Urine

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• Members of the media who wish to receive a copy of the complaint can contact David Schildmeier at [email protected] .
• The lawsuit makes clear that the St. Vincent nurses met their legal obligations to protect their patients, while Tenet management failed to do so.
• When the plaintiff nurses objected to providing unsafe care, SVH and Tenet fired them."
• Founded in 1903, the Massachusetts Nurses Association is the largest union of registered nurses in the Commonwealth of Massachusetts.

• Last year a Melbourne Demons player, Joel Smith, and two Sydney Swans AFLW players were caught with cocaine.
• So how is cocaine considered performance enhancing, and why does it matter when they took it?

What is cocaine and is it performance enhancing?

• Once consumed, cocaine increases the level of a chemical in the brain called dopamine – a messenger molecular that is associated with pleasure and reward.
• A surge in dopamine is responsible for feelings of euphoria, heightened energy, and alertness, which makes cocaine highly sought-after for recreational purposes.
• When used during sport, cocaine is considered to have performance enhancing effects and is prohibited under the World Anti-Doping Code and listed under the Substances of Abuse Category.

Recreational (out of competition) vs performancing-enhancing (in-competition) use

• As a result, instead of a ban from competing, the court gave them 12-month conditional release orders, with no convictions recorded.
• Under the AFL’s anti-doping code, a finding of using cocaine for performance enhancement could come with a four-year ban.
• If he was found to have used it for only recreational purposes, not on game day, the ban would instead just be one or three months.

Can urine testing determine when someone took cocaine?

• Intact cocaine can remain detectable in urine for periods up to 15 days, and BZE can be detectable up to 25 days.
• To determine the date of cocaine use, the concentration of intact drug in the athlete’s urine, and possibly the BZE concentration, need to be considered.
• But there are fundamental flaws in making these comparisons to determine when an athlete took cocaine.

Why is cocaine still considered performance-enhancing?

While it’s unlikely an athlete can genuinely get an athletic edge on their rivals by taking cocaine, it is still on Sports Integrity Australia’s Prohibited List because “all prohibited substances are added to the Prohibited List because they meet two of the three following criteria”:
Athletes really are risking a lot for minimal (if any) athletic reward when they take cocaine – not just the health risks, but the possibility of getting caught with a substance that is extremely unlikely to improve their on-field performances.
Nial Wheate has previously appeared as an expert witness for an athlete accused by Sport Integrity Australia of in-competition cocaine use. Shoohb Alassadi does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

• In case you’re wondering, the human urethra is a tube that carries urine from the bladder to outside the body.
• Some people find it sexually pleasurable to insert objects – known as sounds, which are typically small glass or metal rods – or even fluid into the urethra.
• Many objects have been used for sounding, however, and that’s one of the reasons the practice is so hazardous.
• The urethra is a narrow outflow tube, usually less than 9mm wide, so squeezing objects into it isn’t usually recommended.
• Megalouretha can lead to retention of objects in the urethra or bladder from clinical examinations such as cervical screening.

Risky business

• It takes several turns to pass through the pelvic floor muscles, prostate and then, if inserted far enough, the bladder.
• Urethral damage exposes the underlying connective tissues which can cause blood in the urine, as well as erectile dysfunction and even bladder rupture.
• Trauma and damage may lead to further narrowing of the urethra in later life which may require medical intervention.

Sounds painful

• But sounding can be highly sexually gratifying for some people.
• The arousal and subsequent stimulation of the erectile tissue of the penis and clitoris usually occurs through one of two mechanisms: psychogenic (images or thoughts) or reflexogenic (touching).
• The reflexogenic pathway is served by nerves which also innervate the lining of the urethra – the dorsal nerve(s) of the penis or clitoris.

Adam Taylor does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.