bluuebunny/crossref_metadata_2025 huggingface dataset:
Free Will and the Human Essence
Authors: Baumeister Roy F.
Published: November 2017

This chapter examines free will as a distinctive element of the human essence, arguing that it evolved to enable the development of culture and that culture requires “responsible autonomy”—personal choices for actions that balance the achievement of individual objectives and control with respect for the rules of society. Understanding the human essence as produced by evolution to facilitate culture provides a useful context for understanding free will. The chapter shows that the evolution of free will partly depended on finding a way for the brain to use some of the body’s energy in order to permit advanced and complex psychological processes, including self-control and rational choice. It also considers the incorporation of meaning into the causation of behavior and how meaning is expressed in language. Finally, it explores some uses of self-control in morality and how self-control capacity relates to ego-depletion effects as well as the conservation of willpower.
The Human Essence in Helping Relations
Authors: Nadler Arie
Published: November 2017

This chapter examines the human essence in helping relations, with a particular focus on belongingness, independence, and status. It first reviews research on seeking and receiving help, paying attention to how receiving assistance from others leads to positive and negative consequences for the recipient: positive reactions are expressed in feelings of gratitude, while negative consequences come in the form of threat to self-esteem. The chapter proceeds by discussing the dynamics of inequality in interpersonal and intergroup helping, along with the autonomy versus dependency nature of help (i.e., solutions vs. tools). It explores how generosity breeds prestige within the group. It continues to strategic aspects in intergroup helping relations, considers the ways in which helping relations constitute subtle mechanisms to maintain or challenge existing structural inequality (i.e., the Intergroup Helping as Status Relations model, IHSR). It concludes by explaining the unique human essence of helping relations between individuals and groups.
Does Aggression Make Us Human?
Authors: Vandello Joseph A. , Puryear Curtis
Published: November 2017

This chapter explores the conceptual and practical implications of the idea that aggression is a defining element of the human essence. To determine whether aggression is part of the human essence, the chapter considers historical philosophical perspectives on this issue, such as Sigmund Freud’s belief that humans have an instinct toward destruction and violence. We also review psychological research on the topic that takes into account biological, environmental, personality, and situational influences on human aggression and incorporates cross-cultural, ethological, and evolutionary perspectives. In particular, we examine the role of culture in aggression and aggression as a tool of intrasexual competition. Finally, we discuss aggression in animals from an ethological perspective as well as the possible biological pathways of aggression. Collectively, the evidence suggests great malleability and adaptability in response to human conflict; Aggression is one of many tools humans use to solve problems of social living. Rather than an essence, aggression may be best thought of as a strategy that is sometimes viable and sometimes counterproductive.
The Bible and Slavery in American Life
Authors: Powery Emerson
Published: November 2017

The Bible and slavery share a reciprocal relationship in American life. In the history of the debates surrounding slavery, many have seen the Bible as speaking on both sides of the nation’s greatest moral sin. When the Bible failed to resolve the controversy over slavery on its own, a war determined the direction forward. Whether deliberate or not, “race” and “identity” were often at the forefront of searching the scripture. Interpreters did not always appreciate the historical distance between the Bible’s cultural contexts and US society. These debates should serve as a reminder that the justice of the Bible is not self-authenticating.
The Bible and Judaism in America
Authors: Sarna Jonathan D.
Published: November 2017

The Jewish Holy Scriptures have long served as a defining symbol of American Jewish communal life and culture. A copy of the Torah first arrived in what is now New York City in 1655, and ever after the presence of the Jewish scriptures has helped identify and coalesce Jewish communities throughout the colonies and then the United States. American Jewish communities have continued to privilege the first five books of the Bible, but there are twenty-four books in the Hebrew Bible. The Hebrew Bible (and its several American translations) continues to be a mainstay in American Jewish identity, helping give shape and define the character of Jewish adherents and their communities throughout the United States.
The Bible and Christian Scientists
Authors: Hamilton Michael W.
Published: November 2017

Christian Scientists read and study the Bible in conjunction with Science and Health with Key to the Scriptures by Mary Baker Eddy, a book first published in 1875. Eddy’s Puritan heritage, including her rebellion against the doctrine of predestination, and the convergence of Eddy’s religious commitments with her desire to regain her own health and to more generally relieve human suffering, influenced her approach to the Bible and supplied the dominant motifs for her teaching, writing, preaching, and organizing. Eddy’s ideas were rooted in the bible, but she promoted the same individual agency toward the bible as she did for her readers’ lives in general. This agency would allow readers of her book to make the Bible their own. Her experience demonstrated that the scriptures became more authoritative when it was the spiritual, not the literal meaning that really counted.
The Bible and Art
Authors: Schwain Kristin
Published: November 2017

An artwork picturing biblical subject matter is never a straightforward depiction of a scriptural text. It is a visual translation of it, shaped by available models of interpretation, the aesthetic styles and visual cultures of the era, and the cultural contexts of its production, display, circulation, and reception. This chapter analyzes specific examples of American art to showcase the four primary functions performed by biblical subject matter throughout the nation’s history: to deliver moral instruction, engage sociopolitical concerns, assert communal identity, and render cultural criticism. The expansive and varied visual landscape that results testifies to the bible’s centrality in American art history.
The Bible in the Seventeenth Century
Authors: Brown Robert E.
Published: November 2017

The Bible served as the principal source of religious imagination for English colonials in the seventeenth century. It was that which inspired their radical ecclesiastical, political, and societal reconstructions and that by which they measured their faithfulness to the Christian tradition. It proved to be a remarkable stimulus to the formation of colonial institutions and material culture, and the production of an entire range of literary genres, including spiritual memoir, public rhetoric and exhortation, history, poetry, music, pedagogy, law, and linguistics. The Bible also served as the template upon which colonials worked out their understanding of the alien and the alienating, both among Europeans of differing religious understandings and between Europeans, African slaves, and Native Americans.
Twentieth- and Twenty-First-Century American Biblical Interpretation
Authors: Treier Daniel J. , Hefner Craig
Published: November 2017

Formal theological education underwent a twentieth-century revolution that both enriched and fragmented popular Bible reading. Its legacy includes deeper understanding of the Bible and its contexts, new professions of teaching and scholarship, more professional clergy, and liberating critiques of oppressive ideas and practices. Yet its legacy also includes significant fractures, between academy and church, Bible and theology, and so on. Biblical interpretation became marginal to American intellectual life as it became more informed. Theological education’s hermeneutical story highlights the practical-moral agenda of professionals: they sought to inform, frequently even to reform, how Americans approach their Bibles—with historical awareness and various theological-political agendas ideally displacing literalist private application. The mutual popular and professional tensions in this story, given their impact on its interpretation, call for more generous scholarly attention to popular aspirations for understanding the Bible.
The Bible and Fundamentalism
Authors: Stephens Randall J.
Published: November 2017

This chapter on the Bible and fundamentalism describes the growth of the movement and pinpoints various influences in play since the nineteenth century. Among those were: a new apocalyptic outlook, Scottish Common Sense philosophy, revivalism, biblicism, and a militant style. The chapter also provides important definitions and summarizes some recent scholarly developments in the study of the movement. Much of the cultural energy of adherents came from their strident opposition to theological modernism, evolutionary biology, and a new, permissive popular culture. Because of that historians once described fundamentalists as vociferously anti-modern. Now, however, historians are showing that believers acted and thought in ways that look strikingly modern, even modernist.
Introduction
Authors: Reveron Derek S. , Gvosdev Nikolas K. , Cloud John A.
Published: November 2017

“National security” is one of the most ubiquitous terms in use in politics today—the catch-all justification for all sorts of actions taken by governments (and often the easiest way to justify budget requests). When the term first began to enter general use, it was often understood in terms of protecting a country against internal subversion and external military attack, but over time its definition has expanded to cover anything that poses a threat to a country’s ability to wield the tools of statecraft or that compromises the security and freedoms of its citizenry. In the twenty-first century, it is generally accepted that, alongside military matters, national security must encompass other concerns, including economic, climate, energy, and cyber issues.
Spain and Sovereign Wealth Funds
Authors: Capape Javier , Aguilera Ruth , Santiso Javier
Published: November 2017

During the last decade, Spain has become a sovereign wealth fund (SWF) investment destination. This chapter begins by outlining the factors that have led SWFs to Spain. Second, it discusses the different corporate strategies that SWFs exhibit when investing in Spanish companies. It examines these investments in the context of an existing typology of four different strategic governance approaches: corporate governance supervision, in-house capabilities enhancement, international recognition and developmental and learning goals. It then shows how these four strategies are effectively implemented drawing on four investment SWF cases in Spain. The chapter concludes by proposing four new areas of fruitful research on SWFs in fields such as economics, management and international business.
Populism and Religion
Authors: Zúquete Jose Pedro
Published: November 2017

The study of the relationship between populism and religion has for a long time remained a neglected area of social-scientific research. This chapter provides a comprehensive overview of religious populism. A subtype of populism, religious populism, is analyzed in its two dimensions: as an openly religious manifestation, in the form of the politicization of religion; and as a subtler religious manifestation, tied to the sacralization of politics in modern-day societies. The chapter ends with a discussion on the nexus between politics and religion and on the need to focus on the repeated intersections between the two fields.
Populism and the Principle of Majority
Authors: Urbinati Nadia
Published: November 2017

What puts populism and democracy in tension although they rest on the same principle of majority and claim to be government by the people? The answer is that when it seeks to implement its agenda through state power, populism enters a direct competition with constitutional democracy over the meaning and expression of the people and puts into question a party-democracy’s conception of representation because it is impatient with the tension between pluralism of social interests and unity of the polity that electoral representation triggers and channels. Hence although ingrained in the ideology of the people and the language of democracy, populism as a ruling power tends to give life to governments that stretch the democratic rules toward an extreme majoritarianism.
Populism and Cosmopolitanism
Authors: Ingram James
Published: November 2017

Populism and cosmopolitanism are commonly regarded as antitheses, reducing populism to communalism and cosmopolitanism to elitism. This chapter develops a more nuanced view by turning to the early histories of both phenomena. In Diogenes the Cynic, cosmopolitanism’s ancient inventor, it finds evidence less for elitism than for resistance to politics as such. In the populares, populists of the Roman Republic, it finds the origins of a long history of inclusive popular politics. Drawing on a recent debate between Ernesto Laclau and Jacques Rancière, the chapter argues that populism and cosmopolitanism are essentially ambivalent. Insofar as populism can be inclusive or exclusive and cosmopolitanism elitist or popular, the two can overlap, and each can usefully be regarded as a check on the other.
Populism in the Post-Soviet States
Authors: March Luke
Published: November 2017

In the former Soviet Union (FSU), sustained instances of populism are rare. The demand side does not represent an equally propitious “breeding ground” for populist backlash as in East Central Europe. However, the supply side is still more problematic, given the consolidation of authoritarian tendencies across the region. Without a minimal level of pluralism, it is extremely difficult to develop genuine and stable populist forces, except in (usually temporary) cases of regime breakdown or elite infighting. Anti-populist leaders (such as Vladimir Putin) have become the rule. Such leaders may employ populist rhetoric, but their fundamental impulse is elitist. They co-opt, mimic, or simply oppress social mobilization, making stability their watchword and regarding genuine populism as a dangerous threat to their rule.
Introduction to the Science of Hope
Authors: Gallagher Matthew W. , Lopez Shane J.
Published: November 2017

Hope has long been a topic of interest both within and outside of psychology. Although historical perspectives on hope were mixed, decades of research have now demonstrated that hope can be reliably measured, that hope is malleable, that hope promotes resilience, and that hope is beneficial across contexts and the lifespan. Rick Snyder developed the dominant model of hope that emphasizes agency and pathways thinking as the two core components of hope, and this model has provided the foundation for the scientific study of hope. The two most prominent scientists in the field of hope have now passed away, but hope remains a robust area of positive psychology that is being examined by scientists worldwide. This chapter introduces the goals of this handbook: to review what has been learned about the theory, measurement, promotion, and benefits of hope and to highlight important future directions in the science of hope.
Hope and Well-Being
Authors: Lee Jenny Y. , Gallagher Matthew W.
Published: November 2017

Snyder’s hope theory defines hope as a cognitively based construct that consists of two components: agency, the willpower to achieve a goal, and pathways, the perceived ability to generate ways to achieve that goal. Hope has been consistently linked to positive outcomes in many life domains, including aspects of positive mental health. This chapter reviews the literature on hope and positive aspects of mental health, including specific findings regarding the impact of hope on subjective, psychological, and social well-being. It also explores findings regarding the potential moderating role of gender, age, race, ethnicity, culture, and other demographic factors on the influence of hope on well-being. Future directions on hope and well-being research are discussed as well.
Hope and Work
Authors: Mouton Angela R. , Montijo Monica N.
Published: November 2017

The world has an employee engagement crisis. Low employee engagement has a detrimental impact not only on employee performance and well-being but also on organizational outcomes, including revenue and profitability. This chapter sets out the argument that a key predictor of employee engagement (and therefore performance and well-being) is hope. The relationship between these variables is unpacked from a theoretical and empirical perspective. While the literature has tended to focus on the agency and pathways components of hope theory, this chapter argues that much more attention should given to the fact that hope rests on the pursuit of positively valenced, personally valued, meaningful goals. The chapter offers suggestions on how organizations and employees might amplify hope, engagement, and positive outcomes in the workplace by focusing on goals that matter not only to the organization but to employees also.
Governance and Organizational Challenges
Authors: Couchman Peter
Published: November 2017

The Chief Executive of the Plunkett Foundation, which supports some of the world’s smallest community-based co-operatives in rural areas, looks at what the larger co-operatives and mutuals can learn from them. He explores five different approaches that a co-operative can take (trust-based approach, corporate-governance-based approach, competence-based approach, values-based approach, and open co-operatives approach) and considers the implications of each. The chapter explores how these ideas have evolved since the earliest days of co-operatives and mutuals and how they might continue to evolve in the future. Written in December 2014, it argues that co-operative education has a vital role to play in ensuring robust governance structures in co-operatives and mutuals.
Raiffeisenbanks and Volksbanks for Europe
Authors: Blisse Holger , Hummel Detlev
Published: November 2017

Co-operative banks have become an important part of the national banking systems in Europe since their creation as member-based organizations in the middle of the nineteenth century. They act together with their central institution(s) within a federal structure. Today, as a result of the crisis of financial markets, European regulation tends to prefer the type of a banking corporation. Co-operative banks, Volksbanks as well as Raiffeisenbanks, and their federal structure seem to be put under pressure to transform and to merge. As a result the number of banks (institutional diversity) and the diversity of banks’ legal forms decreases. This chapter recalls various phases of the history of the development of co-operative banks in Germany, concentrates on the switch from member-based to customer-oriented banks, and analyses strategies to reactivate a meaningful membership and to reposition these banks as responsible institutions for local and social problems.
Agricultural Co-operatives in China
Authors: Zhao Li
Published: November 2017

Co-operatives have played a significant role in the agricultural sector in China, particularly since the promulgation of a first national co-operative law in 2007. This chapter offers an analysis of the evolution, diversity, and dynamics of agricultural co-operatives in contemporary China and the institutional environments in which the development of these organizations took place. A multi-dimensional typology of co-operatives is proposed in order to provide a framework of analysis. This analysis enables one to understand the diversified driving forces, the operational patterns, and the organizational missions of agricultural co-operatives in China. The significant contributions provided by each type of co-operative to poverty reduction, work integration, and local community development is emphasized. The chapter concludes with a discussion on the challenges and opportunities for Chinese co-operatives’ future development.
The Social and Political Dimensions of Co-operative Enterprises
Authors: Pestoff Victor A.
Published: November 2017

The role of co-operatives as providers of goods and services, as in the industrial age, more recently became overshadowed by their potential as providers of social services. In the post-industrial or service society, co-operatives are found in a growing number of countries. Co-operative enterprises have a unique capacity to mobilize social capital and provide relational goods that neither public nor private for-profit providers demonstrate. This brings co-operative enterprises full-circle in terms of their historical political role as democratic pioneers, since they can now also contribute to reducing the growing democratic deficit. This chapter explores the political and social dimensions of co-operative enterprises that pursue multiple goals. It also introduces a dynamic model of co-operative development that can be fruitfully employed for analysing the social and political dilemmas faced by co-operative enterprises.
Apuleius
Authors: Harrison Stephen J.
Published: November 2017

This chapter considers the biography, literary career, and literary output of the second-century Platonizing Latin writer Apuleius, born in Roman North Africa in the 120s ce and recorded as active in Carthage and Africa Proconsularis in the late 150s and 160s. In particular, it examines the key features of his two most important surviving works, the Apologia or Pro Se De Magia, a forensic oration of self-defense against charges of magic and other offences, delivered in the late 150s in court at Sabathra, and the Metamorphoses or Golden Ass, a spectacular picaresque fiction concerning the adventures of the young Greek Lucius, who is metamorphosed into a donkey but later becomes an official in the cults of Isis and Osiris. It is shown overall that Apuleius’s literary profile matches those of contemporary Greek sophists and can be usefully described as sophistic.
Poets and Poetry
Authors: Baumbach Manuel
Published: November 2017

This chapter gives an overview of the production and reception of Greek poetry in the Second Sophistic. It addresses questions of its performance and “setting in life,” looks at the generic tradition and creative innovation of epic, drama, melic poetry, epigram, and fable, and takes into account different cultural backgrounds and literary functions. Poetry was at the core of Greek paideia, functioned as a code for the educated elite, was regarded as an essential element of rhetoric, helped to shape Greek identity, and could be used for propaganda by poets belonging to the imperial court. Educated Greeks from all parts of the Roman Empire shared more or less the same knowledge of the Greek literary tradition regardless of their different cultural backgrounds, a function of the uniform Greek educational system based upon literary canons of established genres.
Plutarch’s Lives
Authors: Desideri Paolo
Published: November 2017

This chapter discusses first the general cosmological principles which lie behind Plutarch’s historiographical work, such as can be recovered through significant passages of his Delphic Dialogues. Second, it investigates the reasons why Plutarch wrote biographies, and more specifically parallel biographies, instead of outright histories: in this way, Plutarch aimed to emphasize, on the one hand, the dominant role of individual personalities in the political world of his own time, and, on the other hand, the mutual and exclusive relevance of Greece and Rome in the history of human culture. Third, the chapter seeks to connect the rise-and-fall pattern, typical of biography, with the general rise-and-fall pattern which Plutarch recognizes both in the Greek and in the Roman civilizations; through that connection one can rule out the idea that Plutarch had any providential view of history. Finally, some reflections are offered on Nietzsche’s special interest in Plutarch’s biographies.
Christian Apocrypha
Authors: Johnson Scott Fitzgerald
Published: November 2017

This chapter considers the definition, genres, and major themes of early Christian apocrypha within the context of the Second Sophistic. Christian fiction surrounding Jesus and the Apostles was a fertile area for literary experimentation. Recovering the history of this literature is difficult, however, because of multiform texts, anonymous authorship, and the many different languages the texts survive in. Popular genres included Gospels, Apocryphal Acts, Apocalyptic, and epistolography. When read as a whole, the large and diverse corpus of early Christian imaginative literature corresponds well with the proliferation of new genres and texts in the Second Sophistic. It shows how literary trends spread across religious confessions and how discursive tools were shared between writers in secular and sacred spheres. Early Christian storytelling was a principal means of establishing a distinct identity in the Roman world.
Platonism
Authors: Fowler Ryan C.
Published: November 2017

At the start of the Second Sophistic, following the trend set in the Academy in the second and first centuries bce, the work of Plutarch of Chaeronea (ca. 40–120 ce) began to move Platonism away from the Academic skepticism that had been embraced in the third and second centuries bce. This general shift started the trend toward a dogmatic interpretation of Plato that was, with a few exceptions, the hallmark of Platonic instruction during the early centuries ce. After Plutarch, we have in many cases only the names of those who taught Plato during the Second Sophistic, including figures such as Ammonius, Taurus, Numenius, Atticus, and Theon of Smyrna. More rarely, we have some handbooks and introductions to Plato’s dialogues and his doctrine, primarily from such second-century ce figures as Maximus of Tyre, Apuleius, Galen, Albinus, and Alcinous.
Faculty and Student Perspectives on Mentorship in a Nursing Honors Program
Authors: Nelson Noreen , Lim Fidelindo , Navarra Ann-Margaret , Rodriguez Karla , Witkoski Stimpfel Amy , Slater Larry Z.
Published: November 2017

Honors programs in nursing can facilitate the professional development of high-achieving students, supporting their lifelong engagement in nursing practice, education, research, and health care policy issues. Strong mentoring relationships are commonly identified as essential to the success of nursing honors programs, but literature on mentoring relationships in an honors context is limited. The purpose of this study was to gain insight into faculty and student expectations for mentorship. Faculty and students shared similar expectations for both the mentor and mentee, highlighting key themes of engagement, facilitation, accountability, and collaboration as necessary for the success of an undergraduate nursing honors program.
Nursing Faculty Attitudes and Practices Related to Online Teaching
Authors: Broussard Lisa , Wilson Kathleen
Published: November 2017

Online education as a teaching methodology is relatively new in higher education in comparison to traditional face-to-face instruction. There is often concern that the quality of online classes is inferior and that academic rigor is compromised when faculty are not engaged with students in a classroom. The purpose of this pilot study was to assess nursing faculty attitudes and practices regarding online teaching. Findings indicated that overall, faculty feel that achievement of student learning outcomes in online and hybrid settings is comparable to face-to-face and report excitement with most aspects of teaching online.
Relations Between Self-Reported Daily-Life Fatigue, Hearing Status, and Pupil Dilation During a Speech Perception in Noise Task
Authors: Wang Yang , Naylor Graham , Kramer Sophia E. , Zekveld Adriana A. , Wendt Dorothea , Ohlenforst Barbara , Lunner Thomas
Published: November 2017

Objective:

People with hearing impairment are likely to experience higher levels of fatigue because of effortful listening in daily communication. This hearing-related fatigue might not only constrain their work performance but also result in withdrawal from major social roles. Therefore, it is important to understand the relationships between fatigue, listening effort, and hearing impairment by examining the evidence from both subjective and objective measurements. The aim of the present study was to investigate these relationships by assessing subjectively measured daily-life fatigue (self-report questionnaires) and objectively measured listening effort (pupillometry) in both normally hearing and hearing-impaired participants.

Design:

Twenty-seven normally hearing and 19 age-matched participants with hearing impairment were included in this study. Two self-report fatigue questionnaires Need For Recovery and Checklist Individual Strength were given to the participants before the test session to evaluate the subjectively measured daily fatigue. Participants were asked to perform a speech reception threshold test with single-talker masker targeting a 50% correct response criterion. The pupil diameter was recorded during the speech processing, and we used peak pupil dilation (PPD) as the main outcome measure of the pupillometry.

Results:

No correlation was found between subjectively measured fatigue and hearing acuity, nor was a group difference found between the normally hearing and the hearing-impaired participants on the fatigue scores. A significant negative correlation was found between self-reported fatigue and PPD. A similar correlation was also found between Speech Intelligibility Index required for 50% correct and PPD. Multiple regression analysis showed that factors representing “hearing acuity” and “self-reported fatigue” had equal and independent associations with the PPD during the speech in noise test. Less fatigue and better hearing acuity were associated with a larger pupil dilation.

Conclusions:

To the best of our knowledge, this is the first study to investigate the relationship between a subjective measure of daily-life fatigue and an objective measure of pupil dilation, as an indicator of listening effort. These findings help to provide an empirical link between pupil responses, as observed in the laboratory, and daily-life fatigue.
Induction Therapies Plus Surgery Versus Exclusive Radiochemotherapy in Stage IIIA/N2 Non–Small Cell Lung Cancer (NSCLC)
Authors: Jeremić Branislav
Published: November 2017

In spite of the growing body of data from prospective randomized clinical trials (PRCTs) and meta-analyses, the optimal treatment approach in patients with stage IIIA non–small cell lung cancer remains unknown. This review focuses on the available data directly confronting induction chemotherapy or induction radiochemotherapy (RT-CHT) when followed by surgery with exclusive RT-CHT. Seven PRCTs and 4 meta-analyses investigated this issue. In addition, numerous retrospective studies attempted to identify potential predictors and/or prognosticators that may have influenced the decision to offer surgery in a particular patient subgroup. Several retrospective studies also evaluated exclusive RT-CHT in this setting. There is not a single piece of the highest level of evidence (PRCT or MA) showing any advantage of induction therapies followed by surgery over exclusive RT-CHT with the former treatment option leading to significantly more morbidity and mortality. Although several studies attempted to identify patient subgroups favoring induction therapies followed by surgery, they have invariably been retrospective in nature, and their results have never been reproduced even in other retrospective setting. Furthermore, no PRCT investigated potential pretreatment patient and/or tumor-related predictors of surgical multimodality success. Exclusive RT-CHT achieves similar results to induction therapies followed by surgery but with less morbidity and mortality. This is accompanied with the finding that no pretreatment predictor exists to enable identification of even a subgroup of stage IIIA/pN2 patients benefiting from any surgical approach.
Initiation of a Transanal Total Mesorectal Excision Program at an Academic Training Program: Evaluating Patient Safety and Quality Outcomes
Authors: Maykel Justin A. , Phatak Uma R. , Suwanabol Pasithorn A. , Schlussel Andrew T. , Davids Jennifer S. , Sturrock Paul R. , Alavi Karim
Published: November 2017

BACKGROUND:

Short-term results have shown that transanal total mesorectal excision is safe and effective for patients with mid to low rectal cancers. Transanal total mesorectal excision is considered technically challenging; thus, adoption has been limited to a few academic centers in the United States.

OBJECTIVE:

The aim of this study is to describe outcomes after the initiation of a transanal total mesorectal excision program in the setting of an academic colorectal training program.

DESIGN:

This is a single-center retrospective review of consecutive patients who underwent transanal total mesorectal excision from December 2014 to August 2016.

SETTING:

This study was conducted at an academic center with a colorectal residency program.

PATIENTS:

Patients with benign and malignant diseases were selected.

INTERVENTION:

All transanal total mesorectal excisions were performed with abdominal and perineal teams working simultaneously.

OUTCOME MEASURES:

The primary outcomes measured were pathologic quality, length of hospital stay, 30-day morbidity, and 30-day mortality.

RESULTS:

There were 40 patients (24 male). The median age was 55 years (interquartile range, 46.7–63.4) with a median BMI of 29 kg/m2 (interquartile range, 24.6–32.4). The primary indication was cancer (n = 30), and tumor height from the anal verge ranged from 0.5 to 15 cm. Eighty percent (n = 24) of the patients who had rectal cancer received preoperative chemoradiation. The most common procedures were low anterior resection (67.5%), total proctocolectomy (15%), and abdominoperineal resection (12.5%). Median operative time was 380 minutes (interquartile range, 306–454.4), with no change over time. For patients with malignancy, the mesorectum was complete or nearly complete in 100% of the specimens. A median of 14 lymph nodes (interquartile range, 12–17) were harvested, and 100% of the rectal cancer specimens achieved R0 status. Median length of stay was 4.5 days (interquartile range, 4–7), and there were 6 readmissions (15%). There were no deaths or intraoperative complications.

LIMITATIONS:

This study’s limitations derive from its retrospective nature and single-center location.

CONCLUSIONS:

A transanal total mesorectal excision program can be safely implemented in a major academic medical center. Quality outcomes and patient safety depend on a comprehensive training program and a coordinated team approach. See Video Abstract at http://links.lww.com/DCR/A448.
What Is the Risk of Anastomotic Leak After Repeat Intestinal Resection in Patients With Crohn’s Disease?
Authors: Johnston W. Forrest , Stafford Caitlin , Francone Todd D. , Read Thomas E. , Marcello Peter W. , Roberts Patricia L. , Ricciardi Rocco
Published: November 2017

BACKGROUND:

Approximately half of Crohn’s patients require intestinal resection, and many need repeat resections.

OBJECTIVE:

The purpose of this study was to evaluate the increased risk of clinical anastomotic leak in patients with a history of previous intestinal resection undergoing repeat resection with anastomosis for Crohn’s disease.

DESIGN:

This was a retrospective analysis of prospectively collected departmental data with 100% capture.

SETTINGS:

The study was conducted at the department of colorectal surgery in a tertiary care teaching hospital between July 2007 and March 2016.

PATIENTS:

A cohort of consecutive patients with Crohn’s disease who were treated with intestinal resection and anastomosis, excluding patients with proximal fecal diversion, were included. The cohort was divided into 2 groups, those with no previous resection compared with those with previous resection.

MAIN OUTCOME MEASURES:

Clinical anastomotic leak within 30 days of surgery was measured.

RESULTS:

Of the 206 patients who met criteria, 83 patients had previous intestinal resection (40%). The 2 groups were similar in terms of patient factors, immune-suppressing medication use, and procedural factors. Overall, 20 clinical anastomotic leaks were identified (10% leak rate). There were 6 leaks (5%) detected in patients with no previous intestinal resection and 14 leaks (17%) detected in patients with a history of previous intestinal resection (p < 0.005). The OR of anastomotic leak in patients with Crohn’s disease with previous resection compared with no previous resection was 3.5 (95% CI, 1.3–9.4). Patients with 1 previous resection (n = 53) had a leak rate of 13%, whereas patients with ≥2 previous resections (n = 30) had a leak rate of 23%. The number of previous resections correlated with increasing risk for clinical anastomotic leak (correlation coefficient = 0.998).

LIMITATIONS:

This was a retrospective study with limited data to perform a multivariate analysis.

CONCLUSIONS:

Repeat intestinal resection in patients with Crohn’s disease is associated with an increased rate of anastomotic leakage when compared with initial resection despite similar patient, medication, and procedural factors. See Video Abstract at http://links.lww.com/DCR/A459.
Factors Influencing Squamous Cell Carcinoma In Situ Recurrence and Implications for Treatment Choice
Authors: Matsumoto Andrew J. , Schmitt Adam R. , Skelley Logan M. , Baum Christian L.
Published: November 2017

BACKGROUND

Numerous treatment modalities have been reported for squamous cell carcinoma in situ (SCCIS). Risk factors for recurrence have not been systematically reviewed.

OBJECTIVE

To systematically review and summarize the data on risk factors that contribute to recurrence of SCCIS.

MATERIALS AND METHODS

A PubMed search was completed using the terms “SCCIS,” “Bowen's disease,” “Bowen's disease and recurrence,” and “Bowen's disease and Mohs.” These sources were cross-referenced for the terms “treatment,” “management,” “therapy,” “recurrence,” and “margins.” Studies were selected on the basis of relevance and applicable treatments.

RESULTS

Immunosuppression was the only variable with a statistically signficant association with progression or recurrence of SCCIS. Although there were no data directly correlating subclinical lateral extension or invasive squamous cell carcinoma within SCCIS with recurrence, evidence supports both of these as common features of SCCIS. Other potential recurrence risk factors for which there are limited supporting data included tumor size, depth of follicular extension, and location.

CONCLUSION

Immunosuppression was the only risk factor associated with increased risk of tumor recurrence. Subclinical tumor extension and occult invasive squamous cell carcinoma are relatively common features that theoretically could increase recurrence risk. These factors should be considered when deciding upon treatment for SCCIS. Further study is required to quantify variables that influence recurrence and to identify optimal treatment options.
OUTCOMES OF PARS PLANA VITRECTOMY FOR MACULAR HOLE IN PATIENTS WITH UVEITIS
Authors: Callaway Natalia F. , Gonzalez Marco A. , Yonekawa Yoshihiro , Faia Lisa J. , Mandelcorn Efrem D. , Khurana Rahul N. , Saleh Mohamed G. A. , Lin Phoebe , Sobrin Lucia , Albini Thomas A.
Published: November 2017

Purpose:

Inflammatory macular hole is a rare complication of uveitis, and data on surgical outcomes of closure are scarce. The purpose of this study is to evaluate the anatomical and visual outcomes of conventional pars plana vitrectomy for patients with uveitis.

Methods:

Noncomparative, interventional, and consecutive case series from 6 vitreoretinal surgical centers from 2007 to 2015. Twenty eyes of 19 patients were included with 4 patients separated as viral retinitis. The primary outcome was change in best-corrected visual acuity at Month 3. Secondary outcomes were closure of the macular hole and postoperative optical coherence tomography characteristics.

Results:

All eyes underwent conventional three-port pars plana vitrectomy with indocyanine green–assisted internal limiting membrane peeling. Mean Snellen best-corrected visual acuity improved from 20/200 to 20/63 (P = 0.01 for a difference in logarithm of the minimum angle of resolution) at Month 3. Twelve (75%) of patients achieved 2 or more lines of visual acuity improvement by postoperative Month 3. Surgery resulted in decreased epiretinal membrane (P = 0.002), intraretinal fluid (P < 0.001), subretinal fluid (P = 0.029), central subfield thickness (P < 0.001), and central cube volume (P = 0.041). Surgical intervention achieved anatomical success, as measured by macular hole closure, in 13 (81%) of patients at postoperative Month 3.

Conclusion:

Patients with inflammatory macular hole respond well to conventional surgery, with good anatomical and visual acuity outcomes.
Ocular Features of Cerebro-Costo-Mandibular Syndrome
Authors: Hameed Zoya , Taylor Simon , Lindfield Dan
Published: November 2017

Cerebro-costo-mandibular syndrome (CCMS) is a rare hereditary disorder characterized by micrognathia, posterior rib gaps, and secondary developmental delay. Patients often require ventilation and feeding support throughout life. We describe the first reported ophthalmic findings of CCMS and propose that defects in choroidal permeability lead to chronic macular edema and refractory aqueous misdirection syndrome. Here we discuss the medical and surgical management concerns of recurrent angle closure and raised intraocular pressure in a CCMS patient.
The Keys for Success: Leadership Core Competencies
Authors: Pidgeon Kristopher
Published: November 2017

Providing leaders with skills resulting in positive behaviors, specifically increasing quality performance improvement projects and leadership style, ultimately may deliver an increase in professional development. Consisting of the topic leadership, this article consists of core competencies specifically targeted for learning leadership skills. The purpose of this article is to assist the leader with developing leadership skills, which promotes professional development. This article reviews leadership skills and describes in detail the elements of some core competencies that can enable the leader to develop skills, including strategic thinking, organizational skills, time management, decision-making, leadership skills, conflict resolution, and strategies to enhance performance improvement. The article provides the leader with insight and strategies to develop leadership skills, which can be invaluable to any leader, health care worker, or institution.
Incidence of Infusion Site Reactions in Peripheral Fosaprepitant Infusions
Authors: Gonçalves Sarah C. , Sanches Solange M. , Bueno Camila T. , Villela de Castro Diana L. , Damascena Aline , Santos Giseli R.C.
Published: November 2017

Fosaprepitant is administered intravenously to treat chemotherapy-induced nausea and vomiting. To verify the incidence of infusion site reactions and the relationship among risk factors, a quantitative retrospective cohort study was undertaken. The study included patients seen between October 2013 and February 2014. Fifty-seven patients were included in the study, and there were 105 infusions among them. Infusion site reactions were identified in 42 (40%) cases. Risk factors identified by the study included age (P < .001), insertion at the back of the hand and wrist (P < .001), and first fosaprepitant administration (P < .001). The study found evidence of a higher incidence of infusion site reactions than was reported in the package insert.
Correlating Abdominal Wall Thickness and Body Mass Index to Predict Usefulness of Right Lower Quadrant Ultrasound for Evaluation of Pediatric Appendicitis
Authors: Kwon Jeannie K. , Trexler Nowice , Reisch Joan , Pfeifer Cory M. , Ginos Jason , Powell Jerry Allen , Veltkamp Jennifer , Anene Alvin , Fernandes Neil , Chen Li Ern
Published: November 2017

Objectives

To inform selective and efficient use of appendix ultrasound (US) beyond adult parameters of body mass index (BMI) of less than 25 kg/m2, we correlate abdominal wall thickness (AWT) with age and BMI to generate parameters for male and female children. Information presented in chart format can aid in the decision to utilize US for the evaluation of appendicitis.

Methods

In this observational study, 1600 pediatric computed tomography scans of the abdomen and pelvis were analyzed to obtain measurements of AWT in the right lower quadrant. Measurements were correlated by patient age, BMI, and sex. Results and consensus-based recommendations were presented in chart format with color-coded groupings to allow for convenient referencing in the clinical setting.

Results

One thousand four hundred eighty-eight computed tomography scans and AWT measurements were included. All age groups with BMI of less than 25 kg/m2 and all male and female groups younger than 6 years regardless of BMI had median AWT of less than 4 cm resulting in strong recommendation for US. Males older than 6 years and all female age groups with BMI of greater than 30 kg/m2 and female older than 15 years and BMI of greater than 25 kg/m2 had AWT of more than 5 cm resulting in low recommendation for US.

Conclusions

While the BMI cutoff standard of less than 25 kg/m2 for usefulness of appendix US holds in the adult population, our data expand the acceptable range in children younger than 9 years regardless of BMI and male children with BMI up to 30 kg/m2. Female children younger than 15 years with a BMI up to 30 kg/m2 may also be amenable to right lower quadrant US based on AWT. These parameters inform selective and efficient use of US for appendix evaluation.