bluuebunny/crossref_metadata_2025 huggingface dataset:
Supporting Children’s Autonomy Early On
Authors: Joussemet Mireille , Mageau Geneviève A.
Published: February 2023

There is a growing scientific interest regarding the importance of parental autonomy support (AS) in early childhood. The purpose of this chapter is to review studies on this topic, describe how parental AS toward young children (i.e., infants, toddlers, and preschoolers) has been measured, and document what child characteristics and outcomes have been associated with it. The chapter reviews studies whose AS measure was consistent with self-determination theory’s conceptualization and organizes them by the social context in which it was assessed: play, conversation, help provision, and socialization. After describing each study’s procedure, AS operationalization, and main results, the chapter addresses conceptual issues that should be considered in future studies.
Developmental Issues in Emerging Adulthood
Authors: Ratelle Catherine F. , Guay Frédéric
Published: February 2023

This chapter focuses on emerging adulthood, a developmental stage spanning the late teens, as youths leave adolescence and secondary education, to the mid-20s, when many leave postsecondary education and enter the job market. Based on self-determination theory, the chapter examines young adults’ psychological need satisfaction (for autonomy, competence, relatedness) and motivational functioning (motivations, goals, aspirations) as well as how these processes support their ability to tackle important developmental challenges. Among these issues are young adults’ identity development, their career decision-making, and their psychological adjustment and thriving. Special attention is devoted to the role of psychological need frustration and motivational deficits in the emergence of physical and psychological issues during this period. The chapter ends with recommendations for intervention and future research.
Cognitive Evaluation Theory
Authors: Reeve Johnmarshall
Published: February 2023

Cognitive evaluation theory (CET) explains how environmental events (rewards), social contexts (classroom climates), and intrapersonal events (self-set goals) influence the ups and downs of intrinsic motivation. The theory’s core insight is that the psychological meaning of these events can be informational, controlling, or amotivating, and it is the relative salience of these three aspects that explains the effect of each event on the recipient’s intrinsic motivation. This core insight provided the basic building blocks for the now large literatures on interpersonal motivating styles and the dual-process model. Overall, CET arose as self-determination theory’s first mini-theory to explain the controversy on the effect of extrinsic rewards on intrinsic motivation, and it now provides the contemporary insights self-determination theory needs to continue its theoretical growth and applied relevance.
Self-Determination Theory in Cross-Cultural Research
Authors: Lynch Martin F.
Published: February 2023

Self-determination theory (SDT) has garnered interest from scholars around the world. That interest has generated a large body of cross-cultural, empirical research and has led to important questions for researchers to consider, both conceptual and methodological. Conceptually, the construct of basic psychological needs provides a focus for SDT’s cross-cultural research that is both confirmatory and exploratory. The confirmatory agenda centers on testing the universality of basic needs and whether need satisfaction leads reliably to positive outcomes in countries and cultures around the world. The exploratory agenda involves investigating the possibility that other needs exist that would emerge through deeper inquiries within cultures. This chapter addresses methodological issues relevant to these agenda and suggests several new directions for research, stemming from an understanding of SDT as a critical theory.
How to Motivate People to Care about Prejudice Reduction in the Workplace
Authors: Legate Nicole , Weinstein Netta
Published: February 2023

Despite investing billions of dollars annually, workplace efforts to curb prejudice and discrimination typically fall short of creating effective or long-lasting change. This chapter uses insights from self-determination theory to understand why that is, and suggests the remedy is to motivate employees to care about prejudice reduction. Workplaces can inspire this type of motivation by supporting employees’ needs for autonomy (aligning prejudice reduction with people’s core values and beliefs), competence (providing concrete guidance and skills to change), and relatedness (fostering connections with the motivator and diverse others). The chapter reviews the specific need-supportive strategies that promote motivation to care about prejudice reduction and what these might look like in the context of workplace diversity initiatives. It discusses evidence for existing need-based prejudice-reduction approaches, including within policing, an organizational setting in which prejudice reduction is of utmost importance. It advocates that organizations infuse these motivational strategies into ongoing diversity initiatives to inspire long-lasting change.
Ethics versus Ethical Codes
Authors: Van Alst Emily C. , Pyburn K. Anne
Published: February 2023

Ethical standards codified by major professional archaeological organizations mainly serve an educational purpose, given that sanctions are beyond the purview of most such bodies (but see below discussion of Register of Professional Archaeologists (RPA). The three main problems with these codes are (1) People do not read them; (2) People do not understand them; and (3) Organizations do not update them. To be effective, codes of ethics must be regularly revisited and deliberately founded on a commitment to a defined “good” sensu Wylie’s 2003 interpretations of Kant. In the case of archaeology, that commitment must be to human rights as defined in the United Nations Universal Declaration of Human Rights (1948). Although the ethical practice of archaeology falls under the requirements set out in several of the UN articles, this chapter will focus on Article 12.
Cognitive Systems in NSSI and Co-Occurring Conditions
Authors: Browning Morgan E. , Muehlenkamp Jennifer J.
Published: February 2023

Nonsuicidal self-injury (NSSI) is conceptualized as an emotion-avoidant behavior similar to other co-occurring maladaptive behaviors such as substance abuse, disordered eating, and obsessive-compulsive behaviors. Although all these behaviors are motivated by emotion avoidance resulting in short-term benefits, a variety of cognitive processes are vital to understanding the onset and maintenance of these behaviors. This chapter overviews current research on the cognitive processes and related neurobiological features believed to increase vulnerability to NSSI. The chapter provides an integrative summary proposing that NSSI originates from a cognitive control dysfunction, rumination, and attentional biases toward negative emotions that result in the use of NSSI or other maladaptive regulation strategies. Continued use of the behavior leads to a cyclical pattern of reward that increases positive expectancies, attentional biases, development of rule-governed behavior, and cognitive inflexibility, and reliance on NSSI for coping is exacerbated. The integrated cycle of cognitive processes discussed in this chapter complements recent transdiagnostic models of emotion-avoidant disorders and helps to expand current emotion-focused theoretical understandings of NSSI.
Cultural Planning and a “Community Turn” in the Arts
Authors: Borrup Tom
Published: February 2023

This chapter describes the evolution and purposes of the formal practice of cultural planning since its origins in the 1970s. It compares surveys from 1994 and 2017 asking local arts agencies that commissioned cultural plans about their planning process, expectations, and subsequent outcomes from planning. In earlier years, cultural planning demonstrated an ability to build cooperation among nonprofit arts organizations and to elevate their collective capacity to attract public and private funding. This primarily benefited established and Eurocentric arts institutions and organizations. Surveys provide evidence that more recent cultural planning has mobilized cultural resources in ways that have contributed to a wider variety of civic and social concerns. This represents and parallels what has been described as a “community turn” in the arts. However, one of the areas identified in the more recent survey as having disappointing outcomes is advancing racial equity in the arts. The chapter concludes by describing five forces or phenomena that have limited the potentials in cultural planning.
Analyzing the Cultural and Creative Industries Ecosystem Under the Lens of Complex Adaptive Systems
Authors: Mazzoni Leonardo , Oliva Stefania , Lazzeretti Luciana
Published: February 2023

Despite the growing popularity of the ecosystem vision of complex adaptive systems in the social sciences, the cultural and creative sectors are still theoretically and empirically studied with a prevalent industrial focus. However, several scholars have depicted culture and creativity as connected living organisms, with different components, norms, and behaviors, interacting in local and global networks. This chapter explores how the concept of the cultural and creative industries (CCIs) evolved over time and whether an ecosystem approach may be considered a new representation of the relationships and dynamics of CCIs as an alternative to those based on industrial specializations. Starting from the model of culture-economy-society-technology and moving through the contribution of the complex adaptive systems framework, the chapter maps the evolution of actors, relationships, and structures of the CCIs ecosystem.
Knowledge Management in Arts and Cultural Organizations
Authors: Vakharia Neville
Published: February 2023

This chapter assesses the role of organizational knowledge and knowledge management through multiple bodies of literature and relevant empirical studies. A new conceptual framework for arts and cultural organizations is proposed that links knowledge management enablers, a knowledge management orientation, and organizational performance. By understanding the enabling factors that foster knowledge creation, their relationship to knowledge management practices and behaviors, and the impact on organizational performance, this framework opens a new line of inquiry and a set of related propositions for arts and cultural research. Aligning with and adapting to broader empirical studies and bodies of literature brings this conceptual framework for arts and cultural organizations and research into the larger study of organizational knowledge and its management.
Ethics in Cultural Leadership
Authors: Price Jonathan
Published: February 2023

This chapter analyzes the relationship of cultural leadership to common ethical challenges faced by arts and cultural organizations. It considers issues and dilemmas that arise when different planes of value intersect and come into conflict in cultural practice. Drawing on examples from practice in a range of international contexts, the chapter identifies reasons cultural organizations come under scrutiny in relation to their ethics and are held to account by their stakeholders, distinguishing the self-interested need to protect reputation from the provision of principled ethical leadership. The analysis suggests elements that are distinctly “cultural” about cultural leadership, expanding the definition of this contested term and relating it to questions of direction-finding, prioritization, and value in organizational settings. The analysis produces a framework for assessing integrity in a sector riven with contradictions, and argues for the importance of cultural organizations clearly articulating their ethical identity and differentiating their fundamental purpose from their habitual activities. While arts boards are recognized as key sites of ethical responsibility, problems of accountability are identified in the external influences that distinguish leadership processes from the roles of designated leaders, and in sectoral challenges that exceed the scope of individual organizations.
Influencing Policy and Procedure with Law–Psychology Research
Authors: Bornstein Brian H. , Meissner Christian A.
Published: February 2023

Psycholegal research is, by design, a field devoted to evaluating and addressing issues that directly affect the justice system. At the same time, many scholars in the field have experienced firsthand the frustrations of bridging the divide between research and policy or practice. In this chapter we discuss key issues and challenges involved in bridging this divide by focusing on a number of cardinal questions: Why influence policy? When, where, and how might we do so? How much evidence must there be before adopting a particular policy? And what policies can (or should) we address? We argue that psycholegal research should operate within a translational research framework, and we encourage scholars to communicate their findings to a broader audience, spend time with the professionals for whom their research is intended, introduce students to best practices for conducting policy-relevant research, and reconsider how we evaluate one another’s contributions in the academy.
ALMA detection of 321 GHz water maser emission in the radio galaxy NGC 1052
Authors: Kameno Seiji , Harikane Yuichi , Sawada-Satoh Satoko , Sawada Tsuyoshi , Saito Toshiki , Nakanishi Kouichiro , Humphreys Elizabeth
Published: February 2023

The Atacama Large Millimeter/submillimeter Array (ALMA) serendipitously detected H2O $J_{K_{\rm a}, K_{\rm c}} = 10_{2,9}$–93, 6 emission at 321 GHz in NGC 1052. This is the first submillimeter maser detection in a radio galaxy and the most luminous 321 GHz H2O maser known to-date with the isotropic luminosity of $1090\, L_{\odot }$. The line profile consists of a broad velocity component with FWHM = 208 ± 12 km s−1 straddling the systemic velocity and a narrow component with FWHM = 44 ± 3 km s−1 blueshifted by 160 km s−1. The profile is significantly different from the known 22 GHz 61, 6–52, 3 maser which shows a broad profile redshifted by 193 km s−1. The submillimeter maser is spatially unresolved with a synthesized beam of ${0{^{\prime \prime}_{.}}68} \times {0{^{\prime \prime}_{.}}56}$ and coincides with the continuum core position within 12 pc. These results indicate amplification of the continuum emission through high-temperature (>1000 K) and dense [n(H2O) > 104 cm−3] molecular gas in front of the core.
METTL14 is a chromatin regulator independent of its RNA N
6-methyladenosine methyltransferase activity
Authors: Dou Xiaoyang , Huang Lulu , Xiao Yu , Liu Chang , Li Yini , Zhang Xinning , Yu Lishan , Zhao Ran , Yang Lei , Chen Chuan , Yu Xianbin , Gao Boyang , Qi Meijie , Gao Yawei , Shen Bin , Sun Shuying , He Chuan , Liu Jun
Published: February 2023

METTL3 and METTL14 are two components that form the core heterodimer of the main RNA m6A methyltransferase complex (MTC) that installs m6A. Surprisingly, depletion of METTL3 or METTL14 displayed distinct effects on stemness maintenance of mouse embryonic stem cell (mESC). While comparable global hypo-methylation in RNA m6A was observed in Mettl3 or Mettl14 knockout mESCs, respectively. Mettl14 knockout led to a globally decreased nascent RNA synthesis, whereas Mettl3 depletion resulted in transcription upregulation, suggesting that METTL14 might possess an m6A-independent role in gene regulation. We found that METTL14 colocalizes with the repressive H3K27me3 modification. Mechanistically, METTL14, but not METTL3, binds H3K27me3 and recruits KDM6B to induce H3K27me3 demethylation independent of METTL3. Depletion of METTL14 thus led to a global increase in H3K27me3 level along with a global gene suppression. The effects of METTL14 on regulation of H3K27me3 is essential for the transition from self-renewal to differentiation of mESCs. This work reveals a regulatory mechanism on heterochromatin by METTL14 in a manner distinct from METTL3 and independently of m6A, and critically impacts transcriptional regulation, stemness maintenance, and differentiation of mESCs.
Towards more evidence-based agricultural and food policies
Authors: El Benni Nadja , Grovermann Christian , Finger Robert
Published: February 2023

The goal of this paper is to provide insights into how scientific evidence can be used for policymaking and put evidence-based agriculture and food policies at the top of research and policy agendas. We illustrate how scientific evidence can be used in a targeted manner for better policymaking and present an overview of the rich set of ex-ante and ex-post evaluation methods and tools that agricultural economists use for evaluating agricultural policies to provide evidence for policy decisions. We present insights into both established and new/emerging methods and approaches, including their advantages and disadvantages, and discuss their potential use for policy evaluation. We also discuss how methods and approaches should be combined and could be better targeted towards decision-makers. The paper also discusses the crucial role of high-quality data in supporting the science—policy interface. Finally, we present an overview of papers in this special issue titled ‘Evidence-Based Agricultural and Food Policy: The Role of Research for Policy Making’.
Skin Assessment in Patients with Dark Skin Tone
Authors: Pusey-Reid Eleonor , Quinn Lisa , Samost Mary E. , Reidy Patricia A.
Published: February 2023

There is a scarcity of nursing literature, studies, and educational materials on the assessment and early recognition of both common and serious integumentary and general health issues in people with dark skin tones. Nurses must be exposed to such learning resources to be adequately prepared to care for patients with diverse skin tones and to help reduce health disparities and promote health equity. This article provides faculty, nursing students, and clinicians with basic information about the assessment of dark skin tone and calls for action in academia and professional practice to ensure nurses and nursing students can effectively perform skin assessments in all patients.
Creating a Healthy Work Environment
Authors: Berndt Janeen , Ortelli Tracy A.
Published: February 2023

Resources for health care workers, leaders, and organizations.
Medical Jargon May Lead to Confusion Among Patients
Authors: Rosenberg Karen
Published: February 2023

According to this study:

The use of medical jargon is often confusing to patients and should be avoided to prevent misunderstandings.

Study participants had a mixed understanding of which terms were meant to convey good and bad news.
The Little Things Nurses Do
Authors: Bills Holly
Published: February 2023

After a daughter's type 1 diabetes diagnosis, nurses provide essential coordinates.
Quality and safe anaesthesia for all children
Authors: Machotta Andreas , Hansen Tom G. , Weiss Markus
Published: February 2023

Purpose of review

In 1989, the United Nations passed the ‘Convention on the Rights of the Child’ (UNCRC) and, among others claimed the highest attainable standard of health for children and consequently the highest level of safety and quality in paediatric anaesthesia. SAFETOTS (Safe Anesthesia For Every Tot, www.safetots.org), an initiative of international active paediatric anaesthetists, has derived 10 rights, the ‘10 R’ of children undergoing anaesthesia care, which are critical for the well being of the child.

Recent findings

The current situation in paediatric anaesthesia care in Europe does not always meet the requirements demanded by the UNCRC. Anaesthesia-related complications in children are still persistent. Anaesthesiologists are frequently asked to provide care for newborns, infants and small children without having sufficient child-specific expertise, resulting in an increased morbidity and mortality.

This article will explain these statutes of children's rights and their implications for everyday paediatric anaesthesia. Furthermore, it will also express the institutional and political changes that are needed to guarantee children their right to enjoy the highest attainable standard of health.
Intracranial Volume in Relation to Parent Satisfaction and Expert Opinion: A Novel Look at Surgical Outcomes
Authors: Alhumsi Taghreed , Alshomer Feras , Essbaiheen Fahad , AlKubeyyer Metab , AlKuwaykibi Abdulaziz , Altweijri Ikhlass , AlKhudairy Yasser
Published: February 2023

Background:

Factors like parent satisfaction and expert opinion have been proposed as outcome measures related to craniosynostosis (CS) surgery. However, there is no real tangible score for CS surgery outcomes. In our study, we aimed to explore different factors considered as a tangible outcome measure of CS surgery.

Methods:

A retrospective cohort study of 23 patients with CS who were operated on in a tertiary care university hospital. Parents were interviewed to assess their satisfaction of aesthetic outcome. This was correlated to two expert opinions and to the amount of skull expansion.

Results:

The mean follow-up duration was 2.24 ± 1.12 years. Twelve of the 23 fathers were satisfied, whereas 11 of the 23 mothers were satisfied. The overall combined satisfaction rate of both parents was on the higher side with no difference in between. There was a significant association between expansion rate of 7.65 ± 4.99% and the overall parent’s satisfaction (P = 0.002). Additionally, there was a good correlation between both experts with statistically significant association (P = 0.004). No correlation was found between the parents’ satisfaction and the experts’ opinions.

Conclusions:

The study is valuable, as it investigates the relationship between the expansion rate, parents’ satisfaction, and expert opinion as predicted values of craniosynostosis surgery. The overall satisfaction correlated significantly well with the expansion rate. However, such numerical assessment is not a real guide for assessing clinical outcomes‚ as no association was found between expansion rate, satisfaction rate, and expert opinion.
Dupuytren Disease: A Retrospective Cohort Study Comparing Collagenase Injection and Percutaneous Needle Fasciotomy
Authors: Mehdiyev Turkhan , Maffei Davide , Müller Verena , Mair Waltraud , Zimmermann Robert F. , Baur Eva-Maria
Published: February 2023

Background:

Collagenase Clostridium histolyticum (CCH) injection and percutaneous needle fasciotomy (PNF) are minimally invasive procedures aiming to relieve Dupuytren disease (DD) by disrupting the cord and restoring the normal functionality of the hand. The purpose of this study is to compare the outcomes and recurrence rates for treatment of DD in the proximal interphalangeal (PIP) and metacarpophalangeal (MCP) joints with either collagenase or percutaneous needle at 3-year follow-up. Moreover, we aim to determine the role of these therapeutic modalities and their impact on hand functionality and quality of life.

Methods:

In this retrospective analysis, we compare treatment outcomes in 35 patients, of whom 22 were treated with PNF and 13 with CCH injection.

Results:

The mean outcome in contracture degrees at 3-year follow-up was 9 degrees for MCP joints for both treatment groups, 34 degrees for PNF, and 28 degrees for CCH for PIP joints. There was no statistical significance between the treatment groups in MCP joints (P = 0.786) or in PIP joints (P = 0.474). Contracture recurrences were similar in PIP joints of both groups and greater in MCP joints in the CCH group compared to PNF. The Disabilities of the Arm, Shoulder, and Hand and the Unité Rhumatologique des Affections de la Main scores showed a reduction in impairment in both groups without significant differences between the two groups.

Conclusions:

The results of this study show that PNF appears to be as effective and minimally invasive as CCH injection, but at significantly lower cost. Considering these factors, the authors prefer and recommend the use of PNF over CCH.
Quality of Life in Oncology
Authors: Apolone Giovanni , Brunelli Cinzia
Published: February 2023

Cancer, in Europe, is the second cause of death. In addition, there is an unacceptable variability in terms of access to innovation, quality of care, and outcomes, within and between countries. The European Union has activated an unprecedented initiative to fight cancer by launching Europe's Beating Cancer Plan and the Cancer Mission. The goals are to reduce mortality, increase survival, and ameliorate quality of life by increasing knowledge, improving quality of care, and reducing inequalities through interventions on actionable determinants of variability. A competitive call was launched with the objective to develop and validate a set of quality of life and patient preference measures for cancer patients and survivors, to be used for routine data collection all over Europe. A consortium, the EUonQoL, was funded, including partners from 41 countries with 55 participants. It will start the activities on January 2023 and rresults are expected by December 2024.
Enhanced prognostic value of combined circulating tumor cells and serum carcinoembryonic antigen in patients with colorectal cancer
Authors: Yang Chih-Yung , Lin Chun-Chi , Huang Sheng-Chieh , Lu Ruey-Hwa , Lo Liang-Chuan , Tseng Ju-Yu , Tung Chien-Yi , Lin Chi-Hung , Jiang Jeng-Kai
Published: February 2023

Background:

Circulating tumor cells (CTCs) have been investigated as a potential biomarker for predicting prognosis and monitoring therapeutic responses in colorectal cancer (CRC). However, the sensitivity of CTCs detection is low, thus limiting the clinical utility of CTCs. We aim to examine the clinicopathological parameters that improve prognosis prediction for CRC using CTCs as a biomarker.

Methods:

We enumerated CTCs in 186 CRC patients and associated the number of CTCs with the clinicopathological features and overall survival (OS) using a univariate and multivariate Cox regression model and Kaplan–Meier survival analysis.

Results:

The presence of CTCs from 186 CRC patients was significantly associated with stage, preoperational carcinoembryonic antigen (CEA), and CA19-9 levels. Using Kaplan–Meier survival and Cox regression analysis, patients with five or more CTCs exhibited significantly worse OS compared to patients with fewer than five CTCs. The combination of CTCs with tumor marker CEA has a better OS prediction than individual CTCs or CEA and serves as a more effective prediction model in patients with CRC.

Conclusion:

We identified that patients with more than five CTCs exhibited significantly worse OS. Additionally, patients with the normal level of CEA, but who also had more than five CTCs trended towards a worse OS.
Frequency and Cost of Claims by Injury Type From the Korea Workers’ Compensation Insurance Between 2016 and 2019
Authors: Bae Suk Won , Lee Min-Yong , Park Shin Who , Lee Gangpyo , Leigh Ja-Ho
Published: February 2023

Objective

This study aimed to examine the frequency of worker injuries by affected body part(s) and the associated costs. Methods: We performed a secondary analysis of national workers' compensation claims data from the Korean workers' compensation insurance. The main outcome measures were frequency and cost of claims by injury type. Results: Multiple injuries were ranked as the highest injury type in the number of annual claims and percentage of the total cost/total medical cost. Hand/wrist/finger was the most common single-injury type. The frequency of injury type and the cost amount payable as a percentage of the total cost were the highest for multiple injuries, hand/wrist/finger injuries, and knee/lower leg injuries. Conclusions: Regarding frequency and costs, hand/wrist/finger injuries were highest in cost, by single-injury type. Therefore, these injuries should be recognized as intervention targets.
A retrospective study on the association of keloids with underlying health conditions in African-American Women
Authors: Marella Pooja , Glass Donald A.
Published: February 2023

Background:

Keloids are disfiguring benign scars that develop due to an exaggerated response to cutaneous wound healing, growing beyond the boundaries of the cutaneous insult into normal, previously uninvolved skin. The association of keloids with other underlying health conditions has been postulated, but not well characterized.

Objective:

This study aims to identify whether there is any association of keloids with underlying health conditions in African-American women.

Methods:

This study was done via the use of the National Inpatient Sample, a subset of the Healthcare Cost and Utilization Project. African-American women with keloids who had undergone cesarean sections were compared with a control group of African-American women with no history of keloids who had undergone cesarean sections.

Results:

A total of 301 African-American inpatient encounters with patients with keloids were compared with 37,144 encounters in the control group. The keloid patients had an increased association with peritoneal adhesions compared with the control group.

Limitations:

results are limited to one race and restricted age range; also, unable to differentiate keloids from hypetrophic scarring with ICD-10 codes.

Conclusion:

These findings suggest that keloids and peritoneal adhesions may have similar inflammatory processes.
Probiotics in irritable bowel syndrome and inflammatory bowel disease: review of mechanisms and effectiveness
Authors: So Daniel , Quigley Eamonn M.M. , Whelan Kevin
Published: February 2023

Purpose of review

The gastrointestinal (GI) microbiome has been implicated in the pathogenesis of inflammatory bowel disease (IBD) and has been linked with irritable bowel syndrome (IBS). The aim of this article is to critically review the emerging evidence for the mechanisms and effectiveness of probiotics in the management of these conditions.

Recent findings

The GI microbiome is strongly influenced by ageing, diet and disease. Probiotics may confer health effects to the host by modulating the metabolic activities of the microbiome to propagate anti-inflammatory effects and reinforce the intestinal barrier, and are considered to be safe to use. Many short-term studies have demonstrated the effectiveness of probiotics overall in IBS, with meta-analyses demonstrating efficacy across specific strains albeit with relatively small effect sizes. Within IBD, some probiotics appear to offer clinical benefit in ulcerative colitis but strain-specific effects are unclear. Evidence for the use of probiotics in Crohn's disease remains limited.

Probiotics offer considerable potential for the management of IBS and possibly in IBD, however, any benefits conferred appear to be strain-specific. High quality trials of specific probiotics in IBS and IBD, as well as laboratory investigations of their mechanism of action, are required in order to fully understand their potential therapeutic value.
Cholangioscopy for biliary diseases
Authors: Becq Aymeric , Soualy Adil , Camus Marine
Published: February 2023

Purpose of review

Cholangioscopy is a mini-invasive endoscopic procedure, which consists in a direct intraductal visualization of the biliary tract. The purpose of this review is to summarize the technique, the clinical applications, as well as future perspectives of cholangioscopy.

Recent findings

Numerous technologic advances during the last decades have allowed for an improved utility and functionality, leading to a broader use of this procedure, for diagnostic or therapeutic purposes, in the setting of biliary diseases. Novel tools and emerging indications have been developed and more are yet to come.

Cholangioscopy can be performed by peroral, percutaneous transhepatic or intra-operative transcystic or transcholedochal access. Clinical applications of cholangioscopy are multiple, ranging from visual impression and optical guided biopsies of indeterminate biliary strictures to the management of difficult stones , guidance before biliary stenting and retrieval of migrated ductal stents. Multiple devices such as lithotripsy probes, biopsy forceps, snares and baskets have been developed to help achieve these procedures successfully.

Cholangioscopy has improved the way biliary diseases can be visualized and treated. New technology, accessories, and applications are expected in the future.
Histological evaluation in biliary diseases
Authors: Saffioti Francesca , Vieira Motta Rodrigo , Quaglia Alberto
Published: February 2023

Purpose of review

This review focuses on recent developments of histopathology in the most common biliary disorders affecting adults. The reader is referred to other sources for the specialized topics on paediatric populations and post liver transplantation.

Recent findings

Fibrosis stage at diagnosis is an independent predictor of liver transplant-free survival in patients with primary biliary cholangitis. Immunohistochemistry might have an important role in predicting response to treatment. New histological scoring systems with excellent correlation with long-term clinical outcomes are being developed in primary sclerosing cholangitis (PSC). Quantification of fibrosis with collagen proportionate area can improve risk stratification and could be particularly useful to assess treatment response in PSC.

Gene sequencing on cytology and intrabiliary biopsy may improve risk stratification for cholangiocarcinoma. Genetic variants of ATP8B1, ABCB11 and ABCB4 are relatively common in adults with cholestatic liver disease. New causes of cholestatic liver injury have recently been described.

Histology is often not necessary for the diagnosis of biliary disease, but can provide important information that may assist the clinician in patients’ management. Histopathology remains crucial to confirm a diagnosis of cholangiocarcinoma, and to identify the pattern of biliary injury in immune-mediated cholangiopathies and rarer pathological entities.
Nutritional support in liver disease – an updated systematic review
Authors: Koretz Ronald L.
Published: February 2023

Purpose of review

The association of malnutrition and a poor prognosis does not prove that providing nutrition support improves that prognosis. The proof of such efficacy requires its demonstration in well designed and executed randomized trials. A systematic review of 40 such trials in 2014 failed to make such a finding. The purpose of this work is to update that review.

Recent findings

A search of multiple databases identified 12 new trials (3 of enteral nutrition and 9 of nutritional supplements) comparing the nutritional intervention to standard care. Meta-analyses suggested that the provision of enteral nutrition reduced infection rates in patients undergoing liver transplantation and total complication rates after hepatic resections. Supplement usage appeared to improve mortality in patients with hepatocellular carcinoma or transplanted livers and reduce rates of ascites in patients with cirrhosis and hepatocellular carcinoma as well as improve encephalopathy resolution in those with cirrhosis. However, the risks of bias, some study designs, and the use of potentially pharmacologically active micronutrients limit the reliability of these observations.

There is inadequate evidence for clinicians to be sure that nutrition support is actually of benefit to patients with liver disease.
Prevention of sports-related concussion in soccer: a comprehensive review of the literature
Authors: Indharty Rr Suzy , Siahaan Andre M. P. , Rosarina  , Susanto Martin , Tandean Steven , Risfandi Marsal
Published: February 2023

Introduction:

Concussion is a common complaint among adult and adolescent athletes around the world and poses a safety risk in competitive, recreational, and noncontact sports. It is estimated that concussions occur at a rate of 0.5 per 1000 playing hours; however, the precision of this estimate is uncertain due to variations in the interpretation and reporting of concussions. Athletes with a history of concussions are more likely to sustain additional concussions, which can result in cognitive decline, depression, and early degenerative change. In order to lessen the likelihood of future difficulties, this study compiles the research on preventing sports-related concussion in soccer and presents a summary of the findings.

Material and Methods:

We performed a literature search on PubMed, EBSCO (Elton B. Stephens Company), DOAJ (Directory of Open Access Journals), and Cochrane for the past 20 years. The search strategy was using Boolean terms based on any of the search terms of sports-related-concussion, soccer, and prevention. The studies were included based on inclusion and exclusion criteria.

Results:

This research identified three systematic reviews, seven literature reviews, five cross-sectional studies, one randomized controlled trial, three prospective studies, and one retrospective study. As concussion prevention measures in soccer, several strategies can be implemented, including concussion education, rule/regulation changes, proper heading technique, behavioral skills training, vision training to improve sensory and anticipation, the use of supplements to prevent severe concussion and accelerate recovery, as well as prevention in youth sports and head impact detection.

Conclusion:

Good education, good technique, good training, and a good strengthening program can be implemented to prevent concussions in soccer. To determine the relationship between prevention and concussion, however, additional research is required.
Introducing Magnet® With Distinction
Authors: Lal M. Maureen
Published: February 2023

At the 2022 National Magnet Conference®, leaders of the American Nurses Credentialing Center's Magnet Recognition Program® introduced Magnet Recognition with Distinction (Magnet With Distinction), a new designation recognizing the highest performing Magnet® organizations around the world. Magnet With Distinction is based on validated empirical data, and only a select few hospitals will achieve this elite level of performance. They will serve as exemplary role models for nursing excellence and for creating an environment of care that improves patient outcomes. This month's Magnet Perspectives explores Magnet With Distinction, why it was created, how organizations can achieve it, and who is eligible. The column also discusses the value of implementing a tiered approach to the Magnet program.
The Effect of Work Stressors on RN Exhaustion
Authors: Filipova Anna A.
Published: February 2023

OBJECTIVE

This study examines the effect of work environment stressors on RNs' exhaustion through perceived organizational support (POS).

BACKGROUND

Drawing on conservation of resources theory and POS theory, POS is theorized to act as a buffer or mediator between lack of COVID-related support and communication (LCSC), 3 role stressors (role overload, role ambiguity, nonparticipation), bullying, and exhaustion.

METHODS

A cross-sectional survey design was used. A total of 169 questionnaires (16.6% response rate) were analyzed, performing Pearson correlation, mediation, moderation, and hierarchical robust regression tests.

RESULTS

The 3 role stressors were strongly related to bullying. Support was found for an interactive relationship between LCSC and POS at different levels of bullying. Role overload, role ambiguity, and bullying had positive direct effects on exhaustion, whereas POS had negative direct and indirect effects.

CONCLUSIONS

Cognitive skills training at individual level coupled with organizational-based stress interventions and leadership development programs could reduce exhaustion.
Why They Stay and Why They Leave
Authors: Snyder Amy , Whiteman Kimberly , DiCuccio Marge , Swanson-Biearman Brenda , Stephens Kimberly
Published: February 2023

Registered nurse retention is declining, with a national turnover rate in 2021 of 27%. After implementing a toolkit, nursing leaders in 1 organization completed 75 stay interviews with nurses in a cardiothoracic telemetry and a cardiothoracic surgical intensive care unit. Nurses reported that unit culture, team/peers, and scheduling were important in decisions to stay in their positions, but respondents considered leaving for salary, growth/development, and traveling opportunities. The stay interview process affords nurse leaders an opportunity to examine why nurses stay or leave and supports the development of targeted retention strategies.
Implementation of a Violence Risk Assessment and Interventions Aimed at the Prevention of Patient-Perpetrated Violent Events Across Care Settings
Authors: Croland Jennifer , Overton Sarah , Nimtz-Rusch Kelly , Emmerling Sheryl , Wiegand Lori
Published: February 2023

Healthcare worker violence at the hands of patients is the leading cause of workplace injury with reports demonstrating yearly increases. Literature suggests organizational strategies to reduce workplace injury are necessary to create safe environments for patients to receive care and for healthcare workers to practice, but tactics lack a care continuum focus and largely focus on deescalation and management of violent events. One healthcare system identified that the use of an assessment widely used in Canada, identifying patients at risk for violent behaviors, would supplement already existing efforts at protecting patients. The implementation of this tool across care settings is presented in this article.
Highlighting an Advanced Practice Fellowship for Leadership Transition
Authors: Bugos Kelly , Mansour Salma , Stringer Meredith A. , Kuriakose Clair
Published: February 2023

As the advanced practice provider (APP) workforce continues to rapidly grow in healthcare, there is a greater need for APP leadership positions. Often, these positions are organically designated to the best clinicians on the team, who may not have leadership experience. Stanford Health Care Center for Advanced Practice embarked on formalized leadership training using a newly developed administration specialty within the APP Fellowship Program to support new leader transition.
CLINICAL PHENOTYPES OF SEPSIS-ASSOCIATED ENCEPHALOPATHY: A RETROSPECTIVE COHORT STUDY
Authors: Lu Xin , Qin Mubing , Walline Joseph Harold , Gao Yanxia , Yu Shiyuan , Ge Zengzheng , Gong Chao , Zhu Huadong , Annane Djillali , Li Yi
Published: February 2023

Background: Sepsis-associated encephalopathy (SAE) is a dysfunction of the central nervous system experienced during sepsis with variable clinical and pathophysiologic features. We sought to identify distinct SAE phenotypes in relation to clinical outcomes. Methods: The Medical Information Mart for Intensive Care IV (MIMIC-IV) database and the eICU database were used to conduct a retrospective cohort study. Adult sepsis patients were included and SAE was defined as having a Glasgow Coma Scale (GCS) score ˂15 or delirium. The following our clinical phenotypes were defined as: ischemic-hypoxic, metabolic, mixed (ischemic-hypoxic and metabolic), and unclassified. The primary outcome was in-hospital mortality. Results: The study enrolled 4,120 sepsis patients, 2,239 from MIMIC-IV (including 1,489 patients with SAE, 67%), and 1,881 from eICU (1,291, 69%). For the SAE cohort, 2,780 patients in total were enrolled (median age, 67 years; interquartile range, 56–76.8; 1,589 (57%) were male; median GCS score was 12 [8–14]; median Sequential Organ Failure Assessment score was 6 [4–9]). The SAE phenotype distributions between the MIMIC-IV and eICU cohorts were as follows (39% vs. 35% ischemic-hypoxic, P = 0.043; 38% vs. 40% metabolic, P = 0.239; 15% vs. 15% mixed, P = 0.972; 38% vs. 40% unclassified, P = 0.471). For the overall cohort, the in-hospital mortality for patients with ischemic-hypoxic, metabolic, mixed, or unclassified phenotypes was 33.9% (95% confidence interval, 0.3–0.37), 28.4% (0.26–0.31), 41.5% (0.37–0.46), and 14.2% (0.12–0.16), respectively. In the multivariable logistic analysis, the mixed phenotype was associated with the highest risk of in-hospital mortality after adjusting for age, sex, GCS, and modified Sequential Organ Failure Assessment score (adjusted odds ratio, 2.11; 95% confidence interval, 1.67–2.67; P < 0.001). Conclusions: Four SAE phenotypes had different clinical outcomes. The mixed phenotype had the worst outcomes. Further understanding of these phenotypes in sepsis may improve trial design and targeted SAE management.
Impact of Emend on Perioperative Bariatric Surgery Antiemetic Utilization, Patient Satisfaction, and Costs
Authors: Aghazarian Gary S. , Lind Romulo , Motola David , Perry Melanie , Singletary Norman , Lastrapes Linda , Ghanem Muhammad , Jawad Muhammad A. , Teixeira Andre F.
Published: February 2023

Purpose:

Postoperative nausea and vomiting (PONV) is one of the most common adverse effects of anesthesia and surgery, resulting in patient discomfort and dissatisfaction. Latest research has demonstrated the efficacy of NK-1 receptor antagonists in PONV management and its use in chemotherapy nausea prophylaxis. The authors of this article would like to provide evidence to support the use fosaprepitant, as monotherapy, in postoperative care, replacing a polypharmacological standard of care regimen.

Methods:

This was a retrospective chart review of 400 patients who received standard of care antiemetic regimen or received fosaprepitant (No-Fosaprepitant vs. Fosaprepitant groups, respectively). The primary outcome of this study is to evaluate the impact of fosaprepitant (administered intravenously) on perioperative antiemetic use, treatment cost, and patient satisfaction.

Results:

Total PONV medication cost decreased with the replacement of standard of care regimen for fosaprepitant, from 46.47±20.54 United States Dollars in the no-Fosaprepitant group to 25.69±14.84 United States Dollars in the Fosaprepitant group. There was a significant reduction in antiemetic doses between groups; 0.37±0.745 versus 7.61±5.202 for ondansetron (P=0.001), 92±1.279 versus 2.21±2.399 for promethazine (P=0.001), 0.25±0.685 versus 1.41±0.577 for scopolamine patch (P=0.001), and 0.05±0.218 versus 1.14±0.398 for dexamethasone (P=0.001). Patient satisfaction, measured by a questionnaire, was a 11.6% higher in the Fosaprepitant group.

Conclusion:

Fosaprepitant is a relevant alternative in preventing and treating PONV in patients who underwent bariatric/metabolic surgical procedures.