Instability of contingencies of self-worth: the role of approach-avoidance temperament

Self-esteem has multiple facets and individuals can derive their feelings of self-worth from specific domains in life (i.e., competition, approval of others, virtue; Crocker & Wolfe, 2001). Additionally, research on self-esteem suggests that it evolved as a social monitoring system, known as the sociometer (Leary, Tambor, Terdal, & Downs, 1995). The function of the sociometer is to alert individuals to changes in their relational value to others, which in turn influences their self-esteem, and ultimately their behavior (Leary, Tambor, Terdal, & Downs, 1995; Park & Crocker, 2008). A better understanding of the connection between self-evaluations and behavior can be gained by considering how individuals derive their feelings of self-worth. While people are motivated to succeed and avoid failure, this may particularly be true in the domains from which people derive their feelings of self-worth. Additionally, approach-avoidance motivation may further influence the relationship between evaluations in contingent domains, self-esteem, and behavioral outcomes. The present study expands this research by investigating how approach-avoidance motivation affects the relationship between contingencies of self-worth, self-esteem, and behavioral outcomes. Therefore, I hypothesized that individuals with low self-esteem and avoidance motivation would shift away from a domain that receives negative feedback. Those with high self-esteem and approach motivation, however, would increase the value placed on a domain after receiving negative feedback and positive feedback. Results suggest that avoidantly motivated individuals’ self-worth became increasingly contingent upon other’s approval no matter the feedback they received

An Attribute-Based Approach to Classifying Community-Based Tourism Networks

This conceptual paper proposes the adoption of a collaborative network approach as a prospective means of improving success in implementing community-based tourism (CBT) initiatives. Drawing upon relevant literature, the researchers identify the key attributes that characterise a network-based approach. By proposing alternatives for each attribute, the research provides CBT practitioners with options for making informed decisions about how to build collaboration connecting individual CBT initiatives in multiple locations. The researchers discuss the implications of different approaches for power relations between stakeholders. The proposed framework provides a means of classifying existing CBT networks and analyses the types of network and the circumstances which lead to better outcomes for community development. Further empirical research is required to test the validity of the key network attributes and to develop a comprehensive classification system of CBT networks.School of Hotel and Tourism Managemen

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Altered Doppler flow patterns in cirrhosis patients: an overview

Doppler ultrasonography of the hepatic vasculature is an integral part of evaluating precirrhotic and cirrhotic patients. While the reversal of the portal venous flow is a well-recognized phenomenon, other flow patterns, although not as easily understood, may play an important role in assessing the disease status. This article discusses the different characteristic flow patterns observed from the portal vein, hepatic artery, and hepatic vein in patients with liver cirrhosis or related complications and procedures. Knowledge of these different flow patterns provides additional information that may reinforce the diagnosis of cirrhosis, help in staging, and offer prognostic information for determining the direction of therapy. Doppler ultrasonography is invaluable when liver transplantation is being considered and aids in the diagnosis of cirrhosis and portal hypertension

Altered Doppler flow patterns in cirrhosis patients: an overview.

Doppler ultrasonography of the hepatic vasculature is an integral part of evaluating precirrhotic and cirrhotic patients. While the reversal of the portal venous flow is a well-recognized phenomenon, other flow patterns, although not as easily understood, may play an important role in assessing the disease status. This article discusses the different characteristic flow patterns observed from the portal vein, hepatic artery, and hepatic vein in patients with liver cirrhosis or related complications and procedures. Knowledge of these different flow patterns provides additional information that may reinforce the diagnosis of cirrhosis, help in staging, and offer prognostic information for determining the direction of therapy. Doppler ultrasonography is invaluable when liver transplantation is being considered and aids in the diagnosis of cirrhosis and portal hypertension

Altered Doppler flow patterns in cirrhosis patients: an overview.

Doppler ultrasonography of the hepatic vasculature is an integral part of evaluating precirrhotic and cirrhotic patients. While the reversal of the portal venous flow is a well-recognized phenomenon, other flow patterns, although not as easily understood, may play an important role in assessing the disease status. This article discusses the different characteristic flow patterns observed from the portal vein, hepatic artery, and hepatic vein in patients with liver cirrhosis or related complications and procedures. Knowledge of these different flow patterns provides additional information that may reinforce the diagnosis of cirrhosis, help in staging, and offer prognostic information for determining the direction of therapy. Doppler ultrasonography is invaluable when liver transplantation is being considered and aids in the diagnosis of cirrhosis and portal hypertension

Small Cities? Towards a Research Agenda

This article asserts the importance of studying small cities. We argue that small cities have been ignored by urban theorists who, in seeking to conceptualize broad urban agendas and depict generalizable models (for example relating to epochal urbanism, the structure and nature of the urban hierarchy, global cities and global city-regions), have tended to obscure as much as they illuminate. Given that study of 'the city' has been vital to broader advances in the social sciences, this neglect of smaller urban centres has profound consequences for urban studies. We argue that this situation needs to be rectified. We review literature relating to small cities and signpost a future research agenda. In doing so, we highlight how conceptual and empirical research into small cities can contribute to broader arguments that have championed the necessity of developing sophisticated and nuanced comparative approaches to understanding the complexity of cities and urban life. This article challenges urbanists to think big about thinking small. Copyright (c) 2009 The Authors. Journal Compilation(c) 2009 Joint Editors and Blackwell Publishing Ltd.

The microbiome and its potential as a cancer preventive intervention

It is becoming increasingly clear that microbiota which inhabit our body influence cancer predisposition and etiology. In addition to pathogens with oncogenic properties, our commensal and symbiotic microbiota have tumor-suppressive properties. Our diet and other environmental factors can modulate the abundance of certain members of microbial communities within our gastrointestinal tract and at other anatomical sites. Furthermore, some dietary factors are metabolized by commensal/symbiotic gut microbiota into bioactive food components believed to prevent cancer. For example, dietary fiber undergoes bacterial fermentation in the colon to yield butyrate, which is a short-chain fatty acid and histone deacetylase (HDAC) inhibitor that suppresses the viability and growth of colorectal cancer cell lines. A recent study utilizing gnotobiotic mouse models demonstrates that fiber can protect against colorectal tumorigenesis in a microbiota- and butyrate-dependent manner that involves the Warburg effect. This and other examples suggest that some of the inter-individual variation observed in epidemiology and intervention studies that have investigated associations between diet and cancer risk might be explained by differences in microbiota among the participants. Data from basic research studies also support the idea that probiotics and prebiotics could be plausible chemoprevention strategies that may be utilized to a greater extent in the future