Opioid overdose is a major public health concern in the United States. Naloxone education and distribution can decrease the risk of overdose deaths. A previous study showed that a longitudinal, multi-attempt telephone intervention by a single pharmacy resident was effective for distributing naloxone to a high-risk veteran population. The purpose of this project was to investigate whether a team-based, single-attempt telephone outreach event is effective for distributing naloxone to at-risk outpatient veterans. The Risk Index for Overdose or Serious Opioid-Induced Respiratory Depression (RIOSORD) tool was used to identify patients with risk class ≥4. Pharmacy trainees contacted 164 patients and offered naloxone. https://www.selleckchem.com/products/3-methyladenine.html The primary outcome was the proportion of patients with RIOSORD risk class ≥4 who had naloxone before versus after the intervention. The proportion of patients with RIOSORD class ≥4 who had a naloxone kit before and after the event was 0.28 and 0.63, respectively (difference=0.35, p<1×10 ). Per-protocol analysis showed that of 164 patients contacted, 67% were reached (n=109) and 80 patients accepted naloxone, corresponding to a 73% acceptance rate for those reached. A team-based telephone outreach event is an effective method for distributing naloxone to at-risk outpatient veterans. A team-based telephone outreach event is an effective method for distributing naloxone to at-risk outpatient veterans. The effect of communication between referring and accepting clinicians during patient transitions to the pediatric intensive care unit (PICU) on diagnostic quality is largely unknown. This pilot study aims to determine the feasibility of using focused ethnography to understand the relationship between referral communication and the diagnostic process for critically ill children. We conducted focused ethnography in an academic tertiary referral PICU by directly observing the referral and admission of 3 non-electively admitted children 0-17years old. We also conducted 21 semi-structured interviews of their parents and admitting PICU staff (intensivists, fellows/residents, medical students, nurses, and respiratory therapists) and reviewed their medical records post-discharge. Performing focused ethnography in a busy PICU is feasible. We identified three areas for additional exploration (1) how information transfer affects the PICU diagnostic process; (2) how uncertainty in patient assessment affects the decision to transfer to the PICU; and (3) how the PICU team's expectations are influenced by referral communication. Focused ethnography in the PICU is feasible to investigate relationships between clinician referral communication and the diagnostic process for critically ill children. Focused ethnography in the PICU is feasible to investigate relationships between clinician referral communication and the diagnostic process for critically ill children.An overview of the experiences with deployment of undergraduate medical students in a Dutch university center during the COVID-19 pandemic is provided from organisational and educational perspectives. Medical students' and specialists' experiences during the first peak of COVID-19 underscore the preliminary suggestion that students can be given more enhanced (yet supervised) responsibility for patient care early in their practicums. Critically ill patients are at risk for intra-abdominal hypertension (IAH) and related complications such as organ failure, abdominal compartment syndrome (ACS), and death. This study aimed to determine the value of urinary and serum intestinal fatty acid binding protein (I-FABP) levels as early marker for IAH-associated complications. A prospective observational study was conducted in two academic institutional mixed medical-surgical ICUs in the Netherlands. Adult patients admitted to the ICU with two or more risk factors for IAH (198) were included. Urinary and serum I-FABP and intra-abdominal pressure (IAP) were measured every six hours during 72h. Fifteen (8%) patients developed ACS and 74 (37%) developed new organ failure. I-FABP and IAP were positively correlated. Patients who developed ACS had higher median baseline levels of urinary I-FABP (235(P -P 85-1747)μg/g creat) than patients with IAH who did not develop ACS (87(P -P 33-246)μg/g, p=0.037). With an odds ratio of 1.00, neither urinary nor serum I-FABP indicated increased risk for developing new organ failure or ACS. A relevant diagnostic value of I-FABP levels for identifying individual patients at risk for intra-abdominal pressure related complications could not be demonstrated. A relevant diagnostic value of I-FABP levels for identifying individual patients at risk for intra-abdominal pressure related complications could not be demonstrated. To determine the dimensions of mucosal defects that can be covered by a bipedicled vocal fold mucosal flap. We used 20 adults human larynges (10 of each gender) excised from cadavers, divided into 2 groups of 10 larynges (5 of each gender) each. In one group (the normal flap group), we created the largest possible bipedicled vocal fold mucosal flap and then quantified the dimensions of the largest defect that could be covered by displacing the flap medially. In the other group (the augmented flap group), the flap was augmented laterally with mucosa from the laryngeal ventricle and we determined whether the larger flap would effectively cover larger defects. The mean width of mucosal defect capable of being covered was 1.51 mm when the normal bipedicled flap was employed and was 1.67 mm when the augmented flap was applied. However, the difference was not statistically significant. We found that defect size correlated with vocal fold length, width and flap size in the normal flap group, whereas it correlated only with vocal fold length in the augmented flap group. The bipedicled flap is capable of covering larger defects in males. Enlargement of a bipedicled vocal fold mucosal flap with laryngeal ventricular mucosa does not necessarily translate to an increase in the size of defect that can be covered. On average, the flap should be 30% larger than the width of the defect. The statistical model for predicting the defect size based on the vocal fold length, vocal fold width, and flap size has excellent predictive quality when a normal flap is employed. Enlargement of a bipedicled vocal fold mucosal flap with laryngeal ventricular mucosa does not necessarily translate to an increase in the size of defect that can be covered. On average, the flap should be 30% larger than the width of the defect. The statistical model for predicting the defect size based on the vocal fold length, vocal fold width, and flap size has excellent predictive quality when a normal flap is employed.