Accounts of Chemical Research最新文献

Certified child life specialists (CCLS) depend on collaboration with healthcare professionals for awareness of patient needs; however, historically other healthcare professionals misunderstand the CCLS role. The purpose of this study was to examine how healthcare professionals perceived the CCLS role and provide implications on the contribution of the CCLS to interprofessional collaboration (IPC). This study was a partial replication of two previous survey studies. Participants (N = 67) consisted of 26 child life and 42 other healthcare professionals who were employed at one freestanding children's hospital in the southern United States. Qualitative analyses revealed CCLS responsibilities could be explained with seven categories. Child life professionals were more likely to report CCLS responsibilities as providing patient support and family support and documenting psychosocial assessment and interventions in the medical record than other healthcare professionals. Child life and other healthcare professionals are mostly aligned in their perception of the CCLS role, specifically patient education, play, and normalization and development. Previous misconceptions about the CCLS role may be diminishing among other healthcare professionals; however, continued education about the CCLS role and communication with CCLSs would likely promote IPC.

Primary leiomyosarcoma of the tongue is a rare malignant mesenchymal tumor with high recurrence rate and metastatic potential. Through analysis of one case condition and literature review, this paper discusses the clinical characteristics and treatment methods and recommends that expanded resection surgery should be the first intervention. Postoperative adjuvant radiotherapy and combined chemotherapy should be administered if the case specifically requires such an approach.

This report outlines an exploratory study that investigated whether the "Never Events" system - first used in healthcare contexts to identify and investigate preventable incidents that cause serious harm or death as a result of human error - could be adapted in the context of UK multi-agency child protection. Using a sequential design, two online surveys were carried out that explored practitioners' (n = 46) views about the feasibility of adopting the Never Events model and what, if any, incidents or events could be investigated plausibly using such a model. Practitioners were drawn from a purposive sample. An inter-disciplinary panel of senior practitioners - drawn from nursing, public health, social work and child mental health services- discussed the surveys' findings and the list of proposed child protection Never Events. The findings indicate that the complex, judgment-based nature of child protection contributes to difficulties creating shared understandings about what constitutes harm and the extent to which multi-agency systems can share decision-making and responsibility for the way they identify and support families. Thinking through and discussing the relative strengths and limitations of the Never Events model may nevertheless be a valuable exercise in interprofessional training and the design of highly localized review and reporting systems.

Melanotic neuroectodermal tumor of infancy (MNTI) is a rare benign tumor. Here, we report the diagnosis and treatment of 1 case of MNTI in the maxilla and discuss its clinical and pathological features, imaging features, treatment, and prognosis.

Kaposi's sarcoma (KS) is a vascular sarcoma derived from vascular endothelial cells and presents with multiple lesions. It mainly appears on the skin and oral mucosa, usually in the face, oral mucosa, and genitals. Very few cases of primary lesions in the nasal cavity have been reported. It is often difficult to diagnose only by imaging examination. Here, we describe a case of KS in a patient who was human immunodeficiency virus (HIV)-negative, in which the primary sites were the nasal mucosa and nasal septum. A diagnosis was made according to the patient's clinical presentation, physical examination, laboratory examination, imaging examination, and histopathological results. We used surgical resection combined with chemotherapy, with 6 months' postoperative follow-up without recurrence. We reviewed the relevant literature to identify similar cases and summarize the findings reported on this rare manifestation of KS. We recommend that, where possible, antiviral therapy such as interferon, and regular review should continue, to improve the survival rate and patients' quality of life.

Moral distress arises when constraints outside of healthcare professionals' control prohibit them from acting according to the ethically sound course of action. It can be triggered by poor communication and different perspectives between professionals. We examined whether and how taking the perspective of the other profession reduces moral distress among pediatric intensive care nurses and physicians. Using elements of a previously published scale, we created a Vignette-based Moral Distress Rating Scale (V-MDRS). Study participants from three sites included 105 nurses and 34 physicians who read a patient vignette with their own profession's perspective, completed the V-MDRS, then received the other profession's perspective and completed the V-MDRS again. We conducted semi-structured interviews with nine nurses and nine physicians who completed the V-MDRS to explore how interprofessional perspective-taking impacts moral distress. Nurses experienced higher baseline moral distress than physicians (mean ± standard deviation 31.1 ± 6.9 vs 26.4 ± 5, P < .001), and at two study sites nurses' moral distress declined after reading the physician's perspective. Findings from interviews suggest that physicians were already sensitized to nurses' perspective and that perspective-taking may be particularly beneficial to cohesive teams with strong relationships. Thus, encouraging interprofessional perspective-taking may mitigate moral distress in healthcare professionals.

Today's era of integrated working seeks to bring together different professionals to work in patient-centered teams. As a result leadership perspectives have changed. We now seek leaders who recognize the complexity of moderating across different health, social care and other public and private sector organizations for collective patient/community focussed service. This research focuses on the role of leaders in the UK who were asked to lead a range of practitioners working from Children's Centers. These centers brought together a myriad of practitioners from health, social care, and education to meet the needs of children from wide and diverse backgrounds. We share a qualitative study, exploring the experiences of Children's Center leaders, using critical theory and constructivism. The study explored how leaders enable integrated working to flourish. The research was conducted in two stages: In Stage One, five strategic Children's Center managers were interviewed to illuminate the key ingredients felt to support good leaders. Stage Two brought together 10 Children's Center leaders from across different areas of the UK, to share their experiences using Participatory Action Research. The final synthesis identified four main processes which could help leaders to enable integrated working to flourish. These were: i) Thinking Systematically; ii) Building and re-building relationships; ii) Nourishing self-actualization and; iv) Utilizing alternative approaches to problem solving. Four borderline processes were identified: Interaction, Integrity, Flow and Sensitivity. The final model articulates the skills required to lead integrated services which bring together a wide range of practitioners. The outcomes help leaders to explore new ways of leading and require further testing. The outcomes may apply to other clinical areas of integrated working.

We examined interprofessional collaboration in a pre-service training model which incorporated the merging of three treatments: Occupational Therapy, Speech-Language Pathology, and Applied Behavior Analysis. We examined the effects of changes in the clinician interprofessional skill repertoire on therapeutic outcomes for children with Autism Spectrum Disorder. Three licensed professionals modeled core techniques from their respective professions to establish benchmark standards for skill demonstration in the treatment of children with autism. Treatment phases were implemented sequentially targeting multiple therapist and child behaviors within a multiple-baseline across participants' single case experimental design. Therapist skills improved to show a diverse repertoire of intervention techniques to match supervisor proficiencies. These interprofessional skills were delivered simultaneously in a timely and efficient manner. Assessed outcomes for children with autism included increased frequency of verbalizations, engagement during adult-directed interactions, visual-motor task productivity, and improved postural alignment. The study suggests that integrated training across interprofessional techniques enhanced a diverse repertoire of clinician skills, while systematically demonstrating child improvement on many interprofessional treatment goals.

While acyl radicals have been harnessed in synthetic chemistry since their discovery in 1932, their environmental applications remain largely unexplored. Conventional water treatment predominantly utilizes inorganic radicals (^•OH, SO₄^•–, H^•) for their potent redox capabilities. Recent advances in peracetic acid (PAA)-based advanced oxidation processes (AOPs) have spotlighted the peroxyacetyl radical (AcOO^•), an oxidative derivative of the acetyl radical (Ac^•). Though PAA activation cannot directly generate Ac^•, the untapped capabilities of Ac^• merit dedicated investigation.

Our work bridges this knowledge gap by establishing low-molecular-weight diketones (LDKs) as tunable precursors for targeted Ac^• generation. Through integrated electron paramagnetic resonance, laser flash photolysis, and mass spectrometry, we tracked the generation of Ac^• and its key derivatives─Ac^•(OH)₂ and AcOO^•─in UV/LDK systems. Crucially, dissolved oxygen (O₂) serves as a molecular switch: under oxic conditions, Ac^• reacts barrier-free with O₂ to form oxidative AcOO^•, whereas reductive species (Ac^• and Ac^•(OH)₂) dominate under anoxic conditions. This O₂-dependent speciation creates a unique dual-reactivity platform. Ac^• and its derivatives exhibit moderate yet selective reduction potentials, enabling tailored applications─from precision pollutant degradation and metal resource recovery to point-of-use disinfection─all controlled solely by O₂ modulation without additional chemicals.

By unifying mechanistic insights with environmental innovation, this Account establishes acyl radicals as a transformative paradigm for advanced redox technologies. We invite chemists to expand radical selection criteria beyond conventional oxidants, prioritizing tunable, selective, and operationally simple systems enabled by Ac^• chemistry. Key priorities to advance this field include: (1) establishing systematic frameworks for reaction pathways, kinetics, and structure–reactivity relationships across Ac^• generating systems; (2) quantifying interconversion dynamics among Ac^•, Ac^•(OH)₂, and AcOO^• through combined computational and experimental approaches; and (3) investigating radical acetylation mechanisms and targeted biomolecule modification.