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Background The current expansion of image-guided surgery is closely related to the role played by radio-guided surgery in supporting the sentinel node (SN) procedure during more than three decades. The so-called triple approach (lymphoscintigraphy, gamma probe detection and blue dye) was not only essential in the seminal validation of the SN procedure but also a first collective learning effort based on skill transfer and outcome-related evaluation which laid the fundaments to delineate the field of intraoperative molecular imaging (IMI) based on a similar multimodality approach and multidisciplinary practice. Methods These elements are also becoming valid in the current incorporation of SPECT/CT and PET/CT to existing and new protocols of IMI procedures and SN mapping concerning other clinical applications. On the other hand, there is a growing tendency to combine novel modern technologies in an allied role with gamma guidance in the operating room following the development of hybrid tracers and multimodal detection approaches. Against this background, learning initiatives are required for professionals working in this area. Results This objective has led to a group of European practitioners with large experience in SN mapping and IMI applications to give shape to a programme made up out of specific learning modules aimed to be used as a conductive thread in peripherical or centralised training instances concerning the topic. Conclusion The presented work, written as a tutorial review, is placed in an available prior-art context and is primarily aimed at medical and paramedical practitioners as well as at hardware and software developers.

Al-Jawad and colleagues emphasise the primacy of the patient's wishes in their Practice paper, which is timely and very important. 1 Almost one in five older Irish people report having at least one member of their family with whom they do not want clinical information to be shared, and 38% do not want information to be shared with relatives over the phone. 2 A useful way to manage communication with the patient and family is through a carefully planned and prepared care planning meeting. [...]recently, little guidance was available on how to conduct such meetings for older patients with cognitive and communication deficits and other complex needs. An added challenge is the wide, diverse, and conflicting range of perspectives held by health and social care professionals and other family members. 3 Useful guidelines have been developed, which clarify how to honour the patient's voice and wishes to the greatest extent possible through careful consultation, preparation, and implementation of care planning meetings. 4 Competing interests:

Experience plays a critical role in crafting high-impact scientific work. This is particularly evident in top multidisciplinary journals, where a scientist is unlikely to appear as senior author if he or she has not previously published within the same journal. Here, we develop a quantitative understanding of author order by quantifying this “chaperone effect,” capturing how scientists transition into senior status within a particular publication venue. We illustrate that the chaperone effect has a different magnitude for journals in different branches of science, being more pronounced in medical and biological sciences and weaker in natural sciences. Finally, we show that in the case of high-impact venues, the chaperone effect has significant implications, specifically resulting in a higher average impact relative to papers authored by new principal investigators (PIs). Our findings shed light on the role played by experience in publishing within specific scientific journals, on the paths toward acquiring the necessary experience and expertise, and on the skills required to publish in prestigious venues.

We investigate the relation between tax avoidance and tax uncertainty, where tax uncertainty is the amount of unrecognized tax benefits recorded over the same time period as the tax avoidance. On average, we find that tax avoiders, i.e., firms with relatively low cash effective tax rates, bear significantly greater tax uncertainty than firms that have higher cash effective tax rates. We find that the relation between tax avoidance and tax uncertainty is stronger for firms with frequent patent filings and tax haven subsidiaries, proxies for intangible-related transfer pricing strategies. The findings have implications for several puzzling results in the literature.

Why did you do this work?Criteria led discharge (CLD) of patients can improve patient flow, reduce length-of-stay (LOS) and improve patient experience.1 2 CLD was launched for gastroenteritis, viral-induced wheeze, bronchiolitis and minor head injury, at two sites in Children’s Health Ireland (CHI) in June 2024. Though previously piloted, CLD has not yet been incorporated into practice in Irish paediatric hospitals.This aim of this project was to use QI methodology to support and assess the implementation of CLD of a short-stay, high-turnover paediatric admission unit.What did you do?Two Plan-Do-Study-Act (PDSA) cycles were completed during the study period from June-September 2024. Data on admissions to AMAU was collected using a paper record, to determine the suitability of patients for CLD, along with rate of uptake, and completion of CLD. The team included consultants, junior doctors, nurse managers and staff nurses.Feedback about attitudes to CLD from nursing staff was gathered using an anonymous, E-questionnaire between PDSA cycles, followed by an education session to address concerns and increase staff confidence.Other interventions included consultant and trainee education, posters prompting use of CLD, and championing by the project team. Our team attended QI training.What did you find?In the initial PDSA cycle, 24 of 67 (36%) discharges were deemed CLD-suitable, with 6 out of 24 cases (26%) having CLD initiated and completed.The following PDSA cycle showed an increase in the implementation of CLD, with 6 of 20 discharges deemed CLD suitable, and 4 of 6 cases having CLD initiated and completed. This indicated 66% compliance with CLD – an improvement.Our questionnaire was answered by 7 of 11 eligible nurses. 43% felt nervous about discharging patients, while 57% described themselves as enthusiastic. Only 29% had no major concerns, while the remainder had concerns over discharging a patient too early, receiving a complaint and inadequate training.All respondents had performed CLD and all believed that members of the MDT other than doctors should be able to discharge patients.There was a high level of confidence in CLD of gastroenteritis. Less confidence was noted in viral-induced wheeze and bronchiolitis. This was addressed by an education session.What does it mean?We’ve demonstrated that local compliance with CLD can be improved using QI methodology and multi-disciplinary collaboration, along with targeted staff education. Through the PDSA cycles, we have demonstrated an increase in utilisation of CLD during the period of our study. Our questionnaire suggests that nursing staff are keen for ongoing implementation and increased training.We believe that with ongoing awareness and education around CLD, it can become more routine in our setting, with a view to increased use across CHI.ReferencesLees L, Solihull A. Implementing nurse-led discharge. Nurs Times. 2011;107(39):18–20National Health Service. Criteria-Led Discharge. 2024. Available at: https://www.england.nhs.uk/urgent-emergency-care/improving-hospital-discharge/criteria-led-discharge/ (accessed 12th August 2024).

This study aimed to explore the relationship between parental disciplinary practices and internet addiction. 568 adolescents participated. A Sociodemographic Questionnaire, the Internet Addiction Test (IAT) and the Dimensions of Discipline Inventory - Form C (DDI-C) were used. 73.1% of users with mild and moderate addiction were identified. Mothers showed greater use of all disciplinary dimensions. Differences were found only in the father's inductive discipline, depending on the family setting. However, there were no differences between adolescents from different family setting regarding internet addiction. Associations were observed between parental disciplinary dimensions and internet addiction. Finally, the punitive discipline of the mother and father and the inductive discipline of the mother, were predictors of internet addiction.

The hidden curriculum refers to various dimensions of pedagogical activity that concern (professional) knowledge, power relations and the socio-cultural context in which educators operate. The article presents ways in which school counsellors understand the hidden curriculum. The findings of qualitative analysis of interviews with 37 school counsellors are presented. Focus is given to how school counsellors understand the term hidden curriculum, recognise and respond to it. While the results revealed that school counsellors know the basic definitions of the hidden curriculum, deeper analysis of their answers showed this understanding is often incomplete and inadequate. In the future, greater attention should be paid to the extent to which the hidden curriculum is recognised and present in both schools generally and the work of the school counselling service.

While parental violent disciplining of children is a global concern, children living in low- and middle-income countries like Bangladesh are particularly more vulnerable to harsh disciplinary practices at home. There is limited empirical evidence on the use of disciplinary practices in Bangladesh, impeding the development of prevention practices. This study investigated the extent of violent child disciplining and parental attitudes toward physical punishment and identified their predictor using data from the 2019 Bangladesh Multiple Indicator Cluster Survey. Violent discipline includes any form of physical punishment like spanking, slapping, or hitting any part of the body, as well as psychological aggression such as shouting, screaming, or name-calling. Study participants were 44,570 mothers/caregivers of children aged 2–14 years. Multilevel mixed-effects logistic regression models were fitted to identify the predictors of violent disciplinary practices and parents’ attitudes toward physical punishment. The results revealed a very high prevalence of violent disciplinary practices in Bangladesh. About 89% of the mothers/caregivers reported using at least one form of violent discipline; 39% were spanked, hit, or slapped on the bottom, 29% were hit or slapped on the face, head, or ears, and 5% were beaten up as hard as one could. Younger children, and children from urban areas, certain administrative divisions, poorer families, children with functional difficulties, less educated mothers/caregivers were more likely to experience violent discipline. About 35% of mothers/caregivers supported physical punishment, indicating a large discrepancy between attitude and the practice of violent discipline. Parents’ attitudes appeared as one of the strongest predictors of violent discipline. Prevention efforts should be made to promote positive parenting and minimize the gap between parental attitudes and the practice of physical punishment. Highlights This study documented a very high prevalence (89%) of violent physical punishment to children at home, while only 35% of mothers/caregivers supported physical punishment, indicating a big gap between attitude and practice about child discipline in Bangladesh. Mothers/caregivers’ attitudes toward physical punishment appeared as a major predictor of the usage of violent physical discipline. Changes in attitudes need to be promoted by improving knowledge about the negative consequences of violent physical punishment.

To achieve successful outcomes through cesarean hysterectomy, surgeons must adopt a strategic approach that prioritizes the prevention of urologic injuries, employs techniques for controlling difficult bleeding and, when suitable, considers conservative management options.4 To address this, the gynecologic oncology team at Hôtel-Dieu de France University Hospital in Beirut has developed a structured multidisciplinary protocol for managing patients with placenta accreta spectrum. Over the years, this model has successfully led to standardized approaches in the management of placenta accreta spectrum, focusing on collaborative care involving obstetricians, gynecologic oncologists, and other healthcare professionals in a multidisciplinary approach.7 The group has been active in organizing educational initiatives, such as workshops and conferences, to share knowledge and promote this collaborative practice. Data collection or acquisition and analysis: HEH, NK, YA, MM. Writing the manuscript or report: HEH, DA, MM. Review and editing: HEH, DA, MM, YA, NK.