Formation médicale pour soutenir efficacement les patients qui consomment des substances dans tous les contextes de pratique : Un examen approfondi des compétences recommandées

Background: The responsibility for addressing the healthcare needs of PWUS is the responsibility of all physicians. Within the healthcare system, research consistently reveals inequitable experiences in healthcare with people who use substances (PWUS) reporting stigmatization, marginalization, and a lack of compassion. Objectives: The aim of this scoping review was to find and describe competencies being taught, developed, and fostered within medical education and then to provide recommendations to improve care for this population of patients. Results: Nineteen articles were included. Recommended knowledge competencies tend to promote understanding neurophysiological changes caused by substances, alongside knowing how to evaluate of ‘risky’ behaviours. Commonly recommended skills relate to the screening and management of substance use disorders. Recommended attitude competencies include identifying personal bias and establishing a patient-centered culture among practice teams. The disease model of addiction informed all papers, with no acknowledgement of potential beneficial or non-problematic experiences of substance use. To enhance knowledge-type competencies, medical education programs are advised to include addiction specialists as educators and prevent stigmatization through the hidden curriculum. Conclusion: To reduce experiences of stigmatization and marginalization among patients who use illicit substances and to improve quality of care, knowledge, skills, and attitudes competencies can be more effectively taught in medical education programs.Contexte : Il incombe à tous les médecins de répondre aux besoins en matière de soins de santé des consommateurs de substances psychoactives. Au sein du système de santé, les recherches révèlent régulièrement des expériences inéquitables en matière de soins de santé, les consommateurs de substances faisant état de stigmatisation, de marginalisation et d'un manque de compassion. Objectifs : L'objectif de cette étude exploratoire était de trouver et de décrire les compétences enseignées, développées et encouragées dans le cadre de la formation médicale, puis de formuler des recommandations pour améliorer les soins prodigués à ces patients. Résultats : Au total, 19 articles ont été inclus. Les compétences recommandées en matière de connaissances tendent à promouvoir la compréhension des changements neurophysiologiques causés par les substances, ainsi que la connaissance de l'évaluation des comportements « à risque ». Les compétences couramment recommandées concernent le dépistage et la gestion des troubles liés à l'usage de substances. Les compétences recommandées en matière d'attitude comprennent l'identification des préjugés personnels et l'instauration d'une culture centrée sur le patient au sein des équipes de praticiens. Tous les articles s'appuient sur le modèle pathologique de la toxicomanie et ne reconnaissent pas les expériences potentiellement bénéfiques ou non problématiques de la consommation de substances. Pour améliorer les compétences en matière de connaissances, il est conseillé aux programmes de formation médicale d'inclure des spécialistes de la toxicomanie en tant qu'éducateurs et de prévenir la stigmatisation par le biais d'un programme d’études caché. Conclusion : Pour réduire les expériences de stigmatisation et de marginalisation parmi les patients qui consomment des substances illicites et pour améliorer la qualité des soins, les connaissances, les aptitudes et les attitudes peuvent être enseignées plus efficacement dans les programmes de formation médicale

A comparison of length-related and age-related growth parameters of newaiby Otolithes ruber in Kuwait waters

The growth parameters of Otolithes ruber (Sciaenidae) were determined from both length-frequency and length-at-age data collected from Kuwait waters from 1984 to 1986. The similarity of the growth parameters is reflected in the small range of the parameters o' (=log sub(10)K+2logL) which indicates the compatibility of the two methods for this relatively short-lived species

Oral History Conversation With Chuck Samuelson (Kitchens for Good)

This was a conversation with Chuck Samuelson who runs a social organization (Kitchens for Good)

First Report of Mycotoxins in Second Peanuts Crop in Adana and Osmaniye at Harvest, Drying, Prestorage and Storage Periods

Aflatoxin (AF) and cyclopiazonic acid (CPA) contaminations are very important problems for peanuts and its products. The aim of the study was to detect aflatoxin (types B and G) and cyclopiazonic acid (CPA) occurrence and critical periods of toxin production in peanuts collected from different research areas of Osmaniye and Adana, Turkey, in 2015. Peanut kernels toxin analysis was performed in four different periods during the harvest, drying, prestorage, and storage. Total aflatoxin occurrence in peanut kernels was analyzed by immunoaffinity chromatography‐reversed‐phase high‐performance liquid chromatography (IAC‐HPLC) analysis and cyclopiazonic acid occurrence in peanut kernels was analyzed by thin layer chromatography (TLC). Aflatoxin levels in 76 out of 102 contaminated samples were from 0.3 to 1333.42 μg/kg. Cyclopiazonic acid levels in 18 out of 102 peanut samples were from 16.6 to 44.44 μg/kg. An unusual pattern of mycotoxin production (aflatoxin types B and G simultaneously with CPA) was seen in 11 of 102 peanuts samples. Six of nine samples were from the storage period. Aflatoxin contamination during harvesting (64%) and drying (75%) were higher than prestorage (53%). Aflatoxin (93%) and cyclopiazonic acid (30%) were the most produced during storage. The results showed that storage period was significantly important for the presence of two mycotoxins according to the statistical analysis

A comparison of length-related and age-related growth parameters of newaiby Otolithes ruber in Kuwait waters

Growth, Growth curves, Kuwait, Otolithes ruber

Addressing sarcopenia management in primary care in Türkiye: gaps in the field and training needs of family physicians

Background and objectivesSarcopenia is a current health threat that accompanies nutritional problems, cancers, and chronic diseases all around the world. Individuals in the risk group, especially the older adults, can be protected against sarcopenia with early diagnosis and effective interventions. The aim of this study is to conduct the first national survey to determine the awareness, knowledge, and adequacy levels of Turkish family physicians regarding sarcopenia management.Materials and methodsThis cross-sectional study was performed on family physicians serving in family health centers across Türkiye. The mobile phone numbers of family physicians were accessed through the Federation of Family Physicians Associations. Data were collected through a 33-item online purpose-designed survey from April 1 to June 2024. The Kolmogorov–Smirnov test was used to evaluate the conformity of the variables to the normal distribution. Chi-square test was applied for comparisons between groups.ResultsA total of 405 family physicians representing all seven regions in Türkiye participated in the study. The mean score of the participants’ competence level in sarcopenia management was found to be 3.37 ± 1.98 out of 10 points. Receiving training on palliative care and sarcopenia before and/or after graduation and having people diagnosed with sarcopenia in the immediate environment provided a positive and significant difference in terms of sarcopenia management competence scores (p < 0.001, p = 0.012, p = 0.001, respectively).ConclusionThe findings of the study reveal deficiencies in awareness, knowledge, and management of sarcopenia among family physicians. Expanding the subject of sarcopenia in the medical school curriculum, including sarcopenia management in guidelines for primary health care providers and providing equipment support, ensuring that family physicians are more proactive and competent in the management of sarcopenia may be a rational approach within the scope of protecting and improving individual and public health

Antioksidacijska i antimikrobna aktivnost etil-acetatnog ekstrakta kvasca Saccharomyces cerevisiae

Research background. Antioxidants are important compounds present at low concentrations that inhibit oxidation processes. Due to the side effects of synthetic antioxidants, research interest has increased considerably towards finding natural sources of antioxidants that can replace the synthetic ones. The emergence and spread of antibiotic resistance require the development of new drugs or some potential sources of novel medicine. This work aims to extract the secondary metabolites of Saccharomyces cerevisiae using ethyl acetate as a solvent and to determine the antioxidant and antimicrobial activities of these extracted metabolites. Experimental approach. The antioxidant activity of the secondary metabolites of S. cerevisiae were determined using DPPH, ABTS and FRAP assays. Furthermore, the antimicrobial potential of the ethyl acetate extract of S. cerevisiae against Cutibacterium acnes, Staphylococcus aureus and Staphylococcus epidermidis was assessed. Results and conclusion. Five out of 13 of the extracted secondary metabolites were identified as antioxidants. The antioxidant activity of the S. cerevisiae extract exhibited relatively high IC50 of 455.26 and 294.51 μg/mL for DPPH and ABTS respectively, while the obtained FRAP value, expressed as ascorbic acid equivalents, was 44.40 μg/mL. Moreover, the extract had a significant antibacterial activity (p<0.05) against Staphylococcus aureus and Staphylococcus epidermidis at the concentrations of 100 and 200 mg/mL, respectively. However, no inhibitory effect was observed against Cutibacterium acnes as the extract was only effective against the bacterium at the concentrations of 300 and 400 mg/mL (inhibition zones ranging from 9.0±0.0 to 9.3±0.6) respectively (p<0.05). Staphylococcus aureus was highly sensitive to the extract, with a MIC value of 18.75 mg/mL. Novelty and scientific contribution. This report confirmed the efficacy of the secondary metabolites of S. cerevisiae as a natural source of antioxidants and antimicrobials and suggested the possibility of employing them in drugs for the treatment of infectious diseases caused by the tested microorganisms.Pozadina istraživanja. Antioksidansi su važni spojevi koji već pri niskim koncentracijama inhibiraju oksidacijske procese. Zbog štetnih nuspojava primjene sintetskih antioksidanasa porastao je interes za istraživanjem prirodnih izvora antioksidansa. Pojava i proširenost antibiotske rezistencije potakli su interes za razvojem novih lijekova ili mogućih izvora novih lijekova. Svrha je ovoga rada bila ekstrahirati sekundarne metabolite kvasca Saccharomyces cerevisiae pomoću etil-acetata kao otapala, te odrediti antioksidacijsku i antimikrobnu aktivnost dobivenih metabolita. Eksperimentalni pristup. Antioksidacijska aktivnost sekundarnih metabolita kvasca S. cerevisiae određena je pomoću metoda DPPH, ABTS i FRAP. Osim toga, ispitan je antimikrobni učinak etil-acetatnog ekstrakta kvasca S. cerevisiae na bakterije Cutibacterium acnes, Staphylococcus aureus i Staphylococcus epidermidis. Rezultati i zaključci. Od 13 izdvojenih sekundarnih metabolita, identificirano je njih pet s antioksidacijskim učinkom. Ekstrakt S. cerevisiae imao je relativno veliku IC50 vrijednost, i to 455,27 μg/mL utvrđenu DPPH metodom i 294,51 μg/mL dobivenu ABTS metodom, te FRAP vrijednost, izraženu u ekvivalentima askorbinske kiseline, od 44,40 μg/mL. Osim toga, ekstrakt je imao izraženi antibakterijski učinak (p<0,05) na Staphylococcus aureus pri koncentraciji od 100 mg/mL i Staphylococcus epidermidis pri koncentraciji od 200 mg/mL. Međutim, nije opažena inhibicija bakterije Cutibacterium acnes, budući da je ekstrakt učinkovito (p<0.05) inhibirao tu bakteriju samo pri koncentracijama od 300 i 400 mg/mL (sa zonama inhibicije od 9,0±0,0 do 9,3±0,6). Bakterija Staphylococcus aureus bila je vrlo osjetjiva na djelovanje ekstrakta, s minimalnom inhibicijskom koncentracijom od 18,75 mg/mL. Novina i znanstveni doprinos. U ovom je radu potvrđena učinkovitost sekundarnih metabolita kvasca S. cerevisiae kao prirodnih antioksidacijskih i antimikrobnih spojeva, te je dokazana mogućnost njihove primjene u lijekovima protiv zaraznih bolesti uzrokovanih ispitanim bakterijama

Observations on the Pearl Oyster Fishery of Kuwait

The pearl oyster fishery of Kuwait was monitored daily from January 1989 to May 1990. Landings of pearl oysters in 1989 totaled 287 tons with a market value of U.S. $1.0 million. Commercial pearls (\u3e3 mm) were estimated to be present in one of every 4200 oysters. Most of the pearl oysters landed were new recruits with hinge lengths between 40-56 mm. There was a curvilinear relationship between total weight and size of oysters (length) and the sex ratio approached 1:1. Spawning occurs throughout the year, with a spat settlement peak in early fall. Over the size range examined there was no relationship between the size of oysters and the size of pearls and subsequent resource management strategies are discussed

Clinical Pathway and Monthly Feedback Improve Adherence to Antibiotic Guideline Recommendations for Community-Acquired Pneumonia

Background: Compliance with community-acquired pneumonia (CAP) guidelines remains poor despite a substantial body of evidence indicating that guideline-concordant care improves patient outcomes. The aim of this study was to compare the relative effectiveness of a general educational and a targeted emergency department intervention on improving physicians’ concordance with CAP guidelines. Methods: Two distinct interventions were implemented over specific time periods. The first intervention was educational, focusing on the development of local CAP guidelines and their dissemination through hospital-wide educational programmes. The second intervention was a targeted one for the emergency department, where a clinical pathway for the initial management of CAP patients was introduced, followed by monthly feedback to the emergency department (ED) physicians about concordance rates with the guidelines. Data on the concordance rate to CAP guidelines was collected from a retrospective chart review. Results: A total of 398 eligible patient records were reviewed to measure concordance to CAP guidelines over the study period. Concordance rates during the baseline and educational intervention periods were similar (28.1% vs. 31.2%; p > 0.05). Significantly more patients were treated in accordance with the CAP guidelines after the ED focused intervention when compared to the baseline (61.5% vs. 28.1%; p < 0.05) or educational period (61.5% vs. 31.2%; p < 0.05). Conclusions: A targeted intervention with a CAP clinical pathway and monthly feedback was a successful strategy to increase adherence to empirical antibiotic recommendations in CAP guidelines