Creating A Creative State of Mind: Promoting Creativity Through Proactive Vitality Management and Mindfulness

Most research on employee creativity has been focused on relatively distal antecedents, such as personality or job characteristics, which has resulted in top-down organizational approaches to promote employee creativity. However, such approaches overlook the self-regulating potential of employees and may not explain intraindividual fluctuations in creativity. In the present research, we build on proactive motivation theory to examine how employees may promote their own creativity on a daily basis through the use of proactive vitality management (PVM). To better understand the PVM-creativity link, we zoom in on this process by examining the role of mindfulness as an underlying mechanism. In two daily diary studies, employees from the United States (N = 133 persons, n = 521 data points) and the creative industry in Germany (N = 62 persons, n = 232 data points) reported on their use of PVM and states of mindfulness for five consecutive workdays. Additionally, participants completed a daily creativity test (brainstorming task) in Study 1, whereas supervisors rated participants' daily creative work performance in Study 2. In both studies, multilevel analyses showed that daily PVM was positively related to creative performance through daily mindfulness, supporting our hypotheses. These replicated findings suggest that individuals may bring themselves in a cognitive, creative state of mind on a daily basis, emphasizing the importance of proactive behavior in the creative process

Exploring the Prescribing Process of Domperidone for Low Milk Supply:A Qualitative Study Among Mothers, IBCLCs, and Family Doctors

BACKGROUND: When mothers are confronted with milk supply problems, taking domperidone is regularly suggested. However, domperidone has been associated with sudden cardiac death and caution in prescribing is advised. In 2016, a multidisciplinary group of authors from a tertiary academic hospital (Erasmus MC) published a clinical protocol in a leading Dutch physicians’ journal to support Dutch family physicians in prescribing domperidone to stimulate lactation. RESEARCH AIM: To explore consumer and health care provider perspectives and experiences regarding the prescribing of domperidone for lactation insufficiency following publication of a national clinical protocol. METHODS: A cross-sectional qualitative study was performed using semi-structured interviews (N = 40) based on a topic list covering the prescribing process. Participants were mothers (n = 18) who had been advised to try domperidone to boost their milk supply between November 2016 and May 2018, their International Board Certified Lactation Consultants (n = 9), and their family physicians (n = 15). Another group of participants (mothers; n = 6) answered short questionnaires. All interviews were recorded, transcribed and analyzed using ATLAS.ti software. The resulting list of codes was organized according to the topics. RESULTS: In the process leading to domperidone use to stimulate lactation, participant family physicians relied on the IBCLC, pharmacist, or mother to guide the prescription of domperidone, often citing the published national clinical protocol as back up. The medical safeguards incorporated in the protocol (e.g., taking medical history, physical exam, performing electrocardiograms, limiting dosage) were usually not implemented. CONCLUSIONS: Though the availability of a national clinical protocol in which the prescribing of domperidone for lactation is supported appeared to increase the willingness of participant family physicians to prescribe, gaps were identified between clinical practice and this clinical protocol for prescribing domperidone

Outcomes of First-Line Chemotherapy in Patients with Advanced or Metastatic Leiomyosarcoma of Uterine and Non-Uterine Origin

Although leiomyosarcomas (LMSs) form the largest subgroup of soft tissue sarcomas (STSs), the efficacy of chemotherapy in this group is largely unclear, partly because older studies are contaminated with gastrointestinal stromal tumors (GISTs). In this retrospective study we investigated the outcome of first line chemotherapy in 65 patients with unresectable or metastatic LMS. The overall response rate (ORR) was 18%; and the median progression-free (PFS) and overall survival (OS) were 3.8 and 9.7 months respectively. No statistically significant differences in outcomes for uterine and non-uterine LMS were found. In non-uterine LMS, however, the PFS and OS seemed to be longer for females than for males, potentially negatively affecting outcomes in this group. If our observations are confirmed in other series, they would suggest that studies performed in STS patients should not only stratify for histological subtype but also for uterine versus non-uterine LMS and for gender

Comparative analysis of tertiary control systems for smart grids using the Flex Street model

Various smart grid control systems have been developed with different architectures. Comparison helps developers identify their strong and weak points. A three-step analysis method is proposed to facilitate the comparison of independently developed control systems. In the first step, a microgrid model is created describing demand and supply patterns of controllable and non-controllable devices (Flex Street). In the second step, a version of Flex Street is used to design a case, with a given control objective and key performance indicators. In the last step, simulations of different control systems are performed and their results are analysed and compared. The Flex Street model describes a diverse set of households based on realistic data. Furthermore, its bottom-up modelling approach makes it a flexible tool for designing cases. Currently, three cases with peak-shaving objectives are developed based on scenarios of the Dutch residential sector, specifying various penetration rates of renewable and controllable devices. The proposed method is demonstrated by comparing IntelliGator and TRIANA, two independently developed control systems, on peak reduction, energy efficiency, savings and abated emissions. Results show that IntelliGator---a real-time approach---is proficient in reducing peak demand, while TRIANA---a planning approach---also levels intermediate demand. Both systems yield benefits (\geneuro5--54 per household per year) through reduced transport losses and network investments in the distribution network

Antithrombotic Management in Adult Kidney Transplantation: A European survey study

In kidney transplantation (KTx), renal graft thrombosis (RGT) is one of the main reasons for early graft loss. Although evidence-based guidance on prevention of RGT is lacking, thromboprophylaxis is widely used. The aim of this survey was to obtain a European view of the different thromboprophylactic strategies applied in KTx. An online 22-question survey, addressed to KTx professionals, was distributed by email and via platforms of the European Society for Organ Transplantation. Seventy-five responses (21 countries, 51 centers) were received: 75% had over 10 years' clinical experience, 64% were surgeons, 29% nephrologists, and 4% urologists. A written antithrombotic management protocol was available in 75% of centers. In 8 (16%) centers, respondents contradicted each other regarding the availability of a written protocol. Thromboprophylaxis is preferred by 78% of respondents, independent of existing antithrombotic management protocols. Ninety-two percent of respondents indicated that an anticipated bleeding risk is the main reason to discontinue chronic antithrombotic therapy preoperatively. Intraoperatively, 32% of respondents administer unfractionated heparin (400-10,000 international units with a median of 5,000) in selected cases. Despite an overall preference for perioperative thromboprophylaxis in KTx, there is a high variation within Europe regarding type, timing, and dosage, most likely due to the paucity of high-quality studies. Further research is warranted in order to develop better guidelines.</p

The cardiac sodium channel displays differential distribution in the conduction system and transmural heterogeneity in the murine ventricular myocardium

Cardiac sodium channels are responsible for conduction in the normal and diseased heart. We aimed to investigate regional and transmural distribution of sodium channel expression and function in the myocardium. Sodium channel Scn5a mRNA and Na(v)1.5 protein distribution was investigated in adult and embryonic mouse heart through immunohistochemistry and in situ hybridization. Functional sodium channel availability in subepicardial and subendocardial myocytes was assessed using patch-clamp technique. Adult and embryonic (ED14.5) mouse heart sections showed low expression of Na(v)1.5 in the HCN4-positive sinoatrial and atrioventricular nodes. In contrast, high expression levels of Na(v)1.5 were observed in the HCN4-positive and Cx43-negative AV or His bundle, bundle branches and Purkinje fibers. In both ventricles, a transmural gradient was observed, with a low Na(v)1.5 labeling intensity in the subepicardium as compared to the subendocardium. Similar Scn5a mRNA expression patterns were observed on in situ hybridization of embryonic and adult tissue. Maximal action potential upstroke velocity was significantly lower in subepicardial myocytes (mean +/- SEM 309 +/- 32 V/s; n = 14) compared to subendocardial myocytes (394 +/- 32 V/s; n = 11; P < 0.05), indicating decreased sodium channel availability in subepicardium compared to subendocardium. Scn5a and Na(v)1.5 show heterogeneous distribution patterns within the cardiac conduction system and across the ventricular wall. This differential distribution of the cardiac sodium channel may have profound consequences for conduction disease phenotypes and arrhythmogenesis in the setting of sodium channel diseas