bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictors of Operative Intervention in Patients With Lactic Acidosis
Authors: Bankhead-Kendall Brittany , Slama Eliza M. , Isanaka Pavan , Braddock Amy 
Published: December 2020

Background Lactate levels in clinical practice are often used as a quantitative indicator for the severity of hypoperfusion and the responsiveness to therapeutic interventions. In the hospital acute care setting, lactic acidosis combined with the appropriate clinical exam signs warrants surgical evaluation. The purpose of our study was to evaluate all surgical consults for lactic acidosis in a single community hospital to identify what cofactors were most often predictive of the need for surgical management and operative intervention. Materials and Methods A retrospective chart review within a 5-year period was conducted on all consultations to general surgery in which patients additionally had lactic acidosis defined as >2mEq. Within this population, various subjective and objective parameters were evaluated. Final analysis compared these parameters between patients with lactic acidosis who underwent surgical intervention and those who did not require operative intervention. Results Within the 5-year period, 432 patients met our criteria of a surgical consult placed for lactic acidosis. Final results from the highest quality statistical model showed significant variables as diffuse tenderness on physical exam ( P-value = .0010, Odds Ratio (OR) = 2.77) and focal tenderness on physical exam ( P-value = .0440, OR = 1.76). The presence of peritoneal signs ( P-value = .0521, OR = 2.02) resulted in operative intervention twice as often in patients with lactic acidosis. Discussion To better appropriate health care costs, measures need to be taken to ensure resources are being utilized properly. In patients with lactic acidosis, one should go “back to the basics” with the physical examination to determine which patients truly need a surgical consultation.
A Prospective Study of Family Satisfaction Changes After Tracheostomy Placement in Trauma Patients
Authors: Trust Marc D. , Lara Sabino , Hecht Jonathan , Teixeira Pedro G. , Coopwood Ben , Aydelotte Jayson , Cardenas Tatiana C. P. , Guerra Erin , Ali Sadia , Brown Carlos V. R. 
Published: December 2020

Background Tracheostomy is a commonly performed procedure in surgical intensive care units. Although the indications and benefits of this procedure are well known, little has been studied in the adult surgical/trauma population about patient family satisfaction after tracheostomy placement. Materials and Methods We performed a prospective study at our academic level I trauma center from 2015-2016 in patients who underwent elective tracheostomy. Family members were asked to complete an eight-point questionnaire using a forced Likert scale of graded responses. Questionnaires were administered prior to tracheostomy and again at 24-and 72-hour post-tracheostomy placement. Responses were compared using univariate analysis. Results A total of 26 family members completed all 3 surveys. Family members believed loved ones appeared more comfortable, were more interactive, and were better progressing clinically. After 72 hours, family members felt less anxiety. There was no difference in perceptions of patient distress, ability to provide support, or their worry about scars, or comfort in visiting them. Discussion Family members believed tracheostomies provided greater patient comfort, increased interactive abilities, better progress in their care, and experienced less anxiety after placement. Family satisfaction may therefore be an additional benefit in support of earlier tracheostomy.
Opioid Requirements in Laparoscopic Colectomies: Do Enhanced Recovery After Surgery Protocols Make a Difference?
Authors: Kawak Samer , Wasvary Joanna F. , Ziegler Matthew A. 
Published: December 2020

Background With the growing opioid epidemic and recent focus on the quantity of opioids prescribed at discharge after surgery, enhanced recovery pathways provide another tool to counteract this epidemic. The aim of this current study is to analyze the differences in opioid requirements and pain scores in the immediate postoperative period for patients who underwent laparoscopic colectomies before and after the implementation of enhanced recovery after surgery (ERAS) protocols. Materials and Methods This study is a retrospective review of patients and was conducted at an academically affiliated tertiary care hospital. In patients undergoing elective laparoscopic colectomies before December 1, 2013-July 31, 2015 and after September 1, 2015-May 31, 2018, the implementation of enhanced recovery pathways was included. The primary end point was opioid consumption from the end of surgery until 48 hours after surgery. Secondary end points included pain scores, surgery length of time, and hospital length of stay after surgery. Results A total of 242 patients (122 pre- and 120 postimplementation) were analyzed. Patient characteristics were similar between groups. Pain scores were higher in the preimplementation patients for postoperative day (POD) 0 scores ( P = .019). There was a decrease in the morphine milligram equivalents (MME) on POD 0-2 for the postimplementation patients. This decrease resulted in a 61% reduction in opioid requirements after implementation of ERAS protocols (32 vs. 12.5 MME, P < .0001). Discussion Enhanced recovery after surgery protocols can reduce opioid requirements after elective laparoscopic colectomies without negatively affecting pain scores.
Surgical Faculty Perception of Service-Based Advanced Practice Provider Impact: A Southwestern Surgical Congress Multicenter Survey
Authors: Eaton Barbara C. , Vesselinov Roumen , Ahmeti Mentor , Stansbury Jessica Jean , Regner Justin , Sadler Craig , Nevarez Stephanie , Lissauer Matthew , Stout Lauren , Harmon Laura , Glassett Brittany , Hampton David A. , Castro Helen J. , Cunningham Kyle , Mulkey Sarah , O’Meara Lindsay , Dia Jose J. , Bruns Brandon R. 
Published: December 2020

Background A previous single-center survey of trauma and general surgery faculty demonstrated perceived positive impact of trauma and surgical subspecialty service-based advanced practice providers (SB APPs). The aim of this multicenter survey was to further validate these findings. Methods Faculty surgeons on teams that employ SB APPs at 8 academic centers completed an electronic survey querying perception about advanced practice provider (APP) competency and impact. Results Respondents agreed that SB APPs decrease workload (88%), length of stay (72%), contribute to continuity (92%), facilitate care coordination (87%), enhance patient satisfaction (88%), and contribute to best practice/safe patient care (83%). Fewer agreed that APPs contribute to resident education (50%) and quality improvement (QI)/research (36%). Although 93% acknowledged variability in the APP level of function, 91% reported trusting their clinical judgment. Conclusion This study supports the perception that SB APPs have a positive impact on patient care and quality indicators. Areas for potential improvement include APP contribution to resident education and research/QI initiatives.
Predisposing, enabling and need factors associated with increased use and ongoing increased use of inpatient mental health care: A population-based longitudinal study
Authors: Suesse Bianca , Lago Luise , Westley-Wise Victoria , Cuenca Jose , Pai Nagesh 
Published: December 2020

Objective: The study investigated factors associated with frequent (admissions), high (total length of stay) or heavy (frequent and high) hospital use, and with ongoing increased hospital use, for mental health conditions in a regional health district. Methods: A retrospective population-based study using longitudinal hospital, emergency department and community service use data for people admitted with a mental health condition between 1 January 2012 and 31 December 2016. Multivariate logistic regression models assessed the association of predisposing, enabling and need factors with increased, and ongoing increased, hospital use. Results: A total of 5,631 people had at least one mental health admission. Frequent admission was associated with not being married (odds ratio = 2.3, 95% confidence interval = [1.5, 3.3]), no private hospital insurance (odds ratio = 2.2, 95% confidence interval = [1.2, 3.8]), previous mental health service use (community, emergency department, lengthy admissions) and a history of a substance use disorder, childhood trauma, self-harm or chronic obstructive pulmonary disease. High and heavy hospital use was associated with marital status, hospital insurance, admission for schizophrenia, previous mental health service use and a history of self-harm. Ongoing frequent use was less likely among those aged 65 and older (odds ratio = 0.2, 95% confidence interval = [0.1, 1.0]) but more likely among those with a history of depression (odds ratio = 2.2, 95% confidence interval = [1.1, 4.4]). Ongoing high use was also associated with admissions for schizophrenia and a history of self-harm. Conclusion: Interventions targeted at younger people hospitalised with schizophrenia, a history of depression or self-harm, particularly with evidence of social and or health disadvantage, should be considered to improve long-term consumer and health system outcomes. These data can support policymakers to better understand the context and need for improvements in stepped or staged care for people frequently using inpatient mental health care.
Increases in youth mental health services in Australia: Have they had an impact on youth population mental health?
Authors: Jorm Anthony F , Kitchener Betty A 
Published: December 2020

Background: Mental disorders often have their first onset during youth, which justifies targeting treatment services at this age group. Australia has had a substantial increase in youth mental health services since the introduction of the Medicare Better Access scheme and headspace services in 2006–2007. This paper examines trends in the mental health of Australian youth before and after this time using available national and state datasets. Methods: The following data were examined for age groups available in the age range of 12–25 years: use of mental health services per 100,000 population provided under Medicare by GPs, psychiatrists, clinical psychologists, other psychologists and allied health professionals; per capita accessing of headspace services; and prevalence of high and very high psychological distress (using the K10) in youth age groups in the National Health Survey, the Victorian Population Health Survey and the New South Wales Population Health Survey between 2001 and 2018. Results: There has been a large increase in use of mental health services since the introduction of Better Access and headspace. No significant improvement in youth mental health was evident following the introduction of these schemes. Rather, there appeared to be a worsening of youth mental health from around 2015 onwards. Conclusion: Despite a large increase in the provision of mental health services to Australian youth, there has not been a detectable reduction in the prevalence of psychological distress. There may be other factors that have worsened youth mental health in recent years.
The Dynamics of Export Diversification, Economic Complexity and Economic Growth Cycles: Global Evidence
Authors: Canh Nguyen Phuc , Thanh Su Dinh 
Published: December 2020

This article investigates the dynamics of export diversification, economic complexity and economic growth cycles. By applying several econometric techniques for estimating a panel data set of 70 economies over the period from 1996 to 2014, the results have been threefold. First, there is Granger bi-directional causality between economic complexity and export diversification, while unidirectional Granger causality exists from economic complexity to economic growth cycles. Second, the result attained from the three-stage least squares estimate demonstrates that economic complexity and export diversification significantly impact each other. Notably, the effect of economic complexity is found to be negative on economic growth cycles, implying that the dynamics of economic complexity and export diversification generate a reduction in economic fluctuations. Third, by splitting the sample into two subsamples (i.e., 32 high-income economies and 38 low- and middle-income economies) and two sub-periods (i.e., 1994–2007 and 2008–2014), the results show that the positive dynamics between economic complexity and export diversification are consistent with income levels and time periods. However, the negative impact of economic complexity on economic growth cycles is statistically significant only for the group of high-income economies and during the 1996–2007 period. These findings are checked by several estimators and different proxies of export diversification, economic growth cycles and economic complexity. JEL: F13, F14, O19, E32
Impact of a school-based cooking programme on home cooking participation in Japan
Authors: Yoshii Emi , Akamatsu Rie , Ishihara Yoko , Izumi Betty 
Published: December 2020

Background: Children’s participation in cooking activities at home may have positive effects on diet quality. In Japan, schools are the primary site for food education, which includes cooking. Very few studies have assessed the impact of school-based cooking programmes on children’s participation in cooking activities at home. Objective: The objective of the study was to assess the impact of the cooking programme on children’s participation in cooking at home and their self-efficacy and attitudes towards cooking. Design: Quasi-experimental study with an intervention and a comparison group. Outcomes were measured using pre- and post-programme surveys. Setting: Two public elementary schools (A, B) in Tokyo, Japan. Method: One hundred-seventy children in the third and fourth grades at School A (intervention group) and 142 children at School B (comparison group) completed pre- and post-programme surveys. Students in the intervention school received three 45-minute cooking lessons, including two lessons that focused on peeling apples and one hands-on cooking experience. The main outcome measures were participation in cooking at home, attitudes towards cooking, and self-efficacy with respect to cooking and peeling apples. Results: The number of children participating in cooking-at-home activities increased in the intervention group ( p = .005). Children who started cooking at home during the intervention period improved their cooking self-efficacy ( p = .012) and attitudes towards cooking ( p = .002). Conclusion: Implementation of a short-duration cooking programme focused on improving children’s cooking attitudes, and self-efficacy can encourage participation in cooking activities at home.
Effect of an adolescent peer-led health curriculum on peer educators and participants
Authors: Thompson Michelle A , Nigg Claudio R 
Published: December 2020

Objective: To assess the effectiveness of an adolescent peer-led health curriculum in changing physical activity and fruit and vegetable social-cognitive and behavioural variables among Filipino American adolescents in Hawai’i for participants and peer educators. Design: Quasi-experimental design. Setting: One high school on Oahu, Hawai’i. Method: Filipino American adolescents aged 16–18 years from a grade 12 health class were recruited and trained as peer educators to deliver a health curriculum to grades 9–11 health classes over 8 months. We examined peer educators’ influence on physical activity and fruit and vegetable social-cognitive (knowledge, stage of change, self-efficacy and enjoyment) and behavioural variables (physical activity and consumption). Participants and peer educators completed baseline and follow-up questionnaires. Results: Compared with controls, intervention students showed an increase in physical activity knowledge and self-efficacy. Multiple regression analysis predicted higher physical activity knowledge and moderate-vigorous physical activity follow-up scores for members of the intervention group. A significant effect was found for physical activity stage of change and moderate-vigorous physical activity for peer educators over time. No significant effect was found for any fruit and vegetable variables. Conclusion: A peer-led health curriculum may be a viable method to change physical activity social-cognitive and behavioural variables in Filipino American adolescents and peer educators.
Current status and associated factors of psychological resilience among the Chinese residents during the coronavirus disease 2019 pandemic
Authors: Shen Xin , Li Yuting , Feng Jing , Lu Zuxun , Tian Kunming , Gan Yong 
Published: December 2020

Background: Since December 2019, over 4,600 deaths and 84,000 confirmed cases were reported in China because of the coronavirus disease 2019 (COVID-19) pandemic. However, there is a dearth of studies on the psychological resilience in residents. Aims: This study aims to measure the psychological resilience of Chinese residents to reflect their psychological status as well as influencing factors during the pandemic. Method: We conducted a combination of stratified sampling and snowball sampling to select survey subjects. We employed the psychological resilience and influencing factor questionnaire based on the 10-item Connor and Davidson Resilience Scale (CD-RISC10) for survey. We collected data from 3,398 residents in China between 31 January and 29 February 2020. Multivariable linear stepwise regression analysis was used to determine factors associated with psychological resilience in residents. Results: The mean score of psychological resilience among Chinese residents was 27.11 ± 8.45 ( SD = 7.98). There were some factors significantly associated with psychological status among the Chinese residents during the COVID-19 outbreak. Residents with lower financial status, living in rural areas, unmarried, lacking fixed employment or retirement guarantees, and lacking knowledge of policies were more likely to report a lower level of psychological resilience. Conclusion: Health service policy makers in many countries should adopt relevant measures to improve the psychological resilience of residents during the pandemic. This includes short-term aggressive treatment, strengthening health education, and improving the awareness of residents with respect to emergency health policies. In addition, the financial status, health levels, and risk management capabilities of residents should be increased over the long term.
Training and Incorporating Students in SARS-CoV-2 Case Investigations and Contact Tracing
Authors: Pogreba Brown Kristen , Austhof Erika , Rosa Hernández Ayeisha M. , McFadden Caitlyn , Boyd Kylie , Sharma Jayati , Battaglia Sarah , Shilen Alexandra , Heslin Kelly M. 
Published: December 2020

Objectives In June 2020, Arizona had the fastest-growing number of cases of coronavirus disease 2019 (COVID-19) worldwide. As part of the growing public health response, the University of Arizona Student Aid for Field Epidemiology Response (SAFER) team was able to modify and increase case investigation efforts to assist local health departments. We outline the recommended logistical and management steps to include students in a public health response of this scope. Methods From April 1 through September 1, 2020, the SAFER team identified key components of a successful student team response: volunteer training, management that allows more senior students to manage newer students, adoption of case-management software, and use of an online survey platform for students to conduct interviews consistently and allow for data quality control and management. Results From April 1 through September 1, 2020, SAFER worked with 3 local health departments to complete 1910 COVID-19 case investigations through a virtual call center. A total of 233 volunteers and 46 hourly student workers and staff members were involved. As of September 2020, students were completing >150 interviews per week, including contact-tracing efforts. Practice Implications Developing relationships between applied public health and academic programs can relieve the burden of low-risk, high-volume case investigations at local and state health departments. Furthermore, by establishing a virtual call center, health sciences faculty and students can volunteer remotely during a pandemic with no additional risk of infection.
Rackets and the Markets of Violence: A Case Study of Altavista, Medellín, Colombia
Authors: Alzate-Zuluaga Mary Luz , Jiménez-García Williams Gilberto 
Published: December 2020

An analysis of violence using data from 2018 to 2019 in the village of Altavista in Medellín, Colombia, concludes that economic globalization and a crisis of the social state have led to an increase in inequality and structural violence. This phenomenon, culturally reinforced by the acceptance and normalization of these events, constitutes a window of opportunity for the entrenchment of violent entrepreneurship using extortive economic activities to accumulate capital, resulting in increased precarity for the inhabitants of the village. Un análisis de la violencia en la aldea de Altavista en Medellín, Colombia, utilizando los datos de 2018 a 2019 concluye que la globalización económica y una crisis del estado social han dado lugar a un aumento en la desigualdad y la violencia estructural. Este fenómeno, culturalmente reforzado por la aceptación y normalización de dichos acontecimientos, constituye una ventana de oportunidad para el afianzamiento de una violenta cultura económica basada en la acumulación de capital a partir de la extorsión, lo cual exacerba la presencia de la precariedad en las vidas de los habitantes del pueblo.
State Violence, Capital Accumulation, and Globalization of Crime: The Case of Ayotzinapa
Authors: Frausto Obed , Castellanos Nayar López 
Published: December 2020

The violence perpetrated against the students of the Ayotzinapa Rural Normal School by the Mexican state constitutes an extreme form of social control and capital accumulation. The forced disappearance of the 43 students can be explained in two dimensions, political and economic. The political explanation is that the state administers institutional repression and dispossession against peasant and indigenous communities to inhibit social protest. The economic explanation is that violence meted out by the state and criminal organizations is used to facilitate capital accumulation both by legal means, through the extraction of natural resources, the exploitation of cheap labor, and the establishment of favorable contracts for transnational corporations, and by illegal means, through drug and human trafficking, money laundering, extortion, and the expropriation of community lands. La violencia perpetrada contra los estudiantes de la Escuela Normal Rural de Ayotzinapa por el Estado mexicano constituye una forma extrema de control social y acumulación de capital. La desaparición forzada de los 43 estudiantes puede explicarse en dos dimensiones: la política y la económica. La explicación política es la represión institucional de la protesta social, y la económica es la facilitación de la acumulación de capital tanto por medios legales (la extracción de recursos naturales, la explotación de mano de obra barata y contratos favorables para las empresas transnacionales) como ilegales (el tráfico de drogas y la trata de personas, el lavado de dinero, la extorsión y la expropiación de tierras comunitarias).