects in this group3. Here we analyse 24,202 cases of COVID-19 with critical illness comprising a combination of microarray genotype and whole-genome sequencing data from cases of critical illness in the international GenOMICC (11,440 cases) study, combined with other studies recruiting hospitalized patients with a strong focus on severe and critical disease: ISARIC4C (676 cases) and the SCOURGE consortium (5,934 cases). To put these results in the context of existing work, we conduct a meta-analysis of the new GenOMICC genome-wide association study (GWAS) results with previously published data. We find 49 genome-wide significant associations, of which 16 have not been reported previously. To investigate the therapeutic implications of these findings, we infer the structural consequences of protein-coding variants, and combine our GWAS results with gene expression data using a monocyte transcriptome-wide association study (TWAS) model, as well as gene and protein expression using Mendelian randomization. We identify potentially druggable targets in multiple systems, including inflammatory signalling (JAK1), monocyte–macrophage activation and endothelial permeability (PDE4A), immunometabolism (SLC2A5 and AK5), and host factors required for viral entry and replication (TMPRSS2 and RAB2A).
The aim of this study was to test how practitioners’ pain communication affects the pain information provided by older adults. A posttest only double blind experiment was used to test how the phrasing of practitioners’ pain questions, open-ended and without social desirability bias; closed-ended and without social desirability bias; or open-ended and with social desirability bias, affected the pain information provided by 312 community living older adults with osteoarthritis pain. Older adults were randomly assigned to one of the three pain phrasing conditions to watch and orally respond to a computer displayed videotape of a practitioner asking about their pain. All responded to a second videotape of the practitioner asking if there was anything further they wanted to communicate. Lastly all responded to a third videotape asking if there was anything further they want to communicate about their pain. Transcripts of the audio taped responses were content analyzed using 16 a priori criteria from national guidelines to identify important pain information for osteoarthritis pain management. Older adults described significantly more pain information in response to the open-ended question without social desirability. The two follow up questions elicited significant additional information for all three groups, but did not compensate for the initial reduced pain information from the closed-ended and social desirability biased groups. Initial use of an open-ended pain question without social desirability bias and use of follow-up questions significantly increases the amount of important pain information provided by older adults with osteoarthritis pain.
This study was designed to test how patients' psychiatric diagnoses would affect nursing care for medical problems. Sixty nurses were randomly assigned to three groups in this posttest-only experiment. Control group nurses read a vignette describing a man admitted with a possible myocardial infarction (MI). Nonpsychotic group nurses also read that the person was on alprazolam. Psychotic group nurses read that the person was on haloperidol, benztropine, lorazepam, trazadone, fluoxetine, and lithium. Psychotic group nurses estimated a decreased probability that the patient was having an MI and were less likely to respond to additional possible MI symptoms. An increased awareness of the potential to stereotype medical patients with a history of psychosis might assist nurses when providing care.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.