Understanding the causes and consequences of envy among nurses: A scoping review.

AIM: This scoping review presents an overview of the causes and consequences of envy among clinical nurses. BACKGROUND: Many nurses in the United States have in recent years left their permanent positions for temporary agency assignments that pay higher salaries. Although greed seems like a likely explanation for the rise in travel nursing, humans tend to have a particular interest in wanting what others have. EVALUATION: A five-stage scoping review framework and the PRISMA-ScR checklist guided this review. KEY ISSUES: Social comparison and malicious envy are prevalent among nurses. Envy is a powerful emotion that affects human communication and behaviour in organizations. Scholars have underexplored the potential benefits of leveraging benign envy in the nursing context. CONCLUSION: The results highlight the relational nature of envy. Social comparison and envy provide an insight that suggests that nurses who change jobs are not necessarily greedy. They may be seeking the right mix of tangible and intangible rewards. IMPLICATIONS FOR NURSING MANAGEMENT: Greed and envy can motivate nurses to change jobs. Although envy and greed may produce the same outcome, they are qualitatively different. The motivation to change jobs alludes to nurses' desire to have better control of their professional and personal lives.

A scoping review of the nursing workforce's changing demography: Supporting Baby-Boomer nurses.

AIMS: This scoping review discusses two telecommuting options to advance scholarship regarding Baby-Boomer nurses' delayed retirement and to extend their contribution to bedside nursing. BACKGROUND: Peer-reviewed studies published in the 15 years before COVID-19 indicate that Baby-Boomer nurses' retirement will increase the global nursing shortage. However, three international trends have affected Baby-Boomer nurses' decision to delay their retirement. EVALUATION: This review observed the scoping review framework. KEY ISSUES: COVID-19 further disrupts the current understanding of Baby-Boomer nurses' retirement as they recognize COVID-19's impact on health care systems and younger nurses. Technological advancements and the changing needs of health care delivery have made telecommuting a practical possibility. CONCLUSION: Baby-Boomer nurses can leverage alternative work arrangements to meet their needs and to contribute to clinical practice through telecommuting. This approach extends Baby-Boomer nurses' careers and creates a resource for bedside nurses. IMPLICATIONS FOR NURSING MANAGEMENT: Clinical experience matters at the bedside. Telecommuting maximizes the retention of Baby-Boomer nurses' clinical expertise to benefit patients and to socialize bedside nurses. Baby-Boomer nurses can contribute to patient monitoring as well as patient education and counselling through telehealth. They can also provide asynchronous and synchronous telementoring to bedside nurses.

Social comparison and perceived envy-motivated communication involving travel nurses: A qualitative study.

AIM: This study investigated travel nurses' perception of their communication and relational experiences with other nurses. BACKGROUND: It is common for nurses to offer and to accept help, especially since nurses enter and exit numerous nursing teams throughout their careers and sometimes several times within a single shift. The social norm of reciprocity suggests that nurses supported by other nurses will likely reciprocate in prosocial behaviour. However, when and whom one can or will help highlight differences in individuals' ability to share and compete for personal and professional resources. METHOD: Thematic analysis on data collected through semi-structured interviews. RESULTS: Four categories of perceived envy-motivated communication conceptualize nurses' communication and relational experiences. CONCLUSION: This study underscores the pervasiveness of social comparison and perceived envy-motivated communication among nurses. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers should explore how they might leverage social comparison and the effects of envy to improve unit productivity. One strategy that nurse managers might adopt to promote fairness perception and trust is to communicate expressly how they allocate resources to their nurses. A sequential strategy to level the gap in nurses' exposure to different ways of overcoming resource deficiencies is to encourage mutual learning as prosocial behaviour.

How do nurses' work arrangements influence nurse managers' communication? A qualitative study.

AIM: To understand how nurses' work arrangements influence nurse managers' communication with their nurses. BACKGROUND: Transient work relations affect nurse coordination and the way nurse managers work, especially since giving feedback is an important managerial responsibility. METHOD: Semi-structured interviews conducted between June 2016 and November 2017. RESULTS: Although professional communication on direct patient care is mostly standardized, nurses' work arrangements influence how nurse managers mentor and provide feedback. CONCLUSION: Facilities must explore avenues to provide nurse managers with adequate resources so that they can mentor both permanent and temporary nurses to their full professional potential. The implementation of formal mentoring programmes is important to ensure that temporary nurses receive the same information and support that permanent nurses receive and that permanent nurses feel comfortable to critically evaluate information from trusted sources. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers with limited mentoring resources may have to make practical decisions on whom they mentor, but this practical approach becomes a problem when nurses who do not receive adequate mentoring bring their deficiencies to other facilities. The rise in alternative work arrangements requires a shift in thinking about mentoring as a managerial responsibility to improve nursing care delivery universally and not unit specific.

[Biology and mechanobiology of the intervertebral disc]. / Biología y mecanobiología del disco intervertebral.

The intervertebral disc (IVD) is noted for its low cell content, and being the largest avascular structure of human body. The low amount of cells in the disc have to adapt to an anaerobic metabolism with low oxygen pressure and acidic pH. Apart from surviving in an adverse microenvironment, they are exposed to a high level of mechanical stress. The biological adaptation of cells to acidosis and hyperosmolarity conditions are regulated by mechanoproteins, which are responsible for converting a mechanical signal into a cellular response, thus modifying its gene expression. Mechanobiology helps us to better understand the pathophysiology of IVD and its potential biological repair.

Diplopia as the First Sign of Gastric Carcinoma.

Orbital metastasis may be the initial manifestation of a malignancy of unknown origin. The primary locations of orbital metastasis are usually the lung, prostate, gastrointestinal tract, skin, kidney, eye, or thyroid gland. Metastasis of gastric carcinoma to an extraocular eye muscle is extremely rare. A solitary thickening in an extraocular eye muscle with no inflammatory features is suspect for a tumor. Symptoms such as diplopia, proptosis, ptosis, vision loss, or pain may be associated with an orbital malignancy. Our patient, a 67-year-old man known with radically resected prostate cancer, presented with complaints of vertigo with a tendency to fall, headache, and diplopia when looking to the right. As a coincidental finding, swelling of the rectus lateralis muscle of the left eye was observed on imaging. Extensive additional investigations showed that a gastric carcinoma with intraorbital and leptomeningeal metastasis was the cause. In conclusion, a solitary thickened extraocular eye muscle should be recognized in time and examined further.

Inflammation in the intervertebral disc herniation. / Inflamación en la hernia del disco intervertebral.

Up until fairly recently, it was thought that sciatic pain in the lumbar herniated disc was caused by compression on the nerve root. However, the lumbar herniated disc shows mixed pictures which are difficult to explain by simple mechanical compromise. In recent years various immunology, immunohistochemistry and molecular biology studies have shown that the herniated tissue is not an inert material, but rather it Is biologically very active with the capability of expressing a series of inflammatory mediators: cytokines such as interleukin-1, interleukin-6, interleuquin-8 and tumor necrosis factor being the ones which stand out. The inflammation is not only induced by the chemical irritation of the bioactive substances released by the nucleus pulposus but also by an autoimmune response against itself. Thus, in addition to the mechanical factor, the biomechanical mediation plays an important role in the pathophysiology of sciatic pain and of radiculopathy. Through a review of a wide range of literature, we researched the cellular molecular mediators involved in this inflammatory process around the lumbar herniated disc and its involvement in sciatic pain.

How do nurse managers describe clinical nurses' work arrangements? A qualitative study.

Aim: The researcher sought to understand how nurse managers describe nurses in alternative work arrangements. Design: The researcher conducted this study using grounded theory. Method: Semi-structured interviews. A theoretical sample of 26 baccalaureate-prepared nurse managers located across the United States participated in the study. Results: A typology of five work arrangements provides descriptors that contribute toward greater conceptual clarity on nurses' work arrangements. The data reveal that the typology is fluid because nurses can easily switch across work arrangements. Because the rise in alternative work arrangements means that nurses can leave permanent positions-or explore different work arrangements-when circumstances permit or necessitate, nurses who do not receive continued mentoring will likely bring their deficiencies in skill and/or knowledge to facilities where they find future employment. Hence, inadequate mentoring at the unit level has practical consequences for the quality of patient care at the institutional level.

Alternative work arrangements: Reshaping the future of nurses' workplace communication and relationships.

AIM: This commentary advocates a research agenda for studying how alternative work arrangements (AWAs) affect nurse management and leadership. BACKGROUND: AWAs mitigate burnout and the distributional imbalance of nurses. However, scholarship has shed limited light on how AWAs shape nurses' workplace communication and relationships. EVALUATION: Peer-reviewed nursing and management scholarship. KEY ISSUE: As healthcare systems in many countries move toward team-based care, communication becomes even more important for effective coordination and collaboration among healthcare team members. CONCLUSION: Researchers should invest greater resources to understand the influence that AWAs have on different organizational settings as well as on the relational coordination among nurses and their managers. IMPLICATIONS FOR NURSING MANAGEMENT: Because care delivery and workplace relations depend heavily upon effective collaboration, researchers must update scholarship on AWAs to inform nurses and their managers on how they may strategically and effectively adapt their communication to evolving work environments that undergo frequent changes in nursing staff and teams.

Temporary divergence paralysis in viral meningitis.

A 43-year-old woman who reported diplopia and headache was found to have comitant esotropia at distance fixation and normal alignment at reading distance (divergence paralysis). Eye movement, including abduction, was normal as was the rest of the neurologic examination. Brain MRI was normal. Lumbar puncture showed an elevated opening pressure and a cerebrospinal fluid formula consistent with viral meningitis. The patient was treated with intravenous fluids and analgesics and with a temporary prism to alleviate diplopia. Within 3 weeks, she had fully recovered. This is the first report of divergence palsy in viral meningitis.

A prospective multicentre randomized placebo-controlled superiority trial in patients with suspected bacterial endophthalmitis after cataract surgery on the adjuvant use of intravitreal dexamethasone to intravitreal antibiotics.

PURPOSE: We aimed to determine whether intravitreal dexamethasone as an adjuvant to intravitreal antibiotics is beneficial in the treatment of suspected bacterial endophthalmitis after cataract surgery. METHODS: Randomized, placebo-controlled superiority trial in three tertiary referral centres in the Netherlands. Patients with suspected bacterial endophthalmitis within 6 weeks after cataract surgery were eligible. A diagnostic vitreous biopsy was taken for culture, and patients received intravitreal injections of 400 µg dexamethasone (without preservatives) or placebo, in addition to 0.2 mg vancomycin and 0.05 mg gentamicin. The vancomycin and dexamethasone or placebo injections were repeated once at day 3 or 4. Primary outcome measure was best-corrected visual acuity (BCVA) at 1 year. RESULTS: Between 1 November 2004 and 1 March 2014 (excluding two interruptions totalling 20 months), 324 eligible patients presented. A total of 167 patients (81 dexamethasone, 86 placebo) were available for the intention-to-treat analysis. Biopsies of 114 patients (68%) were culture-positive. Final BCVA did not differ between the dexamethasone and the placebo group (logMAR 0.31 ± 0.58 versus 0.27 ± 0.50; p = 0.90), nor did the number of patients with final vision of no light perception (LP, 7 versus 13). Pain, corneal oedema, the absence of a red fundus reflex on presentation, LP on presentation and culture of virulent pathogens from biopsy were statistically significantly associated with an unfavourable visual outcome. CONCLUSION: Intravitreal dexamethasone without preservatives as an adjuvant to intravitreal antibiotics does not improve visual acuity (VA) in patients treated for suspected bacterial endophthalmitis after cataract surgery.

Inflamación en la hernia del disco intervertebral / Inflammation in the intervertebral disc herniation

Hasta no hace muchos años, se consideró que el dolor ciático, en la hernia del disco intervertebral lumbar, estaba originado por la compresión sobre la raíz nerviosa. Sin embargo, la hernia del disco intervertebral lumbar presenta cuadros muy heterogéneos inexplicables con el simple compromiso mecánico. En los últimos años, numerosos estudios de inmuhistoquímica y de biología molecular han demostrado que el tejido herniado no es un material inerte sino, por el contrario, biológicamente muy activo con capacidad de expresar una serie de mediadores de inflamación entre los que destacan citoquinas proinflamatorias como la interleuquina1, interleuquina 6, interleuquina 8 y el factor de necrosis tumoral. La inflamación parece estar no solo inducida por la irritación química de las sustancias bioactivas liberadas por el núcleo pulposo, sino también mediante una respuesta autoinmune contra el mismo. Por tanto, además del factor mecánico, la mediación bioquímica tiene un papel importante en la fisiopatología del dolor ciático y de la radiculopatía. A través de una extensa revisión sistemática de la literatura se han investigado los mediadores celulares y moleculares que intervienen en dicho proceso inflamatorio alrededor de la hernia del disco intervertebral lumbar y su implicación en el dolor ciático (AU)

Up until fairly recently, it was thought that sciatic pain in the lumbar herniated disc was caused by compression on the nerve root. However, the lumbar herniated disc shows mixed pictures which are difficult to explain by simple mechanical compromise. In recent years various immunology, immunohistochemistry and molecular biology studies have shown that the herniated tissue is not an inert material, but rather it Is biologically very active with the capability of expressing a series of inflammatory mediators: cytokines such as interleukin-1, interleukin-6, interleuquin-8 and tumor necrosis factor being the ones which stand out. The inflammation is not only induced by the chemical irritation of the bioactive substances released by the nucleus pulposus but also by an autoimmune response against itself. Thus, in addition to the mechanical factor, the biomechanical mediation plays an important role in the pathophysiology of sciatic pain and of radiculopathy. Through a review of a wide range of literature, we researched the cellular molecular mediators involved in this inflammatory process around the lumbar herniated disc and its involvement in sciatic pain (AU)

[Laser pointers are not toys; eye injury with permanent loss of visual acuity]. / Een laserpen is geen speelgoed: oogletsel met blijvend visusverlies.

In the nineteen-nineties, there was much hype in the European media about presumed laser pointer maculopathy. However, the recent introduction of more powerful and therefore more dangerous laser pointers and their easy availability on the internet necessitates vigilance on the issue. This is an urgent matter, as here we report three cases of proven maculopathy due to an unsafe laser pointer. Three boys aged 13, 9 and 12 years used an unsafe laser pointer as a toy and looked repeatedly into the pointer, resulting in a permanent reduction in visual acuity due to macular damage. Laser pointers are not designed to be children's toys or instruments to annoy people in a crowd. Health authorities and the ophthalmic community should be aware of the potential danger of improper use of high-output laser pointers and warn the general public before the widespread availability of unsafe laser pointers and consequently laser pointer-induced macular damage becomes a true social problem.

Biología y mecanobiología del disco intervertebral / Biology and mechanobiology of the intervertebral disc

El disco intervertebral (DIV) se caracteriza por su escasa celularidad y por constituir la estructura avascular más grande del cuerpo humano. Las escasas células del disco tienen que adaptarse a un metabolismo anaerobio con baja tensión de O2 y pH ácido. Además de sobrevivir a un microambiente adverso, están expuestas a un elevado estrés mecánico. La adaptación biológica de las células a las condiciones de acidosis e hiperosmolaridad está regulada por mecanoproteínas responsables de convertir una señal mecánica en respuesta celular, modificando su expresión génica. La mecanobiología nos ayuda a entender mejor la biopatología del DIV y su potencial reparación biológica

The intervertebral disc (IVD) is noted for its low cell content, and being the largest avascular structure of human body. The low amount of cells in the disc have to adapt to an anaerobic metabolism with low oxygen pressure and acidic pH. Apart from surviving in an adverse microenvironment, they are exposed to a high level of mechanical stress. The biological adaptation of cells to acidosis and hyperosmolarity conditions are regulated by mechanoproteins, which are responsible for converting a mechanical signal into a cellular response, thus modifying its gene expression. Mechanobiology helps us to better understand the pathophysiology of IVD and its potential biological repair

Effect of intravitreal dexamethasone on vitreous vancomycin concentrations in patients with suspected postoperative bacterial endophthalmitis.

PURPOSE: To study intravitreal dexamethasone and vancomycin concentrations, when used together in patients with suspected postoperative bacterial endophthalmitis. Animal studies had suggested that dexamethasone might decrease the concentration of vancomycin. DESIGN: Prospective randomized clinical trial in a tertiary referral center. METHODS: Twenty-nine consecutive patients with suspected postoperative bacterial endophthalmitis underwent a vitreous biopsy followed by intravitreal injection of antibiotics (0.2 mg vancomycin, 0.05 mg gentamicin) and 400 mug dexamethasone or placebo. After 3-4 days, the intravitreal injection of antibiotics and dexamethasone or placebo was repeated. In 18 patients, a second biopsy was taken for repeat culture and measurement of vancomycin and dexamethasone concentrations. RESULTS: In 20/29 patients (69%) the first vitreous cultures were positive; the second culture was negative in all cases. Thirteen out of 29 patients received dexamethasone. Dexamethasone concentrations showed an average of 25 ng/ml 3 days after injection, with an estimated half-life of 5.5 h. Vancomycin concentrations in patients given dexamethasone tended to be higher compared with those in the placebo group (P=0.061). CONCLUSION: Intravitreal dexamethasone does not lead to decreased vancomycin concentrations, when given simultaneously in the treatment of patients with suspected bacterial endophthalmitis.

Intravitreal dexamethasone as adjuvant in the treatment of postoperative endophthalmitis: a prospective randomized trial.

PURPOSE: To study whether intravitreal dexamethasone as adjuvant to intravitreal antibiotics improves the outcome in patients with suspected postoperative bacterial endophthalmitis. DESIGN: Prospective randomized clinical trial. SETTING: Tertiary referral center. PATIENT POPULATION: Twenty-nine consecutive patients with suspected postoperative bacterial endophthalmitis within 6 weeks of cataract surgery. INTERVENTION: Patients underwent a vitreous biopsy followed by intravitreal injection of antibiotics (0.2 mg vancomycin and 0.05 mg gentamicin) and 400 microg dexamethasone or placebo. After 3-4 days the intravitreal injection of antibiotics and dexamethasone or placebo was repeated. PRIMARY OUTCOME MEASURE: Snellen visual acuity at 3 and 12 months after treatment. RESULTS: In 20/29 patients (69%) the vitreous cultures were positive. 13/29 patients received dexamethasone. Seven patients had a functionally lost eye (final vision of hand movements or less), in four due to retinal detachment. Visual acuity tended to be better in the dexamethasone treated patients than in those given placebo, at both 3 months (P=0.055) and 12 months (P=0.080). CONCLUSION: This small prospective, placebo-controlled series showed a trend towards a better visual outcome in patients with suspected bacterial endophthalmitis when treatment with intravitreal antibiotics was combined with intravitreal dexamethasone. Our findings justify a larger multicenter randomized study.