Previous studies suggest that there are sex differences in endocannabinoid function and the response to exogenous cannabinoids, though data from clinical studies comparing acute cannabinoid effects in men and women under controlled laboratory conditions are limited. To further explore these potential differences, data from 30 cannabis users (N=18 M, 12 F) who completed previous Δ9-tetrahydrocannabinol (Δ9-THC) discrimination studies were combined for this retrospective analysis. In each study, subjects learned to discriminate between oral Δ9-THC and placebo and then received a range of Δ9-THC doses (0, 5, 15 and a “high” dose of either 25 or 30 mg). Responses on a drug-discrimination task, subjective effects questionnaire, psychomotor performance tasks, and physiological measures were assessed. Δ9-THC dose-dependently increased drug-appropriate responding, ratings on “positive” visual analog scale (VAS) items (e.g., Good Effects, Like Drug, Take Again), and items related to intoxication (e.g., High, Stoned). Δ9-THC also dose-dependently impaired performance on psychomotor tasks and elevated heart rate. Sex differences on VAS items emerged as a function of dose. Women exhibited significantly greater subjective responses to oral drug administration than men at the 5 mg Δ9-THC dose, whereas men were more sensitive to the subjective effects of the 15 mg dose of Δ9-THC than women. These results demonstrate dose-dependent separation in the subjective response to oral Δ9-THC administration by sex, which might contribute to the differential development of problematic cannabis use.
There was a disproportionate increase in ED visits and hospitalizations in the geriatric population compared with the younger population during the IPS. The primary factor of the disproportionate impact on the geriatric population appears to be from indirect effects of the hurricane, mainly due to the subsequent power outages, such as "dialysis," "respiratory device," and "social." Further investigation by chart review may provide more insights to better aid with future disaster preparedness.
With the aging population and increasing complexity of patients with pressure ulcers (PrUs), as well as regulatory requirements, PrUs have become an important concern for physicians. Although there are some studies that measure nurses' knowledge of PrUs, there is a paucity of literature about physician knowledge of PrUs. Given that the Centers for Medicare & Medicaid Services is holding physicians accountable for documenting PrU status on admission to hospitals and the increased need for collaboration with revisions to long-term-care documentation MDS 3.0: Skin Condition, physicians' knowledge regarding PrUs takes on new urgency. This study reports on PrU knowledge of physicians using 2 tools: the Pieper Pressure Ulcer Knowledge Tool and a wound photograph test. Physicians' mean scores of 69% on the Pieper Tool were well below average scores of nurses' 76%. Physicians had greatest difficulty identifying suspected deep tissue injury and unstageable ulcers. Pressure ulcer content, including prevention, identification, staging, and treatment, needs to be included in physician education.
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