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The duration of incoming quitline calls may serve as a crude proxy for the potential amount of reactive counseling provided.
To explore whether call duration may be useful for monitoring quitline capacity and service delivery.
Using data on the duration of incoming quitline calls to 1-800-QUIT-NOW from 2012 through 2015, we examined national trends and state-level variation in average call duration. We estimated a regression model of average call duration as a function of total incoming calls, nationally and by state, controlling for confounders.
From 2012 through 2015, average call duration was 11.4 min, nationally, and was 10 min or longer in 33 states. Average call duration was significantly correlated with quitline service provider. Higher incoming call volume was significantly associated with lower average call duration in 32 states and higher average call duration in five states (P-value <0.05). The relationship between call volume and call duration was not correlated with quitline service provider.
Variation in average call duration across states likely reflects different service delivery models. Average call duration was associated with call volume in many states. Significant changes in call duration may highlight potential quitline capacity issues that warrant further investigation.
Childhood maltreatment (CM) plays an important role in the development of major depressive disorder (MDD). The aim of this study was to examine whether CM severity and type are associated with MDD-related brain alterations, and how they interact with sex and age.
Within the ENIGMA-MDD network, severity and subtypes of CM using the Childhood Trauma Questionnaire were assessed and structural magnetic resonance imaging data from patients with MDD and healthy controls were analyzed in a mega-analysis comprising a total of 3872 participants aged between 13 and 89 years. Cortical thickness and surface area were extracted at each site using FreeSurfer.
CM severity was associated with reduced cortical thickness in the banks of the superior temporal sulcus and supramarginal gyrus as well as with reduced surface area of the middle temporal lobe. Participants reporting both childhood neglect and abuse had a lower cortical thickness in the inferior parietal lobe, middle temporal lobe, and precuneus compared to participants not exposed to CM. In males only, regardless of diagnosis, CM severity was associated with higher cortical thickness of the rostral anterior cingulate cortex. Finally, a significant interaction between CM and age in predicting thickness was seen across several prefrontal, temporal, and temporo-parietal regions.
Severity and type of CM may impact cortical thickness and surface area. Importantly, CM may influence age-dependent brain maturation, particularly in regions related to the default mode network, perception, and theory of mind.
The United States today has the highest incarceration rate, as well as the largest number of people living under correctional control more broadly (including probation and parole), than any other country on the globe. The size of the American criminal justice system is not only internationally unparalleled, but it is also historically unprecedented. This apparatus is also deeply racialized. African Americans, Latinos, and indigenous populations (Hawaiian, Puerto Rican, Native American), are all represented in U. S. jails and prisons in numbers dramatically disproportionate to their representation in the population as a whole, and every non-White population is incarcerated at a rate far surpassing that of Whites. Notably, however, while the scale of today’s criminal justice system is unsurpassed and unprecedented, its severe racial disproportionality has always been a defining feature. Only by taking a close look at the long and deeply racialized history of the American criminal justice system, and more specifically at the regularly discriminatory application of the law as well as the consistent lack of equal justice under the law over time, can we fully understand not only why the American criminal justice system remains so unjust, but also why prison populations rose so dramatically when they did.
Registered nurses (RNs) and licensed practical nurses (LPNs) provide the skilled component of nursing care in Canadian residential long-term care facilities, yet we know little about this important workforce. We surveyed 309 RNs and 448 LPNs from 91 nursing homes across Western Canada and report descriptively on their demographics and work and health-related outcomes. LPNs were significantly younger than RNs, worked more hours, and had less nursing experience. LPNs also experienced significantly more dementia-related responsive behaviours from residents compared to RNs. Younger LPNs and RNs reported significantly worse burnout (emotional exhaustion) and poorer mental health compared to older age groups. Significant differences in demographics and work- and health-related outcomes were also found within the LPN and RN samples by province, region, and owner-operator model. These findings can be used to inform important policy decisions and workplace planning to improve quality of work life for nurses in residential long-term care facilities.
Children with CHD and acquired heart disease have unique, high-risk physiology. They may have a higher risk of adverse tracheal-intubation-associated events, as compared with children with non-cardiac disease.
Materials and methods
We sought to evaluate the occurrence of adverse tracheal-intubation-associated events in children with cardiac disease compared to children with non-cardiac disease. A retrospective analysis of tracheal intubations from 38 international paediatric ICUs was performed using the National Emergency Airway Registry for Children (NEAR4KIDS) quality improvement registry. The primary outcome was the occurrence of any tracheal-intubation-associated event. Secondary outcomes included the occurrence of severe tracheal-intubation-associated events, multiple intubation attempts, and oxygen desaturation.
A total of 8851 intubations were reported between July, 2012 and March, 2016. Cardiac patients were younger, more likely to have haemodynamic instability, and less likely to have respiratory failure as an indication. The overall frequency of tracheal-intubation-associated events was not different (cardiac: 17% versus non-cardiac: 16%, p=0.13), nor was the rate of severe tracheal-intubation-associated events (cardiac: 7% versus non-cardiac: 6%, p=0.11). Tracheal-intubation-associated cardiac arrest occurred more often in cardiac patients (2.80 versus 1.28%; p<0.001), even after adjusting for patient and provider differences (adjusted odds ratio 1.79; p=0.03). Multiple intubation attempts occurred less often in cardiac patients (p=0.04), and oxygen desaturations occurred more often, even after excluding patients with cyanotic heart disease.
The overall incidence of adverse tracheal-intubation-associated events in cardiac patients was not different from that in non-cardiac patients. However, the presence of a cardiac diagnosis was associated with a higher occurrence of both tracheal-intubation-associated cardiac arrest and oxygen desaturation.