ABSTRACT
Health care providers are facing increased risk of moral distress during the COVID-19 pandemic because of changes in clinical practice and resource allocation procedures. Health care systems that employ a proactive approach in mitigating the lasting effects of moral distress will fare better in the long run. Psychologists are well poised to apply timely psychological first aid to the crisis needs of patients, colleagues, and even themselves. Key interventions are detailed, including creating and promoting safety, calmness, connectedness, self-efficacy, and hope.
ABSTRACT
Filoviruses are members of the genera Ebolavirus, Marburgvirus, and "Cuevavirus". Because they cause human disease with high lethality and could potentially be used as a bioweapon, these viruses are classified as CDC Category A Bioterrorism Agents. Filoviruses are relatively stable in aerosols, retain virulence after lyophilization, and can be present on contaminated surfaces for extended periods of time. This study explores the characteristics of aerosolized Sudan virus (SUDV) Boniface in non-human primates (NHP) belonging to three different species. Groups of cynomolgus macaques (cyno), rhesus macaques (rhesus), and African green monkeys (AGM) were challenged with target doses of 50 or 500 plaque-forming units (pfu) of aerosolized SUDV. Exposure to either viral dose resulted in increased body temperatures in all three NHP species beginning on days 4-5 post-exposure. Other clinical findings for all three NHP species included leukocytosis, thrombocytopenia, anorexia, dehydration, and lymphadenopathy. Disease in all of the NHPs was severe beginning on day 6 post-exposure, and all animals except one surviving rhesus macaque were euthanized by day 14. Serum alanine transaminase (ALT) and aspartate transaminase (AST) concentrations were elevated during the course of disease in all three species; however, AGMs had significantly higher ALT and AST concentrations than cynos and rhesus. While all three species had detectable viral load by days 3-4 post exposure, Rhesus had lower average peak viral load than cynos or AGMs. Overall, the results indicate that the disease course after exposure to aerosolized SUDV is similar for all three species of NHP.
Subject(s)
Chlorocebus aethiops/virology , Filoviridae Infections/pathology , Filoviridae/pathogenicity , Macaca fascicularis/virology , Macaca mulatta/virology , Aerosols , Alanine Transaminase/blood , Animals , Aspartate Aminotransferases/blood , Blood Pressure , Body Temperature , Disease Models, Animal , Female , Filoviridae Infections/virology , Heart Rate , Inhalation Exposure , Kaplan-Meier Estimate , Leukocyte Count , Leukocytosis/pathology , Leukocytosis/virology , Male , Severity of Illness Index , Telemetry , Time Factors , Vero Cells , Viral LoadABSTRACT
A description of the effects of delirium on attention is provided. Nursing implications pertinent to appropriate assessment for attention deficits, interventions to maintain patient safety, and discharge planning for the older adult with persistent delirium are also discussed.
Subject(s)
Delirium/nursing , Geriatric Assessment/methods , Nursing Assessment/methods , Patient Discharge , Aged , Aged, 80 and over , Delirium/diagnosis , Female , Humans , Needs Assessment/organization & administration , Nurse's Role , Patient Care Planning , Risk Assessment/methods , Safety ManagementABSTRACT
Alzheimer's disease, the leading form of dementia, is expected to increase exponentially in the next 50 years. An overview of types of dementia and the typical presentation of AD are described. In addition, rationale for early assessment and methods for diagnosing the disorder are detailed.
