bluuebunny/crossref_metadata_2025 huggingface dataset:
What are Some of the Challenges in Case Management and how have you Handled Them?
Authors: Kalina Christine M. , Haag Annette B. , Tourigian Robin
Published: March 2019

Case Management Update appears as part of Clinical Rounds in the Journal. The panel approach provides a forum for sharing ideas, viewpoints, and perspectives. Panel members come with expertise from a variety of case management arenas and have agreed to share their opinions and perspectives in response to specific questions or scenarios. Opinions and perspectives are those of the panel members, and do not necessarily represent the views of the AAOHN, the Editor, or the Publisher. We encourage readers to submit their questions or scenarios for the Panel. This month's Panel members include Christine M. Kalina, Annette B. Haag, and Robin Tourigian.
Processes of Care for Individuals with Work Related Asthma: Treatment Characteristics and Impact of Asthma on Work
Authors: Roberts Julie L. , Janson Susan , Gillen Marion , Flattery Jennifer , Harrison Robert
Published: March 2019

The prevalence of asthma among working adults continues to rise each year. The California Department of Health Services conducts surveillance of work related asthma (WRA) to classify each work related exposure using Doctor's First Reports of Occupational Illness and Injury (DFRs). Using a cross-sectional, descriptive, comparative design, additional interviews were conducted and medical records were reviewed to explore workers' and providers' perceptions of follow up care. Two cohorts were compared: workers with WRA who belonged to a large, single HMO (n = 79) and workers with WRA who underwent follow up outside this HMO (n = 76). The interview asked about providers seen, tests ordered, and the impact of asthma on work. The HMO clients were significantly more likely than the non-HMO clients to see occupational medicine specialists (p = .004) and have pulmonary function testing (p = .049) during initial treatment. Twenty-four percent of clients currently working reported missed workdays caused by asthma in the past 6 months. The findings indicate management of WRA varies by health care system in California.
What are Some Effective Chronic Disease Management Strategies that can be Used in Case Management?
Authors: Kalina Christine M. , Haag Annette B. , Tourigian Robin
Published: March 2019

Case Management Update appears as part of Clinical Rounds in the Journal. The panel approach provides a forum for sharing ideas, viewpoints, and perspectives. Panel members come with expertise from a variety of case management arenas and have agreed to share their opinions and perspectives in response to specific questions or scenarios. Opinions and perspectives are those of the panel members, and do not necessarily represent the views of the AAOHN, the Editor, or the Publisher. We encourage readers to submit their questions or scenarios for the Panel. This month's Panel members include Christine M. Kalina, Annette B. Haag, and Robin Tourigian.
Implementation of a Scheduled Toileting Program in a Long Term Care Facility: Evaluating the Impact on Injury Risk to Caregiving Staff
Authors: Engst Chris , Chhokar Rahul , Robinson Dan , Earthy Ann , Yassi Annalee
Published: March 2019

This study evaluated the impact of a scheduled toileting program on the risk of injury to caregivers and on resident agitation or aggressive behaviors. Injury data, ergonomic assessments, staff questionnaires, and resident agitation checklists were used to evaluate the program in a 75 bed unit, with a similar unit acting as a comparison. The program resulted in an increased percentage of residents toileted regularly in the intervention unit, while aggressive incidents declined in both groups. Staff in the intervention unit reported a significantly lower perceived risk of injury to the head and neck than the comparison group. Although the program resulted in increased workload to manage multitasking, monitor an additional aspect of scheduled care, and perform more toileting transfers, overall risk of physical injury was reduced. The toileting program, a shift toward resident focused care, and enhanced agitation awareness combined to reduce resident handling injuries and resident agitation expressed as verbal behaviors or emotional upset, but not as physical behaviors. Clear communication, mentoring, and monitoring were important for successfully changing care practices.
The Return to Work Experiences of Colorectal Cancer Survivors
Authors: Sanchez Kathleen M. , Richardson Jean L. , Mason Hyacinth R.C.
Published: March 2019

Abstract: During the past 15 years, the number of colorectal cancer survivors has risen dramatically. While it is unclear how many colorectal cancer survivors were employed at the time of diagnosis, it is reasonable to expect a significant proportion of these survivors were temporarily displaced from the work force. This article describes the return to work experiences of 250 colorectal cancer survivors. The majority (80%) of the survivors were employed at diagnosis and 89% returned to work. Of those who returned to work, 81% sustained employment 5 years postdiagnosis. Results indicate survivors were successful in their attempt to return to work and sustain employment. However, 34% of survivors delayed their return beyond 2 months postdiagnosis. After controlling for ethnicity, education, and disease severity, the reason for delay was related to chemotherapy treatment Prospective studies of colorectal cancer survivors to document barriers to work return can guide interventions and occupational services to keep survivors healthy and in the workplace.
An Inaugural Conference on Occupational Health in the Gambia: Exploring the World through International Occupational Health Programs
Authors: Culp Kennith , Marquez Shannon P. , Bobb Maram , Jagne D.M.B
Published: March 2019

The next International Commission on Occupational Health (ICOH) Congress will be a celebration of its 100th anniversary, held in Milan Italy from June 11 to 16, 2006. With significant improvements in the understanding of occupational health at the international level, it is hoped that all occupational health professionals throughout the world can celebrate 100 years of progress and accomplishments at this Congress. With this goal, the AAOHN Journal has been running a special series of articles focusing on “Exploring the World Through International Occupational Health Programs” organized by OiSaeng Hong, PhD, RN, Assistant Professor and Director, Occupational Health Nursing Program, Division of Health Promotion and Risk Reduction, School of Nursing, University of Michigan, Ann Arbor, Michigan. This is the second article of the series.
Nurses' Inclination to Report Work-Related Injuries: Organizational, Work-Group, and Individual Factors Associated with Reporting
Authors: Brown Jeanne Geiger , Trinkoff Alison , Rempher Kenneth , McPhaul Kathleen , Brady Barbara , Lipscomb Jane , Muntaner Charles
Published: March 2019

Work-related injuries such as back strain are common among health care workers. Work-related injury data are a primary data source with which managers can assess workplace safety, yet many work-related injuries go unreported. This study examined organizational, work-group, and individual factors, and nurses' inclination to report a work-related injury. Using a cross-sectional mailed survey, a probability sample of currently employed nurses (N = 1,163) indicated their inclination to report a workplace injury. Inclination to report injuries was higher in organizations with onsite health programs and when health and safety committees included non-management nurses and occupational health representatives. Reporting was reduced when nurses felt a lack of concern for staff welfare from supervisors and a climate of blame for worker injuries were present Nurses were also less inclined to report work-related injuries when working in jobs with non-standard work arrangements. Improvements in the reporting climate may influence the completeness and, thus, the value of injury data for identifying hazards in the workplace. These data could provide valuable information for targeting preventive initiatives.
Evaluating Occupational Health Nursing Units in Bangkok Textile Factories
Authors: Silpasuwan Pimpan , Viwatwongkasem Chukiat , Phalee Piangjai , Kalampakorn Surintorn
Published: March 2019

The next International Commission on Occupational Health (ICOH) Congress will be a celebration of its 100th anniversary, held in Milan, Italy from June 11 to 16, 2006. With significant improvements in the understanding of occupational health at the international level, it is hoped that all occupational health professionals throughout the world can celebrate 100 years of progress and accomplishments at this Congress. With this goal, the AAOHN Journal has been running a special series of articles focusing on “ Exploring the World Through International Occupational Health Programs” organized by OiSaeng Hong, PhD, RN, Assistant Professor and Director, Occupational Health Nursing Program, Division of Health Promotion and Risk Reduction, School of Nursing, University of Michigan, Ann Arbor, Michigan. This is the fourth article in the series.

The purpose of this study was to examine the service quality of nursing units in Bangkok textile factories. Descriptive survey research was combined with a qualitative design using participative observation. The sample consisted of factory managers, nurses, and employees. Data were collected between November 2001 and February 2002 using questionnaires, observation, in-depth interviews, and focus groups. Nurses' education levels and quality of design and arrangement of nursing units explained 15.7% of the variance in service quality. Furthermore, qualitative data supported clients' satisfaction with service quality, except for the tangibility of the service. These findings suggest that the quality of nursing service units could be improved by management's attention to unit design, arrangement of nursing units, and nurses' education levels. Hiring registered nurses and restructuring nursing units are recommended.
Cardiovascular Risk among Older Hispanic Women
Authors: Etnyre Annette , Rauschhuber Maureen , Gilliland Irene , Cook Jennifer , Mahon Marveen , Allwein David , Sethness Renee , Lowry Jolynn , Jones Mary Elaine
Published: March 2019

This study used a descriptive correlational design to describe the relationship between cardiovascular risk and anxiety, spirituality, acculturation, and the objective indices of cardiac risk among a sample of 21 adult Hispanic women. Objective indices of risk included weight, blood pressure, blood lipids, and glucose. Four survey instruments were used to assess anxiety, spirituality, acculturation, and perceived risk. Findings revealed that all study participants had 3 or more risk factors, placing them in the moderate risk category for developing heart disease or having a heart attack within 10 years. State and trait anxiety scores were lower than the normative samples for adult women. Spirituality scores were higher than average; individuals with higher anxiety scores had lower spirituality scores. More research is needed to determine the health needs of unskilled workers with limited education in employment settings.
American Nurses Association's Best Practices in Seasonal Influenza Immunization Campaign
Authors: Strasser Patricia B. , Slavin Katie E.
Published: March 2019

The American Nurses Association (ANA) is concerned about the unacceptably low rates of seasonal influenza vaccination among registered nurses and other health care personnel. Despite well-documented evidence of the importance and benefits of influenza immunization of health care personnel, seasonal influenza vaccination rates remain below 50%. In response, ANA developed the 2006–2007 Best Practices in Seasonal Influenza Immunization Campaign to assist health care organizations in conducting successful seasonal influenza immunization programs. Best practices in the top recognized programs have been compiled to represent the successful elements in seasonal influenza vaccination programs that result in increased vaccination acceptance and accessibility among health care professionals. ANA developed a brochure, articles, and other tools reflecting the best practices to assist other organizations nationwide in planning their seasonal influenza immunization programs.
Navigating the OSHA Website
Authors: Tompkins Olga S.
Published: March 2019

The OSHA website is an excellent resource for both new and experienced occupational health nurses.
Occupational Health Nursing Practice, Education, and Research in Taiwan
Authors: Lin Yun-Ping , Hong OiSaeng , Yeh Mei Chang
Published: March 2019

This article describes occupational health nursing practice, education, research, and future perspectives in Taiwan. It also provides a brief overview of major occupational health and safety problems, laws and regulations, and organizations in Taiwan.
The Reynolds Risk Score—Improving Cardiovascular Risk Prediction in Women
Authors: Bassuk Shari S.
Published: March 2019

This new tool improves the accuracy of the Framingham Risk Score but retains its simplicity.
The Energy Envelope Theory and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
Authors: Jason Leonard
Published: March 2019

Individuals with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) have little stamina and endurance, and pose a challenge for nursing professionals. The Energy Envelope Theory, which posits that maintaining expended energy levels consistent with available energy levels may reduce the frequency and severity of symptoms, is particularly useful when working with clients with ME/CFS. Anecdotal support from the client community for this theory supports its use as a management tool for ME/CFS, but little formal research has been done in this area. In this study, a daily energy quotient was established by dividing the expended energy level by the perceived energy level and multiplying by 100. It was predicted that those participants who expended energy beyond their level of perceived energy would have more severe fatigue and symptoms and lower levels of physical and mental functioning. Findings are congruent with the Energy Envelope Theory as they indicated that the daily energy quotient was related to several indices of functioning including depression, anxiety, fatigue, pain, quality of life, and disability. The overall results provide support for a strategy health care professionals can use when working with clients with ME/CFS.
Potential Allergy and Irritation Incidents among Health Care Workers
Authors: Alamgir Hasanat , Yu Shicheng , Chavoshi Negar , Ngan Karen
Published: March 2019

This study describes the types, causes, and outcomes of potential irritation and allergy incidents among workers in British Columbia's health care industry. Data on occupation-induced allergy and irritation incidents were extracted from a standardized database using the number of productive hours obtained from payroll data as a denominator during a 1-year period from three British Columbia health regions. Younger workers, female workers, facility support service workers, laboratory assistants and technicians, and maintenance and acute care workers were found to be at higher risk for allergy and irritation incidents. Major causes of allergy and irritation incidents included chemicals, blood and body fluids, food and objects, communicable diseases, air quality, and latex. A larger proportion of chemically induced incidents resulted in first aid care only, whereas non-chemical incidents required more emergency room visits.
The Returning Veteran—A Lesson in Reintegration
Authors: Maher Helen K.
Published: March 2019

Families, coworkers, employers, and health care providers play a role in the reintegration of returning veterans.
Knowledge, Perceptions, and Attitudes of Managers, Coworkers, and Employed Breastfeeding Mothers
Authors: Stewart-Glenn Jennifer
Published: March 2019

Employer attitudes and practices toward breastfeeding mothers are discouraging overall. Mothers who believe that breastfeeding while employed cannot be done without a considerable amount of additional work and stress may not even consider breastfeeding. Although it is known that lower income women tend not to breastfeed while employed, the relationship between type of employment and sustaining breastfeeding has not been clearly explained. Many women identify employment as a barrier to breastfeeding. Some elements of a workplace environment supportive of breastfeeding have been identified, including private space with a locking door (other than a bathroom stall), time to express milk at work, and adequate refrigeration. In relation to employers, monetary reasons (i.e., decreased productivity) are most frequently cited for not supporting breastfeeding. Only a small percentage of the research on employed breastfeeding mothers has focused on the workplace. Further research is needed to determine how breastfeeding can be beneficial to the mother, the infant, and the employer.
Cultural Diversity
Authors: Glazner Linda K.
Published: March 2019

This article discusses why occupational health nurses need to be concerned about cultural diversity, but is not intended to be an exhaustive report on the subject.
Ecological Model of Disaster Management
Authors: Strasser Patricia B. , Beaton Randal , Bridges Elizabeth , Salazar Mary K. , Oberle Mark W. , Stergachis Andy , Thompson Jack , Butterfield Patricia
Published: March 2019

The ecological model of disaster management provides a framework to guide occupational health nurses who are developing disaster management programs. This ecological model assumes that disaster planning, preparedness, response, and recovery occur at various levels of the organization. These nested, increasingly complex organizational levels include individual and family, workplace, community, state, tribal, federal, and global levels. The ecological model hypothesizes that these levels interact and these dynamic interactions determine disaster planning, preparedness, response, and recovery outcomes. In addition to the features of the hazard or disaster, it is also assumed that parallel disaster planning, preparedness, and response elements, logistical challenges, and flexibility, sustainability, and rehabilitation elements occur at each level of the ecological model. Finally, the model assumes that evaluation of response and recovery efforts should inform future planning and preparedness efforts.
Underreporting of Musculoskeletal Disorders among Health Care Workers
Authors: Menzel Nancy N.
Published: March 2019

Extensive evidence suggests that the numbers of workplace injuries and illnesses reported annually by the U.S. Department of Labor, Bureau of Labor Statistics, are underestimated for all private employers. Several states have passed safe patient handling legislation to reduce work-related musculoskeletal disorders (WMSDs) among health care workers. Research is needed to improve accurate reporting of these types of injuries to allow assessment of the effectiveness of this legislation and to enable hospitals and nursing homes to better target interventions to areas at high risk for WMSDs. In the interim, occupational health nurses and the American Association of Occupational Health Nurses, Inc., can assist in improving the accuracy of occupational surveillance for these work-related injuries.
Sociocultural Contexts and Worker Safety and Health
Authors: Tsai Jenny , Bruck Annie
Published: March 2019

More immigrants are seeking employment in restaurants. Drawing data from an ethnographic study, this article discusses what and how sociocultural contexts shape the safety and health of immigrant restaurant workers. Eighteen Chinese immigrants from China, Hong Kong, and Taiwan participated in the study. Data generation methods included a questionnaire, individual and focus group interviews, and participant observations. Ethnographic analysis revealed that immigration mechanisms, demands of English proficiency for employment, and existence of networks and ethnic communities shaped the participants' employment choices. Working hours and schedules, interpersonal relationships at work, job design and training, occupational safety and health training, and national events and economy further influenced the participants' occupational experiences and well-being. Issues were noted with job security, mental health, family relationships, and risks for occupational injuries and illnesses. Implications for occupational health nursing research and practice to reduce immigrant workers' vulnerability to poor safety and health outcomes conclude this article.
Managers' Perceptions of the Current and Future Role of Occupational Health Nurses in Australia
Authors: Strasser Patricia B. , Mellor Gary , John Winsome St
Published: March 2019

Occupational health nurses face competition from other professionals in the field of occupational health and safety. This study investigated managers' perceptions of Australian occupational health nurses' roles. Managers were asked to rate the importance of occupational health nurses' activities and the time they believe occupational health nurses do or should dedicate to each activity now and in the future. The questionnaire included 22 activity statements grouped into eight areas of practice that were thought to constitute the occupational health nurse role, based on the Australian College of Occupational Health Nurses standards. Data revealed that emergent roles focused on injury prevention, health promotion, management, and research were of increasing importance, with more time being needed for them in the future. Fulfilling these expectations may place occupational health nurses in competition with other occupational health and safety personnel for particular responsibilities and may require negotiation to gain support for taking on these role activities. Fulfilling these emergent role activities effectively will require appropriate professional development and advanced education.
Too Late Smart
Authors: McCullagh Marjorie , Robertson Cheryl
Published: March 2019

Farmers are exposed to hazardous noise from equipment and livestock and experience high rates of noise-induced hearing loss (NIHL); however, their use of hearing protection devices (HPDs) is low. The purpose of this study was to describe farmers' personal experiences using HPDs, influencing others' use of HPDs, and overcoming barriers to the use of HPDs. A purposive sample of farmers who reported a high frequency of HPD use was selected for face-to-face interviews. Findings indicated that farmers have frequent exposure to hazardous noise. They described their motivation to adopt protective behaviors to avoid hearing loss, noise annoyance, or tinnitus. Many tried to influence others' use of HPD, particularly family members. These farmers have developed a variety of methods to ensure convenient access to HPDs when needed, and have developed effective techniques for overcoming common barriers to protection. Findings from this study will be used to form the foundation for future studies aimed at developing and testing an intervention to increase HPD use and decrease rates of NIHL among farmers.
Patient Satisfaction with Nurse Practitioner and Physician Services in the Occupational Health Setting
Authors: Guzik Arlene , Menzel Nancy Nivison , Fitzpatrick Joyce , McNulty Rita
Published: March 2019

The purpose of this research was to determine if patient satisfaction differed when clinical services were provided by nurse practitioners versus physicians in the occupational health setting. This convenience sample included 129 patients visiting community-based occupational medicine clinics for evaluation of a new work-related injury. There was high satisfaction with both nurse practitioner and physician providers. There was no significant difference in overall patient satisfaction between provider types. Results of this study support a practice model using nurse practitioners as primary providers in the occupational health setting.
Use of Occupational Health Services in a Cyprus Oncology Center
Authors: Provan Helen , Raftopoulos Vasilios , Soteriades Elpidoforos
Published: March 2019

Use of occupational health services in the hospital environment is an important parameter for annual health care planning. The objective of this study was to evaluate the clinic utilization at a Cyprus oncology center. All visits to the occupational health clinic during an 18-month period were reviewed and analyzed. During the study period, the center had, on average, 161 employees and offered 67 occupational health clinic sessions. Employees had 338 clinic visits, of which 294 were primary and 44 were follow-up visits, with 5 employees, on average, visiting the clinic at each session. Nurses most frequently visited the center (33.4%), followed by the administrative staff (28.6%) and the employees of the Medical Physics and Radiology Department (22.4%), corresponding to the largest groups of employees. The most frequently cited reason for the visits was administrative purposes (23.6%), including updating health records, followed by pre-placement examinations (14.7%) and vaccinations (10.3%). Administrative and clinical reasons were given for occupational health clinic use at the oncology center across all categories of employees.
Reduction in Force Perspectives—The Occupational Health Nurse as the Employee
Authors: Tompkins Olga
Published: March 2019

The occupational health nurse usually encounters reduction in force issues from a company perspective. This article discusses strategies for the occupational health nurse who is downsized.
Challenges in Hearing Conservation—The Hearing-Impaired Worker
Authors: Chalupka Stephanie
Published: March 2019

Hearing-impaired workers face special challenges in the workplace, including communicating and identifying and using appropriate hearing protection.
Challenges of a Worksite Health Promotion Project
Authors: Gates Donna M. , Brehm Bonnie J.
Published: March 2019

It is estimated that American employers spend more than $900 billion annually on health care and that obesity-attributable health care expenditures total $75 billion. The authors discuss a yearlong health promotion research project aimed at obesity and involving eight small manufacturing companies. Three hundred forty-one employees randomly selected at the intervention and control worksites were followed at baseline and at 3, 6, and 12 months for anthropometric measures, lifestyle behaviors, absences, and work performance. The authors conclude that although the worksite offers unique opportunities to develop health promotion programs, these efforts are not without challenges due to the tensions regarding the need to protect and promote health for the population, the increasing concerns over health care costs and access, and the priority to maintain individuals' rights and privacy.
Nursing Compact
Authors: Tompkins Olga S.
Published: March 2019

A nursing licensure compact is an agreement between two or more states that the licensing of a nurse in one place will be valid in the other. This is especially critical for the occupational health nurse, who may practice in more than one state.
Transitions and Difficult Lessons
Authors: Litchfield Sheila M.
Published: March 2019

When it comes down to it, no job is permanent, unless of course one considers parenthood a job. From an employer perspective, employees are dispensable and they will someday no longer be needed. Are these harsh words or reality? Perhaps both. Sometimes a hard dose of reality is necessary to give one perspective or the opportunity to step back, look at the big picture, and find oneself again. Through this article, I hope to alert fellow occupational health nurses to the impermanence of employment. Rather than instill fear, I hope to encourage an openness to the possibilities of change and preparation for life beyond the current job. I am happy to report there is life (and light) on the other side.
Stressors among Latino Day Laborers
Authors: de Castro A. B. , Voss Joachim G. , Ruppin Ayelet , Dominguez Carlos F. , Seixas Noah S.
Published: March 2019

This pilot study evaluated the feasibility of conducting a research project focused on stressors and allostatic load (AL) among day laborers. A total of 30 Latino men were recruited from CASA Latina, a worker center in Seattle. Participants completed an interview and researchers measured six indicators of AL (body mass index, waist-to-hip ratio, systolic blood pressure, diastolic blood pressure, C-reactive protein, and cortisol). Percentages and mean scores were calculated for several self-reported stressors in work, economic, and social contexts and were compared between low and high AL groups. Overall, participants with high AL reported experiencing more stressors than those with low AL. Additionally, those with high AL generally reported being less healthy both physically and mentally. Findings suggest that Latino day laborers experience stressors that place them at risk for high AL. Also, a study of this nature is possible, but must be conducted with trust and collaboration between researchers and community partners.
Workers' Compensation Management—Changes in Medicare Regulations
Authors: Strasser Patricia B.
Published: March 2019

The Centers for Medicare & Medicaid Services recently enacted legislation to protect Medicare from paying for health care services that should be covered under workers' compensation benefits. The law requires that Medicare be notified about certain workers' compensation claims and that some workers' compensation settlements include mechanisms to protect Medicare's financial interests. This article outlines the legislative changes and addresses the role of occupational health nurses relative to case management and these changes.
Shingles
Authors: Litchfield Sheila M.
Published: March 2019

Shingles, an acute infection of the nervous system, and postherpetic neuralgia (PHN), a painful complication of zoster that can prolong recovery, are likely to be seen more frequently in the U.S. workplace as the population ages and as workers return to the workplace in immunocompromised states (e.g., with AIDS, after treatment for cancer, and after organ transplantation). Shingles and PHN could adversely affect productivity and lead to absenteeism. Zostavax is a new vaccine effective for preventing shingles and PHN. Occupational health nurses can recognize potential cases of shingles and refer for treatment early. Occupational health nurses are also in a position to establish vaccination campaigns or to recommend vaccinations to employees. It is anticipated that early intervention and prevention of shingles could reduce absenteeism, improve productivity in the workplace, and significantly improve quality of life for the aging work force.
Panic Attacks
Authors: Tompkins Olga
Published: March 2019

Panic attack symptoms mimic other serious health problems and have implications for the occupational health nurse. In the workplace, the results of panic disorder may lead to poor job performance and affect the morale and effectiveness of the entire workplace.
The Obesity Epidemic
Authors: Litchfield Sheila M.
Published: March 2019

Obesity is common, serious, and costly. This epidemic has affected all of the United States. The related health care costs are staggering. However, many occupational health nurses have not yet implemented weight management programs at their companies or taken steps to improve their own health. This article explores the obstacles to weight loss and suggests reasons and resources to implement on-site weight loss programs.
Dengue Disease
Authors: Girimont Trina M.
Published: March 2019

Dengue is currently the world's most rapidly spreading mosquito-borne illness.
Facial Affect and Interpersonal Affiliation: Displays of Emotion During Relationship Formation in Social Anxiety Disorder
Authors: Pearlstein Sarah L. , Taylor Charles T. , Stein Murray B.
Published: March 2019

Social anxiety disorder (SAD) often involves difficulty developing relationships. Facial expressions are important in relationship formation, but data are limited regarding facial display production among persons with SAD during social interaction. The current study compared facial displays of individuals diagnosed with SAD ( n = 41) to control participants ( n = 24) as they interacted with a confederate; confederates and observers then rated their desire for future interaction with participants. Automated software used the Facial Action Coding System to classify displays. During portions of the interaction that involved listening to partners, the SAD group smiled less frequently and less intensely than controls, and less smiling was associated with others’ lower desire for future interaction with participants. Diminished positive facial affect in response to interaction partners may disrupt relationship formation in SAD and may serve as an effective treatment target.
Differences in lower quarter Y-balance test with player position and ankle injuries in professional baseball players
Authors: Ryu Chang Hyun , Park Jungu , Kang Mina , Oh Joo Han , Kim You Keun , Kim Yong Il , Lee Ho Seong , Seo Sang Gyo
Published: March 2019

Purpose:

Although there has been research about the correlation between ankle injury and Y-balance test (YBT) conducted in other sports, there has been a lack of research on the correlation between ankle injury among baseball players and YBT scores or on differences in scores according to baseball positions. This study focused on professional baseball players as its subjects with the aims of analyzing the correlation between YBT and ankle injury and assessing differences in YBT between baseball positions.

Methods:

Age, height, weight, body mass index, and spine malleolar distance of 42 professional baseball players were measured. YBT measurements were performed using each foot in three distinct directions. YBT normalized reach distances, composite score, and reach asymmetry were analyzed.

Results:

The mean right posteromedial normalized reach distances for the player positions were significantly different between the pitchers (107.7%) and infielders (113.7%) ( p = 0.028). For the composite score, the difference between the pitchers (92.3%) and infielders (95.0%) was statistically significant ( p = 0.048). The anterior reach asymmetry was larger in the injured group than in the noninjured group ( p = 0.041).

Conclusion:

This study shows that YBT can be used as a way of evaluating the injury of baseball players. It also shows the reference value of YBT according to position in professional baseball players. This study could be useful for the treatment of ankle injury of baseball players. Level of evidence: Level 3.
Dalits, Their Support Base and the Bahujan Samaj Party: A Case Study of the Doaba Region
Authors: Singh Nirmal
Published: March 2019

Scheduled Castes (SCs) comprise 16.6 per cent of India’s population. The distinguishing feature of SCs in Punjab is that they constitute numerical strength, that is, 31.9 per cent (2011 Census). In terms of population share, Punjab accounts for 4.4 per cent of the total SCs’ population in India. During this decade, two more castes, namely, Mochi and Mahatam/Rai Sikh castes, have been notified as SCs in Punjab. Today, it is estimated that the proportion of Dalits may have risen above 32 per cent in Punjab. This article argues as to why the high concentration of Dalit population in Punjab has not translated into success for the Bahujan Samaj Party (BSP). For answering this question, the study examines two aspects, namely, the nature of the party organization and the political strategy of the BSP. The study was qualitative and conducted in the Doaba region of Punjab. It is an analysis of the interactions with 300 respondents of the targeted SCs population and 25 leaders of the BSP and its factional political parties.
Specific aspects of immunotherapy for multiple sclerosis in Switzerland: A structured commentary
Authors: Achtnichts L , Chan A , Czaplinski A , Derfuss T , Du Pasquier R , Findling O , Gobbi C , Hoepner R , Kamber N , Kamm CP , Kuhle J , Lalive P , Lutterotti A , Martin R , Müller S , Papadopoulou A , Pot C , Salmen A , Schippling S , Zecca C ,   In cooperation with the Scientific Advisory Board of the Swiss Multiple Sclerosis Society and the Swiss Neurological Society
Published: March 2019

More than a dozen substances are meanwhile available for the disease-modifying immunotherapy of multiple sclerosis (MS). However, for some substances, there is a clear difference between approval in Switzerland (Swissmedic) and neighboring countries (European Medicines Agency (EMA)). In addition, limitations imposed by the Swiss Federal Office of Public Health in the specialties list (SL) have significant effects on use in daily clinical practice. In the following, we present consensus recommendations, which were reviewed and agreed upon by the Scientific Advisory Board of the Swiss Multiple Sclerosis Society and the Swiss Neurological Society. We explicitly focus on practice-relevant differences in the approval of MS immunotherapies in Switzerland compared with the EMA area and discuss further limitations (SL) and their impact on the use in clinical practice. Immunotherapies with the same approval in Switzerland and the EMA area and symptomatic therapies are not discussed here.
Services for adults with intellectual disability in Aotearoa New Zealand
Authors: McCarthy Jane , Duff Mhairi
Published: March 2019

Aotearoa New Zealand is a country of just under 5 million people with a diverse population, the main ethnic groups being of European descent and Maori. There are well-developed public and private healthcare systems. As in other countries, Aotearoa New Zealand has closed the large institutions and developed community-based services for people with intellectual disability. Aotearoa New Zealand has specific legislation for people with intellectual disability presenting to the criminal justice system and has unusually and explicitly excluded people with intellectual disability from mental health legislation since 1992. Partly as a result, most health professional training schemes have little focus on issues for people with intellectual and developmental disabilities. Therefore, one of the main challenges over the coming decade will be to ensure there is a sufficient workforce of psychiatrists and other professionals who have the training and expertise to work with people with intellectual disability requiring mental health and forensic services.
Utility of a Clinical Decision Support System in Weight Loss Prediction After Head and Neck Cancer Radiotherapy
Authors: Cheng Zhi , Nakatsugawa Minoru , Zhou Xian Chong , Hu Chen , Greco Stephen , Kiess Ana , Page Brandi , Alcorn Sara , Haller John , Utsunomiya Kazuki , Sugiyama Shinya , Fu Wei , Wong John , Lee Junghoon , McNutt Todd , Quon Harry
Published: March 2019

PURPOSE

To evaluate the utility of a clinical decision support system (CDSS) using a weight loss prediction model.

METHODS

A prediction model for significant weight loss (loss of greater than or equal to 7.5% of body mass at 3-month post radiotherapy) was created with clinical, dosimetric, and radiomics predictors from 63 patients in an independent training data set (accuracy, 0.78; area under the curve [AUC], 0.81) using least absolute shrinkage and selection operator logistic regression. Four physicians with varying experience levels were then recruited to evaluate 100 patients in an independent validation data set of head and neck cancer twice (ie, a pre-post design): first without and then with the aid of a CDSS derived from the prediction model. At both evaluations, physicians were asked to predict the development (yes/no) and probability of significant weight loss for each patient on the basis of patient characteristics, including pretreatment dysphagia and weight loss and information from the treatment plan. At the second evaluation, physicians were also provided with the prediction model’s results for weight loss probability. Physicians’ predictions were compared with actual weight loss, and accuracy and AUC were investigated between the two evaluations.

RESULTS

The mean accuracy of the physicians’ ability to identify patients who will experience significant weight loss (yes/no) increased from 0.58 (range, 0.47 to 0.63) to 0.63 (range, 0.58 to 0.72) with the CDSS ( P = .06). The AUC of weight loss probability predicted by physicians significantly increased from 0.56 (range, 0.46 to 0.64) to 0.69 (range, 0.63 to 0.73) with the aid of the CDSS ( P < .05). Specifically, more improvement was observed among less-experienced physicians ( P < .01).

CONCLUSION

Our preliminary results demonstrate that physicians’ decisions may be improved by a weight loss CDSS model, especially among less-experienced physicians. Additional study with a larger cohort of patients and more participating physicians is thus warranted for understanding the usefulness of CDSSs.
Multidisciplinary Lung Cancer Tumor Board Connecting Eight General Hospitals in Japan via a High-Security Communication Line
Authors: Takeda Takayuki , Takeda Sorou , Uryu Kiyoaki , Ichihashi Yoshio , Harada Hiromasa , Iwase Akihiko , Tamura Yukihiro , Hibino Makoto , Horiuchi Shigeto , Kani Hisanori
Published: March 2019

PURPOSE

The complexity of lung cancer treatment is rapidly increasing, necessitating the use of multidisciplinary approaches for improving outcomes. Although it is common for institutions to have their own tumor boards, tumor boards connecting several general hospitals, and therefore allowing for more diverse opinions, are not prevalent.

MATERIALS AND METHODS

A tumor board connecting eight hospitals was formed to discuss patients for whom formulating a treatment strategy was difficult. Physicians and hospital staff accessed a high-security communication line via LiveOn ( Japan Media Systems Corporation, Tokyo, Japan), which is completely isolated from the Internet and password protected, that enables each hospital to share the electronic medical records and images of relevant patients at other hospitals on desktop computers in real time. The lung cancer tumor board began in April 2017 and has since been held every Tuesday evening for 1 hour. Preparatory records containing the age, sex, histology, TNM classification, background, and discussion points for each patient are created before each tumor board meeting. After the tumor board discussion, all conclusions and related articles used in the board are added to the minutes, which are finalized as Microsoft Word files, consolidated, and archived. These files can be retrieved later using key words.

RESULTS

From April 2017 to June 2018, 202 patients were discussed. Although TNM classification was not changed for any patient, diverse opinions led to a change in the proposed strategy for 49 of 202 patients.

CONCLUSION

The multidisciplinary tumor board was useful in obtaining various opinions from the perspectives of different experts. This should be evaluated in a prospective study.
Effect of Chemotherapy With Docetaxel With Androgen Suppression and Radiotherapy for Localized High-Risk Prostate Cancer: The Randomized Phase III NRG Oncology RTOG 0521 Trial
Authors: Rosenthal Seth A. , Hu Chen , Sartor Oliver , Gomella Leonard G. , Amin Mahul B. , Purdy James , Michalski Jeff M. , Garzotto Mark G. , Pervez Nadeem , Balogh Alexander G. , Rodrigues George B. , Souhami Luis , Reaume M. Neil , Williams Scott G. , Hannan Raquibul , Horwitz Eric M. , Raben Adam , Peters Christopher A. , Feng Felix Y. , Shipley William U. , Sandler Howard M.
Published: March 2019

PURPOSE

Radiotherapy (RT) plus long-term androgen suppression (AS) are a standard treatment option for patients with high-risk localized prostate cancer. We hypothesized that docetaxel chemotherapy (CT) could improve overall survival (OS) and clinical outcomes among patients with high-risk prostate cancer.

PATIENTS AND METHODS

The multicenter randomized NRG Oncology RTOG 0521 study enrolled patients with high-risk nonmetastatic disease between 2005 and 2009. Patients were randomly assigned to receive standard long-term AS plus RT with or without adjuvant CT.

RESULTS

A total of 612 patients were enrolled; 563 were evaluable. Median prostate-specific antigen was 15.1 ng/mL; 53% had a Gleason score 9 to 10 cancer; 27% had cT3 to cT4 disease. Median follow-up was 5.7 years. Treatment was well tolerated in both arms. Four-year OS rate was 89% (95% CI, 84% to 92%) for AS + RT and 93% (95% CI, 90% to 96%) for AS + RT + CT (hazard ratio [HR], 0.69; 90% CI, 0.49 to 0.97; one-sided P = .034). There were 59 deaths in the AS + RT arm and 43 in the AS + RT + CT arm, with fewer deaths resulting from prostate cancer in the AS + RT + CT arm versus AS + RT (23 v 16 deaths, respectively). Six-year rate of distant metastasis was 14% for AS + RT and 9.1% for AS + RT + CT, (HR, 0.60; 95% CI, 0.37 to 0.99; two-sided P = .044). Six-year disease-free survival rate was 55% for AS + RT and 65% for AS + RT + CT (HR, 0.77; 95% CI, 0.59 to 1.00; two-sided P = .053).

CONCLUSION

For patients with high-risk nonmetastatic prostate cancer, CT with docetaxel improved OS from 89% to 93% at 4 years, with improved disease-free survival and reduction in the rate of distant metastasis. The trial suggests that docetaxel CT may be an option to be discussed with selected men with high-risk prostate cancer.
Practical Treatment Approach for Angioimmunoblastic T-Cell Lymphoma
Authors: Moskowitz Alison J.
Published: March 2019

Patients with angioimmunoblastic T-cell lymphoma (AITL), one of the most common types of peripheral T-cell lymphoma (PTCL), typically present with advanced disease, systemic symptoms, and immune deregulation. Treatment can be challenging owing to frequent relapses after initial and subsequent therapy. The front-line treatment approach currently mirrors the approach used for other nodal PTCLs with cyclophosphamide, doxorubicin, vincristine, and prednisone chemotherapy and consideration for autologous stem-cell transplant (SCT). In the relapsed and refractory settings, allogeneic SCT offers the chance for long-term remission. Choice of treatment of relapsed or refractory disease depends on whether an allogeneic SCT is planned. Agents with preferential activity in relapsed or refractory AITL include epigenetic modifiers such as histone deacetylase inhibitors and hypomethylating agents. Other targeted agents show promise in AITL, including brentuximab vedotin and phosphoinositide-3-kinase inhibitors. Ongoing studies are evaluating new potential targets for AITL, with particular focus on identifying markers of response and resistance. Additional studies are assessing incorporation of novel agents into the front-line treatment of AITL. These studies will lead to more individualized treatment approaches and, ultimately, improved outcomes for patients with AITL.