We present a case report of an unusual skin infection with Exophiala xenobiotica in a 56-year-old male who presented with a 1-year history of an asymptomatic lump on the right thigh. Excision biopsy revealed suppurative granulomatous inflammation with accompanying pigmented (dematiaceous) deep fungal infection. E. xenobiotica was cultured. This is a rare presentation which can be missed if tissue specimens are not sent for analysis.
The procedures to be followed by nursing staff caring for patients with Covid-19 coronavirus infection have not been emphasised. Though care plans are likely to follow traditional treatment methods, nursing attitudes and methods may be affected by what is currently known about the nature of Covid-19 infection. I describe the salient features of Covid-19 infection and how these affect bedside nursing care, including controversial areas such as control over patient visitors. J Evidence-based Nurs Prac 2020: 1(1); 4-8, republished in Tasman Medical Journal 2023: 5(1); 5-9.
Polyfluoroalkyl compounds have existed since 1939. As a group they are causing increasing concern over adverse effects on human health and biological systems generally, based on th lack of clearance if they escape into the environment. This article summarises the current attitudes, regulation and science of environmental PFAS.
Objective: To describe a new model of care, the Patient Controlled Crisis Admission Plan (PCAP), for the inpatient mental healthcare of youths (16-24 years) with Borderline Personality Disorder (BPD) or BPD traits. This model aims to empower the patient and facilitate patient engagement in decisions about their need for inpatient support increasing self-agency/self-efficacy to manage further crises.
Method: This new service model was developed from existing clinical guidelines, established literature on evidence-based treatment of BPD and clinical experience. The current PCAP model has been operationalised on a youth acute inpatient mental health unit since 2017.
Results: The rationale for the PCAP model of care is detailed. Preliminary data indicated adherence to the model of care and a representative case study demonstrates the experience and possible usefulness of the program to a patient.
Conclusion: The PCAP provides an operationalised, model of care for the management of youth with BPD or BPD traits in an acute youth inpatient setting. The model supports established clinical recommendations for less frequent and shorter inpatient admissions, provides a framework for managing chronic suicidality and non-suicidal self-injury (NSSI), and promotes engagement with community mental health services. Further research is required to gather data on its effectiveness with a youth population in reducing length of stay and presentations to inpatient services.
Australia’s response to environmental PFAS contamination to minimise toxicological effects has been excellent, but several problems remain. These relate to the design of the PFAS Taskforce website and its provenance. I discuss these matters in this review.
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