Parvin Ebrahimi; Zainab Malmoon; Rouhollah Zaboli
Abstract
Background: The high workload of nurses in hospitals has been identified as a patient safety and worker stress problem. Psychological empowerment is a motivational concept demonstrated in four dimensions: meaning, competence, self-determination, and impact. Objective: This study investigated the relationship ...
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Background: The high workload of nurses in hospitals has been identified as a patient safety and worker stress problem. Psychological empowerment is a motivational concept demonstrated in four dimensions: meaning, competence, self-determination, and impact. Objective: This study investigated the relationship between nurses’ workloads and psychological empowerment using structural equations modeling (SEM). Methods: This descriptive correlation study was conducted using SEM. The study was conducted at 17 public hospitals affiliated with Iran University of Medical Sciences (IUMS) in the city of Tehran. The population study was nurses employed in critical care departments. Two questionnaires were used to gather data: the NASA and the Psychological Empowerment Questionnaires. Differences in categorical variables were analyzed using one-way analysis of variance (ANOVA). Confirmatory factor analyses were used to confirm the relationships between latent variables and indicator variables; SEM was used to find the direct and indirect effects of nurse’s workload on psychological empowerment. Data analyses were performed using SPSS 18, and all models were tested in LISREL 8.8. Results: Correlations among indicators of nurse’s workload showed that highest correlations were performances (0.61), and the highest correlations among psychological empowerment were competence (0.03). The overall correlations among nursing workloads and psychological empowerment were 0.74. The proposed structural model fit was acceptable (χ2 = 525.5, df = 89, RMSEA = 0.13, GFI = 0.91). Conclusion: Increasing the workload of nurses in hospitals will better engage the nurses and allow them to face new problems they encounter in their jobs.
Mohammad Javad Behzadnia
Viroj Wiwanitkit
Amir Vahedian-Azimi; Somayeh Makvandi; Leila Karimi
Luis Rafael Moscote-Salazar; Ezequiel Garcia-Ballestas; Amit Agrawal; Md Moshiur Rahman; Sabrina Rahman
Ali Soroush; Mohammad Mohseni; Saeed Komasi; Nadia Baharirad; Farideh Moradi
Josef Finsterer; Fulvio A. Scorza; Carla A. Scorza; Ana C. Fiorini
Reza Bidaki; Bonnie Bozorg; Mohammad Ayatollahi; Mehrdad Roozbeh
Abstract
Introduction: Delusion of pregnancy is a bizarre delusion in which one feels s/he is carrying a fetus. The etiology is unknown, but aloneness, masturbation, and stress may precipitate this disorder. Case Presentation: We introduce a young, single man who has delusions of pregnancy. This type of delusion ...
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Introduction: Delusion of pregnancy is a bizarre delusion in which one feels s/he is carrying a fetus. The etiology is unknown, but aloneness, masturbation, and stress may precipitate this disorder. Case Presentation: We introduce a young, single man who has delusions of pregnancy. This type of delusion is not a well-known disorder; based on investigated articles, this type of somatic delusion is rare. Conclusion: This was a chronic case, the exact cause and development of which was unknown. We suggest this phenomenon as a novel symptom. No similar case was found in the literature.
Reza Bidaki; Seyed Masood Moosavi
Ahmet Karabulut
Abstract
Introduction: Coronary artery anomalies are rare clinical entities reported in 0.6% to 5.6% of diagnostic coronary angiographies. Anomalous origins of coronary arteries from distal segments are rarely reported. Presented herein is a coronary anomaly in which the circumflex artery (CX) originated as a ...
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Introduction: Coronary artery anomalies are rare clinical entities reported in 0.6% to 5.6% of diagnostic coronary angiographies. Anomalous origins of coronary arteries from distal segments are rarely reported. Presented herein is a coronary anomaly in which the circumflex artery (CX) originated as a continuation of the posterolateral branch of the right coronary artery (RCA) with separate left anterior descending (LAD) artery origination from the left sinus of Valsalva. The clinical presentation of such a rare anomaly is discussed, and the current literature regarding the congenital absence of CX is reviewed. Case Presentation: A 66-year-old male presented with angina pectoris. Coronary angiography revealed critical stenosis in the mid segment of the LAD artery and an anomalous origin of CX artery from the distal RCA. The CX was coursing as a continuation of the posterolateral branch of the RCA. Coronary angioplasty and stent deployment was performed for the LAD lesion, and the patient was discharged with medical therapy. The patient did not report recurrent anginal symptoms under medical therapy. Conclusion: The congenital absence of the circumflex coronary artery is a rare coronary anomaly. The clinical presentation may vary, though most cases are asymptomatic during diagnosis. Such cases require close clinical follow-up since they entertain a future risk for being symptomatic, especially in the setting of atherosclerotic disease.
Amir Hossain Mirhashemi; Mohammad Hossain Kalantar Motamedi; Sedigheh Mirhashemi; Hamidreza Taghipour; Zahra Danial
Farideh Moradi; Mohammad Mohseni; Majid Nakhaee; Ali Soroush
Pezhman Farshidmehr; Roozbeh Cheraghali; Hossein Zabihi Mahmoudabadi; Mohammad Sadra Nazari; Ali Gilani; Ehsan Rahimpour
Abstract
Background: The primary patency rate (PPR) is still controversial in angioplasty and heart bypass surgery for blood vessel repair and reconstruction in patients with femoropopliteal disease. Objectives: This study aimed to investigate the prolonged PPR rate in patients with stenosis/occlusion of the ...
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Background: The primary patency rate (PPR) is still controversial in angioplasty and heart bypass surgery for blood vessel repair and reconstruction in patients with femoropopliteal disease. Objectives: This study aimed to investigate the prolonged PPR rate in patients with stenosis/occlusion of the femoropopliteal artery undergoing superficial femoral artery (SFA) and popliteal angioplasty. Methods: A case series study population consisted of patients demonstrating femoropopliteal artery occlusion referred to Sina Hospital, Tehran, Iran for angiography during 2016-2018. After angiography, patients underwent either stent placement or balloon angioplasty in the case of stenosis/occlusion of femoropopliteal arteries. After angioplasty, patients were followed up in the 3rd, 12th, and 24th months for re-examination, and color Doppler ultrasonography of femoropopliteal arteries was also performed to measure the patency rate. The SPSS Statistics version 21.0 was used to analyze the data. The Kaplan–Meier method and a log-rank test were utilized to evaluate this rate. Results: Sixty patients were included in the study, from which 44 were women (73.3%) and 16 were men (26.6%) with a mean age of 69.9 years. Fifty-two, 41, and 29 patients were examined at intervals of 3, 12, 24 months, with PPRs of 86%, 79%, and 68%, respectively. There was a significant relationship between claudication degree and procedure success (P = 0.02). Conclusion: The prolonged PPR rate of patients after femoropopliteal artery angioplasty was acceptable and was a safe and effective treatment. For future studies, an increase in the number of study variables, a more comprehensive classification, and PPR-related variables are suggested.
Ensieh Vahedi; Seyed Jalal Madani; Hamideh Molaee; Esmat Davoudi-Monfared
Abstract
Background: Pneumomediastinum and pneumothorax are usually rare conditions after pneumonia. This study examines the progress of pneumonia of the coronavirus disease 2019 (COVID-19) to spontaneous pneumothorax and pneumomediastinum in a patient. Case Presentation: The patient was a 40-year-old man who ...
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Background: Pneumomediastinum and pneumothorax are usually rare conditions after pneumonia. This study examines the progress of pneumonia of the coronavirus disease 2019 (COVID-19) to spontaneous pneumothorax and pneumomediastinum in a patient. Case Presentation: The patient was a 40-year-old man who complained of nonproductive cough and dyspnea. He also complained of fever, sore throat, back, and chest pain. The patient used to smoke but now he quit .His O2 saturation was 89% at the time of admission. He was assessed with suspicion of COVID-19. CT scans of the chest showed brief changes of emphysema and a ground glass view was also seen in the lungs. In the patient’s tests, RT-PCR testing of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was performed and it was positive. Treatment was initiated and because of the progression of symptoms, the serial CT scanning of the patient’s lungs was performed daily; and cavitary changes, air-fluid appearance, and destructive changes of lungs were reported. After eight days, the patient’s cough worsened. CT scans of the patient’s lungs showed some bullaes, pneumothorax, and pneumomediastinum, thus a chest tube was inserted and oxygen therapy was begun on the patient with 3-6 L/min. After 5 days in CT, the patient was relieved of pneumothorax and pneumomediastinum and after a week, the chest tube came out. Conclusion: Pulmonary lesions of COVID 19 can progress to bullae, pneumomediastinum, and pneumothorax. Deterioration of dyspnea and respiratory symptoms can be a warning of pneumomediastinum and pneumothorax that can be confirmed by graphics and timely treatment of the patient can be life-saving.
Reza Gerami; Ramezan Jafari; Niloufar Nazeri; Amin Saburi
Abstract
Osteoarthritis (OA) is the most common form of arthritis, causing pain and progressive disability in millions of people worldwide. The commonly prescribed medications for OA, including non-steroidal anti-inflammatory drugs, have many side effects which has led the scientists to consider safer drugs as ...
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Osteoarthritis (OA) is the most common form of arthritis, causing pain and progressive disability in millions of people worldwide. The commonly prescribed medications for OA, including non-steroidal anti-inflammatory drugs, have many side effects which has led the scientists to consider safer drugs as an alternative. Therapeutic effects of Curcumin on OA are increasingly declared, and its various aspects in suppressing inflammation and reducing the disease progression are examined more thoroughly. This study aims to discuss curcumin and OA to help scientists working in these fields. In this brief review, we took a look at OA pathogenesis, the role of the immune system, and the biomarkers involved in the onset and progression of the disease. We focused on available data on the anti-inflammatory effect and mechanism of treatment by curcumin on OA.
Sanat Kumar Khanna; Saurabh Maheshwari; Sai Vishal Goud Vaggu; Himanshu Chhagan Bayad; Shruti Samyal
Abstract
Background: The coronavirus disease 2019 (COVID-19) pandemic resulted in the diversion of all the resources, attention, and energy of the medical personnel and administration towards the management of COVID-19 patients. This resulted in unforeseen difficulties and hazards for non-COVID-19 patients in ...
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Background: The coronavirus disease 2019 (COVID-19) pandemic resulted in the diversion of all the resources, attention, and energy of the medical personnel and administration towards the management of COVID-19 patients. This resulted in unforeseen difficulties and hazards for non-COVID-19 patients in accessing healthcare professionals and facilities.Objectives: The objective of this study was to analyze the impact of the COVID-19 pandemic and repeated lockdowns on the non-COVID patients; to understand the social, psychological, and medical issues faced by them; and propose solutions for difficulties faced by this specific cohort of patients.Methods: We conducted a retrospective observational study on all non-COVID patients reporting for non-COVID-19 illnesses. We conducted the data analysis by comparing the trends for 15 months each in the pre-pandemic (1 January 2019 to 31 March 2020) and pandemic periods (1 April 2020 to 30 June 2021).Results: There was a 65.92% decrease in Out Patient Department (OPD) attendance, a 56.05% decrease in admissions, and a 90.33 % decrease in elective surgical procedures in non-COVID-19 patients. However, there was a significant increase in emergency surgeries by 62.16%.Conclusion: There has been a significant albeit much-needed diversion of time, energy, and resources to manage COVID-19 patients in recent times. This has led to a paucity of care opportunities for non-COVID-19 patients, which has been further compounded by the frequent lockdowns. We attempted to understand the impact of the pandemic on non-COVID-19 patients, particularly in peripheral hospitals in Hilly Terrains. We propose the solutions to tackle these issues and describe our experience with them.
Hamid Reza Aghaei Meybodi; Seyedeh Zahra Fotook Kiaee; Marjan Akhavan; Samira Abbasloo; Mahnaz Pejman Sani
Abstract
Background: The world is still witnessing a largely ongoing spread of coronavirus disease 2019 (COVID-19); therefore, the scientific findings in this area need to be shared promptly.Objectives: This study aimed to assess the usefulness of Atorvastatin treatment in reducing COVID-19 mortality in patients ...
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Background: The world is still witnessing a largely ongoing spread of coronavirus disease 2019 (COVID-19); therefore, the scientific findings in this area need to be shared promptly.Objectives: This study aimed to assess the usefulness of Atorvastatin treatment in reducing COVID-19 mortality in patients with or without diabetes mellitus (DM) and to correlate them with C-reactive protein (CRP) levels.Methods: This study consecutively enrolled patients with pneumonia symptoms, positive lung CT scan, and confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on reverse transcription-polymerase chain reaction (RT-PCR). The outcome was defined as intensive care unit (ICU) admission and death. Clinical data and history of atorvastatin administration were evaluated. CRP levels were measured at baseline and repeated after one week in all patients.Results: A total of 200 patients were included. Their mean age was 60.5 (SD = 16.5) years, 113 (56.5%) patients were male, 47 (23.5%) with pre-existing diabetes, and 64 (32%) patients were taking atorvastatin routinely. 68 (34%) required ICU admission of all the studied patients. No gender differences were found in ICU admission and death. The baseline CRP was not significantly different, but the secondary CRP was significantly different between DM and non-DM groups. Secondary CRP also showed a significant reduction in patients receiving atorvastatin (P = 0.017). The mortality was the same in atorvastatin or non-atorvastatin groups (P = 0.715).Conclusion: It seems that taking statin has only some beneficial effects on improving CRP levels in patients with COVID-19. To achieve a reliable result, clinical trials are recommended.
Manisha Sarkar; Urmila Dasgupta
Abstract
Background: Efficient hospital bed utilization is an important function of hospital administrators. Scarcity of beds, overcrowding, and flooring are often the picture of tertiary hospitals.Objectives: This study aims to find out hospital bed utilization indicators such as average daily census, bed occupancy ...
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Background: Efficient hospital bed utilization is an important function of hospital administrators. Scarcity of beds, overcrowding, and flooring are often the picture of tertiary hospitals.Objectives: This study aims to find out hospital bed utilization indicators such as average daily census, bed occupancy rate (BOR), average length of stay (ALS), bed turnover rate (BTR), and bed turnover interval (BTI) in Medicine ward of a tertiary hospital in West Bengal, India.Methods: A descriptive cross-sectional study was conducted in acute male and female as well as chronic male and female wards under medicine department of a tertiary hospital in West Bengal from June to August 2018.The record of active beds, patient days, daily admissions and discharge were reviewed for May 2018 by complete enumeration method from admission, discharge and death registers and recorded in a pre-designed pretested checklist. Average daily census, BOR, ALS, BTR, and BTI were computed using standard formula. Pabon Lasso model was used to analyse the performance of the nedicine ward.Results: Average daily census, ALS, BOR, BTR, BTI in medicine ward were 261.81 patients, 8 days, 108.55%, 4.22 patients/ bed and -0.63 days respectively. Pabon Lasso graph reflected high BOR and high discharges per bed (productivity) in acute medicine wards reflecting good quantitative performance in contrast to chronic medicine wards with low discharges per bed (productivity or BTR) and higher ALS.Conclusion: Medicine ward reflected higher BOR and ALS but lower BTR (productivity) as per the Pabon Lasso graph. Efforts must be made to reduce ALS in chronic medicine wards.
Mojtaba Fazel; Ali Ardalan; Abbas Ostad Taghizadeh; Tahereh Yaghoubi
Abstract
Background: Various studies indicate that in many cases, fire has broken out in hospitals.Objectives: This study aims to assess fire protection in the selected units of Imam Khomeini hospital located in Tehran, Iran in 2020.Methods: In this descriptive-analytic study, first, a researcher-made checklist ...
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Background: Various studies indicate that in many cases, fire has broken out in hospitals.Objectives: This study aims to assess fire protection in the selected units of Imam Khomeini hospital located in Tehran, Iran in 2020.Methods: In this descriptive-analytic study, first, a researcher-made checklist was developed for the data collection by valid scientific resources (CVI = 0.90 and CVR > 0.62). After revising and the final confirmation of reliability, the checklist was separately completed by two members of the risk management committee in 22 units of Imam Khomeini Hospital, Tehran, Iran. Cronbach’s weighted Kappa statistical test was calculated.Results: The domain of Ability and Capability of Fire Prevention was 66.1%; the domain of Responsiveness was 65.1%, and the domain of Urgent Evacuation Ability was 27.3%. In the domain of Responsiveness, the highest scores were relevant to accessing fire extinguishers cylinder in the units (95.5%) and holding fire extinguishing practice courses, and doing seasonal practices with that region’s fire station (90.9% for both). The highest scores in the domain of Urgent Evacuation Ability were assigned to accessing adequate ambulances to evacuate patients (90.9%) and mapping the units as well as determining patient evacuation routes when a fire breaks out (72.7%).Conclusion: The essential protection measures should be taken in order to improve the hospitals’ fire protection by better access to the exits, increasing the number of the exits and standardizing the emergency exits, enhancing the due fire extinguishing practices and hospital evacuation as well as training the staff.
Hasan Jafari; Parvin Jafari; Mohammad Kazem Rahimi; Roohollah Arab Saniabadi; Farzaneh Zare Banadkooki
Abstract
Background: Canceling surgery imposes the high cost of the healthcare provider system and wasted many energy and time from the patient and the care team.Objectives: This study examined the extent and reasons of canceling of surgeries in one of the hospitals affiliated to Shahid Sadoughi University of ...
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Background: Canceling surgery imposes the high cost of the healthcare provider system and wasted many energy and time from the patient and the care team.Objectives: This study examined the extent and reasons of canceling of surgeries in one of the hospitals affiliated to Shahid Sadoughi University of Medical Sciences, Yazd, Iran.Methods: This was a descriptive-applied study. In order to get the number of operations from April 2018 to March 2020, the hospital used HIS software and then extracted the reasons from the operating room office and the quality improvement office in the hospital. Data were analyzed by SPSS version 21 software.Results: Among 8654 planned surgeries, 0.9% were cancelled. The highest frequency of surgical cancellation is associated with general surgery, and the highest rate of surgical cancellation is associated with the ENT specialty. The highest cancellation rate was 1.82% in August 2018 and 2.87% in February 2019. The lack of preparation of patients and patients did not require surgery was the main and worst reason for discontinuing surgery, respectively.Conclusion: The lack of clinical preparation of the patient was the main reason for the cancellation. Therefore, pre-surgery patient evaluation can help solve this problem, make the operating room more effective, and increase patient satisfaction.
Zahra Kamiab; Ali Esmaeili Nadimi; Fatemeh Bahrehmand
Abstract
Introduction: During the current worldwide pandemic of coronavirus disease 2019 (CPVID-19), this disease was first identified in Iran at the end of February. This study was conducted to examine patients with severe COVID-19 disease, who were treated with three medications, namely ReciGen, methylprednisolone, ...
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Introduction: During the current worldwide pandemic of coronavirus disease 2019 (CPVID-19), this disease was first identified in Iran at the end of February. This study was conducted to examine patients with severe COVID-19 disease, who were treated with three medications, namely ReciGen, methylprednisolone, and Sovodak.Case Presentation: We identified 10 patients (3 males and 7 females) with the mean (± SD) age of 55.70 ± 21.48 years, who were admitted to the only referral hospital in Rafsanjan County (Iran) from March to July 2020 with confirmed infections with severe COVID-19. They were treated with the combination therapy of subcutaneous ReciGen interferon every other day, methylprednisolone at a dose of 250 mg every 6 hours for 5 days, and one tablet of Sovodak daily.Conclusion: In the series of cases investigated in this study, the general conditions of all patients improved in terms of their clinical parameters after receiving the combination therapy, and all patients were discharged with a blood oxygen level of ≥ 93% and in good general conditions.
Brikshya Gurung; Saurabh Maheshwari; Darshan Singh Grewal; Pratik Regmi; Ajay Khadka
Abstract
Introduction: Hemochromatosis of the pituitary gland is a form of iron overload disease which occurs in different clinical conditions related to multiple blood transfusions.Case Presentation: We present a case of secondary hemochromatosis involving the pituitary gland and choroid plexus in an eight-year-old ...
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Introduction: Hemochromatosis of the pituitary gland is a form of iron overload disease which occurs in different clinical conditions related to multiple blood transfusions.Case Presentation: We present a case of secondary hemochromatosis involving the pituitary gland and choroid plexus in an eight-year-old female with imaging findings and a review of the relevant literature. Our patient has had a history of cessation of growth in height for the last 1 year. She was diagnosed with a thalassemia major at the age of 6 months. She has been on regular blood transfusions since then. Magnetic resonance imaging (MRI) revealed evidence of iron deposition in the pituitary gland.Conclusion: This diagnosis should be suspected on clinical presentation and history of multiple blood transfusions. It can be confirmed based on characteristic imaging findings. The patient should be strictly monitored with serum iron levels, and a tailored iron chelation therapy should be initiated.
Mohsen Saberi Isfeedvajani
Olayinka Stephen Ilesanmi; Aanuoluwapo Adeyimika Afolabi; Ayomide Esther Bello
Abstract
The African continent is a known malaria-endemic region. Amid the COVID-19 pandemic, COVID-19/malaria co-infection is of critical importance in Africa due to the similarities in the manifestation of their symptoms. To avert compromising the health status of individuals on the African continent during ...
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The African continent is a known malaria-endemic region. Amid the COVID-19 pandemic, COVID-19/malaria co-infection is of critical importance in Africa due to the similarities in the manifestation of their symptoms. To avert compromising the health status of individuals on the African continent during the COVID-19 pandemic, this commentary sought to examine the link between COVID-19 and malaria, outlining strategies for improving the diagnosis and prevention of COVID-19 and malaria in Africa. A scale-up of malaria-focused care should be considered to ensure adequate reporting of COVID-19 cases in Africa. Likewise, individuals who present for malarial testing should be linked to COVID-19 testing and treatment care in Africa. Also, surveillance activities should be scaled up to ensure accurate COVID-19 case reporting and improved case notification. Regular refresher trainings should be organized for healthcare workers to promote healthcare service delivery.
Shervin Assari; Babak Najand; Ali Ayoubian
Abstract
Background: Age is a major determinant of chronic respiratory disease (CRD). This is important because CRD have a main role in shaping morbidity and mortality of individuals and populations. However, less research is done on whether age-related changes in development of CRD differ across diverse racial ...
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Background: Age is a major determinant of chronic respiratory disease (CRD). This is important because CRD have a main role in shaping morbidity and mortality of individuals and populations. However, less research is done on whether age-related changes in development of CRD differ across diverse racial groups.Objectives: Using a conceptual model that considers race as a proxy of racism rather than genetics and attributing racial differences to sociological rather than biological differences, this study was conducted to explore racial differences in the effects of age on CRD. Based on Marginalization-related Diminished Returns (MDRs) framework, we expect diminished relevance of risk and resources for marginalized people due to racism, segregation, and social stratification.Methods: Using data from baseline PATH-Adults data, we included 23761 adults. The independent variable was age treated as a categorical variable. The primary outcome was presence of any CRD including asthma, bronchitis, emphysema, and chronic obstructive pulmonary disease (COPD). Sex and education were the covariates. Race, as a proxy of racism, was the moderator. To analyze the data, we used logistic regression mode with and without interaction term between age and race.Results: Higher age was associated with higher odds of CRD, while sex, and socioeconomic status (SES) was controlled. In line with the MDRs framework, the positive association between age and CRD was weaker for Black than White adults.Conclusion: Under racism, age loses some of its effect as a major determinant of CRD across racialized groups.