PurposeAcute mesenteric ischaemia (AMI) accounts for about 1:1000 acute hospital admissions. Untreated, AMI will cause mesenteric infarction, intestinal necrosis, an overwhelming inflammatory response and death. Early intervention can halt and reverse this process leading to a full recovery, but the diagnosis of AMI is difficult and failure to recognize AMI before intestinal necrosis has developed is responsible for the high mortality of the disease. Early diagnosis and prompt treatment are the goals of modern therapy, but there are no randomized controlled trials to guide treatment and the published literature contains a high ratio of reviews to original data. Much of that data comes from case reports and often small, retrospective series with no clearly defined treatment criteria.MethodsA study group of the European Society for Trauma and Emergency Surgery (ESTES) was formed in 2013 with the aim of developing guidelines for the management of AMI. A comprehensive literature search was performed using the Medical Subject Heading (MeSH) thesaurus keywords “mesenteric ischaemia”, “bowel ischaemia” and “bowel infarction”. The bibliographies of relevant articles were screened for additional publications. After an initial systematic review of the literature by the whole group, a steering group formulated questions using a modified Delphi process. The evidence was then reviewed to answer these questions, and recommendations formulated and agreed by the whole group.ResultsThe resultant recommendations are presented in this paper.ConclusionsThe aim of these guidelines is to provide recommendations for practice that will lead to improved outcomes for patients.

There was probably an overtriage to the closest hospital, and the time of the blasts proved crucial for the adequacy of the medical and surgical response. The number of blast lung injuries seen is probably the largest reported by a single institution, and the critical mortality rate was reasonably low.

The Academic Motivation Scale is one of the most frequently used instruments to assess academic motivation. It relies on the self-determination theory of human motivation. However, motivation has been understudied in dental education. Therefore, to address the lack of valid instruments to assess academic motivation in dental education and contribute to future research in the ield, the aim of this study was to analyze the psychometric properties of this instrument in a sample of dental students. Participants were 989 Chilean undergraduate dental students (86% response rate) who completed a survey containing a Chilean face-valid version of the Spanish Academic Motivation Scale and three other motivation-related instruments to assess the survey's construct and criterion validity. Later, 76 of the students (out of 100 invited) took the survey again to assess its test-retest stability. The instrument's construct validity was supported by the superior goodness of it of the seven-subscale Academic Motivation Scale over competing models through conirmatory factor analysis and by the expected correlations among its subscales. The concurrent criterion validity was supported by the conirmation of correlations between its subscales and external criteria. Adequate internal consistency and test-retest correlations were also found. The evidence from this study suggests that the Academic Motivation Scale is a preliminarily valid and reliable instrument to assess motivation in the predoctoral dental context.

Our findings regarding dental education expand on the research outcomes from other health professions about how teachers may support students to internalise behaviours. An autonomy-supportive environment may lead students to value and engage in academic activities and eventually foster the use of an autonomy-supportive style to motivate their patients.