Dexmedetomidine improves success of paediatric MRI sedation

OBJECTIVE: To improve success rates of children requiring sedation for MRI. METHODS: Audits of sedation success for children attending planned MRI using three different approaches: (1) National Institute for Health and Care Excellence (NICE) guidance (chloral hydrate if <15 kg and oral midazolam if ≥15 kg), (2) Chloral hydrate for all patients, (3) Chloral hydrate±intranasal dexmedetomidine if <15 kg and intranasal dexmedetomidine alone if ≥15 kg. RESULTS: 74 patients had 85 MRI scan attempts. Overall success rates were significantly higher when using intranasal dexmedetomidine compared with following NICE guidance (81% vs 52% p=0.017). Dexmedetomidine performed better than oral midazolam for the same indication (76% vs 33% p=0.026). The side effect profile for dexmedetomidine was as reported in larger studies. CONCLUSIONS: Intranasal dexmedetomidine is an effective alternative to oral midazolam for sedation for MRI and as a rescue medication where chloral hydrate has been ineffective

Differing Relationships Between Instagram and Twitter on Suicidal Thinking: The Importance of Interpersonal Factors

Suicide is a major public health problem. For young adults in the United States, the rate of death by suicide has increased substantially. The evidence for the effects of social media on mental health are contradictory. However, there is limited research investigating effects of social media usage on suicide ideation. Given the interpersonal nature of social media (SM), we examined the relationship between Instagram, Twitter, and suicidal ideation in the context of the Interpersonal Theory of Suicide in 449 young adults. We found a significant indirect effect of Instagram use on lower suicide ideation through lower perceived burdensomeness. Our results are inconsistent with the literature demonstrating negative mental health effects associated with SM usage. Rather, our results indicate that some SM platforms may be associated with positive mental health outcomes. Our results also demonstrate that different SM platforms may result in differing effects on mental health and interpersonal factors specifically. Future research should examine the content and activities that users engage in while using SM to provide a deeper understanding of these relationships. </jats:p

Robust Systems of Cooperation in the Presence of Rankings: How Displaying Prosocial Contributions Can Offset the Disruptive Effects of Performance Rankings

Sustaining systems of cooperation in the face of strong self-interest is a subject of longstanding inquiry in the social sciences. Much of this work has focused on understanding the antecedents and outcomes associated with cooperation, noting that the inertial properties of a system should sustain cooperation over time. This paper shifts the focus toward examining how cooperation is maintained in the face of potentially disruptive forces. To advance theory, research, and practice on how to maintain cooperation over time, we examine how systems of cooperation interact with, withstand, or succumb to a potentially disruptive force that is commonplace in organizational contexts: rankings. Using a longitudinal, no-deception, between-groups experimental design, we assess how systems of cooperation respond to the introduction of performance rankings. Examining data from more than 11,000 rounds of decision-making from 592 participants clustered in 74 teams, we find that cooperation plummets when performance rank information is introduced. However, the addition of reputation information—individuals’ histories of prosocial contributions—enables a system of cooperation to withstand the disruptive effects of performance rankings. Actors use reputation information to make decisions that reduce perceived inequity. Our study contributes to theories of cooperation, performance feedback, macro-level prosocial behavior, and management practice.