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Increasing Registration for a VA Multidrug-Resistant Organism Alert Tool
- Cara Ray, Cassie Cunningham Goedken, Ashley Hughes, Katie Suda, Marylou Guihan, Geneva Wilson, Natalie Hicks, Martin Evans, Makoto Jones, Christopher Pfeiffer, Margaret Fitzpatrick, Stacey Klutts, Charlesnika Evans
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- Journal:
- Antimicrobial Stewardship & Healthcare Epidemiology / Volume 3 / Issue S2 / June 2023
- Published online by Cambridge University Press:
- 29 September 2023, pp. s124-s125
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Objectives: To address the importation of multi-drug-resistant organisms (MDROs) when a colonized or infected patient is transferred from another VA facility, the Veterans Health Administration (VHA) launched the Inpatient Pathogen Tracker (IPT) in 2020. IPT tracks MDRO-infected/colonized patients and alerts MDRO Program Coordinators (MPCs) and Infection Preventionists (IPs) when such patients are admitted to their facility to facilitate rapid identification and isolation of infected/colonized patients. IPT usage has been low during initial rollout (32.5%). The VHA and the CARRIAGE QUERI Program developed targeted implementation strategies to increase utilization of IPT’s second iteration, VA Bug Alert (VABA). Methods: Familiarity with IPT was assessed via pre-education survey (3/2022). All sites received standard VABA implementation including: 1) adaptation of VABA features based on end-user feedback (completed 4/2022), 2) development and delivery of an educational module regarding the revised tool (completed 4/2022), and 3) internal facilitation from the VHA MDRO Program Office (ongoing) (see Figure for all key timepoints). Intent to register for VABA was assessed via post-education survey (4-5/2022). Sites (125 eligible) not registered for VABA by 6/1/2022 were randomly assigned to receive one of two conditions from 6/2022–8/2022: continued standard implementation alone or enhanced implementation. Enhanced implementation added the following to standard implementation: 1) audit and feedback reports and 2) external facilitation, including interviews and education about VABA. We compared the number of sites with ≥1 MPC/IP registered for VABA to-date between implementation conditions. Results: Pre-education survey. 168 MPC/IPs across 117 sites responded (94% of eligible sites). Among respondents, 25% had used IPT, 35.1% were familiar with but had not used IPT, and 39.9% were unfamiliar with IPT. Post-education survey. 93 MPC/IPs across 80 sites responded (59% of eligible sites). Of these, 81.7% said they planned to register for VABA, 4.3% said they would not register, and 14.0% said they were unsure. Post-6/1/2022 Registrations. By 6/1/2022, 71% of sites had ≥1 registered VABA user. Of the 28 unregistered sites eligible for enhanced implementation, thirteen were assigned to receive enhanced implementation, and fifteen were assigned to receive continued standard implementation. Eight sites in the enhanced implementation condition (61.5%) registered for VABA. Seven standard-implementation-only sites (46.7%) registered. The number of registered sites did not significantly differ by implementation condition (Fisher’s exact p=0.476). Conclusions: Standard and enhanced implementation were equally effective at encouraging VABA registration, suggesting that allocating resources to enhanced implementation may not be necessary.
Disclosures: None.
A survey of infection control strategies for carbapenem-resistant Enterobacteriaceae in Department of Veterans’ Affairs facilities
- Swetha Ramanathan, Katie J. Suda, Margaret A. Fitzpatrick, Marylou Guihan, Cassie Cunningham Goedken, Nasia Safdar, Martin Evans, Makoto Jones, Christopher D. Pfeiffer, Eli N. Perencevich, Michael Rubin, Charlesnika T. Evans, the QUERI CARRIAGE Program
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 43 / Issue 7 / July 2022
- Published online by Cambridge University Press:
- 22 September 2020, pp. 939-942
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- July 2022
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A survey of Veterans’ Affairs Medical Centers on control of carbapenem-resistant Enterobacteriaceae (CRE) and carbapenem-producing CRE (CP-CRE) demonstrated that most facilities use VA guidelines but few screen for CRE/CP-CRE colonization regularly or regularly communicate CRE/CP-CRE status at patient transfer. Most respondents were knowledgeable about CRE guidelines but cited lack of adequate resources.
Molecular epidemiology of methicillin-susceptible Staphylococcus aureus in infants in a neonatal intensive care unit
- Hye-Kyung Cho, Joshua N. Yang, Scott A. Cunningham, Kerryl E. Greenwood-Quaintance, Mary L. Dalton, Christopher A. Collura, Jennifer L. Fang, Angela L. Heinrich, W. Charles Huskins, Robin Patel
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 41 / Issue 12 / December 2020
- Published online by Cambridge University Press:
- 16 September 2020, pp. 1402-1408
- Print publication:
- December 2020
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Objective:
To investigate the molecular epidemiology of methicillin-susceptible Staphylococcus aureus (MSSA) in infants in a neonatal intensive care unit (NICU) using whole-genome sequencing.
Design:Investigation of MSSA epidemiology in a NICU.
Setting:Single-center, level IV NICU.
Methods:Universal S. aureus screening was done using a single swab obtained from the anterior nares, axilla, and groin area of infants in the NICU on a weekly basis. Core genome multilocus sequence type (cgMLST) analysis was performed on MSSA isolates detected over 1 year (2018–2019).
Results:In total, 68 MSSA-colonized infants were identified, and cgMLSTs of 67 MSSA isolates were analyzed. Overall, we identified 11 cgMLST isolate groups comprising 39 isolates (58%), with group sizes ranging from 2 to 10 isolates, and 28 isolates (42%) were unrelated to each other or any of the isolate groups. Cases of infants colonized by MSSA were scattered throughout the 1-year study period, and isolates belonging to the same cgMLST group were typically detected contemporaneously, over a few weeks or a few months. Overall, 13 infants (19.7%) developed MSSA infections: bacteremia (n = 3), wound infection (n = 5), conjunctivitis (n = 4), and cellulitis (n = 1). We detected no association between these clinically manifest infections and specific cgMLST groups.
Conclusions:Although MSSA isolates in infants in a NICU showed high diversity, most were related to other isolates, albeit within small groups. cgMLST facilitates an understanding of the complex transmission dynamics of MSSA in NICUs, and these data can be used to inform better control strategies.
Recommendations for Patients with Complex Nerve Injuries during the COVID-19 Pandemic
- Kristine M. Chapman, Michael J. Berger, Christopher Doherty, Dimitri J. Anastakis, Heather L. Baltzer, Kirsty Usher Boyd, Sean G. Bristol, Brett Byers, K. Ming Chan, Cameron J.B. Cunningham, Kristen M. Davidge, Jana Dengler, Kate Elzinga, Jennifer L. Giuffre, Lisa Hadley, A Robertson Harrop, Mahdis Hashemi, J. Michael Hendry, Kristin L. Jack, Emily M. Krauss, Timothy J. Lapp, Juliana Larocerie, Jenny C. Lin, Thomas A. Miller, Michael Morhart, Christine B. Novak, Russell O’Connor, Jaret L. Olsen, Benjamin R. Ritsma, Lawrence R. Robinson, Douglas C. Ross, Christiaan Schrag, Alexander Seal, David T. Tang, Jessica Trier, Gerald Wolff, Justin Yeung
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- Journal:
- Canadian Journal of Neurological Sciences / Volume 48 / Issue 1 / January 2021
- Published online by Cambridge University Press:
- 27 August 2020, pp. 50-55
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Whole-genome sequencing for methicillin-resistant Staphylococcus aureus (MRSA) outbreak investigation in a neonatal intensive care unit
- Theresa Madigan, Scott A. Cunningham, Robin Patel, Kerryl E. Greenwood-Quaintance, Jean E. Barth, Priya Sampathkumar, Nicolynn C. Cole, Peggy C. Kohner, Christopher E. Colby, Garth F. Asay, Jennifer L. Fang, Christine A. Baker, Angela L. Heinrich, Kelly A. Fjerstad, Maria J. Lujero, Nicholas Chia, Patricio R. Jeraldo, Heidi Nelson, W. Charles Huskins
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 39 / Issue 12 / December 2018
- Published online by Cambridge University Press:
- 04 October 2018, pp. 1412-1418
- Print publication:
- December 2018
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Objective
To evaluate whole-genome sequencing (WGS) as a molecular typing tool for MRSA outbreak investigation.
DesignInvestigation of MRSA colonization/infection in a neonatal intensive care unit (NICU) over 3 years (2014–2017).
SettingSingle-center level IV NICU.
PatientsNICU infants and healthcare workers (HCWs).
MethodsInfants were screened for MRSA using a swab of the anterior nares, axilla, and groin, initially by targeted (ring) screening, and later by universal weekly screening. Clinical cultures were collected as indicated. HCWs were screened once using swabs of the anterior nares. MRSA isolates were typed using WGS with core-genome multilocus sequence typing (cgMLST) analysis and by pulsed-field gel electrophoresis (PFGE). Colonized and infected infants and HCWs were decolonized. Control strategies included reinforcement of hand hygiene, use of contact precautions, cohorting, enhanced environmental cleaning, and remodeling of the NICU.
ResultsWe identified 64 MRSA-positive infants: 53 (83%) by screening and 11 (17%) by clinical cultures. Of 85 screened HCWs, 5 (6%) were MRSA positive. WGS of MRSA isolates identified 2 large clusters (WGS groups 1 and 2), 1 small cluster (WGS group 3), and 8 unrelated isolates. PFGE failed to distinguish WGS group 2 and 3 isolates. WGS groups 1 and 2 were codistributed over time. HCW MRSA isolates were primarily in WGS group 1. New infant MRSA cases declined after implementation of the control interventions.
ConclusionWe identified 2 contemporaneous MRSA outbreaks alongside sporadic cases in a NICU. WGS was used to determine strain relatedness at a higher resolution than PFGE and was useful in guiding efforts to control MRSA transmission.
Low-Frequency Carbon Recombination Lines in the Orion Molecular Cloud Complex
- Chenoa D. Tremblay, Christopher H. Jordan, Maria Cunningham, Paul A. Jones, Natasha Hurley-Walker
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- Publications of the Astronomical Society of Australia / Volume 35 / 2018
- Published online by Cambridge University Press:
- 02 May 2018, e018
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We detail tentative detections of low-frequency carbon radio recombination lines from within the Orion molecular cloud complex observed at 99–129 MHz. These tentative detections include one alpha transition and one beta transition over three locations and are located within the diffuse regions of dust observed in the infrared at 100 μm, the Hα emission detected in the optical, and the synchrotron radiation observed in the radio. With these observations, we are able to study the radiation mechanism transition from collisionally pumped to radiatively pumped within the H ii regions within the Orion molecular cloud complex.
Failure to Communicate: Transmission of Extensively Drug-Resistant blaOXA-237-Containing Acinetobacter baumannii—Multiple Facilities in Oregon, 2012–2014
- Genevieve L. Buser, P. Maureen Cassidy, Margaret C. Cunningham, Susan Rudin, Andrea M. Hujer, Robert Vega, Jon P. Furuno, Steven H. Marshall, Paul G. Higgins, Michael R. Jacobs, Meredith S. Wright, Mark D. Adams, Robert A. Bonomo, Christopher D. Pfeiffer, Zintars G. Beldavs
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 38 / Issue 11 / November 2017
- Published online by Cambridge University Press:
- 05 September 2017, pp. 1335-1341
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- November 2017
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OBJECTIVE
To determine the scope, source, and mode of transmission of a multifacility outbreak of extensively drug-resistant (XDR) Acinetobacter baumannii.
DESIGNOutbreak investigation.
SETTING AND PARTICIPANTSResidents and patients in skilled nursing facilities, long-term acute-care hospital, and acute-care hospitals.
METHODSA case was defined as the incident isolate from clinical or surveillance cultures of XDR Acinetobacter baumannii resistant to imipenem or meropenem and nonsusceptible to all but 1 or 2 antibiotic classes in a patient in an Oregon healthcare facility during January 2012–December 2014. We queried clinical laboratories, reviewed medical records, oversaw patient and environmental surveillance surveys at 2 facilities, and recommended interventions. Pulsed-field gel electrophoresis (PFGE) and molecular analysis were performed.
RESULTSWe identified 21 cases, highly related by PFGE or healthcare facility exposure. Overall, 17 patients (81%) were admitted to either long-term acute-care hospital A (n=8), or skilled nursing facility A (n=8), or both (n=1) prior to XDR A. baumannii isolation. Interfacility communication of patient or resident XDR status was not performed during transfer between facilities. The rare plasmid-encoded carbapenemase gene blaOXA-237 was present in 16 outbreak isolates. Contact precautions, chlorhexidine baths, enhanced environmental cleaning, and interfacility communication were implemented for cases to halt transmission.
CONCLUSIONSInterfacility transmission of XDR A. baumannii carrying the rare blaOXA-237 was facilitated by transfer of affected patients without communication to receiving facilities.
Infect Control Hosp Epidemiol 2017;38:1335–1341
Time To Change the Bathwater: Correcting Misconceptions About Performance Ratings
- C. Allen Gorman, Christopher J. L. Cunningham, Shawn M. Bergman, John P. Meriac
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- Industrial and Organizational Psychology / Volume 9 / Issue 2 / June 2016
- Published online by Cambridge University Press:
- 04 July 2016, pp. 314-322
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Recent commentary has suggested that performance management (PM) is fundamentally “broken,” with negative feelings from managers and employees toward the process at an all-time high (Pulakos, Hanson, Arad, & Moye, 2015; Pulakos & O'Leary, 2011). In response, some high-profile organizations have decided to eliminate performance ratings altogether as a solution to the growing disenchantment. Adler et al. (2016) offer arguments both in support of and against eliminating performance ratings in organizations. Although both sides of the debate in the focal article make some strong arguments both for and against utilizing performance ratings in organizations, we believe there continue to be misunderstandings, mischaracterizations, and misinformation with respect to some of the measurement issues in PM. We offer the following commentary not to persuade readers to adopt one particular side over another but as a call to critically reconsider and reevaluate some of the assumptions underlying measurement issues in PM and to dispel some of the pervasive beliefs throughout the performance rating literature.
Let's Correct Ourselves and How We Handle Unreliability in Performance Evaluation
- Christopher J. L. Cunningham, Neil Morelli
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- Industrial and Organizational Psychology / Volume 7 / Issue 4 / December 2014
- Published online by Cambridge University Press:
- 10 April 2015, pp. 535-538
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You Lost Me at Hello: Aren't We I-O Psychologists Still?
- Christopher J. L. Cunningham
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- Industrial and Organizational Psychology / Volume 3 / Issue 3 / September 2010
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- 07 January 2015, pp. 262-265
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My reaction to Ryan and Ford's (2010) tipping point discussion stems from the footnote assigned to the title of their article, “In keeping with recent trends in the field, we use ‘organizational psychology’ rather than industrial/organizational psychology throughout, except when directly quoting a source or providing a historical referent.” This one sentence vividly illustrates the identity crisis Ryan and Ford have aptly discussed; even among like-minded colleagues, we are unable to agree on what we should call ourselves and what that label might actually imply. I was especially confused by this choice of professional labeling when Ryan and Ford later concluded that, “[Our field's] distinctiveness is not well articulated for new entrants, affecting the extent to which organizational psychology becomes a deep-structure identity of individuals that will affect, over time, the viability of the collective identity.” What message are we sending to potential new entrants if we are not willing to retain the field's existing moniker because it is too cumbersome or difficult to explain to others? The typical student reaction I experience when discussing our professional name and identity is something along the lines of: “What do you mean SIOP wants to change its name? What's wrong with the one that it already has?”
How Interrole Conflict Research Can Have a Greater Impact
- Christopher J. L. Cunningham
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- Industrial and Organizational Psychology / Volume 4 / Issue 3 / September 2011
- Published online by Cambridge University Press:
- 07 January 2015, pp. 370-374
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Establishment of a Statewide Network for Carbapenem-Resistant Enterobacteriaceae Prevention in a Low-Incidence Region
- Christopher D. Pfeiffer, Margaret C. Cunningham, Tasha Poissant, Jon P. Furuno, John M. Townes, Andrew Leitz, Ann Thomas, Genevieve L. Buser, Robert F. Arao, Zintars G. Beldavs
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 35 / Issue 4 / April 2014
- Published online by Cambridge University Press:
- 10 May 2016, pp. 356-361
- Print publication:
- April 2014
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Objective.
To establish a statewide network to detect, control, and prevent the spread of carbapenem-resistant Enterobacteriaceae (CRE) in a region with a low incidence of CRE infection.
Design.Implementation of the Drug Resistant Organism Prevention and Coordinated Regional Epidemiology (DROP-CRE) Network.
Setting and Participants.Oregon infection prevention and microbiology laboratory personnel, including 48 microbiology laboratories, 62 acute care facilities, and 140 long-term care facilities.
Methods.The DROP-CRE working group, comprising representatives from academic institutions and public health, convened an interdisciplinary advisory committee to assist with planning and implementation of CRE epidemiology and control efforts. The working group established a statewide CRE definition and surveillance plan; increased the state laboratory capacity to perform the modified Hodge test and polymerase chain reaction for carbapenemases in real time; and administered surveys that assessed the needs and capabilities of Oregon infection prevention and laboratory personnel. Results of these inquiries informed CRE education and the response plan.
Results.Of 60 CRE reported from November 2010 through April 2013, only 3 were identified as carbapenemase producers; the cases were not linked, and no secondary transmission was found. Microbiology laboratories, acute care facilities, and long-term care facilities reported lacking carbapenemase testing capability, reliable interfacility communication, and CRE awareness, respectively. Survey findings informed the creation of the Oregon CRE Toolkit, a state-specific CRE guide booklet.
Conclusions.A regional epidemiology surveillance and response network has been implemented in Oregon in advance of widespread CRE transmission. Prospective surveillance will determine whether this collaborative approach will be successful at forestalling the emergence of this important healthcare-associated pathogen.
Contributors
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- By Ioannis P. Androulakis, Djillali Annane, Gérard Audibert, Lisa L. Barnes, Paolo Bartolomeo, Walter S. Bartynski, David A. Bennett, Nicolas Bruder, Nathan E. Brummel, Steve E. Calvano, Alain Cariou, F. Chretien, Jan Claassen, Colm Cunningham, Souhayl Dahmani, Robert Dantzer, Dimitry S. Davydow, Sanjay V. Desai, E. Wesley Ely, Frédéric Faugeras, Karen J. Ferguson, Brandon Foreman, Sadanand M. Gaikwad, Rebecca F. Gottesman, Maura A. Grega, Richard D. Griffiths, Marion Griton, Stefan D. Gurney, Hebah M. Hefzy, Michael T. Heneka, Dustin M. Hipp, Ramona O. Hopkins, Christopher G. Hughes, James C. Jackson, Christina Jones, Peter W. Kaplan, Keith W. Kelley, Raymond C. Koehler, Matthew A. Koenig, Jan Pieter Konsman, Felix Kork, John P. Kress, Stephen F. Lowry, Alawi Luetz, David Luis, Alasdair M. J. MacLullich, Guy M. McKhann, Jean Mantz, Panteleimon D. Mavroudis, Mervyn Maze, Bruno Mégarbane, Lionel Naccache, Dale M. Needham, Pratik P. Pandharipande, Jean-Francois Payen, V. Hugh Perry, Margaret Pisani, C. Rauturier, Benjamin Rohaut, Jennifer Ryan, Robert D. Sanders, Jeremy D. Scheff, Frederic Sedel, Ola A. Selnes, Tarek Sharshar, Martin Siegemund, Yoanna Skrobik, Jamie W. Sleigh, Romain Sonneville, Claudia D. Spies, Luzius A. Steiner, Robert D. Stevens, Raoul Sutter, Fabio Silvio Taccone, Richard E. Temes, Willem A. van Gool, Christel C. Vanbesien, F. Verdonk, Odile Viltart, Julia Wendon, Catherine N. Widmann, Robert S. Wilson
- Edited by Robert D. Stevens, Tarek Sharshar, E. Wesley Ely, Vanderbilt University, Tennessee
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- Brain Disorders in Critical Illness
- Published online:
- 05 October 2013
- Print publication:
- 19 September 2013, pp viii-xii
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- By Krista Adamek, Ana Luisa K. Albernaz, J. Marcio Ayres†, Andrew J. Baker, Karen L. Bales, Adrian A. Barnett, Christopher Barton, John M. Bates, Jennie Becker, Bruna M. Bezerra, Júlio César Bicca-Marques, Richard Bodmer, Jean P. Boubli, Mark Bowler, Sarah A. Boyle, Christini Barbosa Caselli, Janice Chism, Elena P. Cunningham, José Maria C. da Silva, Lesa C. Davies, Nayara de Alcântara Cardoso, Manuella A. de Souza, Stella de la Torre, Ana Gabriela de Luna, Thomas R. Defler, Anthony Di Fiore, Eduardo Fernandez-Duque, Stephen F. Ferrari, Wilsea M.B. Figueiredo-Ready, Tracy Frampton, Paul A. Garber, Brian W. Grafton, L. Tremaine Gregory, Maria L. Harada, Amy Harrison-Levine, Walter C. Hartwig, Stefanie Heiduck, Eckhard W. Heymann, André Hirsch, Leandro Jerusalinsky, Gareth Jones, Richard F. Kay, Martin M. Kowalewski, Shawn M. Lehman, Laura Marsh, Jesús Martinez, William A. Mason, Hope Matthews, Wynlyn McBride, Shona McCann-Wood, W. Scott McGraw, D. Jeffrey Meldrum, Sally P. Mendoza, Nohelia Mercado, Russell A. Mittermeier, Mirjam N. Nadjafzadeh, Marilyn A. Norconk, Robert Gary Norman, Marcela Oliveira, Marcelo M. Oliveira, Maria Juliana Ospina Rodríguez, Erwin Palacios, Suzanne Palminteri, Liliam P. Pinto, Marcio Port-Carvalho, Leila Porter, Carlos Portillo-Quintero, George Powell, Ghillean T. Prance, Rodrigo C. Printes, Pablo Puertas, P. Kirsten Pullen, Helder L. Queiroz, Luis Reginaldo R. Rodrigues, Adriana Rodríguez, Alfred L. Rosenberger, Anthony B. Rylands, Ricardo R. Santos, Horacio Schneider, Eleonore Z.F. Setz, Suleima S.B. Silva, José S. Silva Júnior, Andrew T. Smith, Marcelo C. Sousa, Antonio S. Souto, Wilson R. Spironello, Masanaru Takai, Marcelo F. Tejedor, Cynthia L. Thompson, Diego G. Tirira, Raul Tupayachi, Bernardo Urbani, Liza M. Veiga, Marianela Velilla, João Valsecchi, Jean-Christophe Vié, Tatiana M. Vieira, Suzanne E. Walker-Pacheco, Rob Wallace, Patricia C. Wright, Charles E. Zartman
- Edited by Liza M. Veiga, Universidade Federal do Pará, Brazil, Adrian A. Barnett, Roehampton University, London, Stephen F. Ferrari, Universidade Federal de Sergipe, Brazil, Marilyn A. Norconk, Kent State University, Ohio
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- Evolutionary Biology and Conservation of Titis, Sakis and Uacaris
- Published online:
- 05 April 2013
- Print publication:
- 11 April 2013, pp xii-xv
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- By Chris Beyers, Amy Branam, Alan Brown, Mark Canada, Patricia A. Cunningham, Satwik Dasgupta, David Dowling, John Evelev, Michael J. Everton, Benjamin F. Fisher, Paul Fisher, Meghan A. Freeman, Christopher Gair, Andrea Goulet, Jonathan Hartmann, Kevin J. Hayes, Gregory Hays, Alvin Holm, Lindsey Hursh, James M. Hutchisson, Paul Christian Jones, Katherine Kim, Nathaniel Lewis, Bruce Mills, Travis Montgomery, Tara Moore, Bran Nicol, Philip Edward Phillips, Anne Boyd Rioux, Therese M. Rizzo, Kathryn K. Shinn, Heidi Silcox, Peter Swirski, Jonathan Taylor, John Tresch, Lois Davis Vines, Jeffrey Andrew Weinstock, Brett Zimmerman
- Edited by Kevin J. Hayes, University of Central Oklahoma
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- Edgar Allan Poe in Context
- Published online:
- 05 November 2013
- Print publication:
- 29 October 2012, pp ix-xiv
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- By Rose Teteki Abbey, K. C. Abraham, David Tuesday Adamo, LeRoy H. Aden, Efrain Agosto, Victor Aguilan, Gillian T. W. Ahlgren, Charanjit Kaur AjitSingh, Dorothy B E A Akoto, Giuseppe Alberigo, Daniel E. Albrecht, Ruth Albrecht, Daniel O. Aleshire, Urs Altermatt, Anand Amaladass, Michael Amaladoss, James N. Amanze, Lesley G. Anderson, Thomas C. Anderson, Victor Anderson, Hope S. Antone, María Pilar Aquino, Paula Arai, Victorio Araya Guillén, S. Wesley Ariarajah, Ellen T. Armour, Brett Gregory Armstrong, Atsuhiro Asano, Naim Stifan Ateek, Mahmoud Ayoub, John Alembillah Azumah, Mercedes L. García Bachmann, Irena Backus, J. Wayne Baker, Mieke Bal, Lewis V. Baldwin, William Barbieri, António Barbosa da Silva, David Basinger, Bolaji Olukemi Bateye, Oswald Bayer, Daniel H. Bays, Rosalie Beck, Nancy Elizabeth Bedford, Guy-Thomas Bedouelle, Chorbishop Seely Beggiani, Wolfgang Behringer, Christopher M. Bellitto, Byard Bennett, Harold V. Bennett, Teresa Berger, Miguel A. Bernad, Henley Bernard, Alan E. Bernstein, Jon L. Berquist, Johannes Beutler, Ana María Bidegain, Matthew P. Binkewicz, Jennifer Bird, Joseph Blenkinsopp, Dmytro Bondarenko, Paulo Bonfatti, Riet en Pim Bons-Storm, Jessica A. Boon, Marcus J. Borg, Mark Bosco, Peter C. Bouteneff, François Bovon, William D. Bowman, Paul S. Boyer, David Brakke, Richard E. Brantley, Marcus Braybrooke, Ian Breward, Ênio José da Costa Brito, Jewel Spears Brooker, Johannes Brosseder, Nicholas Canfield Read Brown, Robert F. Brown, Pamela K. Brubaker, Walter Brueggemann, Bishop Colin O. Buchanan, Stanley M. Burgess, Amy Nelson Burnett, J. Patout Burns, David B. Burrell, David Buttrick, James P. Byrd, Lavinia Byrne, Gerado Caetano, Marcos Caldas, Alkiviadis Calivas, William J. Callahan, Salvatore Calomino, Euan K. Cameron, William S. Campbell, Marcelo Ayres Camurça, Daniel F. Caner, Paul E. Capetz, Carlos F. Cardoza-Orlandi, Patrick W. Carey, Barbara Carvill, Hal Cauthron, Subhadra Mitra Channa, Mark D. Chapman, James H. Charlesworth, Kenneth R. Chase, Chen Zemin, Luciano Chianeque, Philip Chia Phin Yin, Francisca H. Chimhanda, Daniel Chiquete, John T. Chirban, Soobin Choi, Robert Choquette, Mita Choudhury, Gerald Christianson, John Chryssavgis, Sejong Chun, Esther Chung-Kim, Charles M. A. Clark, Elizabeth A. Clark, Sathianathan Clarke, Fred Cloud, John B. Cobb, W. Owen Cole, John A Coleman, John J. Collins, Sylvia Collins-Mayo, Paul K. Conkin, Beth A. Conklin, Sean Connolly, Demetrios J. Constantelos, Michael A. Conway, Paula M. Cooey, Austin Cooper, Michael L. Cooper-White, Pamela Cooper-White, L. William Countryman, Sérgio Coutinho, Pamela Couture, Shannon Craigo-Snell, James L. Crenshaw, David Crowner, Humberto Horacio Cucchetti, Lawrence S. Cunningham, Elizabeth Mason Currier, Emmanuel Cutrone, Mary L. Daniel, David D. Daniels, Robert Darden, Rolf Darge, Isaiah Dau, Jeffry C. Davis, Jane Dawson, Valentin Dedji, John W. de Gruchy, Paul DeHart, Wendy J. Deichmann Edwards, Miguel A. De La Torre, George E. Demacopoulos, Thomas de Mayo, Leah DeVun, Beatriz de Vasconcellos Dias, Dennis C. Dickerson, John M. Dillon, Luis Miguel Donatello, Igor Dorfmann-Lazarev, Susanna Drake, Jonathan A. Draper, N. Dreher Martin, Otto Dreydoppel, Angelyn Dries, A. J. Droge, Francis X. D'Sa, Marilyn Dunn, Nicole Wilkinson Duran, Rifaat Ebied, Mark J. Edwards, William H. Edwards, Leonard H. Ehrlich, Nancy L. Eiesland, Martin Elbel, J. Harold Ellens, Stephen Ellingson, Marvin M. Ellison, Robert Ellsberg, Jean Bethke Elshtain, Eldon Jay Epp, Peter C. Erb, Tassilo Erhardt, Maria Erling, Noel Leo Erskine, Gillian R. Evans, Virginia Fabella, Michael A. Fahey, Edward Farley, Margaret A. Farley, Wendy Farley, Robert Fastiggi, Seena Fazel, Duncan S. Ferguson, Helwar Figueroa, Paul Corby Finney, Kyriaki Karidoyanes FitzGerald, Thomas E. FitzGerald, John R. Fitzmier, Marie Therese Flanagan, Sabina Flanagan, Claude Flipo, Ronald B. Flowers, Carole Fontaine, David Ford, Mary Ford, Stephanie A. Ford, Jim Forest, William Franke, Robert M. Franklin, Ruth Franzén, Edward H. Friedman, Samuel Frouisou, Lorelei F. Fuchs, Jojo M. Fung, Inger Furseth, Richard R. Gaillardetz, Brandon Gallaher, China Galland, Mark Galli, Ismael García, Tharscisse Gatwa, Jean-Marie Gaudeul, Luis María Gavilanes del Castillo, Pavel L. Gavrilyuk, Volney P. Gay, Metropolitan Athanasios Geevargis, Kondothra M. George, Mary Gerhart, Simon Gikandi, Maurice Gilbert, Michael J. Gillgannon, Verónica Giménez Beliveau, Terryl Givens, Beth Glazier-McDonald, Philip Gleason, Menghun Goh, Brian Golding, Bishop Hilario M. Gomez, Michelle A. Gonzalez, Donald K. Gorrell, Roy Gottfried, Tamara Grdzelidze, Joel B. Green, Niels Henrik Gregersen, Cristina Grenholm, Herbert Griffiths, Eric W. Gritsch, Erich S. Gruen, Christoffer H. Grundmann, Paul H. Gundani, Jon P. Gunnemann, Petre Guran, Vidar L. Haanes, Jeremiah M. Hackett, Getatchew Haile, Douglas John Hall, Nicholas Hammond, Daphne Hampson, Jehu J. Hanciles, Barry Hankins, Jennifer Haraguchi, Stanley S. Harakas, Anthony John Harding, Conrad L. Harkins, J. William Harmless, Marjory Harper, Amir Harrak, Joel F. Harrington, Mark W. Harris, Susan Ashbrook Harvey, Van A. Harvey, R. Chris Hassel, Jione Havea, Daniel Hawk, Diana L. Hayes, Leslie Hayes, Priscilla Hayner, S. Mark Heim, Simo Heininen, Richard P. Heitzenrater, Eila Helander, David Hempton, Scott H. Hendrix, Jan-Olav Henriksen, Gina Hens-Piazza, Carter Heyward, Nicholas J. Higham, David Hilliard, Norman A. Hjelm, Peter C. Hodgson, Arthur Holder, M. Jan Holton, Dwight N. Hopkins, Ronnie Po-chia Hsia, Po-Ho Huang, James Hudnut-Beumler, Jennifer S. Hughes, Leonard M. Hummel, Mary E. Hunt, Laennec Hurbon, Mark Hutchinson, Susan E. Hylen, Mary Beth Ingham, H. Larry Ingle, Dale T. Irvin, Jon Isaak, Paul John Isaak, Ada María Isasi-Díaz, Hans Raun Iversen, Margaret C. Jacob, Arthur James, Maria Jansdotter-Samuelsson, David Jasper, Werner G. Jeanrond, Renée Jeffery, David Lyle Jeffrey, Theodore W. Jennings, David H. Jensen, Robin Margaret Jensen, David Jobling, Dale A. Johnson, Elizabeth A. Johnson, Maxwell E. Johnson, Sarah Johnson, Mark D. Johnston, F. Stanley Jones, James William Jones, John R. Jones, Alissa Jones Nelson, Inge Jonsson, Jan Joosten, Elizabeth Judd, Mulambya Peggy Kabonde, Robert Kaggwa, Sylvester Kahakwa, Isaac Kalimi, Ogbu U. Kalu, Eunice Kamaara, Wayne C. Kannaday, Musimbi Kanyoro, Veli-Matti Kärkkäinen, Frank Kaufmann, Léon Nguapitshi Kayongo, Richard Kearney, Alice A. Keefe, Ralph Keen, Catherine Keller, Anthony J. Kelly, Karen Kennelly, Kathi Lynn Kern, Fergus Kerr, Edward Kessler, George Kilcourse, Heup Young Kim, Kim Sung-Hae, Kim Yong-Bock, Kim Yung Suk, Richard King, Thomas M. King, Robert M. Kingdon, Ross Kinsler, Hans G. Kippenberg, Cheryl A. Kirk-Duggan, Clifton Kirkpatrick, Leonid Kishkovsky, Nadieszda Kizenko, Jeffrey Klaiber, Hans-Josef Klauck, Sidney Knight, Samuel Kobia, Robert Kolb, Karla Ann Koll, Heikki Kotila, Donald Kraybill, Philip D. W. Krey, Yves Krumenacker, Jeffrey Kah-Jin Kuan, Simanga R. Kumalo, Peter Kuzmic, Simon Shui-Man Kwan, Kwok Pui-lan, André LaCocque, Stephen E. Lahey, John Tsz Pang Lai, Emiel Lamberts, Armando Lampe, Craig Lampe, Beverly J. Lanzetta, Eve LaPlante, Lizette Larson-Miller, Ariel Bybee Laughton, Leonard Lawlor, Bentley Layton, Robin A. Leaver, Karen Lebacqz, Archie Chi Chung Lee, Marilyn J. Legge, Hervé LeGrand, D. L. LeMahieu, Raymond Lemieux, Bill J. Leonard, Ellen M. Leonard, Outi Leppä, Jean Lesaulnier, Nantawan Boonprasat Lewis, Henrietta Leyser, Alexei Lidov, Bernard Lightman, Paul Chang-Ha Lim, Carter Lindberg, Mark R. Lindsay, James R. Linville, James C. Livingston, Ann Loades, David Loades, Jean-Claude Loba-Mkole, Lo Lung Kwong, Wati Longchar, Eleazar López, David W. Lotz, Andrew Louth, Robin W. Lovin, William Luis, Frank D. Macchia, Diarmaid N. J. MacCulloch, Kirk R. MacGregor, Marjory A. MacLean, Donald MacLeod, Tomas S. Maddela, Inge Mager, Laurenti Magesa, David G. Maillu, Fortunato Mallimaci, Philip Mamalakis, Kä Mana, Ukachukwu Chris Manus, Herbert Robinson Marbury, Reuel Norman Marigza, Jacqueline Mariña, Antti Marjanen, Luiz C. L. Marques, Madipoane Masenya (ngwan'a Mphahlele), Caleb J. D. Maskell, Steve Mason, Thomas Massaro, Fernando Matamoros Ponce, András Máté-Tóth, Odair Pedroso Mateus, Dinis Matsolo, Fumitaka Matsuoka, John D'Arcy May, Yelena Mazour-Matusevich, Theodore Mbazumutima, John S. McClure, Christian McConnell, Lee Martin McDonald, Gary B. McGee, Thomas McGowan, Alister E. McGrath, Richard J. McGregor, John A. McGuckin, Maud Burnett McInerney, Elsie Anne McKee, Mary B. McKinley, James F. McMillan, Ernan McMullin, Kathleen E. McVey, M. Douglas Meeks, Monica Jyotsna Melanchthon, Ilie Melniciuc-Puica, Everett Mendoza, Raymond A. Mentzer, William W. Menzies, Ina Merdjanova, Franziska Metzger, Constant J. Mews, Marvin Meyer, Carol Meyers, Vasile Mihoc, Gunner Bjerg Mikkelsen, Maria Inêz de Castro Millen, Clyde Lee Miller, Bonnie J. Miller-McLemore, Alexander Mirkovic, Paul Misner, Nozomu Miyahira, R. W. L. Moberly, Gerald Moede, Aloo Osotsi Mojola, Sunanda Mongia, Rebeca Montemayor, James Moore, Roger E. Moore, Craig E. Morrison O.Carm, Jeffry H. Morrison, Keith Morrison, Wilson J. Moses, Tefetso Henry Mothibe, Mokgethi Motlhabi, Fulata Moyo, Henry Mugabe, Jesse Ndwiga Kanyua Mugambi, Peggy Mulambya-Kabonde, Robert Bruce Mullin, Pamela Mullins Reaves, Saskia Murk Jansen, Heleen L. Murre-Van den Berg, Augustine Musopole, Isaac M. T. Mwase, Philomena Mwaura, Cecilia Nahnfeldt, Anne Nasimiyu Wasike, Carmiña Navia Velasco, Thulani Ndlazi, Alexander Negrov, James B. Nelson, David G. Newcombe, Carol Newsom, Helen J. Nicholson, George W. E. Nickelsburg, Tatyana Nikolskaya, Damayanthi M. A. Niles, Bertil Nilsson, Nyambura Njoroge, Fidelis Nkomazana, Mary Beth Norton, Christian Nottmeier, Sonene Nyawo, Anthère Nzabatsinda, Edward T. Oakes, Gerald O'Collins, Daniel O'Connell, David W. Odell-Scott, Mercy Amba Oduyoye, Kathleen O'Grady, Oyeronke Olajubu, Thomas O'Loughlin, Dennis T. Olson, J. Steven O'Malley, Cephas N. Omenyo, Muriel Orevillo-Montenegro, César Augusto Ornellas Ramos, Agbonkhianmeghe E. Orobator, Kenan B. Osborne, Carolyn Osiek, Javier Otaola Montagne, Douglas F. Ottati, Anna May Say Pa, Irina Paert, Jerry G. Pankhurst, Aristotle Papanikolaou, Samuele F. Pardini, Stefano Parenti, Peter Paris, Sung Bae Park, Cristián G. Parker, Raquel Pastor, Joseph Pathrapankal, Daniel Patte, W. Brown Patterson, Clive Pearson, Keith F. Pecklers, Nancy Cardoso Pereira, David Horace Perkins, Pheme Perkins, Edward N. Peters, Rebecca Todd Peters, Bishop Yeznik Petrossian, Raymond Pfister, Peter C. Phan, Isabel Apawo Phiri, William S. F. Pickering, Derrick G. Pitard, William Elvis Plata, Zlatko Plese, John Plummer, James Newton Poling, Ronald Popivchak, Andrew Porter, Ute Possekel, James M. Powell, Enos Das Pradhan, Devadasan Premnath, Jaime Adrían Prieto Valladares, Anne Primavesi, Randall Prior, María Alicia Puente Lutteroth, Eduardo Guzmão Quadros, Albert Rabil, Laurent William Ramambason, Apolonio M. Ranche, Vololona Randriamanantena Andriamitandrina, Lawrence R. Rast, Paul L. Redditt, Adele Reinhartz, Rolf Rendtorff, Pål Repstad, James N. Rhodes, John K. Riches, Joerg Rieger, Sharon H. Ringe, Sandra Rios, Tyler Roberts, David M. Robinson, James M. Robinson, Joanne Maguire Robinson, Richard A. H. Robinson, Roy R. Robson, Jack B. Rogers, Maria Roginska, Sidney Rooy, Rev. Garnett Roper, Maria José Fontelas Rosado-Nunes, Andrew C. Ross, Stefan Rossbach, François Rossier, John D. Roth, John K. Roth, Phillip Rothwell, Richard E. Rubenstein, Rosemary Radford Ruether, Markku Ruotsila, John E. Rybolt, Risto Saarinen, John Saillant, Juan Sanchez, Wagner Lopes Sanchez, Hugo N. Santos, Gerhard Sauter, Gloria L. Schaab, Sandra M. Schneiders, Quentin J. Schultze, Fernando F. Segovia, Turid Karlsen Seim, Carsten Selch Jensen, Alan P. F. Sell, Frank C. Senn, Kent Davis Sensenig, Damían Setton, Bal Krishna Sharma, Carolyn J. Sharp, Thomas Sheehan, N. Gerald Shenk, Christian Sheppard, Charles Sherlock, Tabona Shoko, Walter B. Shurden, Marguerite Shuster, B. Mark Sietsema, Batara Sihombing, Neil Silberman, Clodomiro Siller, Samuel Silva-Gotay, Heikki Silvet, John K. Simmons, Hagith Sivan, James C. Skedros, Abraham Smith, Ashley A. Smith, Ted A. Smith, Daud Soesilo, Pia Søltoft, Choan-Seng (C. S.) Song, Kathryn Spink, Bryan Spinks, Eric O. Springsted, Nicolas Standaert, Brian Stanley, Glen H. Stassen, Karel Steenbrink, Stephen J. Stein, Andrea Sterk, Gregory E. Sterling, Columba Stewart, Jacques Stewart, Robert B. Stewart, Cynthia Stokes Brown, Ken Stone, Anne Stott, Elizabeth Stuart, Monya Stubbs, Marjorie Hewitt Suchocki, David Kwang-sun Suh, Scott W. Sunquist, Keith Suter, Douglas Sweeney, Charles H. Talbert, Shawqi N. Talia, Elsa Tamez, Joseph B. Tamney, Jonathan Y. Tan, Yak-Hwee Tan, Kathryn Tanner, Feiya Tao, Elizabeth S. Tapia, Aquiline Tarimo, Claire Taylor, Mark Lewis Taylor, Bishop Abba Samuel Wolde Tekestebirhan, Eugene TeSelle, M. Thomas Thangaraj, David R. Thomas, Andrew Thornley, Scott Thumma, Marcelo Timotheo da Costa, George E. “Tink” Tinker, Ola Tjørhom, Karen Jo Torjesen, Iain R. Torrance, Fernando Torres-Londoño, Archbishop Demetrios [Trakatellis], Marit Trelstad, Christine Trevett, Phyllis Trible, Johannes Tromp, Paul Turner, Robert G. Tuttle, Archbishop Desmond Tutu, Peter Tyler, Anders Tyrberg, Justin Ukpong, Javier Ulloa, Camillus Umoh, Kristi Upson-Saia, Martina Urban, Monica Uribe, Elochukwu Eugene Uzukwu, Richard Vaggione, Gabriel Vahanian, Paul Valliere, T. J. Van Bavel, Steven Vanderputten, Peter Van der Veer, Huub Van de Sandt, Louis Van Tongeren, Luke A. Veronis, Noel Villalba, Ramón Vinke, Tim Vivian, David Voas, Elena Volkova, Katharina von Kellenbach, Elina Vuola, Timothy Wadkins, Elaine M. Wainwright, Randi Jones Walker, Dewey D. Wallace, Jerry Walls, Michael J. Walsh, Philip Walters, Janet Walton, Jonathan L. Walton, Wang Xiaochao, Patricia A. Ward, David Harrington Watt, Herold D. Weiss, Laurence L. Welborn, Sharon D. Welch, Timothy Wengert, Traci C. West, Merold Westphal, David Wetherell, Barbara Wheeler, Carolinne White, Jean-Paul Wiest, Frans Wijsen, Terry L. Wilder, Felix Wilfred, Rebecca Wilkin, Daniel H. Williams, D. Newell Williams, Michael A. Williams, Vincent L. Wimbush, Gabriele Winkler, Anders Winroth, Lauri Emílio Wirth, James A. Wiseman, Ebba Witt-Brattström, Teofil Wojciechowski, John Wolffe, Kenman L. Wong, Wong Wai Ching, Linda Woodhead, Wendy M. Wright, Rose Wu, Keith E. Yandell, Gale A. Yee, Viktor Yelensky, Yeo Khiok-Khng, Gustav K. K. Yeung, Angela Yiu, Amos Yong, Yong Ting Jin, You Bin, Youhanna Nessim Youssef, Eliana Yunes, Robert Michael Zaller, Valarie H. Ziegler, Barbara Brown Zikmund, Joyce Ann Zimmerman, Aurora Zlotnik, Zhuo Xinping
- Edited by Daniel Patte, Vanderbilt University, Tennessee
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- Book:
- The Cambridge Dictionary of Christianity
- Published online:
- 05 August 2012
- Print publication:
- 20 September 2010, pp xi-xliv
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Contributors
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- By Matthew L. Albert, Joseph M. Antony, Karina Apricò, Miles H. Beaman, Bruce J. Brew, Nicole Bye, Leonard H. Calabrese, Tina Chadha, Anthony L. Cunningham, Heather Donaghy, George F. Duna, Britta Engelhardt, Reinhard Hohlfeld, David N. Irani, Bevyn Jarrott, Martin Kerschensteiner, Andrew J. Kornberg, Thomas Kossmann, Claudia F. Lucchinetti, Justin C. McArthur, Edgar Meinl, Danny A. Milner, Trine H. Mogensen, Cristina Morganti-Kossmann, Phuong Nguyen, Carolyn F. Orr, Lars Østergaard, Christopher Power, Natalie Prow, Shanu F. Roemer, Stephen J. Rogerson, Laveniya Satgunaseelan, Nicoline Schiess, Lisa Walter, Hartmut Wekerle, Edwina J. Wright, Eppie M. Yiu
- Edited by Trevor Kilpatrick, Richard M. Ransohoff, Steven Wesselingh, Monash University, Victoria
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- Book:
- Inflammatory Diseases of the Central Nervous System
- Published online:
- 05 July 2016
- Print publication:
- 29 October 2009, pp vii-viii
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The race to prevent the extinction of South Asian vultures
- Deborah J. Pain, Christopher G. R. Bowden, Andrew A. Cunningham, Richard Cuthbert, Devojit Das, Martin Gilbert, Ram D. Jakati, Yadvendradev Jhala, Aleem A. Khan, Vinny Naidoo, J. Lindsay Oaks, Jemima Parry-Jones, Vibhu Prakash, Asad Rahmani, Sachin P. Ranade, Hem Sagar Baral, Kalu Ram Senacha, S. Saravanan, Nita Shah, Gerry Swan, Devendra Swarup, Mark A. Taggart, Richard T. Watson, Munir Z. Virani, Kerri Wolter, Rhys E. Green
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- Journal:
- Bird Conservation International / Volume 18 / Issue S1 / September 2008
- Published online by Cambridge University Press:
- 07 August 2008, pp. S30-S48
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Gyps vulture populations across the Indian subcontinent collapsed in the 1990s and continue to decline. Repeated population surveys showed that the rate of decline was so rapid that elevated mortality of adult birds must be a key demographic mechanism. Post mortem examination showed that the majority of dead vultures had visceral gout, due to kidney damage. The realisation that diclofenac, a non-steroidal anti-inflammatory drug potentially nephrotoxic to birds, had become a widely used veterinary medicine led to the identification of diclofenac poisoning as the cause of the decline. Surveys of diclofenac contamination of domestic ungulate carcasses, combined with vulture population modelling, show that the level of contamination is sufficient for it to be the sole cause of the decline. Testing on vultures of meloxicam, an alternative NSAID for livestock treatment, showed that it did not harm them at concentrations likely to be encountered by wild birds and would be a safe replacement for diclofenac. The manufacture of diclofenac for veterinary use has been banned, but its sale has not. Consequently, it may be some years before diclofenac is removed from the vultures' food supply. In the meantime, captive populations of three vulture species have been established to provide sources of birds for future reintroduction programmes.
13 - The dynamic influence of individual characteristics on employee well-being: a review of the theory, research, and future directions
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- By Christopher J.L. Cunningham, University of Tennessee at Chattanooga, USA, Gabriel M. De La Rosa, Bowling Green State University, USA, Steve M. Jex, Bowling Green State University, USA
- Edited by Katharina Naswall, Stockholms Universitet, Johnny Hellgren, Stockholms Universitet, Magnus Sverke, Stockholms Universitet
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- The Individual in the Changing Working Life
- Published online:
- 13 October 2009
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- 06 March 2008, pp 258-283
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Summary
Continuing changes to the nature of work brought on by technological leaps (e.g. Kurland and Bailey, 1999), increasingly diverse workforces, changes to the traditional contractual nature of work (e.g. Barley and Kunda, 2006), and shifting industry demands make it necessary for researchers who study workers and their work environments to consider dynamic relationships at multiple levels within people and work organizations. Employees are consistently being forced to adapt to meet these changing work demands and a potential cost is personal well-being.
Much of this book focuses on how changing work environments and roles can influence the well-being of employees. It is also critically important to attend to the role of individual characteristics in this process. Throughout this chapter the terms “individual characteristics/differences” represent dispositions and more malleable personal qualities. We will provide a conceptual model that integrates many existing findings regarding these issues and offers a set of clear options for future exploration. We encourage readers to think critically about relationships between individual characteristics and well-being in their own research and practice.
This chapter begins with a discussion of the critically important, complex, and yet underdiscussed well-being criterion. Our conceptual framework is presented, followed by a selective review of research on individual characteristics associated with well-being that we feel are particularly relevant in a changing work environment. Finally, we provide a summary and thoughts for future work in this area.
Well-being and the workplace
There is no single, widely applicable theory of well-being.
13 - Lower gastrointestinal surgery
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- By Douglas M Bowley, Department of Colorectal Surgery, John Radcliffe Hospital, Headley Way, Headington, Oxford, UK, Christopher Cunningham, Department of Colorectal Surgery, John Radcliffe Hospital, Headley Way, Headington, Oxford, UK
- Edited by Andrew N. Kingsnorth, Derriford Hospital, Plymouth, Aljafri A. Majid
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- Book:
- Fundamentals of Surgical Practice
- Published online:
- 15 December 2009
- Print publication:
- 27 April 2006, pp 249-263
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Summary
SURGICAL ANATOMY
Accurate understanding of the pelvic anatomy is critical to achieving good oncological and functional outcomes after rectal excision. Heald et al. (1998) in Basingstoke introduced the concept of total mesorectal excision during the 1980s. Total Mesorectal Excision (TME) consists of separate high ligation of the inferior mesenteric vessels to define the proximal limits of the lymphatic clearance, followed by rectal mobilisation with sharp dissection under direct vision in the avascular plane outside the mesorectum excising the entire mesorectum and leaving the autonomic nerve plexuses intact. This surgical innovation has been shown to reduce local recurrence dramatically, while maximising the chances of sphincter-preserving surgery.
Permanent impotence in men has been reported to be almost universal in some series of abdominoperineal excisions of rectum and occurs in up to half of all men after anterior resection of the rectum for rectal cancer. The incidence of permanent bladder denervation after rectal excisional surgery has been reported to be up to 19% in some series. The presumed mechanism for sexual and urinary dysfunction is damage to the pelvic autonomic parasympathetic and/or sympathetic nerves during surgery.
The risk of sympathetic nerve damage occurs in the abdomen during ligation of the inferior mesenteric artery pedicle, and high in the pelvis during initial posterior rectal dissection adjacent to the large hypogastric nerves.