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Discusses the interdisciplinary needs of library users and the activities that create those needs. Analysis of the knowledge system; Factors influencing the interdisciplinary fields; Indications that interdisciplinary is no longer peripheral to the academy but is regarded in many quarters as essential to the knowledge system; Description of the cumulative effect of alternative organizations of knowledge.

Since World War II there has been a growing momentum for interdisciplinary problem-focused research (IDR) performed by teams of disciplinary specialists. Increased efforts to understand the nature and successful management of IDR have led to an exponential increase in, and a growing consolidation of scholarship on the subject. By tracing the evolution of the current body of knowledge on IDR, we can not only determine the sociological and epistemological factors in the production and use of that knowledge but also ascertain the current state of the art in the field. [ABSTRACT FROM PUBLISHER]

The article focuses on integrative learning interdisciplinary studies. Heightened interest in integrative learning and interdisciplinary studies has led many to wonder about the relationship between these concepts. "Integrative learning" is the broader of the two. It is an umbrella term for structures, strategies, and activities that bridge numerous divides, such as high school and college, general education and the major, introductory and advanced levels, experiences inside and outside the classroom, theory and practice, and disciplines and fields. There is no unique or single pedagogy for integrative interdisciplinary learning. Recalling the role faculty in experimental colleges played in developing both interdisciplinary curricula and integrative pedagogies. Multidisciplinary approaches align subjects or disciplines in parallel schedules or units. However, students do not necessarily have integrative experiences. Contextuality, conflict, and change are the defining parameters of this kind of learning. Contextuality is a different metaphor of knowledge and education than unity, which assumed consistent, logical relations within a linear framework with the expectation of achieving certainty and universality.

The inflammatory bowel diseases (IBD) known as Crohn's disease (CD) and ulcerative colitis (UC) are chronic inflammatory diseases of the gastrointestinal tract believed to arise because of an imbalance between the epithelial, immune and microbial systems. It has been shown that biological differences (genetic, epigenetic, microbial, environmental, etc.) exist between patients with IBD, with multiple risk factors been associated with disease susceptibility and IBD-related phenotypes (e.g. disease location). It is also known that there is heterogeneity in terms of response to therapy in patients with IBD, including to biological therapies that target very specific biological pathways (e.g. TNF-alpha signaling, IL-23R signaling, immune cell trafficking, etc.). It is hypothesized that the better the match between the biology targeted by these advanced therapies and the predominant disease-associated pathways at play in each patient will favor a beneficial response. The aim of this pilot study was to identify potential biological differences associated with differential treatment response to the anti α4β7 integrin therapy known as Vedolizumab. Our approach was to measure a broad range of analytes in the serum of patients prior to initiation of therapy and at the first clinical assessment visit, to identify potential markers of biological differences between patients at baseline and to see which biomarkers are most affected by treatment in responders. Our focus on early clinical response was to study the most proximal effects of therapy and to minimize confounders such as loss of response that occurs further distal to treatment initiation. Specifically, we performed targeted analyses of >150 proteins and metabolites, and untargeted analyses of >1100 lipid entities, in serum samples from 92 IBD patients (42 CD, 50 UC) immediately prior to initiation of therapy with vedolizumab (baseline samples) and at their first clinical assessment (14-week samples). We found lower levels of SDF-1a, but higher levels of PDGF-ββ, lactate, lysine, phenylalanine, branched chain amino acids, alanine, short/medium chain acylcarnitines, and triglycerides containing myristic acid in baseline serum samples of responders as compared to non-responders. We also observed an increase in serum levels of CXCL9 and citrate, as well as a decrease in IL-10, between baseline and week 14 samples. In addition, we observed that a group of metabolites and protein analytes was strongly associated with both treatment response and BMI status, although BMI status was not associated with treatment response., Competing Interests: COMPETING INTERESTS STATEMENT Authors have no potential conflicts (financial, professional, or personal) or competing interests relevant to the manuscript.

Background: The metabolic environment plays a crucial role in the development of heart failure (HF). Our prior research demonstrated that myo-inositol, a metabolite transported by the sodium-myo-inositol co-transporter 1 (SMIT-1), can induce oxidative stress and may be detrimental to heart function. However, plasmatic myo-inositol concentration has not been comprehensively assessed in large cohorts of patients with heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF)., Methods: Plasmatic myo-inositol levels were measured using mass spectrometry and correlated with clinical characteristics in no HF subjects and patients with HFrEF and HFpEF from Belgian (male, no HF, 53%; HFrEF, 84% and HFpEF, 40%) and Canadian cohorts (male, no HF, 51%; HFrEF, 92% and HFpEF, 62%)., Findings: Myo-inositol levels were significantly elevated in patients with HF, with a more pronounced increase observed in the HFpEF population of both cohorts. After adjusting for age, sex, body mass index, hypertension, diabetes, and atrial fibrillation, we observed that both HFpEF status and impaired kidney function were associated with elevated plasma myo-inositol. Unlike HFrEF, abnormally high myo-inositol (≥69.8 μM) was linked to unfavourable clinical outcomes (hazard ratio, 1.62; 95% confidence interval, [1.05-2.5]) in patients with HFpEF. These elevated levels were correlated with NTproBNP, troponin, and cardiac fibrosis in this subset of patients., Interpretation: Myo-inositol is a metabolite elevated in patients with HF and strongly correlated to kidney failure. In patients with HFpEF, high myo-inositol levels predict poor clinical outcomes and are linked to markers of cardiac adverse remodelling. This suggests that myo-inositol and its transporter SMIT1 may have a role in the pathophysiology of HFpEF., Funding: BECAME-HF was supported by Collaborative Bilateral Research Program Québec - Wallonie-Brussels Federation., Competing Interests: Declaration of interests Jean-Claude Tardif reports grants from Amarin, AstraZeneca, Ceapro, DalCor Pharmaceuticals, Esperion, Ionis, Merck, Novartis, Pfizer and RegenXBio; honoraria from AstraZeneca, DalCor Pharmaceuticals, HLS Pharmaceuticals, Pendopharm and Pfizer; minor equity interest in DalCor Pharmaceuticals; and authorship of patents on pharmacogenomics-guided CETP inhibition and use of colchicine after myocardial infarction. No other conflict of interest was declared for the present study., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

Background: The mortality rate of pediatric patients who require continuous renal replacement therapy is approximately 42%, and outcomes vary considerably depending on underlying disease, illness severity, and time of dialysis initiation. Delay in the initiation of such therapy may increase mortality risk, prolong intensive care unit stay, and worsen clinical outcomes., Local Problem: In the pediatric intensive care unit of an urban level I trauma children's hospital, continuous renal replacement therapy initiation times and factors associated with delays in therapy were unknown., Methods: This quality improvement process involved a retrospective review of data on patients who received continuous dialysis in the pediatric intensive care unit from January 1, 2017, to December 31, 2021. The objectives were to examine the characteristics of the children requiring continuous renal replacement therapy, therapy initiation times, and factors associated with initiation delays that might affect unit length of stay and mortality., Results: During the study period, 175 patients received continuous renal replacement therapy, with an average initiation time of 11.9 hours. Statistically significant associations were found between the degree of fluid overload and mortality (P < .001) and between the presence of acute kidney injury and prolonged length of stay (P = .04). No significant association was found between therapy initiation time and unit length of stay or mortality, although the average initiation time of survivors was 5.9 hours shorter than that of nonsurvivors., Conclusion: Future studies are needed to assess real time delays and to evaluate if the implementation of a standardized initiation process decreases initiation time., (©2024 American Association of Critical-Care Nurses.)

Orthopedic surgical patients who use nicotine are at a high risk for postoperative complications including infection, respiratory failure, cardiac arrest, and death. Periprosthetic joint infections may result from nicotine-induced immunosuppression and microvascular changes, increasing perioperative morbidity and mortality. These complications result in higher health care costs, increased length of stay, and loss of reimbursement due to readmissions. Four weeks of nicotine cessation prior to arthroplasty decreases these risks; however, perioperative teams may lack reliable nicotine screening and cessation education methods. This project identified inconsistencies in nicotine screening and cessation counseling in the preoperative setting, which contributed to surgery cancellations among patients who required to demonstrate nicotine cessation preoperatively. Standardization of preoperative nicotine screening and patient cessation education resources can improve the identification of orthopedic patients who use nicotine and provide concrete, proven methods of achieving nicotine cessation prior to elective primary arthroplasty. Investment from perioperative staff is essential to ensure success., Competing Interests: All authors declare that they have no conflicts of interest., (Copyright © 2024 by National Association of Orthopaedic Nurses.)

Cast immobilization remains the standard of care in managing pediatric fractures. Cast complications often result in emergency department visits, office calls and visits, or lasting patient morbidities that burden the healthcare institution from a time and economic standpoint. The purpose of this quality improvement project was to create a multimodal cast care education protocol with an aim of decreasing cast complications over a 6-week period. Qualified patients (0-18) placed in cast immobilization received a quick response (QR) code sticker on their casts linked to a custom cast care website with text, pictures, and video instructions. Incidence of cast complications, complication type, effect(s) on workflow, and patient demographics were recorded. The complication rate declined 7.6%, but it was not statistically significant. Continuous access to clinic-specific cast instructions demonstrates decreased cast complications in pediatric populations, and this approach to patient education can be easily utilized across all medical specialties., Competing Interests: The authors have disclosed no conflicts of interest., (Copyright © 2022 by National Association of Orthopaedic Nurses.)

This project is aimed to identify whether recovery times could be reduced in patients undergoing an outpatient liver biopsy. Liver biopsies are typically performed in a hospital setting, and many facilities require patients to recover for multiple hours, sometimes ranging from 4 to 6 hours. This can discourage the patient from undergoing the biopsy. Multiple studies have examined recovery times and determined patients can safely recover and be discharged within 1-2 hours post-liver biopsy. In this retrospective review, the data of 60 outpatients who underwent a liver biopsy from June to December 2020 were analyzed. Analysis included comparing vital signs and symptoms at the 2-hour recovery period and 4-hour discharge time also to see whether there were any hospital admissions 1 week post-liver biopsy. Descriptive statistics were utilized for the data collected in this study. Results demonstrated that after 2 hours, 55 (91.7%) patients had vital signs within safe parameters, pain less than 5 on a 10-point pain scale and denied any other symptoms. The remaining five patients (8.3%) did not meet discharge criteria at the 2-hour mark because of pain greater than 5 on the pain scale yet were still discharged safely at the 4-hour mark., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2022 Society of Gastroenterology Nurses and Associates.)

Background: Parents of preterm hospitalized infants, whose lengths of stay can range from a few days to several months, often experience emotional liability. Because the Neonatal Intensive Care Unit (NICU) or Special Care Nursery (SCN) is a stressful and intimidating environment, prompt attention should be given to reducing parental stress and increasing parental confidence in preparation to care for their child post-discharge., Methods: A quality improvement pilot project was designed to evaluate the parent education and support program, titled HUG Your Baby, in a Level II SCN for its ability to decrease stress and increase confidence for postpartum mothers of preterm infants born at less than 35 weeks gestation during the infant's hospitalization., Results: The outcomes demonstrated a statistically significant decrease in maternal stress and a statistically significant increase in maternal confidence., Discussion: The HUG Your Baby program is an effective parent education and support program that would benefit NICU and SCN families., (Copyright © 2018 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.)