Illegitimate Tasks, Negative Affectivity, and Organizational Citizenship Behavior among Private School Teachers: A Mediated–Moderated Model

Social sustainability has gained popularity over the last decade, with a growing body of research calling for researchers to focus on the personal-level determinants of employee satisfaction and well-being in the pursuit of social sustainability. By using negative affectivity as a mediating mechanism and gender and passive leadership as moderators, this study examines a novel sequential mediation–moderation model that explores the relationship between unreasonable tasks and teachers’ Organizational Citizenship Behavior (OCB). It employs the Conservation of Resources (COR) and Stress as Offense to Self (SOS) paradigms as a comprehensive theoretical framework for organizational stressors and organizational behavior. A total of 415 matched questionnaire responses were collected from private school teachers in the UAE. Confirmatory factor analysis (CFA) is conducted using AMOS 20, hierarchical linear modeling (HLM) is utilized to verify the causal and moderation hypotheses, and the resulting moderated mediated conceptual model is evaluated by employing Hayes PROCESS analysis. Results demonstrate the effects of illegitimate tasks on OCB are indirect and statistically significant and are mediated through negative affectivity. The cumulative effect of illegitimate tasks and negative affectivity on OCB is magnified by the moderating effects of passive leadership

Choriocarcinoma following scar pregnancy: a case report

Choriocarcinoma following scar pregnancy is a very rare entity. Here we present such a unique case. The index pregnancy was a sterilization failure which developed in the scar of previous caesarean. The scar pregnancy was evacuated through a hysterotomy incision and she was re sterilized. The histopathology report of the evacuated products showed normal villi. Two and a half months later she presented with bleeding per vaginum. Her beta HCG was raised and she had a vascular mass in the lower uterine myometrium. Gestational trophoblastic neoplasia was suspected and three courses of methotrexate folinic acid regime were administered. But the fall in beta HCG was inappropriate. She had no desire for future fertility and was not willing for combination chemo therapy. So hysterectomy was done. Histopathology revealed choriocarcinoma. Chest x-ray was apparently normal but CT chest showed micro metastasis. She had three courses of EMA-CO and is under follow up. She is asymptomatic and her beta HCG is less than 5 IU/l

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

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

Choriocarcinoma following scar pregnancy: a case report

Choriocarcinoma following scar pregnancy is a very rare entity. Here we present such a unique case. The index pregnancy was a sterilization failure which developed in the scar of previous caesarean. The scar pregnancy was evacuated through a hysterotomy incision and she was re sterilized. The histopathology report of the evacuated products showed normal villi. Two and a half months later she presented with bleeding per vaginum. Her beta HCG was raised and she had a vascular mass in the lower uterine myometrium. Gestational trophoblastic neoplasia was suspected and three courses of methotrexate folinic acid regime were administered. But the fall in beta HCG was inappropriate. She had no desire for future fertility and was not willing for combination chemo therapy. So hysterectomy was done. Histopathology revealed choriocarcinoma. Chest x-ray was apparently normal but CT chest showed micro metastasis. She had three courses of EMA-CO and is under follow up. She is asymptomatic and her beta HCG is less than 5 IU/l

Chronic Pain in Hospitalized Infants: Health Professionals' Perspectives

Potentially significant numbers of infants hospitalized in Neonatal Intensive Care Units (NICUs) and Pediatric Intensive Care Units (PICUs) experience chronic pain. However, the phenomenon of chronic pain in infancy has neither been defined nor described adequately by researchers. To stimulate and focus further work in the area, the purpose of this study was to explore expert opinions on definitional and assessment parameters of infant chronic pain. Forty-five health care professionals, with a median of 17 years of clinical experience, were recruited from 4 tertiary-level, university-affiliated institutions. Individual (n=24) and group (n=21) interviews were conducted by trained interviewers. Qualitative data were analyzed using a standard descriptive method. Health care professionals were able to offer preliminary definitions of chronic pain in infants. The most contentious definitional issue was whether iatrogenically prolonged pain (pain induced and maintained by medical procedures) should be considered chronic pain. Possible indicators for chronic pain included inability to settle, social withdrawal, constant grimacing, tense body, hypo- or hyper-reactions to acute pain, and dysregulated sleep or feeding patterns. These indicators differed significantly from those traditionally used to measure acute pain

Paradigm Shift in Libraries: A Festschrift to Rev. Fr. Jose Viruppel.

The book consists of papers reflecting views on modernization of libraries. An inevitable shift from the traditional functions and services of libraries has now become essential. The book includes ten papers dealing with various topics such as shift of the role of librarians to cybrarians, newly garbed libraries, user approach to library services, proposal for a union catalogue of libraries of institutions in higher education, study on N-LIST, need for developing information literacy skills in e-learning environment, personal learning network for professional development, use of Linux operating systems in libraries, the role of face book pages in libraries, and Scientometric study of open access psychology journals

Non-pharmacological management of infant and young child procedural pain: An abridged Cochrane review

BACKGROUND: Acute pain and distress during medical procedures are commonplace for young children. OBJECTIVE: To assess the efficacy of nonpharmacological interventions for acute procedural pain in children up to three years of age. METHODS: Study inclusion criteria were: participants <3 years of age, involved in a randomized controlled or crossover trial, and use of a ‘no-treatment’ control group (51 studies; n=3396). Additional studies meeting all criteria except for study design (eg, use of active control group) were qualitatively described (n=20). RESULTS: For every intervention, data were analyzed separately according to age group (preterm-born, term-born neonate and older infant/young child) and type of pain response (pain reactivity, immediate pain-related regulation). The largest standardized mean differences (SMD) for pain reactivity were as follows: sucking-related interventions (preterm: −0.42 [95% CI −0.68 to −0.15]; neonate −1.45 [CI −2.34 to −0.57]), kangaroo care (preterm −1.12 [95% CI −2.04 to −0.21]), and swaddling/facilitated tucking (preterm −0.97 [95% CI −1.63 to −0.31]). For immediate pain-related regulation, the largest SMDs were: sucking-related interventions (preterm −0.38 [95% CI −0.59 to −0.17]; neonate −0.90 [CI −1.54 to −0.25]), kangaroo care 0.77 (95% CI −1.50 to −0.03]), swaddling/facilitated tucking (preterm −0.75 [95% CI −1.14 to −0.36]), and rocking/holding (neonate −0.75 [95% CI −1.20 to −0.30]). The presence of significant heterogeneity limited confidence in nonsignificant findings for certain other analyses. CONCLUSIONS: Although a number of nonpharmacological treatments have sufficient evidence supporting their efficacy with preterm infants and healthy neonates, no treatments had sufficient evidence to support efficacy with healthy older infants/young children