bluuebunny/crossref_metadata_2025_split huggingface dataset:
Understanding the Cumulative Burden of Basic Needs Insecurities: Associations With Health and Academic Achievement Among College Students
Authors: Leung Cindy W. , Farooqui Sara , Wolfson Julia A. , Cohen Alicia J. 
Published: August 2020

Purpose: Food insecurity is a concern on college campuses and is correlated with other basic needs insecurities. We examined the cumulative burden of food, financial, and housing insecurities on college students’ health and academic performance. Design: Cross-sectional survey. Setting: Large, public Midwestern university. Sample: A total of 793 college students completed an online survey in 2018 (43% response rate). Measures: Food, financial, and housing insecurity were measured using validated instruments. Primary outcomes were general health status, anxiety and depression, and grade point average (GPA). Analysis: Weighted linear and logistic regression analyses were used to examine associations between cumulative basic needs insecurities and primary outcomes. Results: Approximately 11% of students experienced all 3 insecurities. Compared to fully secure students, students with all 3 insecurities were more likely to have anxiety and depression (odds ratio [OR] = 4.65, 95% CI: 4.31-5.01), fair/poor health (OR = 4.06, 95% CI: 3.73-4.42), and lower GPA (β = −0.19, 95% CI: −0.30 to −0.09), adjusting for sociodemographic characteristics. Conclusion: Interventions that address multiple basic needs insecurities are needed to promote college students’ well-being and foster academic success.
Impact of a Pharmacist-Led Group Diabetes Class
Authors: Lakey Hannah , Boehmer Kaci , Johnson Chris 
Published: August 2020

Background/Objectives: Diabetes is a chronic disease that is associated with many other health problems, but studies have shown that patient education can improve outcomes. The purpose of this project was to determine if a pharmacist-led group diabetes education class led to improvement in hemoglobin A1c levels. Methods: Pharmacists in a family medicine clinic conduct a group diabetes education class for patients seen within the health system. The once monthly, 90-minute education class includes content regarding pathophysiology, complications, monitoring, dietary and exercise recommendations, and common antidiabetic medications. Data were collected via retrospective chart reviews and included 66 patients. The primary outcome was change in A1c from pre-class measurement to first, post-class measurement at least 3 months after pre-class measurement. Secondary outcomes included pre-class to post-class changes in weight, systolic blood pressure (SBP), and diastolic blood pressure (DBP). Outcome data were analyzed using a paired t-test and demographic data were presented with descriptive statistics. Results: The pharmacist-led diabetes education class was associated with statistically significant improvements on A1c lab values (mean decrease = 1.16%, p-value = 0.001) and weight (mean decrease = 1.8 kg, p-value = 0.03). However, SBP (mean decrease = 1.5 mmHg, p-value = 0.57) and DBP (mean decrease = 3.4 mmHg, p-value = 0.15) did not improve significantly. Implications: The results from this study support the idea that diabetes education classes are beneficial for the patient in learning how to properly manage this disease state. Pharmacists can play a vital role in diabetes management through counseling and patient education, which can improve patient outcomes.
Training hour requirements to provide acupuncture in the United States
Authors: Bleck Roselle R , Gold Melanie A , Westhoff Carolyn L 
Published: August 2020

Introduction: The National Academy of Medicine recommends, and Joint Commission requires, offering non-pharmacologic approaches to pain management, including acupuncture, to reduce opioid overuse in the United States. This study describes 2019 state training requirements to evaluate how they represent opportunities and barriers to increasing access to acupuncture. Methods: We searched publicly available databases to identify Acupuncture Practice Acts and additional statutes and regulations pertaining to acupuncture training requirements on state licensure board websites. We then extracted state-specific acupuncture training requirements for individuals with and without a healthcare-related professional license. Results: Thirty-three states allow physicians to provide acupuncture without requiring any additional training requirements, 11 states and the District of Columbia (DC) require 200–300 training hours, and three require physicians to obtain a separate acupuncture license. Three states have no regulatory agency ruling. Forty states require non-healthcare professionals to complete an accredited program of more than 1900 h and pass an examination. Twenty-three states have an Acupuncture Detoxification Specialist designation allowing individuals without a clinical professional license to provide auricular acupuncture for substance use disorder treatment after a 70-h training course. Discussion: State-level training requirements are intended to increase safe and effective care, but variations represent a potential barrier to increasing the number of acupuncture providers in the United States. Allowing non-physician medical professionals to complete reduced training requirements for specific indications could be a model to increase access to acupuncture. The influence of training requirements on acupuncture access and opioid overuse needs examination.
Informal Payments for Maternal and Neonatal Health Services in Public Hospitals in Central India
Authors: Tripathi Narayan , John Denny , Chatterjee Prabir K , Murthy Shruti , Parganiha Nitish , Brokar Arti 
Published: August 2020

Background: Informal payments are unauthorised ‘unregistered’ out-of-pocket payments, outside the official payment system, for purchase or service meant to be covered/provided by the healthcare system. This study attempts to measure and report the extent and magnitude of informal payments based on the entitlements in Janani-Shishu Suraksha Karyakram (JSSK) in the Indian context. Methods: A cross-sectional study using convenience sampling and a semi-structured interview schedule was conducted among 281 participants in 2016 in 26 JSSK-notifying health facilities from all five divisions of Chhattisgarh. Pregnant women and women who delivered in the previous year, and provided informed consent, were included. After reviewing various definitions, informal payment was operationally defined in the context of JSSK for India as ‘payments made in cash or kind, unregistered or non-reimbursed, made by/on behalf of the beneficiary or someone related thereof, for free and cashless entitlements in a JSSK-listed health facility, to an individual or institutional healthcare provider/staff who provides/arranges for provision of the service’. Results: Of 281 participants, 91.8 per cent reported informal payments across all JSSK entitlements categories. A relative majority of these payments was made at the district hospital (37%), ranging from ₹2 to ₹6,500 (US$0.03–101). Investigations incurred the greatest median amount of informal payments, at, ₹455 (US$7). Informal payments ranged between three and seven times higher than the JSSK price cap in Chhattisgarh. No significant association was found between participant characteristics and informal payments. Conclusion: Further research is required to understand the magnitude and motivation of informal payments made in programmes like JSSK.
Instructive Messages and Lessons From Chinese Countermarching Nurses of Caring for COVID-19 Patients: A Qualitative Study
Authors: He Qilian , Li Ting , Su Yunpeng , Luan Yuquan 
Published: August 2020

Introduction: The World Health Organization declared the COVID-19 outbreak as a Public Health Emergency of International Concern on January 31, 2020. China was the first country to experience the challenges of controlling COVID-19. Therefore, the purpose of this study was to examine the experiences of Chinese nurses who countermarched to the outbreak city for medical support in the very first period of this global infection. Methodology: A qualitative study of phenomenological research design was used to describe the experiences of 10 Chinese nurses. Data were collected in February 2020 through in-depth interviews and analyzed by conventional content analysis methods. Results: Chinese nurses experienced different psychological stages, work pressure, and challenges. New concepts of nursing also emerged during their clinical care for COVID-19 patients. Discussion: The guidance synthesized from the Chinese nurse stories could give specific direction for a well-prepared global nursing workforce and high-quality patient care in the present and future epidemics. The worries about discrimination of COVID-19 patients’ needs to be addressed culturally and emotionally as a priority by health care workers when they care for COVID-19 patients.
Promotion of Thriving Among Hong Kong Chinese Adolescents: Evidence From Eight-Wave Data
Authors: Shek Daniel T. L. , Zhu Xiaoqin 
Published: August 2020

Objectives: This study evaluated the longitudinal effect of a positive youth development (PYD) program entitled “Positive Adolescent Training through Holistic Social Programmes” (Project P.A.T.H.S.) on perceived thriving among Chinese adolescents in Hong Kong. Method: Individual growth curve modeling analyses were performed using eight waves of data collected over 5 years from 23 experimental schools ( N = 3,607) and 24 control schools ( N = 3,574). Results: Adolescent thriving declined faster among control school students relative to experimental school students. While the two groups did not differ at Wave 1 and Wave 2 on the mean thriving levels, experimental school students showed higher thriving levels at Wave 3 to Wave 7 than did the control group students. Such differences between the two groups were more salient among girls than among boys, suggesting a stronger intervention effect for girls. Conclusion: The present findings suggest that PYD programs can promote thriving in Chinese adolescents.
Augmentative and Alternative Communication (AAC) Use Among Patients Followed by a Multidisciplinary Cleft and Craniofacial Team
Authors: Brown Mark N. , Grames Lynn Marty , Skolnick Gary B. 
Published: August 2020

Objective: To establish preliminary data describing the number of patients who visit a multidisciplinary cleft and craniofacial team who use augmentative and alternative communication (AAC) supports. Design: This retrospective study consisted of chart reviews for all patients who visited a single site’s multidisciplinary cleft and craniofacial team for 1 calendar year. Setting: A single multidisciplinary craniofacial team at a tertiary teaching hospital. Participants: Four hundred sixty-four patients met the inclusion criteria for this study. Of these, 59.9% (n = 278) were male and 40.1% (n = 186) were female. Results: Of the sample population, 6.9% (n = 32) were AAC users as they received AAC intervention in a therapeutic context, while 93.1% (n = 432) were not. The AAC group had a mean age of 5.1 years (standard deviation [SD]: 4.2) and was 68.8% (n = 22) male. The non-AAC group had a mean age of 6.3 (SD: 4.9) and was 59.3% (n = 256) male. Within the AAC group, 40.6% (n = 13) were found to have an identified syndromic diagnosis in comparison to 17.6% (n = 76) of the non-AAC group ( P = .003). Conclusions: This is the first study to report the prevalence of AAC use among patients in the care of multidisciplinary cleft and craniofacial teams. Our findings suggest that a subset of craniofacial team patients may have complex communication disorders that require AAC supports. Craniofacial teams should be aware of resources available for these patients so that the patients’ communication needs are met in the hospital, in school, and in the community.
Real World Prescribing Strategies for Patients With an Indication for Oral Anticoagulation Undergoing Percutaneous Coronary Intervention
Authors: Kerley Robert N. , Fitzgerald Gearoid , Coughlan John Joseph , Kelly Ciaran , Waters Max , Reynolds Anne , Mulcahy David , Moore David P. , Loo Bryan , Curtin Ronan 
Published: August 2020

Background: Limited data are available regarding real-world prescribing in patients with an indication for oral anticoagulation (OAT) who undergo percutaneous coronary intervention (PCI). Most current guidelines recommend a period of triple therapy with OAT and dual antiplatelet (DAPT) agents over dual therapy with an OAT and DAPT but the clinical benefit is still unclear giving rise to limited evidence-based recommendations. Aim: To analyze the appropriateness of OAT and anti-platelet strategies post PCI in a real-world cohort of patients in 2 academic teaching hospitals. Methods and Results: In total, 103 patients were retrospectively analyzed. As the initial 3 month stragey, 97 patients (94.2%) received triple therapy, 4 received Dual Therapy (3.9%) and 2 received DAPT (1.9%). Patients with predominant bleeding risk were significantly less likely to receive triple therapy (75% vs. 95.7% vs. 95.8%, P < 0.05). Apixaban was the most common OAT (65.7%) which in most cases was prescribed at an inappropriately reduced dose of 2.5 mg BD (80.4%). The MACE, bleeding and all-cause mortality rates did not differ significantly between groups. Discussion: Our study demonstrates the widespread use of triple therapy for the first 3 months of treatment in 2 Irish academic hospitals. DOACs were prescribed in most cases at reduced doses not currently known to prevent stroke. This study highlights the need for more explicit management algorithms to improve evidence-based management in this area.
Incidence of fibroblastic sleeve and of catheter-related venous thrombosis in peripherally inserted central catheters: A prospective study on oncological and hematological patients
Authors: Trezza Carmela , Califano Catello , Iovino Vincenzo , D’Ambrosio Carmela , Grimaldi Giuseppe , Pittiruti Mauro 
Published: August 2020

Background: Insertion of peripherally inserted central catheters in oncological patients is potentially associated with catheter-related thrombosis and fibroblastic sleeve; the actual incidence and interactions between these two non-infective complications have never been investigated in a prospective clinical study on peripherally inserted central catheters. Methods: In a cohort of oncological/hematological patients with peripherally inserted central catheter, we evaluated the occurrence of catheter-related thrombosis and/or fibroblastic sleeve, examining all patients by ultrasound scan at days 7, 14, 21, and 28 after insertion. We correlated our findings with the type of disease. Results: We enrolled 254 patients with power injectable polyurethane 4Fr peripherally inserted central catheters. Ultrasound scan of the veins of the arm showed fibroblastic sleeve in 76 patients (29.9%); the fibroblastic sleeve was first detected on day 7 in 45 cases (17.7%), on day 14 in 26 cases (10.2%), on day 21 in 3 cases (1.2%), and on day 28 in 2 cases (0.79%). There was no correlation between the type of disease and the development of fibroblastic sleeve. The incidence of asymptomatic catheter-related thrombosis was 5.12%: all catheter-related thromboses were detected before day 14. There was only one case of symptomatic catheter-related thrombosis (0.39%) in a leukemia patient. Fibroblastic sleeve and catheter-related thrombosis were associated only in two cases (0.78%). Conclusion: Fibroblastic sleeve is a frequent (29.9%) but asymptomatic finding in oncological and hematological patients with peripherally inserted central catheter, and—in the vast majority of cases—it occurs within 2 weeks after insertion. If compared to fibroblastic sleeve, asymptomatic catheter-related thrombosis is less frequent (5.51%); symptomatic catheter-related thrombosis is rare (<1%).
Using Online Communication Skills Training to Increase Organ Donation Authorization
Authors: Siminoff Laura A. , Gardiner Heather M. , Alolod Gerard P. , Wilson-Genderson Maureen 
Published: August 2020

Introduction: Family denial of organ donation from deceased donor-eligible patients is a major contributor to the deficit of transplantable organs in the United States. Research Question: Does an evidence-based communication intervention improve deceased organ donor authorization rates from family decision-makers? Design: This implementation and dissemination study used Communicating Effectively about Donation on Organ Procurement Organization professionals responsible for discussing donation and obtaining authorization from family decision-makers. A 14-month, nationwide social marketing campaign generated a sample of 682 requesters, yielding a final analyzable sample of 253 participants. Serving as their own controls, participants spent the first 3 months in a preintervention period, completed the web-based intervention, and progressed to a 3-month postintervention period. Participants completed brief online weekly surveys to assess the intervention’s impact on their communication skills. Results: Authorization rates did not improve overall between the pre- and postintervention periods. A differential effect of the intervention on 3 distinct groups of requesters was found: one group exhibited high and stable authorization rates pre–post (78%-74%); a second group had low initial authorization rates that increased after exposure to the intervention (46%-73%); the third had low and variable rates of authorization that failed to improve after the intervention (45%-36%). Conclusion: This study underscores the value of evidence-based communication training. Training targeted to requesters’ skill levels is needed to realize overall improvements in individual performance, the quality of donation discussions, and rates of family decision-maker authorization to solid organ donation.
Proof of Concept for a New Raman-Based Prototype for Noninvasive Glucose Monitoring
Authors: Pleus Stefan , Schauer Sebastian , Jendrike Nina , Zschornack Eva , Link Manuela , Hepp Karl Dietrich , Haug Cornelia , Freckmann Guido 
Published: August 2020

Background: Noninvasive glucose monitoring (NIGM) in diabetes is a long-sought-for technology. Among the many attempts Raman spectroscopy was considered as the most promising because of its glucose specificity. In this study, a recently developed prototype (GlucoBeam, RSP Systems A/S, Denmark) was tested in patients with type 1 diabetes to establish calibration models and to demonstrate proof of concept for this device in real use. Methods: The NIGM table-top prototype was used by 15 adult subjects with type 1 diabetes for up to 25 days at home and in an in-clinic setting. On each day, the subjects performed at least six measurement units throughout the day. Each measurement unit comprised two capillary blood glucose measurements, two scans with an intermittent scanning continuous glucose monitoring (CGM) system, and two NIGM measurements using the thenar of the subject’s right hand. Results: Calibration models were established using data from 19 to 24 days. The remaining 3-8 days were used for independent validation. The mean absolute relative difference of the NIGM prototype was 23.6% ± 13.1% for the outpatient days, 28.2% ± 9.9% for the in-clinic day, and 26.3% ± 10.8% for the complete study. Consensus error grid analysis of the NIGM prototype for the complete study showed 93.6% of values in clinically acceptable zones A and B. Conclusions: This proof of concept study demonstrated a practical realization of a Raman-based NIGM device, with performance on par with early-generation CGM systems. The findings will assist in further performance improvements of the device.
Automated Self-Adjusting Subcutaneous Insulin Algorithm for Patients NPO or on TPN or Enteral Feedings
Authors: Patzek Sophie , MacMaster Heidemarie W. , Rov-Ikpah Esther , San Luis Craig , Johnson Craig , Juttukonda Venkateswarlu , Rushakoff Robert J. 
Published: August 2020

Background: Perioperative diabetes patients are often treated with sliding-scale insulin, despite a lack of evidence to support therapeutic effectiveness. We introduced an automated subcutaneous insulin algorithm (SQIA) to improve glycemic control in these patients while maintaining the simplicity of a q4 hour adjustable sliding-scale insulin order set. Methods: In this pilot study, we implemented a fully programmed, self-adjusting SQIA as part of a structured order set in the electronic medical record for adult patients who are nil per os, or on continuous enteral tube feedings or total parenteral nutrition. The nurse only enters the current glucose in the Medication Administration Record, and then the calculated dose is shown. The new dose is based on previous dose, and current and previous glucoses. The SQIA titrates the glucose to 120-180 mg/dL. For this pilot, this order set was utilized for complex perioperative oncologic patients. Results: The median duration on the SQIA was 58 hours. Glucoses at titration initiation were highest at 206 ± 63 mg/dL, and came down to 156 ± 29 mg/dL by 72 hours. The majority of measured glucoses (66.8%, n = 647) were maintained between 80 and 180 mg/dL. There were no glucoses lower than 60 mg/dL, and only 0.3% (n = 3) were below 70 mg/dL. There was a low rate of errors (1%). Conclusions: A simple automated SQIA can be used to titrate insulin to meet the changing metabolic requirements of individuals perioperatively and maintain glucose within the target range for these hospitalized patients.
Lighting Control in Patient Rooms: Understanding Nurses’ Perceptions of Hospital Lighting Using Qualitative Methods
Authors: McCunn Lindsay J. , Safranek Sarah , Wilkerson Andrea , Davis Robert G. 
Published: August 2020

Purpose: This study differs in its methodological approach from previously published research by interpreting qualitative results against existing literature to understand how nurses conceptualize medical–surgical patient rooms as productive settings in relation to lighting, as well as the ways in which nurses believe these spaces could be enhanced for patient satisfaction. Methods: Content analysis was used to interpret themes emerging from nurses’ subjective responses to open-ended items. Three of the facilities had older, traditional lighting systems; one had a contemporary framework. Results: A theme of environmental control over both overhead and task lighting emerged from data from all items. Although controllability was among the “best” lighting attributes, more refinement is necessary for optimal staff productivity and patient satisfaction. Daylighting was also considered to be among the best attributes. Control over light level via additional dimming capability for patients, as well as additional light sources, was prominent across the four hospitals. Unique to the more modern facility, trespassing of light was problematic for nurses considering the experiences of patients—even where modern models exist, more attention can be paid to the ways in which window shades, and light sources outside of rooms, penetrate spaces and affect users. Conclusion: The finding that nurses and patients desire greater control over the lighting in patient rooms is consistent with Ulrich’s theory of supportive design for healthcare and coincides with advances in lighting technology. Despite differences in the level of sophistication in lighting among the four facilities, control continues to be a primary concern for nurses.