bluuebunny/crossref_metadata_2025 huggingface dataset:
CGM Benefits and Burdens: Two Brief Measures of Continuous Glucose Monitoring
Authors: Messer Laurel H. , Cook Paul F. , Tanenbaum Molly L. , Hanes Sarah , Driscoll Kimberly A. , Hood Korey K.
Published: March 2019

Background:

Continuous glucose monitors (CGM) are underutilized by individuals with type 1 diabetes (T1D), particularly during the adolescent years. Little is known about perceptions of CGM benefit and burdens, and few tools exist to quantify this information.

Methods:

Two questionnaires were developed and validated—Benefit of CGM (BenCGM) and Burdens of CGM (BurCGM)—in a sample of adolescents ages 12-19 years involved in the T1D Exchange Registry. We chose to start the validation process with adolescents given their low CGM uptake and high risk for suboptimal glycemic outcomes. Exploratory and confirmatory factor analyses were conducted to confirm factor structure and select items. The resultant scales were tested for internal reliability and convergent/divergent validity with critical diabetes and quality of life outcomes: age, depression, diabetes distress, self-efficacy, technology attitudes, and diabetes technology attitudes.

Results:

A total of 431 adolescents with T1D completed the questionnaires (51% female, mean age 16.3 ± 2.26, 83% white non-Hispanic, 70% having used CGM). Two single factor scales emerged, and scales were reduced to 8 items each. Those who perceived higher benefit of CGM exhibited lower diabetes distress, higher self-efficacy, and more positive attitudes toward technology. Those who perceived higher burden of CGM exhibited higher diabetes distress, lower self-efficacy, and less positive technology attitudes.

Conclusion:

The BenCGM and BurCGM questionnaires each comprise 8-items that demonstrate robust psychometric properties for use in adolescents with T1D, and can be used to develop targeted interventions to increase CGM wear to improve diabetes management.
Ethical problems in virtual research: Enmeshing the blurriness with Twitter data
Authors: Power Kerry
Published: March 2019

When conceptualising knowledge gained from tapping into an internet data pool, one may question many things which can include the role of the researcher and the researched, privacy and ethics, intention, authenticity and the vastness of scope. The researcher, regardless of research intention including moral or ethical positions, must acknowledge that there are billions of nuances affecting online user participation. Ethical boundaries surrounding available data deemed ‘public’ in a program like Twitter, for example, are not easily wrapped in a terms of service agreement. Ethical problems in virtual research are expansive, and it is necessary to frame how and why researchers should address them. In the following paper, I outline some significant ethical issues in virtual research and address perceived pluralities as enmeshment. Drawing on Barad's ( 2007 , 2010 , 2014 ) theoretical model of diffraction, I poke holes through ethical blurriness and think through ethical possibilities for researchers, including online presence, data collection practices and participant agency.
Volunteering for children or volunteering with children? A co-creation initiative to prepare student volunteers
Authors: Amigó María Florencia , Bilous Rebecca , Rawlings-Sanaei Felicity
Published: March 2019

This article delves into the controversies of student volunteers working around children in developing world contexts, by proposing a model where the organisations that send and those that receive volunteers can collaborate to ensure volunteers’ purposeful involvement. The article is based on the results of a collaborative initiative between an Australian university and its international non-governmental partner organisations who receive student volunteers through a university experiential learning programme. The authors of this article contest the universalisation of the concept of childhood, offer a critique of detrimental forms of international volunteering and then discuss a co-creation process between the university and its international non-governmental organisation partners that resulted in a series of training resources intended to shed light on three important issues for volunteers to consider: the complexity of defining who is a child and how a child should live, the challenges of child protection and the need to enable children’s empowerment. The resources generated during the co-creation process were turned into freely available online learning modules to enhance the value volunteers can add to the improvement of children’s lives around the world, and to their own communities upon return.
Mitochondrial dysfunction in adults after out-of-hospital cardiac arrest
Authors: Wiberg Sebastian , Stride Nis , Bro-Jeppesen John , Holmberg Mathias J , Kjærgaard Jesper , Larsen Steen , Donnino Michael W , Hassager Christian , Dela Flemming
Published: March 2019

Background:

While preclinical studies suggest that mitochondria play a pivotal role in ischaemia–reperfusion injury, the knowledge of mitochondrial function in human out-of-hospital cardiac arrest remains scarce. The present study sought to compare oxidative phosphorylation capacity in skeletal muscle biopsies from out-of-hospital cardiac arrest patients to healthy controls.

Methods:

This was a substudy of a randomised trial comparing targeted temperature management at 33°C versus 36°C for out-of-hospital cardiac arrest patients. Skeletal muscle biopsies were obtained from adult resuscitated comatose out-of-hospital cardiac arrest patients 28 hours after initiation of targeted temperature management, i.e. at target temperature prior to rewarming, and from age-matched healthy controls. Mitochondrial function was analysed by high-resolution respirometry. Maximal sustained respiration through complex I, maximal coupled respiration through complex I and complex II and maximal electron transport system capacity was compared.

Results:

A total of 20 out-of-hospital cardiac arrest patients and 21 controls were included in the analysis. We found no difference in mitochondrial function between temperature allocations. We found no difference in complex I sustained respiration between out-of-hospital cardiac arrest and controls (23 (18–26) vs. 22 (19–26) pmol O2/mg/s, P=0.76), whereas coupled complex I and complex II respiration was significantly lower in out-of-hospital cardiac arrest patients versus controls (53 (42–59) vs. 64 (54–68) pmol O2/mg/s, P=0.01). Furthermore, electron transport system capacity was lower in out-of-hospital cardiac arrest versus controls (63 (51–69) vs. 73 (66–78) pmol O2/mg/s, P=0.005).

Conclusions:

Mitochondrial oxidative phosphorylation capacity in skeletal muscle biopsies was reduced in out-of-hospital cardiac arrest patients undergoing targeted temperature management compared to age-matched, healthy controls. The role of mitochondria as risk markers and potential targets for post-resuscitation care remains unknown.
Healthcare providers’ knowledge, readiness, prescribing behaviors, and perceived barriers regarding routine HIV testing and pre-exposure prophylaxis in DeLand, Florida
Authors: Gunn Laura H , Janson Brittani , Lorjuste Ismode , Summers Lindsay , Burns Paula , Bryant Thomas
Published: March 2019

Objectives:

Florida ranks highest in the United States among newly diagnosed HIV infections. This ranking reflects the need for investigation of healthcare providers’ knowledge, readiness, prescribing behaviors, and perceived barriers to routine HIV testing and pre-exposure prophylaxis.

Methods:

We adapted national questionnaires with questions co-developed with Florida Department of Health to form a 25-item instrument. Questionnaires were distributed to the population of eligible healthcare providers in DeLand, Florida.

Results:

Results from an approximate 20% response rate that encompasses 12 providers demonstrate baseline findings to inform future studies. For example, 75% of respondents were aware of FL Administrative Code 64D-3.042 that pregnant women should receive HIV testing during first and third trimesters. However, 50% of respondents rarely or never offer tests to pregnant women according to practice guidelines. About 75% of respondents strongly agree or agree with willingness to prescribe pre-exposure prophylaxis to high-risk patients, yet 8.3% always or very often prescribe pre-exposure prophylaxis.

Conclusions:

Results convey the importance of and need for greater collaboration between providers and the Florida Department of Health to enhance providers’ knowledge, readiness, and, ultimately, behaviors regarding routine HIV testing and pre-exposure prophylaxis prescription.
How autonomy makes an experience pleasurable: The roles of risk perception and personal control
Authors: Lunardo Renaud , Saintives Camille
Published: March 2019

This research challenges the notion that autonomy is beneficial for consumers in every situation. Specifically, this research demonstrates across two experiments and one field study that autonomy can lead to pleasure only when risk is low. Importantly, these studies also identify personal control as a mechanism that explains why autonomy makes the consumption experience more or less pleasurable, depending on risk perceptions. In Study 1, we demonstrate that perceived risk moderates the effect that autonomy may have on making the experience pleasurable, with a lack of risk making autonomy increase personal control. Study 2 replicates this moderating effect of risk in a field study. To test if the effects replicate using another type of perceived risk, Study 3 manipulates social risk and replicates its moderating effect on the relationship between autonomy and personal control on the pleasure observed in Studies 1 and 2. Collectively, this research draws attention to the need to consider risk when making consumers autonomous, and it offers novel contributions to the work on consumer autonomy.
Palliative Management of Nonoperative Femoral Neck Fractures With Continuous Peripheral Indwelling Catheters: Case–Control Series
Authors: Rashidifard Christopher H. , Romeo Nicholas , Richardson Mark , Muccino Paul , DiPasquale Thomas , Bush Chelsea M.
Published: March 2019

Introduction:

This case–control study evaluates the success of indwelling pain catheters in nonoperatively treated femoral neck fractures (FNFs) for end-of-life pain management.

Methods:

Patients older than 65 years with nonoperatively treated FNFs were retrospectively identified at a level 1 trauma center between March 2012 and September 2015. Twenty-three received indwelling continuous peripheral pain catheters (experimental) and 10 received traditional pain control modalities (control). Pain scores 24 hours before/after pain management interventions, ambulation status at admission and discharge, mortality at 30 days/1 year, and length of hospital stay (LOS) were compared between treatment groups.

Results:

The experimental and control groups were similar with respect to demographics, differing only in pre-fracture ambulatory status ( P = .03). The 30-day mortality was 52% versus 50% (odds ratio, OR: 1.1 [95% confidence interval, CI: 0.25-4.82], P = .99) and 1-year mortality was 87% versus 80% (OR: 1.67 [95% CI: 0.23-11.9], P = .63) for experimental and control groups, respectively. The LOS did not statistically significantly differ for experimental and control groups (5.3 ± 3.56 days vs 3.8 ± 1.81 days, P = .15), respectively. The experimental group experienced twice the improvement in ambulation status (1.0 ± 0.56 vs 0.5 ± 0.71, P = 0.03) and greater improvement in pain scores (4.5 ± 2.19 vs 1.2 ± 2.72, P = .002).

Discussion:

Operative management of FNFs may not be indicated in patients with advanced age and comorbidities. Regardless, these patients require pain palliation and early mobilization while minimizing hospital LOS and opiate consumption.

Conclusion:

This case–control study demonstrates significant improvement in both pain level and ambulatory status for patients treated with indwelling continuous peripheral catheters. Future studies should further evaluate with a larger sample size; however, this study provides an excellent launching point for palliative management of this complex population.
Bring on Epidemiologic Research!
Authors: Litchfield Sheila M.
Published: March 2019

It is often challenging finding time to carefully read research articles and determine how findings apply to clinical practice. Many occupational health nurses may be unfamiliar with or out of practice using various epidemiologic concepts and terms from clinical research. This article provides a brief overview of these concepts and terms. Understanding the basics of research is the first step toward using research findings in evidence-based practice.
Sexual Assault in the Workplace
Authors: Garrett Linda H.
Published: March 2019

Women are sexually assaulted at an alarming rate, and the workplace is a frequent arena for assault. However, in recent decades, attention has been given to improving responses to sexual assault. Sexual assault is a frequent cause of injury and death for women in the United States. One in five American women admit they have experienced a completed rape during their lifetime. These estimates are conservative because sexual assault and sexual violence are both underreported and underprosecuted. Fear of job loss and discrimination are frequent reasons women do not report sexual assault in the workplace. Women are entering the workplace in greater numbers due in part to more single parent families and the depressed economy. Also, women are entering work environments that have traditionally been the domain of male workers: corporate headquarters, semi trucks, health care providers' offices, rural farms, and rural factories. Employers must have a plan to protect female employees and effectively address any incidents of sexual assault or violence. Occupational health nurses and nurse practitioners can assist both employees and employers to prevent sexual assault and resolve the aftermath of sexual assault. However, to accomplish this goal, occupational health nurses and nurse practitioners must be trained in sexual assault and violence response as well as preventive interventions.
Preventing Heat-Related Illness among Hispanic Farmworkers
Authors: Culp Kennith , Tonelli Shalome , Ramey Sandra L. , Donham Kelley , Fuortes Laurence
Published: March 2019

Hispanic and Latino farmworkers are at risk for negative occupational health and safety outcomes due to issues such as their extreme work conditions, their reliance on employer beneficence, and cultural barriers. The purpose of this article is to explain the unique characteristics of heat-related illness in the Hispanic agricultural work force and to provide an overview of the problems of poor hydration and heat exposure in this population. Culturally appropriate preventive strategies are discussed because industrial-type solutions may not work in a crop production environment where language and beliefs may interfere with adaptation.
Wisdom in Old-Time Self-Treatment
Authors: Litchfield Sheila M.
Published: March 2019

Most people have been taking care of themselves for a long time. Sometimes they might share surprising old-time self-healing wisdom that rings true with currently accepted nursing practice. Nurses must learn about clients' health care practices and resources to be of assistance.
Integrating Results from Smoking Cessation Drug Research and Development into Clinical Occupational Health Practice
Authors: Weinsier Stephanie T.
Published: March 2019

This article documents evidence-based pharmacologic interventions to promote successful smoking cessation among employees who smoke. The article also highlights supporting evidence for the use of pharmacologic agents to treat tobacco dependence and can guide successful, personalized, pharmacologic smoking cessation interventions in occupational clinical practice. Prescribing clinicians will also find information about the latest research and development of medications to promote smoking cessation, including recently implemented black box warnings by the U.S. Food and Drug Administration.
The American Association of Occupational Health Nurses, Inc.—Lessons Learned for Building a Strong Future
Authors: Litchfield Sheila M.
Published: March 2019

It has been an honor and a privilege representing American Association of Occupational Health Nurses, Inc. (AAOHN) members on the Board of Directors for the past 3 years. A large portion of this time has necessarily been spent working with fellow Board members in a process of financial recovery. This article offers the perspective of one Board member and highlights lessons learned and strengths of AAOHN identified during a critical time in the Association's history.
Internet-Based Outpatient Telerehabilitation following Total Knee Arthroplasty
Authors: Chalupka Stephanie
Published: March 2019

Outcomes achieved via telerehabilitation 6 weeks following total knee arthroplasty were comparable to those achieved via conventional rehabilitation.
A Family History Intervention
Authors: McNeill Jeanette A. , Cook Jennifer D. M. , Mahon Marveen , Allwein David A. , Rauschhuber Maureen , Richardson Cynthia O. , Muñoz Laura R. , Estrada Rosanna , Jones Mary Elaine
Published: March 2019

This article describes the effect of individualized counseling using family history data and objective cardiovascular risk factors on intent to change and actual exercise behavior in a diverse sample of working adults. Using a longitudinal, quasi-Bxperimental, crossover design, objective data (blood lipids, glucose, blood pressure, and body mass index) and subjective data (awareness of heart disease risk, depression, spirituality, and knowledge of family history) were collected from 91 (mostly female and with a mean age of 45 years) primary and secondary teachers in a southwestern city. The Transtheoretical Model of Change guided the study and measured intent to exercise. Objective risks in this sample mirrored national indices of risk for obesity and abnormal lipids. Although some participants increased their exercise, no significant differences were found between the groups in exercise behavior at 6 and 12 months. Using knowledge of family history to raise awareness and encourage lifestyle changes related to cardiovascular risk warrants further study.
Nothing to Fear but Fear Itself?
Authors: Litchfield Sheila M.
Published: March 2019

As radiation levels around the crippled Fukushima Dai-ichi nuclear plant in Japan increase, the Japanese people as well as individuals around the world have expressed fear of radiation that some experts say could be more unhealthy than the levels of leaked radioactive contamination. This article addresses why individuals fear radiation and provides resources occupational health nurses can consult when answering clients' questions.
Assessment of Blood Pressure Knowledge among Workers in a Midwestern Manufacturing Plant
Authors: Fearn Cindy L. , Brick Gail Y. , Lizer Shannon , Doughty Andrea , MacDowell Martin
Published: March 2019

This pilot study assessed knowledge of blood pressure among employees in a midwestern manufacturing plant. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) guidelines were used to define blood pressure categories. The Roy Adaptation Model served as the framework. Results indicated two statistically significant relationships—one between knowledge of blood pressure and employees taking blood pressure medication, and one between employees' knowledge of blood pressure readings and increased interest in learning about lifestyle modifications impacting blood pressure. Of those correctly identifying the blood pressure ranges for prehypertension, 94.4% indicated interest in learning about lifestyle modifications to improve blood pressure. Occupational health nurses in industrial settings have a unique opportunity to influence employees' blood pressure knowledge, which can propel employees to consider lifestyle modifications or wellness programs that may favorably impact indirect and direct costs.
Health Disparities of Coal Miners and Coal Mining Communities
Authors: Apostle Elisa P. , O'Connell Marykate E. , Vezeau Toni M.
Published: March 2019

This article investigates how the health disparities of Appalachian coal miners and coal mining communities could be decreased through a partnership with occupational health nurses. On-site health clinics managed by occupational health nurses working in the coal mining industry are proposed as a means to improve health care outcomes. Health effects, economic considerations, environmental impacts, and U.S. coal mining legislation and regulation are examined. An epidemiological approach is presented to the unique health effects experienced by Appalachian coal miners and coal mining communities within the context of existent socioeconomic disparities. The long-standing health crisis in Appalachian coal mining communities requires a multidisciplinary approach led by occupational health nurses.
Yoga to Treat Nonspecific Low Back Pain
Authors: Carter Catherine , Stratton Carol , Mallory Debra
Published: March 2019

Low back pain is common and poses a challenge for clinicians to find effective treatment to prevent it from becoming chronic. Chronic low back pain can have a significant impact on an employee's ability to remain an active and productive member of the work force due to increased absenteeism, duty restrictions, or physical limitations from pain. Low back pain is the most common cause of work-related disability among employees younger than 46 years. Advancing technology and less invasive surgical procedures have not improved outcomes for employees who suffer from low back pain. Most continue to experience some pain and dysfunction after conventional treatments such as injections and surgery. An alternative treatment that could reduce nonspecific chronic low back pain would benefit both employees and employers. Exercising and remaining active are part of most guidelines' routine care recommendations but are not well defined.
Effects of a Worksite Physical Activity Intervention for Hospital Nurses Who are Working Mothers
Authors: Tucker Sharon J. , Lanningham-Foster Lorraine M. , Murphy Justyne N. , Thompson Warren G. , Weymiller Audrey J. , Lohse Christine , Levine James A.
Published: March 2019

Hospital nurses who are working mothers are challenged to maintain their personal health and model healthy behaviors for their children. This study aimed to develop and test an innovative 10-week worksite physical activity intervention integrated into the work flow of hospital-based nurses who were mothers. Three volunteer adult medical-surgical nursing units participated as intervention units. Fifty-eight nurses (30 intervention and 28 control) provided baseline and post-intervention repeated measurements of physical activity (steps) and body composition. Intervention participants provided post-intervention focus group feedback. For both groups, daily steps averaged more than 12,400 at baseline and post-intervention. No significant effects were found for physical activity; significant effects were found for fat mass, fat index, and percent fat ( p < .03). Focus group findings supported the intervention and other data collected. The worksite holds promise for targeting the health of working mothers. Future research is warranted with a larger sample, longer intervention, and additional measures.
Exercise among Commercial Truck Drivers
Authors: Turner Lisa M. , Reed Deborah B.
Published: March 2019

This study examines the exercise habits and perceived barriers to exercise of a convenience sample of 300 commercial truck drivers. Participants reported minimal amounts of exercise, with nearly 20% not exercising in the past week. A high prevalence of obesity was found in this sample: 93.3% of study participants had a body mass index (BMI) of 25 or higher. Drivers with BMIs of greater than 30 were significantly more likely to rate the exercise environment as terrible/bad. Drivers who had at least one health condition engaged in significantly less aerobic exercise, used fewer strengthening exercises, did not exercise for 30 minutes continuously, and had a higher BMI. Drivers who spent most of their off-duty time in their truck while their partner drove were also significantly more likely to not exercise regularly. Most drivers cited lack of time and place as the primary barriers to exercising. This study adds to the limited knowledge about exercise behaviors among commercial truck drivers.
Swedish Entrepreneurs' Use of Occupational Health Services
Authors: Gunnarsson Kristina , Andersson Ing-Marie , Josephson Malin
Published: March 2019

Small-scale enterprises are less often covered by occupational health services and have insufficient awareness about health and risks in the work environment. This study investigated how Swedish entrepreneurs in small-scale enterprises use occupational health services. The study used a questionnaire sent in two waves, 5 years apart. At baseline, 496 entrepreneurs responded, and 251 participated 5 years later. The questionnaire included items about affiliation with and use of occupational health services, physical and psychosocial work environments, work environment management, sources of work environment information, and membership in professional networks. Only 3% of entrepreneurs without employees and 19% of entrepreneurs with employees were affiliated with an occupational health service. Entrepreneurs affiliated with occupational health services were more active in work environment management and gathering information about the work environment. The occupational health services most used were health examinations, health care, and ergonomic risk assessments. Affiliation with occupational health services was 6% at both measurements, 4% at baseline, and 10% 5 years later.
The Value of HAZWOPER Medical Surveillance
Authors: Huss R. Gail , Williamson Kristen N. , Alvis Kimberly L. , Hewitt David J.
Published: March 2019

Medical surveillance is mandated for workers with potential exposure to hazardous materials. However, little guidance is provided regarding the components of a medical surveillance testing program for these individuals. This article describes the medical surveillance program for a group of 72 employees who respond to hazardous material releases throughout the United States. Conditions related to chemical exposures were not identified in this group. However, several non-occupational health conditions were identified, including a relatively high prevalence of one or more signs of metabolic syndrome. Medical surveillance may provide valuable information regarding an individual's underlying health status and non-occupational health conditions to be addressed at an early stage.
Managing the Risks of On-Site Health Centers
Authors: Gorman Kathleen M. , Miller Ross M.
Published: March 2019

This review sought to assess compliance concerns, determine risk management strategies, and identify opportunities for future research to contribute to employers' understanding of the laws and regulations that apply to on-site care. A comprehensive review of databases, professional organizations' websites, and journals resulted in 22 publications reporting on the consequences of noncompliance among on-site health centers accepted for inclusion. None of those studies reported a study design or quantifiable outcome data. Two noncompliance themes were repeated among the publications. First, direct penalties included fines, civil actions, loss of licensure, and, potentially, criminal charges. Second, noncompliance also resulted in indirect costs such as employee mistrust and lowered standards of care, which jeopardize on-site health centers' ability to demonstrate a return on investment. Further research with rigorous methodology is needed to inform employer decisions about on-site health services and associated risk management.
An Integrated Approach to Worker Self-Management and Health Outcomes
Authors: Miller Colleen
Published: March 2019

Employee health, prevention, and maintenance programs are growing exponentially each year as costs continue to rise across the health care continuum. Employers and payers alike continue to be challenged by chronic health risks, effective prevention strategies, optimal health and wellness strategies, and programs that are effective for America's work force. In light of these challenges, new and exciting health management approaches are evolving. Changes in occupational health nursing practice can ultimately affect the way occupational health nurses plan, structure, and conduct education sessions. New trends, such as health coaching, embrace the incorporation of health research through evidence-based practice and standards of care to provide the science clinicians need to support interventions. Through knowledge of chronic conditions, evidence-based practice, and health coaching, occupational health nurses possess the skills and strategies that form the foundation necessary to affect and safely guide employee self-discovery and self-management and produce optimal health outcomes.
Soy Isoflavones for the Prevention of Menopausal Symptoms and Bone Loss—A Safe and Effective Alternative to Estrogen?
Authors: Chalupka Stephanie
Published: March 2019

Daily administration of soy isoflavones for 2 years did not prevent bone loss or menopausal symptoms.
Does Previous Hip Arthroscopy Affect the Clinical Outcomes of Total Hip Arthroplasty?
Authors: Haynes Jacob A. , Xiong Ao , Nepple Jeffrey J. , An Tonya , Nunley Ryan M. , Clohisy John C.
Published: March 2019

Background:

Failure of hip arthroscopy procedures and the need for subsequent total hip arthroplasty (THA) have been estimated to be as high as 16%. Prior literature has shown that failed ipsilateral knee arthroscopy may have a negative impact on the functional outcome of subsequent total knee arthroplasty. To date, there is limited information regarding the impact of failed hip arthroscopy on the clinical outcomes of subsequent primary THA.

Purpose:

To compare clinical outcomes in primary THA between patients with and without prior arthroscopic hip surgery.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Patients undergoing primary THA with a history of ipsilateral hip arthroscopy were matched and compared in a 1:2 manner with patients undergoing primary THA without a history of hip arthroscopy. Patient-reported clinical outcomes were measured with the modified Harris Hip Score, the University of California–Los Angeles Activity Score, and 3 subscales from the Western Ontario and McMaster Universities Osteoarthritis Index (Pain, Stiffness, and Physical Function).

Results:

At a mean follow-up of 42 months, there was no significant difference in any of the outcome measures between the 58 study hips and 116 matched controls. Additionally, both groups exhibited an absolute change in outcome scores that exceeded the minimum clinically important difference.

Conclusion:

Prior ipsilateral arthroscopic hip surgery does not adversely affect the clinical outcome of subsequent THA.
Patients’ Experiences of Nurse Case-Managed Osteoporosis Care: A Qualitative Study
Authors: Wozniak Lisa A , Rowe Brian H , Ingstrup Meghan , Johnson Jeffrey A , McAlister Finlay A , Bellerose Debbie , Beaupre Lauren A , Majumdar Sumit R
Published: March 2019

Background:

Osteoporosis is a chronic condition that is often left untreated. Nurse case-managers can double rates of appropriate treatment in those with new fractures. However, little is known about patients’ experiences of a nurse case-managed approach to osteoporosis care.

Objective:

Our aim was to describe patients’ experiences of nurse case-managed osteoporosis care.

Methods:

A qualitative, descriptive design was used. We recruited patients enrolled in a randomized controlled trial of a nurse case-management approach. Individual semi-structured interviews were conducted which were transcribed and analyzed using content analysis. Data were managed with ATLAS.ti version 7.

Results:

We interviewed 15 female case-managed patients. Most (60%) were 60-years or older, 27% had previous fracture, 80% had low bone mineral density tests, and 87% had good osteoporosis knowledge. Three major themes emerged from our analysis: acceptable information to inform decision-making; reasonable and accessible care provided; and appropriate information to meet patient needs.

Conclusions:

This study provides important insights about older female patients’ experiences with nurse case-managed care for osteoporosis. Our findings suggest that this model to osteoporosis clinical care should be sustained and expanded in this setting, if proven effective. In addition, our findings point to the importance of applying patient-centered care across all dimensions of quality to better enhance the patients’ experience of their health care.
Educational Disparities in Adult Health: U.S. States as Institutional Actors on the Association
Authors: Montez Jennifer Karas , Hayward Mark D. , Zajacova Anna
Published: March 2019

Despite numerous studies on educational disparities in U.S. adult health, explanations for the disparities and their growth over time remain incomplete. The authors argue that this knowledge gap partly reflects an individualist paradigm in U.S. studies of educational disparities in health. These studies have focused largely on proximal explanations (e.g., individual behaviors) to the neglect of contextual explanations (e.g., economic policies). The authors draw on contextual theories of health disparities to illustrate how U.S. states, as institutional actors, shape the importance of education for health. Using two nationally representative data sets and seven health measures for adults aged 45 to 89 years, the authors show that the size of the educational gradient in health varies markedly across states. The size varies because of variation in the health of lower educated adults. The authors use state excise taxes on cigarettes to illustrate one way states shape educational disparities in health. These findings underscore the necessity of contextualizing these disparities.
Undergraduate Student-Run Business Development Services Firms: A New Educational Opportunity and Growth Alternative for Small and Medium Enterprises
Authors: Delaney Peter G. , Harrington Ken , Toker Emre
Published: March 2019

This article explores undergraduate-run business development services firms catering to small and medium enterprises (SMEs) as a new educational opportunity for students as the gig economy expands and as a growth alternative for SMEs. It describes how to structure the firm in the space between students, the university, and the regional community, and why this is an important model moving forward. This approach offers the dual benefit of providing SMEs with high-quality services at affordable rates and provides undergraduates with authentic work experiences that teach students to be flexible, operate on a per-project basis, and prepare themselves for “portfolio careers” of the future. Founded in 2015, Bear Studios has completed 82 projects with 62 different companies, split between health care (49%), education (20%), software (16%), consumer goods (6%), and other industries (9%). Involving 43 student fellows and having generated over $52,000 in billings to date, the company expanded to Baltimore and is expanding into the Salt Lake City metropolitan area. Students can become better prepared for postgraduate careers through this model. We propose how students can gain valuable work experience prior to graduation as a participant in the new workforce, while functioning as a cost-effective alternative for SMEs.
Delafloxacin for the Treatment of Acute Bacterial Skin and Skin Structure Infections
Authors: Lee Young Ran , Burton Caitlin Elizabeth , Bevel Kolton Rucks
Published: March 2019

Objective: To review the microbiological activity, safety, and efficacy of the new fluoroquinolone delafloxacin for the treatment of acute bacterial skin and skin structure infections (ABSSSIs). Data Sources: A PubMed search from 1945 to September 2018 was done using the terms delafloxacin, acute bacterial skin and skin structure infections, skin and soft tissue infections, and fluoroquinolone. Additional sources include the Food and Drug Administration website, ClinicalTrials.gov, and the Melinta Therapeutics website. Study Selection and Data Extraction: The literature search was limited to those published in the English language and included in vitro and human studies that evaluated microbiological coverage, pharmacokinetics, pharmacodynamics, safety, and/or efficacy. Data Synthesis: Delafloxacin is a new fluoroquinolone with a unique structure for its class that covers both methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas. This new antibiotic has demonstrated noninferiority to vancomycin plus aztreonam for the treatment of ABSSSIs in both an intravenous-only regimen and an intravenous to an oral regimen. Relevance to Patient Care and Clinical Practice: ABSSSIs are infections that are most often caused by Staphylococcus and represent one of the most common types of hospital infections. MRSA represents about half of all staphylococcal skin infections, and along with gram-negative infections, increase the rates of patient morbidity and health care costs. Delafloxacin is an additional treatment option that covers both of these types of microorganisms. Conclusions: Delafloxacin is a safe and effective treatment option for ABSSSIs, particularly in those with polymicrobial infections and those with MRSA.
Subungual Exostosis: High-Resolution Ultrasound Findings
Authors: Whittle Carolina , Aguirre Javiera , Catalán Veronica , Fajre Ximena , Vargas Fabiola
Published: March 2019

Subungual exostosis is a rare solitary benign osteocartilaginous tumor that arises from the tuft of the distal phalanx beneath the nail. Because of its multiple clinical presentations, it is commonly underdiagnosed, resulting in delayed diagnosis and inadequate treatment. This report provides results from a 6-year retrospective study. All patients with a sonographic diagnosis of subungual exostosis confirmed surgically were selected. The data came from a series of 19 patient cases. Only 15.7% were clinically suspected. The median age was 21 years, and 63% were females. The sonographic findings were nail dystrophy, distal onycholysis, abnormal nail incurvation, subungual space enlargement, and the presence of hyperechogenic subungual image with acoustic shadowing that continued until the phalanx surface. Sonography provides an excellent diagnostic method for subungual exostosis, with findings that are pathognomonic.
A retrospective analysis of two tertiary care dizziness clinics: A multidisciplinary chronic dizziness clinic and an acute dizziness clinic
Authors: Staibano Phillip , Lelli Daniel , Tse Darren
Published: March 2019

Background

Vertigo remains a diagnostic challenge for primary care, emergency, and specialist physicians. Multidisciplinary clinics are increasingly being employed to diagnose and manage patients with dizziness. We describe, for the first time in Canada, the clinical characteristics of patients presenting with chronic and acute dizziness to both a multidisciplinary chronic dizziness clinic (MDC) and a rapid access dizziness (RAD) clinic at The Ottawa Hospital (TOH).

Methods

We performed a retrospective review of all patients presenting to the MDC and RAD clinics at TOH from July 2015 to August 2017.

Results

Overall, 211 patients (median age: 61 years old) presented to the RAD clinic and 292 patients (median age: 55 years old) presented to the MDC. In the RAD clinic, 63% of patients had peripheral dizziness, of which 55% had BPPV, and only one patient had functional dizziness. Interestingly, only 25% of RAD diagnoses were concordant with emergency department diagnoses; moreover, only 33% of RAD patients had HiNTS completed, while 44% had CT scans, of which only one scan had an abnormal finding. Prior to assessment, all patients in the MDC had an unclear cause of dizziness. 28% of patients had vestibular dizziness and 21% had functional dizziness, of which 43% had persistent postural perceptual dizziness. Moreover, 12% of patients with functional dizziness also suffered from comorbid severe anxiety and depression.

Conclusions

Dizziness is a heterogeneous disorder that necessitates multidisciplinary care, and clinics targeting both the acute and chronic setting can improve diagnostic accuracy, ensure appropriate diagnostic testing, and facilitate effective care plans for patients with dizziness.
Cardiac proteomics reveals the potential mechanism of microtubule associated protein 4 phosphorylation-induced mitochondrial dysfunction
Authors: Li Lingfei , Zhang Junhui , Zhang Qiong , Huang Yuesheng , Hu Jiongyu
Published: March 2019

Background

Our previous work suggested that microtubule associated protein 4 (MAP4) phosphorylation led to mitochondrial dysfunction in MAP4 phosphorylation mutant mice with cardiomyopathy, but the detailed mechanism was still unknown. Thus, the aim of this study was to investigate the potential mechanism involved in mitochondrial dysfunction responsible for cardiomyopathy.

Methods

The present study was conducted to explore the potential mechanism underlying the mitochondrial dysfunction driven by MAP4 phosphorylation. Strain of mouse that mimicked constant MAP4 phosphorylation (S737 and S760) was generated. The isobaric tag for relative and absolute quantitation (iTRAQ) analysis was applied to the heart tissue. Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), and protein-protein interaction (PPI) were all analyzed on the basis of differential expressed proteins (DEPs).

Results

Among the 72 cardiac DEPs detected between the two genotypes of mice, 12 were upregulated and 60 were downregulated. GO analysis showed the biological process, molecular function, and cellular component of DEPs, and KEGG enrichment analysis linked DEPs to 96 different biochemical pathways. In addition, the PPI network was also extended on the basis of DEPs as the seed proteins. Three proteins, including mitochondrial ubiquitin ligase activator of NF-κB 1, reduced form of nicotinamide adenine dinucleotide (NADH)-ubiquinone oxidoreductase 75 kDa subunit, mitochondrial and growth arrest, and DNA-damage-inducible proteins-interacting protein 1, which play an important role in the regulation of mitochondrial function, may correlate with MAP4 phosphorylation-induced mitochondrial dysfunction. Western blot was used to validate the expression of the three proteins, which was consistent with iTRAQ experiments.

Conclusions

These findings revealed that the DEPs caused by MAP4 phosphorylation in heart tissue using iTRAQ technique and may provide clues to uncover the potential mechanism of MAP4 phosphorylation-induced mitochondrial dysfunction.
A 3D reflection ray-tracing method based on linear traveltime perturbation interpolation
Authors: Li Tongyu , Liu Jie , Zhang Jianzhong
Published: March 2019

The linear traveltime interpolation (LTI) method, one of the common methods to calculate the wavefront traveltimes and the raypaths in complex media, is based on the assumption that the traveltime varies linearly along each cell boundary of a discrete model. The linear assumption may result in large calculation errors when the cell size is large. To solve this problem, we have adopted a linear traveltime perturbation interpolation (LTPI) method. In LTPI, the original traveltime is decomposed into two parts: a reference traveltime and a traveltime perturbation. The reference traveltime, being one propagating in the equivalent homogeneous medium, varies nonlinearly. The traveltime perturbation, defined as the difference between the original and reference traveltimes, is assumed to be linear along each cell boundary. The traveltime perturbation is much less than the reference traveltime; therefore, the original traveltime keeps its nonlinearity. We modify LTPI to suit to irregular hexahedral cells for simulating the undulating interfaces more precisely. By combining the modified LTPI with the wavefront group-marching method, we have developed a reflection ray-tracing method in 3D complex media. Numerical experiments indicate that the modified LTPI is more accurate than LTI in computing wavefront traveltimes and raypaths. Besides, the modified LTPI performs more consistently than LTI in different grid spacing. Therefore, under a certain accuracy requirement, the modified LTPI is more efficient than LTI.
Transmission compensated primary reflection retrieval in the data domain and consequences for imaging
Authors: Zhang Lele , Thorbecke Jan , Wapenaar Kees , Slob Evert
Published: March 2019

We have developed a scheme that retrieves primary reflections in the two-way traveltime domain by filtering the data. The data have their own filter that removes internal multiple reflections, whereas the amplitudes of the retrieved primary reflections are compensated for two-way transmission losses. Application of the filter does not require any model information. It consists of convolutions and correlations of the data with itself. A truncation in the time domain is applied after each convolution or correlation. The retrieved data set can be used as the input to construct a better velocity model than the one that would be obtained by working directly with the original data and to construct an enhanced subsurface image. Two 2D numerical examples indicate the effectiveness of the method. We have studied bandwidth limitations by analyzing the effects of a thin layer. The presence of refracted and scattered waves is a known limitation of the method, and we studied it as well. Our analysis indicates that a thin layer is treated as a more complicated reflector, and internal multiple reflections related to the thin layer are properly removed. We found that the presence of refracted and scattered waves generates artifacts in the retrieved data.
DICER1 Mutations in the Era of Expanding Integrative Clinical Sequencing in Pediatric Oncology
Authors: Bailey Kelly M. , Jacobs Michelle F. , Anderson Bailey , Rabah Raja , Wu Yi-Mi , Else Tobias , Mody Rajen J.
Published: March 2019

PURPOSE

DICER1 syndrome is a recently described inherited cancer predisposition syndrome caused by pathogenic variants in DICER1. With the recent increase in integrative clinical sequencing for pediatric patients with cancer, our understanding of the DICER1 syndrome continues to evolve, as new and rare pathogenic variants are reported. As the frequency of integrative clinical sequencing increases, discussions regarding challenges encountered in the interpretation of sequencing results are essential to continue to advance the field of cancer predisposition. The purpose of this work was to identify patients with somatic and/or germline DICER1 variants in our patient population and to discuss sequencing interpretation and the clinical recommendations that result from the integrative clinical sequencing results.

METHODS

Patients were enrolled in the PEDS-MIONCOSEQ study. This integrative clinical sequencing study includes paired tumor/normal whole-exome sequencing and tumor transcriptome sequencing. Patients identified as having DICER1 variants were included.

RESULTS

We report a DICER1 variant of unknown clinical significance in a patient with a highly unusual response to therapy. Two patients had diagnoses clarified once the integrative clinical sequencing revealing a DICER1 variant was available. We also discovered a patient with low-level DICER1 mosaicism and the challenges encountered in the sequencing interpretation for this patient. In addition to the sequencing data and result interpretation, this work also highlights testing and screening recommendations made to patients with DICER1 variants and their families on the basis of these results.

CONCLUSION

This work serves to extend the DICER1 phenotype and advance the utility of clinical integrative sequencing in the fields of pediatric oncology and cancer genetic predisposition.