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Adolescent females may undergo pregnancy screening while receiving critical care services, but the frequency and results are unknown. The objectives of this study are to evaluate patient characteristics, pregnancy screening frequency, and rate of positive pregnancy screens in adolescent females of childbearing age who require critical care services. We hypothesize that when adolescent pregnancy screening is performed in the critical care setting, it occurs in a higher frequency in older subjects.This is a multicenter retrospective observational cohort study utilizing TriNetX, an electronic health record database. The following electronic health record data were collected and evaluated in adolescent females aged 12-18 years and billed for critical care services: age, race, ethnicity, diagnostic codes, selected radiology and surgical procedure codes, number of deaths, pregnancy screening laboratory codes, and pregnancy screening results.A total of 5,241 subjects (2,242 [42.8%] subjects for whom pregnancy screen was noted and 2,999 [57.2%] subjects for whom it was not noted) were included in this study. Subjects aged 15-18 years (odds ratio = 1.56, 95% confidence interval = 1.38-1.77, p value.0001) and had Hispanic or Latina ethnicity (odds ratio = 1.46, 95% confidence interval = 1.28-1.66, p value.0001) had a higher association with pregnancy screening. A positive pregnancy screen was identified in 18 (0.8%) subjects.In our study, positive pregnancy screens were infrequent, not all subjects were screened, and there was an association between pregnancy screening and ethnicity. Because of the potential for screening bias, this study suggests that clinicians should strongly consider routine pregnancy screening for all females of childbearing age and that hospital policies should require this type of screening.

Background Preadmission discussions in the study institution’s pediatric intensive care unit are not standardized and admission plans were thought to be disjointed, leading to a perceived lack of organization and preparation for the arrival of a critically ill child. Objective To evaluate the impact of a new, formalized preadmission pediatric intensive care unit interdisciplinary huddle on clinician perceptions of interprofessional communication. The hypothesis was that preadmission huddles would improve unit clinicians’ perceptions of interprofessional communication. Methods Interprofessional pediatric intensive care unit clinicians (physicians, advanced practice providers, nurses, and respiratory therapists) completed surveys before and 7 months after preadmission interdisciplinary huddle implementation. Huddle compliance and perceptions of interprofessional communication in the unit were evaluated. Results Of 265 eligible pediatric intensive care unit admissions, 69 huddles (26.0%) occurred. The postintervention survey revealed increased odds (odds ratio [95% CI]) of responding “strongly agree” or “agree” to questions about the opportunity to “communicate effectively with health care team members” (2.42 [1.10-5.34]), “respond to feedback from health care team members” (2.54 [1.23-5.24]), and “convey knowledge to other health care team members” (2.71 [1.31-5.61]) before an admission. Discussion This study introduced a formalized huddle that improved pediatric intensive care unit clinicians’ perceived communication with other health care team members in the preadmission period. Conclusions Future studies are needed to determine if this perceived improvement in communication significantly affects health care outcomes of critically ill children or if these results are generalizable to other pediatric intensive care unit settings.

Video conference software has been increasingly used during the COVID-19 pandemic, but it is unknown if pediatric critical care providers would participate in culinary training via video conference in an effort to improve their wellness. The study aims were to (1) assess the feasibility of implementing a video-based culinary training wellness intervention; and (2) understand the barriers and motivators to attaining wellness from the perspective of pediatric critical care clinicians. We conducted, transcribed, and analyzed pre- and post-intervention semi-structured interviews using a directed content analysis approach. Four participants were included in this study. Pre-intervention qualitative analysis identified 3 themes: (1) Job-specific constraints contributed to poorer eating habits; (2) Poor nutrition was related to anxiety levels and job stress; (3) Meal preparation improved healthy eating. Post-intervention analysis identified 3 themes: (1) Wellness intervention was enhanced by involving loved ones; (2) Course improvement suggestions focused on more participants; (3) Major impacts from the course focused on cooking higher quality meals, obtaining new cooking tools, and applying new techniques. By providing pediatric critical care clinicians an opportunity to participate in virtual interactive culinary training experiences, we found that participants reported increased motivation to prepare quick and nutritious meals to improve their overall wellness.

Mitigation strategies were implemented during the coronavirus disease 2019 (COVID-19) pandemic that slowed the spread of this virus and other respiratory viruses. The objective of this study is to assess the impact of COVID-19 mitigation strategies on the medical services that children less than 1 year of age with acute bronchiolitis required (emergency department services, hospitalization, critical care services, and mechanical ventilation).This was a retrospective observational cohort study utilizing TriNetX ® electronic health record (EHR) data. We included subjects less than 1 year of age with a diagnosis of acute bronchiolitis. After the query, the study population was divided into two groups [pre-COVID-19 (March 1st, 2019 until February 29th, 2020) and COVID-19 (March 1st, 2020 until February 1th, 2021)]. We analyzed the following data: age, sex, race, diagnostic codes, common terminology procedures (CPT), and antimicrobials administered.A total of 5063 subjects (n,%) were included [4378 (86.5%) pre-COVID-19 and 685 (13.5%) during the COVID-19 pandemic]. More subjects were diagnosed with acute bronchiolitis in the pre-COVID time frame (4378, 1.8% of all hospitalizations) when compared to the COVID-19 pandemic time frame (685, 0.5%). When diagnosed with acute bronchiolitis, the frequency of emergency department services, critical care services, hospitalization, and mechanical ventilationwere similar between the two cohorts.During the COVID-19 pandemic, less infants were diagnosed with acute bronchiolitis but the frequency of emergency department services, hospitalization, and mechanical ventilation, reportedly required was similar. Longer-term studies are needed to evaluate the benefits of COVID-19 mitigation strategies on common viruses that require critical care.

I begin this chapter with a brief elaboration of Aristotle’s classical account of chronological time, aided by one of C. P. Cavafy’s poems. I will then use this as the critical basis from which Henri Bergson’s thought on time departs, before segueing into Proust’s own related impressions of time in his novel In Search of Lost Time (A la recherche du temps perdu). Next I will show how through the concept of involuntary memory Proust avoids errors made about time highlighted by Bergson, and develops the notion of what is referred to as ontological time (understood symbolically as a deeper, geological time) that differs from chronological time. I will then conclude by stressing the implications of Proust’s insights while drawing attention to possible misinterpretations of his thought.

This essay examines a key theme in the work of the medieval mystical theologian, Meister Eckhart, namely, the Father giving birth to the Son in the soul. It explores this theme in the light of feminist theology, and argues that Eckhart is deliberately applying to God a female act and therefore characteristic. Criticisms of the efficacy of such female imagery are considered, but countered through a defence of what is argued to be Eckhart’s incontestable qualification of the male symbol through a metaphor based on a biological fact. In turn the image of women in the limited biological role of giving birth is critically examined, while Eckhart is argued in his life and work to have risen above any position that fixes and limits the roles and identities of women. Further it is shown that Eckhart has not simply substituted female imagery for male, thereby reinforcing binary gender opposition and any negative consequences that befall. Eckhart is rather shown to employ an androgynous and transgendered metaphor in that the male Father-God is simultaneously a female Mother-God. The nature and purpose of Eckhart’s transgendered metaphor is then explored in relation to its apophatic context.

Summary Background Acute kidney injury occurs in one in four children admitted to an intensive care unit (ICU) and its severity is independently associated with increased patient morbidity and mortality. Early prediction of acute kidney injury has the potential to improve outcomes. In smaller, single-centre trial populations, we have previously derived and validated the performance of a renal angina index, a context-driven risk stratification system, to predict severe acute kidney injury in children and adolescents. Here, we tested the predictive accuracy of this index for severe acute kidney injury in a large heterogeneous population. Methods We did a prospective, observational study (AWARE) that recruited patients in the ICUs of 32 hospitals in nine countries across Asia, Australia, Europe, and North America. All patients aged between 3 months and 25 years who were admitted to an ICU at least 48 h previously were eligible. Exclusion criteria were a history of stage 5 chronic kidney disease (ie, estimated glomerular filtration rate 2 or on maintenance dialysis) or kidney transplantation in the preceding 90 days. Patients' medical records were reviewed to collect data up to 3 months before (serum creatinine only), daily during the first 7 days, and on day 28 after ICU admission. For the assessment of the renal angina index, we included patients from the AWARE study who had full data from the day of ICU admission, day 3, and day 28, including serum creatinine concentrations and urine output measurements. The primary outcome was the presence of severe acute kidney injury (stage 2–3 acute kidney injury, according to Kidney Disease Improving Global Outcomes [KDIGO] guidelines) on the third day after ICU admission. We compared the performance of the renal angina index with changes in serum creatinine relative to baseline for prediction of the primary outcome. A score of eight points or more on the renal angina index defined fulfilment of renal angina; serum creatinine concentration relative to baseline was calculated using maximum serum creatinine concentration in the first 12 h of ICU admission). This trial is registered with ClinicalTrials.gov, number NCT01987921. Findings Between Jan 1 and Dec 31, 2014, we obtained data for 1590 patients. 286 patients (18%) had fulfilment of renal angina. At day 3, severe acute kidney injury occurred in 121 (42%) patients positive for renal angina and 247 (19%) patients negative for renal angina (relative risk [RR] 2·23, 95% CI 1·87–2.66, p vs 18 [2%], p vs 53 [4%], p=0·01). Fulfilment of renal angina showed better prediction for severe acute kidney injury than serum creatinine greater than baseline (RR 1.61, 95% CI 1·33–1·93; p vs serum creatinine greater than baseline 0·68, 0·49–4·94). Interpretation Earlier and better prediction of severe acute kidney injury has the potential to improve patient outcomes associated with acute kidney injury. Compared with isolated, context-free changes in serum creatinine, renal angina risk assessment improved accuracy for prediction of severe acute kidney injury in critically ill children and young people. Funding US National Institutes of Health.

Acute kidney injury is common after pediatric hematopoietic stem cell transplant with a reported incidence of 21–55% in the first 3 mo after transplant. Acute kidney injury is associated with decreased survival and the development of chronic kidney disease in this patient population. In this review, current definitions of acute kidney injury are discussed. The epidemiology and risk factors for acute kidney injury in this patient population are described, and current hypotheses on the pathophysiology are reviewed. Current and emerging ideas about changes to management strategies to mitigate acute kidney injury are presented, and areas for further research are proposed.

On behalf of The Eckhart Society, I would like to welcome you to Medieval Mystical Theology 29.2. This issue comprises papers that were presented at the 32nd Annual Eckhart Conference on the theme ...

This article explores how Meister Eckhart's understanding of Christ is necessarily connected to his approach to biblical exegesis. So much so that it is argued that the two cannot be separated. The article begins by broadly outlining modern historical and literal approaches to biblical exegesis shared by both faith-based and rational accounts of Christianity. I then discuss why Eckhart's hermeneutics differ radically from these modern interpretations, before elucidating the nature and scope of his spiritual interpretation of scripture. Developing this further I demonstrate how, for Eckhart, Christ is found in and through the spiritual sense of scripture, so that the scriptures are not merely about Christ but are the source in which to find him as him. The significance and implications of this are then examined and Eckhart's interpretation of Christ established.

This essay reassesses the role language plays in Zen-Buddhist teaching. I begin by exploring what has come to be a standard interpretation of language in Zen, in relation to the actual reality and direct experience of enlightenment. This reflects an ‘instrumental’ view of language, and I discuss the implications of this in Zen thought. It is then suggested that this interpretation is no longer credible given the insights provided by a more contemporary understanding of language. This different approach reflects a ‘constitutive’ view of language, which I explore largely through the ontological linguistics of Martin Heidegger. Finally, I examine how this view of language has in fact always been a significant element of Zen teaching in terms of attaining enlightenment.

Exploration of the interface between mystical theology and continental philosophy is a defining feature of the current intellectual and even devotional climate. But to what extent and in what depth are these disciplines actually speaking to one another; or even speaking about the same phenomena? This book draws together original contributions by leading and emerging international scholars, delineating emerging debates in this growing and dynamic field of research, and spanning mystical and philosophical traditions from the ancient, to the medieval, modern, and contemporary. At the heart of which lies Meister Eckhart, perhaps the single most influential Christian mystic for modern times. The book is organised around significant historical and contemporary figures who speak across the intersections of philosophy and theology, offering new insights into key interlocutors such as Pseudo-Dionysius, Augustine, Isaac Luria, Eckhart, Hegel, Heidegger, Marion, Kierkegaard, Deleuze, Laruelle, and Žižek. Designed both to contribute to current trends in mystical theology and philosophy, and elicit dialogue and debate from further afield, this book speaks within an emerging space exploring the retrieval of the mystical within a post-secular context.

This paper examines the findings of a study we completed into progressive social work education in Canadian schools of social work. In our research, we found that schools of social work offer three key functions for the university: a connection to the community, a spacethatvalues diversity and a space of innovation.We investigate these themesinrelation to the dynamics of performativity and fabrication. From conversations with those who participated in our research, it is clear that schools of social work play a key role in the university in terms of constructing a particular institutional image—a fabricated image.Wearticulatesomekeyaspectsofperformancethataredrawnuponinfabricating contemporary Canadian universities and the ways in which social work is positioned to enhance this fabrication. In the conclusion, we reflect upon what these findings and analysis mean for social work education.

This paper identifies five different uses of the word ‘nothing’ in the work of Meister Eckhart. These senses of nothing are understood to function within an ontological hierarchy, beginning with the understanding that all nothings are things, and moving in ascending order to the assertions that all things are nothing, that things are nothing but God, nothing but God, and finally God as Nothing. This scale of degrees is ultimately understood to mean that the nothings are nothinged by the nothinger nothinged. The mystical, theological, and philosophical implications of this are then discussed. Accordingly, the metaphysical significance of the word ‘nothing’ as relative rejection, rather than absolute denial, is seen to point to a grammatical ground as opposed to a grammatical fiction.

With individual and institutional subscriptions steadily increasing world-wide and a healthy stock of papers constantly being received from international authors, the journal’s reputation appears to be growing positively. With this in mind, and to help with the added pressure, I am delighted to welcome three associate editors to the team. These are, Dr Joseph Milne, Dr Rico Monge, and Dr Rebecca Stephens. Both Joseph and Rebecca are stalwarts and long-serving trustees of The Eckhart Society, and possibly share the record for contributions to the journal when it was under the name of the Eckhart Review. Both bring with them a wealth of academic and editorial experience. Joseph is also the editor of a journal for the Henry George Foundation called Land and Liberty, while Rebecca is also a novelist. Rico previously served as a guest editor for volume 21, number 1, of Medieval Mystical Theology, a process made that much easier by his enthusiasm, organization, and professionalism. Rico is based in the US and will represent the journal at conferences while also looking out for quality papers. In July 2014, I was pleased to organize with my colleagues, David Lewin and Simon Podmore, an enjoyable and successful conference titled, Mystical Theology and Continental Philosophy: Historical and Contemporary Perspectives. This collaboration between the Mystical Theology Network and the Association for Continental Philosophy of Religion was held at Liverpool Hope University, and attracted a strong international delegation of speakers bringing with them a thought-provoking array of papers. Prominent at the conference were our publishers, Maney, and I would like to thank Liverpool Hope University, The Eckhart Society, and Ashgate for generously sponsoring different aspects of the event. Selected proceedings from the conference will be published as part of an ongoing series by Ashgate, while a good number of authors have also expressed an interest or have already sent their papers to MMT for consideration. I hope you enjoy the papers in this present issue as well as the introduction from Martin Ganeri, who was responsible for first gathering the authors together for this comparative theme that comprised the 26 Annual Eckhart Society Conference. medieval mystical theology, Vol. 23 No. 2, November, 2014, 99