Operational Definition Research Articles

Workplace Spirituality in the Tourism and Hospitality Sector: A Systematic Literature Review

Workplace spirituality has gained increasing recognition for its potential to enhance both employee and customer experiences. However, in the tourism and hospitality sector, which centres on employee–customer interactions, this subject remains notably underexplored, underscoring the need for further research to fully understand its impact in this setting. This gap likely stems from a limited understanding of workplace spirituality in this context. Most studies on workplace spirituality in tourism and hospitality emphasize its impact on business outcomes but provide little insight into its conceptualization, theoretical framework and measurement tools. Inconsistencies in operationalizing concepts and variations in dimensions further contribute to the confusion. A comprehensive review is crucial to bridging these gaps and advancing the field. The current study systematically reviews workplace spirituality studies by examining their definitions, theoretical backgrounds, instruments and role in tourism and hospitality. This study used the PRISMA technique to screen articles published between 2000 and 2023 in SCOPUS-listed journals. The authors found several operational definitions of the workplace spirituality used in tourism and hospitality studies. Importantly, the use of various instruments to operationalize concepts makes it challenging to compare findings across studies and leads to inconsistencies in the literature. Given the nature of work in the tourism and hospitality sector, we propose the inclusion of a workplace spirituality dimension. This dimension aims to assist practitioners and academics in measuring employees’ experiences with guests in tourism and hospitality settings. In addition, this study extensively discusses research gaps.

Performance Quality Rating Scale for Somatosensation After Stroke Version 3: Reliability, Feasibility.

The Performance Quality Rating Scale for Somatosensation after Stroke (PQRS-SS) guides observation of survivors of stroke performing client-selected occupations, using common operational definitions. We aimed to determine the inter- and intra-rater reliability, standard error of measurement, and feasibility (via interviews and thematic analysis) of the PQRS-SS version 3. Videos of 22 survivors of stroke with somatosensory impairment completing 38 client-selected occupations on two occasions (76 clips) were viewed by four clinicians twice, 6 weeks apart (PQRS-SS version 3). Intraclass correlation coefficients (ICC), standard error of measurement (SEM), and interview data are reported. For PQRS-SS version 3, inter-rater reliability was moderate to excellent (ICC2,1 = 0.71, ICC2,4 = 0.91) and intra-rater reliability was good (ICC3,1 = 0.76-0.87). Clinician raters reported the PQRS-SS version 3 was easy to use. The PQRS-SS version 3 is ready for use by trained, experienced clinicians and is ready for ongoing psychometric testing.

Management of extremity and pelvic fractures in earthquake: our observations and recommendations

BackgroundEarthquakes frequently cause injuries to the musculoskeletal system. Studies conducted after earthquakes often report on injured limbs, fractures, and surgeries. This study aimed to enhance preparedness for future earthquakes by acquiring knowledge about the prevalence of fractures and the relationship between fracture types and injury mechanisms.MethodsA retrospective analysis was conducted on medical records of patients with fractures admitted to our hospital following the 2023 Kahramanmaraş Earthquake. Patients with fractures resulting from traffic accidents or other causes unrelated to earthquakes were excluded. The recorded data included age, gender, fracture site, fracture type, mechanism of injury, date, duration of surgery, and peak creatine kinase (CK) level. The injury mechanisms were classified into four main categories: injured by falling objects, falling while running, falling from height, and being trapped under rubble. The study investigated the relationship between fractures and other factors.ResultsThe study included 185 patients with a mean age of 39.62 ± 20.83 years. The most frequent mechanism of injury was being trapped under rubble. In total, there were 214 fractures, with pelvic fractures being the most common (21.50% of all fractures). Tibia fractures were the most common fractures in the lower extremities (15.89%). Women had a significantly higher occurrence of pelvic fractures (33.3%) compared to men (14.5%) (p = 0.003). The frequency of pelvic fractures significantly increased as age decreased (p = 0.007). Patients with pelvic fractures had a significantly greater peak CK concentration (p = 0.006). Open fractures were more common in the first few days, and Kirschner wires were the first treatment applied at a mean of 74 h and external fixators at a mean of 94.3 h.ConclusionInjuries from falling objects from roofs and jumping from heights are important in earthquakes. In addition to lower extremity fractures, pelvic fractures are common in earthquake disasters. Most pelvic fractures are simple lateral compression fractures and it is important to follow the patients for crush syndrome in the first days instead of focusing on definitive fracture treatment. Open fractures should be prioritized for fracture surgery within the first few days. External fixators and Kirschner wires are recommended. Closed fractures should be treated conservatively and definitive surgical procedures should be postponed to the following weeks.

On the Dynamics of a Quasi-Strictly Non-Volterra Cubic Stochastic Operator

In this study, we examine cubic stochastic operators, which we will refer to as quasi-strictly non-Volterra cubic operators. Firstly, the definition of a quasi-strictly non-Volterra operator is provided, and the structure of an arbitrary quasi-strictly nonVolterra cubic operator on a two-dimensional simplex S 2 is described. Secondly, the fixed and limit points of the quasi-strictly non-Volterra operator on S 2 are investigated. It is proven that there exists a repelling unique fixed point

The Management Pathway of Patients with Cystic Echinococcosis in Iran Prior to Definitive Surgical Treatment.

Patients with cystic echinococcosis (CE) regularly undergo surgery in medical centers in endemic countries. Our understanding of the challenges patients face on the pathway toward the final diagnosis and treatment of CE is poor. The present study was conducted to evaluate the medical care-seeking pathway and the underlying causes of the delayed surgical treatment of CE. Information related to 68 CE patients who underwent surgery in Kerman, Southeast Iran, was collected through face-to-face visits or telephone calls. All the patients were interviewed, and the medical records of each patient were reviewed. The pathway taken by the patient to seek care, the workups performed for diagnosis and management, and the length of time between the onset of symptoms and definitive diagnosis and surgery were evaluated. The patients were visited by at least two physicians; the median number of physicians was four. A total of 47% of the patients were referred to a general practitioner on their first visit. The mean times between the first visit and CE diagnosis and surgery were 1.5 and 3.2 months, respectively. A definitive diagnosis of CE was made for 35.3% of the patients in less than 1 month after the first visit. However, it took 4 months or more for 51.4% of the patients to receive hydatid surgery. The fear of anesthesia and surgery, the cost of management, unsuccessful chemotherapy for CE patients, pregnancy, and issues related to immigrant patients and refugees are among the factors involved in the protraction of CE diagnosis and treatment. Establishing practice guidelines for CE diagnosis and treatment, continuing education for healthcare professionals, and improving access to diagnostic facilities for endemic communities are required to address challenges in the management of CE in endemic regions.

Mismeasuring STEM?: Assessing STEM Course Taking Among US Bachelor’s Degree Graduates

Abstract STEM refers to four fields of study and occupation: science, technology, engineering, and mathematics. But STEM has taken on social and political meaning far beyond the sum of its component parts. Public and policy discussions of STEM, whether in education or employment, rest on a startling lack of clarity about what counts as STEM. Most studies of postsecondary STEM education focus on students’ programs of study as the measure of STEM education, but we find this metric leads to substantial mismeasurement. Instead, we argue that examining STEM course taking is a more accurate measure of STEM preparation among college students. This descriptive study establishes conceptual and operational definitions of STEM coursework and uses nationally representative college student transcript data to develop a more accurate measure STEM course taking. Finally, we analyze the extent of potential mismeasurement and estimate STEM course taking using this revised classification system. Among bachelor’s degree students, we find wide variation in the number of STEM courses completed by students both within and between programs of study. Moreover, we find that many students in non-STEM programs of study complete substantial amounts of STEM coursework at levels comparable to that of many STEM students.

Venolaryngeal Obstruction Syndrome (VLOS): Characterizing Airway Obstruction in Massive Thyroid Goiters.

Characterize the presentation of chronic airway obstruction for patients presenting with massive thyroid goiters. Demographic data acquisition was undertaken on 5 patients who presented with a compressive goiter and had pre-operative severe airway obstruction secondary to supraglottic and laryngeal edema. Each patient had a resolution of severe airway obstruction post-thyroidectomy. In all, 5 patients were diagnosed with severe airway obstruction due to chronic obstruction by a thyroid goiter. Several airway management interventions were pursued during definitive surgery (conventional or videolaryngoscopic intubation and a hybrid endoscopic approach incorporating the Seldinger technique). Successful thyroidectomy led to rapid resolution of laryngeal edema. Venolaryngeal obstruction syndrome is proposed as a term to describe the laryngeal findings in compressive goiters. The pathophysiological sequence resulting in chronic airway obstruction may have similar mechanisms to expanding neck hematomas after thyroid surgery.

Operational Definitions of Polypharmacy and Their Association with All-Cause Hospitalization Risk: A Conceptual Framework Using Administrative Databases

Polypharmacy, defined as the concurrent use of multiple medications, increases the risk of various adverse outcomes. However, the variability in definitions across the literature contributes to substantial heterogeneity. Building on the published literature, this study aimed to identify a set of operational definitions of polypharmacy applicable to administrative databases and to assess their association with all-cause hospitalization. Data from the pharmacy refill and hospitalization databases of the Local Health Unit (LHU) of Bergamo, Lombardy, were analyzed. Patients aged ≥40 with at least one reimbursed drug prescription in 2017 were included. Prescription coverage was evaluated using total defined daily doses (DDDs), and all-cause hospitalizations from January to June 2018 were considered. Definitions explored included (i) the WHO’s criterion of ≥5 medications by ATC fourth-level code; (ii) the exclusion of prescriptions usually for short-term treatments; and (iii) drugs with cumulative annual DDD ≥ 60. Approaches were assessed annually, quarterly, and monthly, and logistic regression was used to estimate odds ratios (ORs) for hospitalization risk. Among 431,620 patients, the DDD ≥ 60 definition showed the least variability (20.47–21.16%) and identified an older more complex cohort. All definitions showed a dose-dependent association with hospitalization risk. Different definitions of polypharmacy result in varying prevalence, with DDD ≥ 60 being the most consistent. A patient-centric approach is crucial to assess the appropriateness of polypharmacy.

A prospective multi-site translational study investigating the association of gut microbiome (GM) diversity with pathological complete response (pCR) after neoadjuvant treatment in early stage rectal and esophageal cancer.

TPS849 Background: The diversity of the GM is defined as the number and relative abundance distribution of distinct types of microorganisms colonizing within the gut. Studies have suggested that dysbiosis of the GM confers a predisposition to certain malignancies and impacts response to immunomodulating therapies. The influence of the GM diversity on the pathological response after neoadjuvant chemotherapy and radiotherapy is unclear. Some studies have suggested that the GM may offer predictive biomarkers for response to chemoradiation in rectal cancer. Other studies in early-stage rectal cancer patients indicated an association between GM diversity and pathological outcomes following neo-adjuvant therapy (NAT). We hypothesize that a more diverse GM constitution at baseline leads to an improved pathological response at the time of definitive surgery. Methods: We designed a cross-institutional translational study investigating the impact of the GM diversity on the efficacy of NAT in GI cancers by assessing its association with pathological response. The study population includes patients with early-stage rectal or esophageal cancer due to commence NAT (including chemotherapy and chemoradiation) who are planned for definitive surgery. Exclusion criteria includes prior allogenic tissue/solid organ transplantation and prior receipt of anti-cancer therapy. The study assessments include fecal sampling of the GM prior to NAT, upon completion and again six months post completion of therapy. Fecal samples are analysed by 16S RNA sequencing. Pathological response will be examined at time of surgery and patients will be classified as responders (complete pathological response) or non-responders. The primary endpoint of the study is to examine the association between the GM diversity and pathological response. Exploratory analysis will include the assessment of the association between cf-DNA and the GM diversity as well as an assessment of the association between cf-DNA at baseline and pCR. Species richness (Alpha Diversity) will be analysed using the Shannon diversity index and Jaccard similarity index will be used to calculate beta diversity. Following planned study recruitment, classification and clustering analysis will be performed with Principal Component Analysis (PCA) and Random Forest analysis. Logistic regression analysis adjusting for potential confounding factors will be employed to assess the primary endpoint of the association between GM and complete pCR in the final statistical analysis. Adjusted odds ratios (OR) and 95% confidence intervals will be presented. This trial accrued 11 patients between May 2023 and Sept 2024. Out of the 11 patients enrolled, 9 patients have undergone their planned surgery. We are expecting to have 30 patients accrued prior to Jan 2025.

Stage IIIA Non-Small Cell Lung Cancer Treatment and Outcomes: A Single Institution Retrospective Analysis.

Stage III non-small cell lung cancer (NSCLC) treatment remains challenging, with a multitude of treatment options available. We assessed Stage IIIA NSCLC outcomes by treatment received. We performed a single-institution retrospective review of NSCLC patients with Stage IIIA disease treated January 01, 2010-March 01, 2022. Demographics, treatments, outcomes, and failure patterns were collected. Progression-free survival (PFS) and overall survival (OS) were assessed using Kaplan-Meier analysis. Failure patterns were assessed for differences using chi-square analysis. Of 270 Stage III NSCLC patients, 134 had Stage IIIA disease with a median follow-up of 29.9 months and a median age of 66 years (IQR 60-75). 66 (49.3%) patients were male, and 105 (78.4%) were current/former smokers (with 30 median pack-years). Patients were treated with definitive radiation with/without chemotherapy (CRT; n = 77, 57.5%), surgery with neoadjuvant chemotherapy and/or radiation (Neoadj; n = 42, 31.3%), and surgery without neoadjuvant therapy (Surg; n = 15, 11.2%). Median PFS was 25.4 months (95% CI 12.5-42.6) for CRT, 22.6 months (95% CI 12.2-44.4) for Neoadj, and 22.8 months (95% CI 5.2-NA) for Surg with no significant intergroup difference (p = 0.99). Median OS was 57.0 months (95% CI 37.4-77.5) for CRT, 51.5 months (95% CI 36.7-65.5) for Neoadj, and 35.3 months (95% CI 16.8-NR) for Surg with no significant intergroup difference (p = 0.99). In this single institution retrospective study, we find no significant differences in PFS, OS, and failure patterns between patients with Stage IIIA NSCLC treated with definitive (chemo)radiation and surgery with or without neoadjuvant therapy. Further work in the immunotherapy era is needed.

Influence of time to first therapy (TTFT) variable on survival outcomes of neoadjuvant chemotherapy versus upfront surgery approach in resectable pancreatic ductal adenocarcinoma.

720 Background: Evidence demonstrating overall survival (OS) benefit of neoadjuvant chemotherapy (NAC) followed by surgical resection over upfront surgical resection for resectable pancreatic ductal adenocarcinoma (PDAC) has been mixed. The time to first therapy (TTFT) variable has not been studied as a contributing factor. Methods: A nationwide retrospective analysis using the National Cancer Database to evaluate patients with clinical stage T1 and T2 PDACs from 2010 to 2020. Cox proportional hazards model was used to evaluate the impact of NAC followed by definitive surgery compared to upfront surgery on OS with and without TTFT. Results: Total of 43,196 patients were included – 9,880 patients with clinical stage T1 and 33,316 patients with T2 PDACs. There were increasing trends in the NAC approach from 2.9% in 2010 to over 25% by 2020 and decreasing trends in the upfront surgery approach from 69.35% in 2010 to 31.84% by 2020. There were significant differences in TTFT according to the treatment choice with upfront surgery group having a significantly shorter TTFT – proportion of those receiving first treatment within the 1 st week was 24.32% in the upfront surgery compared to 4.22% in the NAC group. In the adjusted cox regression without the TTFT variable, there was a 25% higher rate of death in the upfront surgery compared to the NAC group (HR 1.25, 95% CI 1.19 – 1.30). When the adjusted regression was performed with addition of a TTFT interaction term, there was survival disadvantage of upfront surgery approach in patients whose TTFT occurred after 1 week, but not in those with TTFT occurring in less than 1 week (HR 1.01, 95% CI 0.86 - 1.17). Conclusions: Our study emphasizes the importance of incorporating TTFT variable when comparing NAC versus upfront surgery approach in PDAC. Future studies comparing NAC to upfront surgery in resectable PDAC should consider incorporating the TTFT variable.

Nucleus reuniens: Modulating emotional overgeneralization in peri-adolescents with anxiety.

Anxiety affects 4.4-million children in the USA with an onset between childhood and adolescence, a period marked by neural changes that impact emotions and memory. Negative overgeneralization - or responding similarly to innocuous events that share features with past aversive experiences - is common in anxiety but remains mechanistically underspecified. The nucleus reuniens (RE) has been considered a crucial candidate in the modulation of memory specificity. Our study investigated its activation and functional connectivity with the medial prefrontal cortex (mPFC) and hippocampus (HPC) as neurobiological mechanisms of negative overgeneralization in anxious youth. As part of a secondary data analysis, we examined data from 34 participants between 9 and 14years of age (mean age ± SD, 11.4 ± 2.0years; 16 females) with varying degrees of anxiety severity. During the Study session participants rated images as negative, neutral, and positive. After 12h, participants returned for a Test session, where they performed a memory recognition test with repeated (targets) and similar (lures) images. Labeling negative relative to neutral lures as "old" (false alarms) was our operational definition of negative overgeneralization. Negative relative to neutral false alarmed stimuli displayed elevated RE activation (at Study and Test) and increased functional connectivity with the Cornu Ammonis (CA) 1 (at Test). Elevated anxiety severity was associated with reductions in the RE-mPFC functional coupling for neutral relative to negative stimuli. Exploratory analyses revealed similar patterns in activation and functional connectivity with positive stimuli. Our findings demonstrate the importance of the RE in negative overgeneralization and anxiety.

Interpersonal process features of collaboration between probation and behavioral health practitioners.

This study sought to identify and conceptualize the central interpersonal process features that comprise good collaboration between behavioral health practitioners (BHPs) and probation officers (POs). Eighteen POs and 21 BHPs from geographically adjacent jurisdictions in a Midwestern state each participated in one of six focus groups. Researchers systematically coded focus group transcripts for interpersonal collaborative themes using both inductive and deductive strategies. Seven core themes-shared values and beliefs, communication and information sharing, knowledge of the other, trust, respect, team-based decision making, and equitable contribution-were identified and coded for importance, as indexed by frequency, latent tone, and group consensus. An initial working operational definition of these constructs, based on practitioners' dialogue, is also provided. This study is one of the first to provide BHPs and POs who work with justice-involved people with prescriptive guidance about interpersonal actions and approaches that will best serve their professional collaborative efforts. Future research should examine whether these constructs hold across other samples and contexts and work to fully operationalize and measure these constructs and their importance for affecting various outcomes. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

On the Sufficient Conditions for the Univalence of Definite Integral Operators Involving Certain Functions in S Class

In general terms, integral operators play a very important role as a useful mathematical tool in order to reach the desired results and make different inferences by analyzing the relevant issues in mathematics and applied sciences. It is important to understand the conditions under which integral operators map certain analytic functions to starlike and convex functions and effectively characterizing and using them is of great importance for studies in this field. In present article, some integral operators preserving class S are examined from a different perspective and the relevant inequalities and equations for their univalence are determined and solved.

Evidence of content validity of the "Blood Transfusion Reaction" (code 0700) nursing outcome from the nursing outcomes classification.

The objective of study was to present evidence of the content validity of conceptual and operational definitions of the "Blood Transfusion Reaction (code 0700)" nursing outcome from the Nursing Outcomes Classification (NOC). A methodological study was implemented in four phases. The first phase consisted of a narrative literature review in which the main indicators related to blood transfusion were identified: 25 new indicators that were not present in NOC, in addition to 14 existing indicators, for a total of 39 to be studied. In the second phase, conceptual and operational definitions, and magnitude of NOC indicators were developed. The third phase consisted of analysis of evidence of content validity of conceptual and operational definitions of indicators, through assessment by experts. In the fourth phase, a pilot test was applied to 40 electronic medical records of patients who received blood components and presented with a transfusion reaction. A total of 27 articles were analyzed and served as support to develop conceptual and operational definitions, and magnitude of indicators, considered for the outcome under study. It was assessed by a group of 10 experts, requiring three rounds to reach the established critical content validity ratio in which four of these indicators were excluded, leaving 35 indicators in the final version. A pilot test on 40 records revealed the presence of 13 indicators, of which six were present in the classification. The conceptual and operational definitions and magnitude developed for the "Blood Transfusion Reaction (code 0700)" nursing outcome demonstrated adequate evidence of content validity in the 21 indicators found in the literature, along with 14 indicators already present in NOC, and 13 of these indicators were present in patients receiving blood components who presented a transfusion reaction. Nurses can use this nursing outcome as a clinical assessment tool for monitoring blood transfusion recipients' clinical signs.

Prevalence of selected chronic diseases, health seeking behaviour and associated factors among the elderly workers of a selected district of Sri Lanka

Introduction: Sri Lankan demographic transition has shifted the country to a fast-ageing population. Consequently, elderly in labour force will be noteworthy. Ageing increases the prevalence of non-communicable diseases. Hence, its prevalence, health seeking behaviour and associated factors need to be sought to improve the health of elderly workforce. Objectives: To describe the sociodemographic and work-related characteristics of elderly workers, health status, health seeking behaviour and association between the health seeking behaviour and sociodemographic and work-related characteristics in Gampaha District of Sri Lanaka Methods: A community-based descriptive cross-sectional study was conducted using multistage cluster sampling in Gampaha District, Sri Lanka among 835 elderly workers who met the operational definition and eligibility criteria. Data were collected using a pretested interviewer-administered questionnaire, covering sociodemographic and occupational details, and information on chronic illnesses and health-seeking behaviour. Bivariate analysis was carried out using Chi--squared test, considering a p-value of 0.05 as statistically significant. Results: Majority of the workers (78.4%; n=655) were having at least one chronic illness and the occupation of 58% of them was affected by their chronic illness. For acute and chronic illness, 48.1% were taking treatment from private medical centres. The healthcare seeking behaviour for chronic conditions among the elderly was influenced by factors such as educational level, income, marital status, living arrangements, skill level and working patterns. Conclusions & Recommendations: The findings emphasize the need for policies and interventions that address socio-demographic disparities in healthcare access by promoting family support, insurance schemes, and adopting the health care facility provision according to the workplaces and working patterns.

Studying Repeat Victimization: A Consideration of Measurement Issues

Decades of research have recognized the phenomenon of repeat victimization and its policy relevance. Although there are continuing efforts to explain the theoretical underpinnings of repeat victimization, there are still measurement-related issues that limit our understanding of the topic and ability to inform interventions, including varying operational definitions, data constraints, and sampling and nonsampling error. In this article, we review theoretical advances in the literature over the past decade, propose operationalizations that can foster greater consistency across studies, comprehensively assess the data constraints around commonly used public data sources to study repeat victimization, and empirically demonstrate how one of these constraints—missing data—can be considered. Recommendations for future research in the area of repeat victimization are provided.

Supporting secondary school students’ understanding of time dilation through simulation-based inquiry learning

ABSTRACT While time dilation is considered one of the most iconic outcomes of Einstein’s special theory of relativity, it is widely recognised as a challenging topic in physics education. Rather than performing classroom experiments, students may explore time dilation by performing guided virtual experiments in a simulation environment. We describe the development of a 90-minute research lesson that aims to introduce time dilation through simulation-based inquiry learning. The research lesson was designed, performed, observed and evaluated collaboratively in a team of researchers and physics teachers, following the approach of Lesson Study. Results indicate that the simulation activities supported students in uncovering and specifying cognitive conflict, and that learning gains in the simulation activities were generalised and transferred in post-lesson activities. For many students, however, it was challenging to interpret and explain the simulations correctly, especially with regard to the relativistic behaviour of light. We conclude that a stronger emphasis on foundational concepts and operational definitions may be required for students to yield meaningful conceptual understanding from the simulation activities.

Development of a novel instrument to measure Japanese psychiatric nurses' technological competency as caring in nursing.

To effectively advance person-centered care (PCC) practice, it is important to equip healthcare providers with person-centered values and beliefs while simultaneously transforming their work environment to align with PCC. Thus, instruments to measure caring practice status in nursing competency for psychiatric-specific behavioral limitations, ethico-moral behavior, technology use, and PCC need to be developed. This study developed the Technological Competency as Caring in Psychiatric Nursing Instrument (TCCNPNI) to measure practice status and test its content and construct validity. Five different phases were followed: 1) Literature Review; 2) Operational definition of the construct and development of items; 3) Two-round Delphi method; 4) Validity measure; and 5) Reliability measure. The online survey was conducted in 2024. The developed instrument comprises 22 items with a 4-factor structure: competency to practice caring and person-centered care (Factor 1); competency to recognize and respond to ethical issues in psychiatry (Factor 2); competency to utilize technology in psychiatry (Factor 3); and competence to practice care for the preservation of human dignity and shared decision making (Factor 4). Cronbach's alpha for the entire scale was 0.864, while that for factors 1-4 was 0.911, 0.814, 0.773, and 0.64, respectively. Cumulatively, these four factors contributed 49.6% and explained nearly 50% of the total data. Item-total correlation values were 0.6 or higher among factors 1-3. However, factor 4, for which items were Q30, Q33, Q34, and Q35 (r = 0.03, 0.04, 0.21, 0.11, respectively), were inverted items and had low I-T correlation values. These low correlations suggest that these items capture different concepts. The developed TCCNPNI allows for the measurement of the practice of nursing as caring in psychiatry, the state of ethico-moral behavior, and the practice status of technological competency as caring in psychiatric nursing. This study demonstrated satisfactorily and efficiently evaluated the practice status of technological competency in psychiatric nurses' caring. Measuring technological competency as caring in psychiatric nursing can be an important adjunct for in-service education in psychiatric hospitals or formalized nursing education in nursing universities.

The effectiveness of ERCP in managing preoperative complications of choledochal cysts in children and its role in facilitating early surgical intervention

IntroductionCurrently, there is no established guideline for the application of ERCP in children with choledochal cyst. This study aimed to investigate the safety and effectiveness of ERCP in managing preoperative complications of choledochal cyst in children, as well as the timing for definitive surgery following ERCP.MethodsWe conducted a retrospective review of medical records for 68 pediatric patients who presented with complications of choledochal cyst, including pancreatitis and biliary obstruction combined with cholangitis. All patients underwent ERCP treatment followed by definitive surgery. The primary outcomes assessed included treatment efficacy, post-ERCP complication, and the impact of ERCP on definitive surgical procedures.ResultsAmong the 68 patients studied, 41 presented with pancreatitis, while the remaining patients had biliary obstruction and cholangitis. Sixty-five patients successfully completed their treatments, with 64 experiencing alleviation of symptoms. Significant improvements were observed in serum amylase levels and liver function tests following ERCP. Post-ERCP complications occurred in three cases, including one case of pancreatitis and two cases of infection. The median interval between ERCP and surgery was 11 days. There was no significant difference in primary outcomes, such as surgical duration, rate of minimally invasive surgery, conversion to open surgery, intraoperative bleeding volume, intraoperative blood transfusion, postoperative complications, or average length of hospital stay, between the early surgery group (≤2 weeks) and the late surgery group (>2 weeks).ConclusionsERCP was proved to be a safe and effective intervention for alleviating preoperative complications in pediatric patients with choledochal cyst. Early definitive surgery following ERCP did not significantly impact the perioperative outcomes of pediatric patients.