This pilot study examined the usability, acceptability, and effectiveness of a free Provider Resilience (PR) mobile application (app) designed by the National Center for Telehealth and Technology to ...reduce provider burnout. Outpatient mental health providers (N = 30) used the PR app for 1 month. Participants rated the PR app on the System Usability Scale with an overall score of 79.7, which is in the top quartile for usability. Results of paired sample
t
tests on the Professional Quality of Life Scale indicated significant decreases on the Burnout (
t
= 3.65,
p
< .001) and Compassion Fatigue (
t
= 4.54,
p
< .001) subscales. The Provider Resilience app shows promise in reducing burnout and compassion fatigue in mental health care providers.
Abstract Advances in critical care, operative techniques, early fluid resuscitation, antimicrobials to control bacterial infections, nutritional support to manage the hypermetabolic response and ...early wound excision and coverage has improved survival rates in major burns patients. These advances in management have been associated with increased recognition of invasive infections caused by Candida species in critically ill burns patients. Candida albicans is the most common species to cause invasive Candida infections, however, non- albicans Candida species appear to becoming more frequent. These later species may be less fluconazole susceptible than Candida albicans . High crude and attributable mortality rates from invasive Candida sepsis are multi-factorial. Diagnosis of invasive candidiasis and candidemia remains difficult. Prophylactic and pre-emptive therapies appear promising strategies, but there is no specific approach which is well-studied and clearly efficacious in high-risk burns patients. Treatment options for invasive candidiasis include several amphotericin B formulations and newer less toxic antifungal agents, such as azoles and echinocandins. We review the currently available data on diagnostic and management strategies for invasive candidiasis and candidemia; whenever possible providing reference to the high-risk burn patients. We also present an algorithm for the management of candidemia and invasive candidiasis in burn patients.
Recent in vitro studies of human sex chromosome aneuploidy showed that the Xi ("inactive" X) and Y chromosomes broadly modulate autosomal and Xa ("active" X) gene expression. We tested these findings ...in vivo. Linear modeling of CD4+ T cells and monocytes from individuals with one to three X chromosomes and zero to two Y chromosomes revealed 82 sex-chromosomal and 344 autosomal genes whose expression changed significantly with Xi and/or Y dosage in vivo. Changes in sex-chromosomal expression were remarkably constant in vivo and in vitro; autosomal responses to Xi and/or Y dosage were largely cell-type specific (∼2.6-fold more variation than sex-chromosomal responses). Targets of the sex-chromosomal transcription factors ZFX and ZFY accounted for a significant fraction of these autosomal responses both in vivo and in vitro. We conclude that the human Xi and Y transcriptomes are surprisingly robust and stable, yet they modulate autosomal and Xa genes in a cell-type-specific fashion.Recent in vitro studies of human sex chromosome aneuploidy showed that the Xi ("inactive" X) and Y chromosomes broadly modulate autosomal and Xa ("active" X) gene expression. We tested these findings in vivo. Linear modeling of CD4+ T cells and monocytes from individuals with one to three X chromosomes and zero to two Y chromosomes revealed 82 sex-chromosomal and 344 autosomal genes whose expression changed significantly with Xi and/or Y dosage in vivo. Changes in sex-chromosomal expression were remarkably constant in vivo and in vitro; autosomal responses to Xi and/or Y dosage were largely cell-type specific (∼2.6-fold more variation than sex-chromosomal responses). Targets of the sex-chromosomal transcription factors ZFX and ZFY accounted for a significant fraction of these autosomal responses both in vivo and in vitro. We conclude that the human Xi and Y transcriptomes are surprisingly robust and stable, yet they modulate autosomal and Xa genes in a cell-type-specific fashion.
The increased understanding on the impact of partial deafness (PD) with residual low-frequency hearing has led to new hearing rehabilitation strategies using hearing preservation techniques during ...cochlear implantation with the aim to make use of the combined electric acoustic stimulation (EAS) in the affected ear. As a first report, we describe minor forms of the incomplete cochlear partition type II (IP- II) involving the apical 1.5 turns, which were found in the majority of our patients presenting with congenital PD. We investigated the hearing preservation rates and hearing outcomes of these patients after EAS cochlear implantation (EAS-CI).
We present a review of a case series of 4 children and 1 adult with documented congenital PD. They all underwent audiologic and radiologic assessment for CI. Hearing preservation rates and speech perception outcomes were assessed at 1, 3, 6, 12, and 24 months after EAS-CI.
Three (75%) of the 4 pediatric patients and 1 adult patient with congenital PD showed the pattern of isolated IP-II variants involving the apical 1.5 cochlear turns with a normal basal turn, without associated inner ear anomalies. Complete hearing was preserved in all patients. Speech performance improved significantly in all patients.
As a first report, we describe minor IP-II variants identified in the majority of our patients with congenital PD; these IP-II variants could be useful as an indicator of malformation for congenital PD. Detection requires careful radiologic evaluation of the cochlea. EAS-CI is not a contraindication in these patients and should be considered early to prevent permanent speech and language deficits.
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