bluuebunny/crossref_metadata_2025_split huggingface dataset:
Incidence of Total Knee Replacement in Patients With Previous Anterior Cruciate Ligament Reconstruction
Authors: McCammon James , Zhang Yiyang , Prior Heather J. , Leiter Jeff , MacDonald Peter B. 
Published: September 2020

Objective:
To determine the rate of total knee replacement (TKR) after anterior cruciate ligament reconstruction (ACL-R) compared to the general population.

Design:
Retrospective review.

Setting:
All hospitals that performed TKR and ACL-R in Manitoba between 1980 and 2015.

Participant:
All patients that underwent TKR and ACL-R in Manitoba between 1980 and 2015.

Intervention:
Patient factors gathered at time of surgery included: age, sex, urban or rural residence, neighborhood income quintile, and resource utilization band (RUB). Each person was matched with up to 5 people from the general population who had never had ACL-R and had not had a TKR at the time of the case ACL-R.

Main Outcome Measures:
The rate of TKR after ACL-R.

Results:
Overall from 1980 to 2015, 8500 ACL-R were identified within the 16 to 60 years age group with a resultant 42 497 population matches. Sex was predominantly male. The mean age of the ACL-R group at the time of TKR was 53.7 years, whereas the mean age for the matched cohort was 58.2 years, P < 0.001. Those with ACL-R were 4.85 times more likely to go on to have TKR. Apart from age, no other risk factors examined (location, year of surgery, place of residence, income quintile, and RUB) seemed to increase risk of TKR after ACL-R.

Conclusion:
Patients who underwent ACL-R were 5 times more likely to undergo TKR.
The shared decision-making model: Providers' and patients' knowledge and understanding in clinical practice
Authors: Baca-Dietz Debbie , Wojnar Danuta M. , Espina Christine R. 
Published: September 2020

ABSTRACT

Background:
Shared decision making (SDM) is a collaborative approach to patient care that facilitates patient engagement in self-care by upholding the patient's values and perspectives. The Affordable Care Act (2010) offers provisions for using SDM in clinical practice to improve care outcomes; however, inconsistent evidence exists about the provider–patient satisfaction and effectiveness of using SDM in Federally Qualified Health Centers (FQHCs), which offer care predominantly to the underserved.

Purpose:
This study assessed providers' and patients' knowledge and understanding of SDM in two FQHC in the Pacific Northwest.

Methodological orientation:
Descriptive phenomenological approach guided the investigation. Data were gathered through in-person interviews. Interviews were analyzed using the method discussed by Colaizzi (1978).

Sample:
A purposive sample of 13 providers and 6 patients.

Conclusions:
Although providers and patients had divergent understandings of SDM, they highly valued this approach to care. An overarching theme “We use SDM as a Cornerstone of Patient Centered Care” and two subthemes: “We are partners in care” and “Being in the driver seat may not be comfortable but necessary” captured the providers' experiences. “They tell you what's up and we do it together” was a key theme that emerged from the patients' narratives. Several processes further described provider and patient experiences with SDM in the FQHC.

Implications for practice:
Findings suggest that the use of SDM in FQHC contributes to provider and patient satisfaction and improved patient engagement in self-care. Providers should therefore strongly consider using SDM model when working with the underserved.
A multidisciplinary care model to increase access to neurologic ambulatory care
Authors: Hill Chloe E. , Thomas Bethany , Amendt Alisha , Lawler Meredith , Kalfin Michael 
Published: September 2020

ABSTRACT

Background:
Expert patient care has been associated with improved outcomes for neurology patients, yet timely access to specialists is challenging. The employment of nurse practitioners (NPs) holds great potential to increase access to neurologic ambulatory care, however little practical guidance exists to date for how this may be achieved.

Local problem:
To improve timely care provision for patients with neurologic disease, we employed a multidisciplinary care utilization framework that used NPs to expand clinic appointment availability.

Methods and intervention:
After evaluating our baseline performance, we applied a standardized approach to the deployment of NPs in neurology clinic with regard to scheduling clinic sessions and patient appointments. The primary outcome measure was appointment availability measured over 6 months preintervention (June to November 2016) and 6 months postintervention (June to November 2017). Secondary measures included NP effort allocation.

Results:
The postintervention period demonstrated an increase in available appointments (3,731 preintervention vs. 4,318 postintervention) and scheduled appointments (2,014 vs. 2,685). Nurse practitioners spent more time practicing at the fullest extent of their licensure. All improvements were accomplished without the hiring of additional staff.

Conclusions:
A multidisciplinary care utilization framework for NP employment across neurology subspecialties resulted in an increase in appointment availability. Furthermore, this model is likely to be sustainable due to provider satisfaction and financial viability.
Impact of nurse practitioner care on patients with chronic conditions
Authors: Dusseldorp Loes van , Groot Marieke , Adriaansen Marian , Vught Anneke van , Vissers Kris , Peters Jeroen 
Published: September 2020

ABSTRACT

Background:
A previous study found that care provided by a nurse practitioner (NP) during oncological or palliative care was highly regarded. These patients, however, were considered a special population due to suffering from life-threatening illnesses. It remains unclear whether the results are transferable to patients with chronic conditions. Patient's perceptions of the quality of NP care have reflected that it equals or exceeds that of physicians, but the root causes of these remarks remain unclear.

Purpose:
To describe the difference in perception of NP care by patients suffering from chronic heart failure (CHF) or inflammatory bowel disease (IBD) in contrast with NP oncological or palliative care.

Methodological orientation:
A qualitative study from a phenomenological perspective was conducted. Data were analyzed using Colaizzi's seven-step method and the Metaphor Identification Procedure.

Sample:
In 2018 and 2019, 16 outpatients receiving CHF or IBD care were interviewed.

Conclusions:
Although chronic and life-threatening diseases may differentiate patients' perspectives, it can be generally stated that patients value NPs to be reliable, helpful, and empathic. Patients feel empowered, at peace and in control thanks to integrated care by dedicated experts.

Implications for practice:
Outpatients highly appreciate the “communicator role” and “skilled companionship” performed by NPs, to fulfill their needs for attention to the “complete picture.” Therefore, further consideration of these competencies is recommended.
Visual analysis of global comparative mapping of the practice domains of the nurse practitioner/advanced practice nursing role in respondent countries
Authors: Sastre-Fullana Pedro , Gray Deborah C. , Cashin Andrew , Bryant-Lukosius Denise , Schumann Lorna , Geese Franziska , Rae Bernadette , Duff Elsie , Bird Beverley 
Published: September 2020

ABSTRACT

Background:
Internationally, there is increasing demand for nurse practitioner (NP) and advanced practice nursing (APN) roles; however, high variability exists in how NP/APN roles are defined and understood.

Purpose:
The aim of this research was to improve our understanding of how the NP/APN is defined globally by: 1) examining role definitions, competencies, and standards of practice for advanced practice nurses internationally; 2) describing from a global perspective the core concepts and common features of NP/APN associated with practice domains; and 3) exploring the utility of text mining and visual analytics in identifying the clustered core concepts common to NP/APN roles organized around the five advanced practice domains of the Strong Advanced Practice Model.

Methods:
This article describes the findings of a secondary analysis of an international NP/APN competency mapping project, using innovative text mining and visual analysis techniques to reexamine and summarize the NP/APN role in 19 countries from Africa, Australia, Asia, Europe, and North America.

Results:
Although weak aggrupation/associations suggest that further work is needed to define the domains of advanced practice with associated model development, visual analysis points to the identification of common concepts and linkages between concepts for each practice domain of advanced practice outlined in the Strong Model.

Implications for practice:
The secondary text mining and visual analysis presented in this article allows for comparison of core elements between advanced practice role descriptions, standards, and competencies globally to ultimately provide a global perspective on the common features of NP/APN roles and areas where further delineation is required.
Electronic health record usage among nurse practitioners, physician assistants, and junior residents
Authors: Watson Michael D. , Elhage Sharbel A. , Scully Casey , Peterson Sabrina , Gulledge Marialice , Cunningham Kyle , Sachdev Gaurav 
Published: September 2020

ABSTRACT

Background:
Studies demonstrate significant electronic health record (EHR) use by junior residents; however, few studies have investigated this for nurse practitioners and physician assistants (NPs/PAs).

Purpose:
The aim of this study was to quantify the time spent on the EHR by NPs/PAs and junior residents.

Methods:
Electronic health record usage data were collected from April 2015 through April 2016. Monthly EHR usage was compared between NPs/PAs and postgraduate second and third year residents. Further subgroup analysis of NPs/PAs and residents from surgical or nonsurgical fields was conducted.

Results:
Data for 22 NPs/PAs (16 surgical and six nonsurgical) and 125 residents (31 surgical and 94 nonsurgical) were analyzed. Nurse practitioners/physician assistants opened fewer charts per day (4.9 ± 1.5 vs. 5.4 ± 3.1), placed more orders per month, and spent more daily time on the EHR (176.5 ± 51.7 minutes vs. 152.3 ± 71.9 minutes; p < .0001). Compared with residents, NPs/PAs spent more time per patient in all categories (chart review, documentation, order entry) and in total time per patient chart (all p < .05). Comparing surgical NPs/PAs to surgical residents, findings were similar with fewer charts per day, more total daily EHR time, and more EHR time per patient in every tracked category (all p < .05).

Implications for practice:
This is the first study to quantify time on the EHR for NPs/PAs. Nurse practitioners/physician assistants spent more time on the EHR than residents, and this is accentuated with surgical NPs/PAs. Electronic health record utilization appears more burdensome for NPs/PAs; however, the reason for this is unclear and highlights the need for targeted interventions.
Parkinson's disease: Addressing health care practitioners' automatic responses to hypomimia
Authors: Lilly Mary LuAnne , Hermanns Melinda , Dallam Deborah L. , Soomro Amal 
Published: September 2020

ABSTRACT
Hypomimia/reduced facial mobility in individuals living with Parkinson's disease can lead to negative impressions and judgments by nurse practitioners and other health care practitioners. Negative impressions and judgments can affect the quality of an episode of care. To attenuate automatic judgments, nurse practitioners must self-monitor and correct, recognizing that hypomimia is due to an underlying neurological condition and does not provide information on the personality or character of the person living with Parkinson's. Nurse practitioners can integrate inquiries that go beyond a problem focused approach to include questions about pleasurable, positive events in the life of a person living with Parkinson's disease.
Reducing sexually associated transmission of COVID-19 in men who have sex with men
Authors: Blackwell Christopher W. 
Published: September 2020

ABSTRACT
Believed to be zoonotic in origin, COVID-19 is a novel coronavirus subtype, which spreads from person to person through droplet transmission. As of late April, 2020, 895,766 cases of COVID-19 infections were recorded in the United States. This infection was responsible for 50,439 deaths. Because of close, person-to-person proximity, coupled with possible contact with body fluids, transmission of COVID-19 during sexual activity is possible. However, some activities carry higher risks of transmission than others. This article explores the risks of COVID-19 transmission associated with kissing, oral sex (fellatio and annilingus), and anal receptive and anal insertive intercourse among men who have sex with men (MSM). Recommendations for counseling MSM on safer sexual decision-making, many of which are applicable in the general prevention of sexually transmitted infections, are also provided. Nurse practitioners can serve as advocates in preventing sexually associated COVID-19 communication in MSM and contribute to the advancement of this continuously evolving area of public health science.
Pharmacologic heart failure treatment: A case-based review of current guidelines
Authors: Albert Nancy M. , Lindstrom Rachel C. 
Published: September 2020

ABSTRACT
Heart failure (HF) is a growing health problem associated with high morbidity and mortality. Use of evidence-based therapies improves clinical outcomes in patients with HF with reduced ejection fraction (HFrEF). However, in real-world research studies, adults with HFrEF were often medically undermanaged, including failure to use the right medications and failure to up titrate core HF therapies to doses similar to those used in randomized controlled trials. Although guidelines provide best-practice statements about care management, nurse practitioners and physician assistants (NPs and PAs) and clinical nurses often have questions about how to implement guideline-directed therapies in patient care management. With emerging new medications for managing HFrEF, and the possibility of new medications for patients with HF with preserved ejection fraction, complexity of care management will continue to increase. The aims of this review are to provide a summary of the 2017 updates to the national chronic HF management guidelines and use a case-based approach to discuss treatment change considerations associated with optimal guideline-based clinical care.
Comparison of Speech Recognition and Localization Ability in Single-sided Deaf Patients Implanted With Different Cochlear Implant Electrode Array Designs
Authors: Speck Iva , Ketterer Manuel Christoph , Arndt Susan , Aschendorff Antje , Jakob Till F. , Hassepass Frederike 
Published: September 2020

Objective:
Choice of electrode array (EA) design and differences in outcome are major concerns both to patients with single-sided deafness (SSD) and to surgeons before cochlear implant (CI) surgery. The present work investigates the effects of EA design on 1) insertion depths, and 2) audiological outcomes of SSD CI recipients.

Study Design:
Retrospective study.

Setting:
Tertiary academic center.

Patients:
Forty patients with acquired SSD matched according to duration of deafness

Main Outcome Measures:
Fourteen CI recipients were implanted with a perimodiolar electrode (cochlear perimodiolar [CPM]), 12 with a shorter lateral wall electrode (cochlear lateral wall [CLW]), and 14 with a longer lateral wall electrode array (medEl lateral wall [MLW]). Postoperative rotational tomography was evaluated to determine cochlear size and EA angle of insertion depth (AID). Binaural speech comprehension in noise (in three configuration presentations) and localization ability were assessed 12 months postoperatively with CI.

Results:
AID was significantly deeper in MLW (mean 527.94 degrees) compared with the CPM (mean 366.35 degrees) and CLW groups (mean 367.01 degrees). No significant difference in AID was seen between the CPM and CLW groups (difference 0.66 degrees). Cochlear sizes revealed no significant differences between any groups. All three groups showed significant improvement in head shadow effect (difference on average CPM: 6.3 dB SPL, CLW 5 dB SPL, and MLW 4.05 dB SPL) and localization ability at 12 months postoperatively (difference on average CPM: 19.72 degrees, CLW: 24 degrees, and MLW: 12.9 degrees). No significant difference in the extent of audiological benefit was observed between any groups.

Conclusion:
No effect on binaural benefit was apparent from the selection of the three EA designs in SSD CI recipients. Further studies focusing on subjective results, sound quality, and music perception depending on EA design in SSD CI recipients are needed.
Cochlear Dysfunction Is a Frequent Feature of Facioscapulohumeral Muscular Dystrophy Type 1 (FSHD1)
Authors: Frezza Erica , Fuccillo Emanuela , Petrucci Antonio , Greco Giulia , Nucera Gabriele , Bruno Ernesto , Giardina Emiliano , Tupler Rossella , Di Mauro Roberta , Di Girolamo Stefano , Massa Roberto 
Published: September 2020

Introduction:
Facioscapulohumeral muscular dystrophy type 1 (FSHD) represents one of the most common forms of muscular hereditary diseases and it is characterized by a great clinical variability with the typical muscular symptoms and other clinical features, including hearing impairment. However, etiopathogenetic mechanisms of auditory dysfunction are still not completely understood and it has been suggested that it could be assigned to a cochlear alteration that is present even in those subjects with a normal pure tonal audiometry (PTA) examination.

Methods:
We found out the cochlear function in 26 patients with molecular diagnosis of FSHD1 and in healthy controls. All patients underwent complete neurological and audiological examinations, including FSHD clinical score, pure-tone audiometry (PTA), and otoacoustic emissions (OAEs), in particular transient evoked otoacoustic emissions (TEOAEs) and distortion product evoked otoacoustic emissions (DPOAEs).

Results:
All FSHD1 patients showed significantly reduced DPOAEs and TEOAEs, bilaterally and at all frequencies, even when considering only subjects with a normal PTA or a mild muscular involvement (FSHD score ≤ 2). No correlation between OAEs and FSHD clinical score was found.

Discussion:
Cochlear echoes represent a sensitive tool in detecting subclinical cochlear dysfunction in FSHD1 even in subjects with normal hearing and/or subtle muscle involvement. Our study is focused on the importance of evaluating the cochlear alteration through OAEs and, in particular, by performing TEOAEs and DPOAEs sequentially, to evaluate more frequent specificities of cochlear dysfunction with a wider spectrum of analysis.
Preimplant Hearing Threshold: An Important Predictor of Hearing Preservation in Cochlear Implantation With Lateral Wall Electrodes
Authors: Lee Geonho , Lee Seulgi , Chung Jee-Hye , Choi Jin Woong 
Published: September 2020

Objective:
To evaluate the outcomes and association factors of long-term hearing preservation (HP) in cochlear implantation with lateral wall (LW) electrode arrays.

Study Design:
Retrospective case review.

Setting:
Tertiary academic center.

Patients:
Thirty-four consecutive ears from 32 patients with a ≤ 80 dB HL preoperative low-frequency pure-tone average of 250 to 500 Hz were included.

Intervention:
Cochlear implantation with LW electrode arrays and the intention of achieving HP.

Main Outcome Measures:
HP classifications according to the HEARRING group and functional HP methods (≤ 85 dB HL of pure-tone threshold at 250 Hz) at 1 year postoperatively.

Results:
Based on the HEARRING classification, complete, partial, and minimal HP was achieved in 7 ears (21%), 12 ears (35%), and 4 ears (12%), respectively. Under functional classification, 14 ears (41%) exhibited functional hearing after surgery. The average threshold shift was 17.1 dB HL (SD = 16.9 dB HL). Among various clinical features, a ≤ 60 dB HL preimplant pure-tone threshold of 250 Hz was associated with HP outcome in both classifications (OR = 12.95, 95% CI = 1.29–130.01, p = 0.029 in HEARRING classification; OR = 14.36, 95% CI = 1.07–191.40, p = 0.044 in functional classification). The following parameters were not associated with HP (p > 0.05): patient demographics, surgical aspects (insertion route and depth), electrode array size, scalar electrode position, and presence of comorbidity.

Conclusion:
With LW electrode arrays, HP was achieved in 68% of HEARRRING group patients and 41% of functional classification patients. A ≤ 60 dB HL preimplant pure-tone threshold of 250 Hz was significantly associated with an increased rate of long-term HP.
Posterior Tympanotomy Versus Subtotal Petrosectomy: A Comparison of Complications in Cochlear Implantation
Authors: Lee Seulgi , Lee Jong Bin , Chung Jee-Hye , Choi Jin Woong 
Published: September 2020

Objective:
To compare the postoperative complications between posterior tympanotomy cochlear implantation (PTCI) and subtotal petrosectomy cochlear implantation (SPCI).

Study Design:
A retrospective cohort study.

Setting:
Two tertiary referral centers.

Patients:
Two hundred ninety-eight patients who underwent PTCI and 33 who underwent SPCI.

Interventions:
Cochlear implantation using either posterior tympanotomy or subtotal petrosectomy.

Main Outcome Measures:
Postoperative complications between the two groups were compared after categorization into minor complications (requiring conservative management) and major complications (requiring surgical revision or hospitalization treatment).

Results:
Dizziness was the most common complication in both groups. The major complication rate in the SPCI group was significantly higher than in the PTCI group (12.1% [4 of 33] versus 1.3% [4 of 298], p = 0.004), while the minor complication rate was similar between the two groups. Among the major complications, device migration was significantly more common when SPCI was performed (9.1% [3 of 33] versus 0.3% [1 of 298], p = 0.003).

Conclusions:
Major complication rate of SPCI was higher than that of PTCI; particularly, device migration was more commonly observed after SPCI than PTCI. Therefore, special attention should be paid to device placement and fixation during SPCI.