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Despite evidence regarding the value of palliative care, there remains a translation-to-practice gap in the intensive care setting. The purpose of this article is to describe challenges and propose solutions to palliative care integration through the presentation and discussion of a critical care patient scenario. We also present recommendations for a collaborative palliative care practice framework that holds the potential to improve quality of life for patients and families. Collaborative palliative care is characterized by close working relationships with families, interprofessional intensive care unit healthcare teams, and palliative care specialists. The shortage of palliative care specialists has become a pressing policy and practice issue and highlights the importance of increasing primary palliative care delivery by the intensive care team. Underexplored aspects of collaborative palliative care delivery include the interprofessional communication required, identification of key skills, and expected outcomes. Increased recognition of intensive care unit palliative care as a process of engagement among nurses, providers, patients, and their family members heralds a vital culture shift toward collaborative palliative care. The interprofessional palliative specialist team has the expertise to support intensive care teams in developing their primary palliative skills and recognizing when specialist palliative care support is required. Promotion of strategic palliative care delivery through this collaborative framework has the potential to decrease suffering among patients and families and reduce moral distress among healthcare professionals.

The present studies examined how gender and race information shape children’s prototypes of various social categories. Children (N=543; Mage=5.81, range=2.75 - 10.62; 281 girls, 262 boys; 193 White, 114 Asian, 71 Black, 50 Hispanic, 39 Multiracial, 7 Middle-Eastern, 69 race unreported) most often chose White people as prototypical of boys and men—a pattern that increased with age. For female gender categories, children most often selected a White girl as prototypical of girls, but an Asian woman as prototypical of women. For superordinate social categories (person and kid), children tended to choose members of their own gender as most representative. Overall, the findings reveal how cultural ideologies and identity-based processes interact to shape the development of social prototypes across childhood.

Objectives: Interventions in pregnancy are commonly evaluated for their effects on birth outcomes because maternal infection and poor nutrition are the primary contributors to adverse pregnancy outcomes, especially in low- and middle-income countries (LMICs). However, the extent to which such interventions directly impact maternal health and nutrition has not been succinctly characterized.Methods: We conducted a scoping review of systematic reviews and meta-analyses of 27 pregnancy interventions to summarize the evidence of impact on maternal outcomes.Results: Overall, these were reported incompletely, and we failed to find any evidence for eight interventions. Influenza vaccination, insecticide-treated bed nets, intermittent preventive treatment for malaria, anthelmintic therapy, and treatment of bacterial vaginosis, asymptomatic bacteriuria, and periodontal disease during pregnancy provided direct benefit to women, with reductions in infection risk. Nutritional interventions such as micronutrient supplementation and balanced energy and protein improved outcomes of maternal anemia and gestational weight gain, particularly in deficient populations. Calcium and low dose aspirin significantly reduced the risk of pre-eclampsia.Conclusion: These findings highlight antenatal interventions benefitting maternal health and provide insights into pathways for impacting birth and infant outcomes.

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Original Research Background. Compassion fatigue is emotional distress experienced by providers from contact with patients' suffering. Burnout is job-related distress due to uncontrollable workplace factors that manifest in career dissatisfaction. Compassion satisfaction is emotional fulfillment derived from caring for others. The body of literature on BO in healthcare providers is extensive, whereas CF and CS have not been comprehensively studied. Research Objectives. Due to ongoing exposure to patient and family distress, PPC providers may be at particular risk for CF. To address this, we conducted a study of CF, BO, and CS among PPC providers across the United States. Methods. A modified CFand CS Self-Test for Helpers and questionnaire of professional and personal characteristics were distributed anonymously to a self-generated list of providers. Multivariable logistic and linear regression models for CF, BO, and CS as a function of potential risk factors were constructed. Results. The survey response rate was 39%. The prevalence of CF, BO, and CS was 18%, 12%, and 25%, respectively. Distress about a 'clinical situation,' physical exhaustion, and personal loss were significant determinants of CF. Distress about 'coworkers,' emotional depletion, social isolation, and involvement in 'non-introduction of life-prolonging therapies' were significant determinants of BO. Not feeling distressed was a significant predictor of higher CS scores, whereas physical exhaustion, history of trauma, involvement in 'non-introduction of life-prolonging therapies,' and not talking about distressing issues were predictors of lower CS scores. Conclusion. CF, BO, and CS have direct influences on well-being and professional performance of PPC providers. To provide effective, compassionate care to patients, PPC providers must be attentive to predictors of these phenomena as well as cognizant of the impact that clinical experiences may have on these phenomena.

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