Christine Brown Mahoney

Background/Objectives: Platelet-rich plasma (PRP) has been extensively used in clinical practice to treat musculoskeletal (MSK) and spinal maladies. PRP applications and preparation methods focus on variables such as delivery technique, formulation, and device performance. Few PRP preparation methods consider the variability in the biological status of the individual patient following a comprehensive homeostatic tissue repair response. In recent years, more information has become available for addressing the efficacy of PRP devices and preparation methods. Furthermore, the impact of the PRP dose and bioformulation on different pathoanatomical tissues and patient outcomes has been more widely discussed. This review aims to examine different variables in the optimization of PRP preparation methods, focusing on several platelet indices that influence hematopoiesis, subsequent to homeostasis and neuronal regulation, and how this relates to the release of platelets with variable densities, the mean platelet volume (MPV), platelet distribution width (PDW), and ultimately platelet concentration. Methods: A literature review was conducted using the PubMed, Medline, and Cochrane databases. Results: The literature indicates that the overall physiological platelet dynamics, from bone marrow megakaryocytes to peripheral blood release, differ continuously between health and disease. This study demonstrates that variations in platelet density, as indicated by mean platelet volume (MPV), and platelet count are associated with deviations in the total platelet distribution width. Conclusions: Incorporating platelet indices (PIs) into platelet-rich plasma (PRP) preparation protocols and methodologies is recommended to optimize the recovery of denser, more reactive, and regenerative platelets inherent in peripheral blood, which are integral to the patient’s homeostatic tissue repair mechanisms. Pre-procedural assessment of the patient’s platelet biological status allows for the preservation of an optimal platelet profile within PRP preparations, potentially enhancing clinical efficacy.

The purpose of this symposium is to illustrate factors resided on a personal and contextual level that effect the sustainability of a career in the nursing profession. Based on a systematic literat...

This longitudinal study among Registered Nurses has four purposes: (1) to investigate whether emotional, quantitative and physical demands, and family-work conflict have a negative impact on nurses’ perceived effort; (2) to investigate whether quality of leadership, developmental opportunities, and social support from supervisors and colleagues have a positive impact on meaning of work; (3) to investigate whether burnout from the combined impact of perceived effort and meaning of work mediates the relationship with occupational turnover intention; and (4) whether the relationships in our overall hypothesized framework are moderated by age (nurses categorized under 40 years versus ≥ 40 years old). In line with our expectations, emotional, quantitative, and physical demands, plus family-work conflict appeared to increase levels of perceived effort. Quality of leadership, developmental opportunities, and social support from supervisors and colleagues increased the meaning of work levels. In addition, increased perceived stress resulted in higher burnout levels, while increased meaning of work resulted in decreased burnout levels. Finally, higher burnout levels appeared to lead to a higher occupational turnover intention. Obviously, a nursing workforce that is in good physical and psychological condition is only conceivable when health care managers protect the employability of their nursing staff, and when there is a dual responsibility for a sustainable workforce. Additionally, thorough attention for the character of job demands and job resources according to nurses’ age category is necessary in creating meaningful management interventions.

Sustainability depends on a balanced relationship of the triple bottom line – people, profit and planet. However, limited research exists on how employees comprise the people component as vital stakeholders. The advancement of sustainability research has been hampered by the lack of a comprehensive measure incorporating three dimensions. Hence, three studies were conducted to develop a measure. In Study 1, qualitative interviews with 16 sustainability executives and a literature review led to development of 41 items. In Study 2, exploratory factor analysis of the measure with 102 working adults confirmed three dimensions and reduced it to 34 items. In Study 3, confirmatory factor analysis of panel data from 119 human resource managers resulted in a fit with three dimensions. SEM analysis indicated an antecedent relationship with innovative culture, learning orientation, and a supportive and collaborative culture. The people dimension is related to organizational identification as an important outcome. Strengths, limitations and directions for future research are discussed.

By Kathleen Dale, Marilyn Fox & 1 more. values, value congruence, stress

Background: The objective of this study was to assess whether the use of staple line reinforcement (SLR) reduces staple line complications (SLC). Mechanical staple lines are essential for gastrointestinal surgery such as bariatric surgery. However, SLC, such as bleeding and leakage, still occur. The purposes of this study were to provide quantitative evidence on the relative efficacy of gastric SLR and to compare the rates of effectiveness of three commonly used methods. Methods: A search of the medical literature in English language journals identified studies from Jan 1, 2000, to Dec 31, 2013, using the following reinforcement types: (1) no reinforcement, (2) oversewing, (3) a biocompatible glycolide copolymer, and (4) bovine pericardium after gastric bypasses and sleeve gastrectomies. Types of reinforcement were compared using a random-effects model. Results: This meta-analysis reviewed 16,967 articles, extracting data on 56,309 patients concerning leak and 41,864 patients concerning bleeding. Over 40 % of patients had no reinforcement, resulting in the highest leak rate (2.75 %) and bleed rate (3.45 %). Overall, reinforcing with bovine pericardium had the lowest leak (1.28 %) and bleed (1.23 %) rates. Suture oversewing was better than no reinforcement but not as effective as bovine pericardium for leak (2.45 %) and bleed (2.69 %) rates. Buttressing with a biocompatible glycolide copolymer resulted in the second highest leak rate (2.61 %) and a bleed rate of 2.48 % but had significantly lower bleed rates than no reinforcement. Conclusions: SLR provided superior results for patients compared to no reinforcement for reducing SLC. Buttressing with bovine pericardium resulted in the most favorable outcomes. The effectiveness of different methods used to reinforce the staple line in gastric surgery does not appear to be equal.