Blakelands Hospital

Prolonged radiation exposure remains a critical occupational hazard in the catheterization lab, typically mitigated by lead aprons, which contribute to orthopedic injury. Recent innovations like the Rampart M1128 enhanced radiation protection system (Rampart IC) aim to reduce these risks, but their impact on door-to-balloon (D2B) time in ST-elevation myocardial infarction (STEMI) has not been evaluated. We conducted a single-center retrospective cohort study comparing D2B times among 174 STEMI patients undergoing percutaneous coronary intervention: 87 treated using lead aprons and 87 treated utilizing the Rampart M1128 system. Patients were randomly selected from a pool of 298. Analyses were adjusted for potential confounders, including bleeding, use of vasopressors, intubation, mechanical support, electrical instability, access type, and prior revascularization. Unadjusted median D2B time was 31.0 minutes in the Rampart group vs 31.1 minutes in the lead apron group. Adjusted analysis yielded a mean D2B difference of 1.51 minutes (95% CI, -0.86 to 3.87; P = .21), well within the prespecified 5-minute noninferiority margin. No statistically significant differences were observed across expanded models or one-at-a-time covariate models. The presence of shock or respiratory failure did not prolong D2B times in the Rampart group. Implementation of an enhanced radiation protection system was noninferior to standard lead apron use regarding D2B time in STEMI patients. This suggests such systems can enhance operator safety without compromising the quality of patient care. Broader adoption may be justified to reduce occupational harm while maintaining high-quality cardiovascular outcomes.

Context:Released by the US Department of Health and Human Services (HHS) every decade since 1980, Healthy People identifies science-based objectives with targets to monitor progress and motivate and focus action. Healthy People 2030 is the current iteration of the Healthy People initiative.Program:Healthy People 2030 includes 3 sets of measures—Healthy People 2030 objectives, Leading Health Indicators (LHIs), and Overall Health and Well-being Measures (OHMs). Collectively, these components of Healthy People 2030 drive progress toward the initiative's vision of “a society in which all people can achieve their full potential for health and well-being across the life span.”Implementation:The Healthy People 2030 LHIs and OHMs were developed with input from multiple subject matter experts and launched in December 2020. Designed as an entry point for users interested in improving the health of their communities and selected for their ability to improve health and well-being, the LHIs will be assessed annually. As broad, global outcome measures of overall health and well-being, the OHMs will be assessed at least 3 times before 2030.Evaluation:The 23 LHIs are a subset of Healthy People 2030 core objectives that have been selected to drive action toward improved health and well-being. LHIs are intended to help organizations, communities, and states across the nation focus resources and efforts to improve the health and well-being of all people. The OHMs include 8 broad, global outcome measures of overall health and well-being that help assess progress toward the Healthy People 2030 vision. The Healthy People 2030 OHMs include the addition of a measure of overall well-being.Discussion:Together with the Healthy People 2030 objectives, the LHIs and OHMs provide a plan of action to improve the health and well-being of the nation through a framework for assessing progress, addressing health disparities and social determinants of health, and advancing health equity.

Childhood obesity has grown into a national epidemic since the 1980s. Many school-based intervention efforts that target childhood obesity involve curriculum and programming that demands instructional time, which disincentivizes school participation. Stand-biased classrooms are an environmental intervention that promotes standing rather than sitting by utilizing standing height desks that allow students to stand during normal classroom activities. The quasi-experimental pilot study was conducted in 5 first-grade classrooms in a Texas elementary school, with 2 control classrooms, 2 treatment classrooms, and 1 classroom that was a control in the fall and treatment in the spring (to allow for within-group comparisons). This intervention has been shown effective in significantly increasing caloric expenditure. In addition, the present study reveals potential behavioral effects from standing. This article presents lessons learned from the pilot study that may prove useful for others implementing similar interventions and calls for additional research on the academic benefits of standing for students.

Plagiarism is a much older concept than copyright. In this article we consider the distinction between the two and the various types of plagiarism. There are not always legal implications from an act of plagiarism, but there can be, and they can range much wider than copyright law. There are clearly risks for publishers in dealing with alleged or actual plagiarism, but most of these can be managed with prudent forethought. We illustrate some ways in which this can be achieved.

Journal Article A nontraditional approach to internship programs Get access Dominick A. Caselnova, III, M.H.A., Dominick A. Caselnova, III, M.H.A. Director of Pharmacy Address reprint requests to Mr. Caselnova at HCA L. W. Blake Hospital, 2020 59th Street West, Bradenton, FL 34209. Search for other works by this author on: Oxford Academic Google Scholar Gary J. Algozzine, Pharm.D., Gary J. Algozzine, Pharm.D. Clinical Coordinator Search for other works by this author on: Oxford Academic Google Scholar Rebecca L. Sprenger, Pharm.D., Rebecca L. Sprenger, Pharm.D. Assistant Director of Pharmacy, HCA L. W. Blake Hospital, Bradenton, FL. Search for other works by this author on: Oxford Academic Google Scholar Gabrial S. Zimmer, Pharm.D. Gabrial S. Zimmer, Pharm.D. Student at the University of Florida College of Pharmacy, Gainesville. Search for other works by this author on: Oxford Academic Google Scholar American Journal of Hospital Pharmacy, Volume 48, Issue 6, 1 June 1991, Pages 1260–1261, https://doi.org/10.1093/ajhp/48.6.1260 Published: 01 June 1991

The present conditions for plants and animals have changed in the last 100 000 years (as described in chapter 3), especially under the influence of man.