bluuebunny/crossref_metadata_2025_split huggingface dataset:
Older Adults’ Attitudes About Future Mobility Changes and the Usefulness of Mobility Assessment Materials
Authors: West Bethany A. , Bergen Gwen , Moreland Briana 
Published: August 2020

Objectives: To understand older adults’ attitudes about future mobility and usefulness of mobility assessment materials. Methods: Data came from a telephone survey of 1,000 older adults aged 60–74 years. After answering baseline questions, respondents received mobility assessment materials, then completed follow-up interviews. Respondents were asked about future mobility challenges. During baseline and follow-up, subjects were asked four questions about their mobility as they aged which measured thinking about mobility, thinking about protecting mobility, confidence in protecting mobility, and motivation to protect mobility. Differences in percent of respondents’ attitudes between baseline and follow-up and 95% confidence intervals were calculated. Results: Driving (42%) was the most commonly reported challenge. Significant increases from baseline to follow-up in thinking about mobility (25%), thinking about protecting mobility (39%), and confidence in protecting mobility (29%) were reported. Discussion: Brief mobility assessment materials can encourage older adults to consider future mobility. Planning for changes can prolong safe mobility.
Assessing the Palliative and End-of-Life Care Education-Practice-Competence Triad in Intensive Care Units: Content Validity, Feasibility, and Reliability of a New Tool
Authors: Eltaybani Sameh , Igarashi Ayumi , Yamamoto-Mitani Noriko 
Published: August 2020

Background: To date, a comprehensive, psychometrically robust instrument to assess palliative and end-of-life (PEOL) care education, practice, and perceived competence among intensive care unit (ICU) nurses does not exist. Objective: To examine content validity and reliability of a proposed instrument to assess the PEOL care education-practice- competence triad among ICU nurses. Methods: An international modified e-Delphi and a cross-sectional pilot questionnaire survey. The Delphi involved 23 panelists from 11 countries. The pilot study involved 40 staff nurses and 3 nurse managers from 3 adult ICUs in a randomly selected hospital in Egypt. An instrument was developed and judged for content validity by international panelists, and then pretested in a pilot study, where data were collected at 2 time points using self-administered questionnaires, followed by cognitive interviews. Test-retest reliability was examined using intraclass correlation (ICC), standard error of measurement (SEM), and repeatability coefficient (RC). Results: The panelists confirmed content validity of the proposed instrument, and staff nurses confirmed its comprehensibility. At the level of the instrument’s total scores, the lowest ICC was .9 (95% confidence interval: .8-.9); and the highest SEM and RC were 4.8 and 13.3, respectively. Conclusions: The PEOL Care Index is a comprehensive, comprehensible, content valid, and reliable instrument to assess the PEOL care education-practice-competence triad among ICU nurses. Construct and criterion validities need to be confirmed in future studies. Applicability of the PEOL Care Index in different settings and cultures needs to be examined.
Hospital Preparedness and Resilience in Public Health Emergencies at District Hospitals and Community Health Centres
Authors: Sharma Sandesh Kumar , Sharma Neeraj 
Published: August 2020

Background: Public health emergencies (PHE) caused by natural hazards spread from one particular locality to adjacent geographic areas and then encompass the entire planet in today’s fast global connectivity mode. Each country, including India, has its own set of potential disasters based on the hazards present as well as the unique vulnerabilities of the community and community’s preparedness to respond to particular disasters. Currently, human history is observing a very critical time fighting an invisible enemy—COVID-19. Therefore, in this study, we seek to understand the standardised measures of public hospital preparedness and resilience at times of health emergencies, including a pandemic, the most current one being COVID-19. Methods: We conducted a descriptive, cross-sectional study among health officials of district hospitals (DHs) and community health centres (CHCs) of Rajasthan using a semi-structured online questionnaire, with COVID-19 in mind, and sending it to those who had attended a training programme on disaster preparedness in hospitals. Results: In all, questionnaires were sent to 80 health officials of DHs and CHCs, of which 58 responded, with a response rate of 72.5 per cent. We collected responses on public health emergency preparedness, training-related issues, the capacity to deal with emergencies and prior experience in managing an emergency. Conclusion: The resilience and preparedness of DHs and CHCs in Rajasthan appear to be limited. From the studies it has been revealed that proper training and education on disasters like the current COVID-19, which is of significant importance for healthcare workers, is limited to only 37.9 per cent of healthcare workers. It also emerges that the staff members whenever required could mark and perform in the triage area, but the Isolation room haven’t got the request facilities and equipped to stabilise a critical patient despite availability of emergency stock of medicine. The stated functional status of DHs and CHCs reveals that the level of emergency preparedness is between low and medium and also varies from hospital to hospital and from CHC to CHC. Hence, it is time to reassess and upgrade emergency preparedness plans, which include mitigation, preparedness, response and recovery. Federal-, state- and local-level emergency management agencies’ functioning has to be effective and well-coordinated with the local level of operation.
COVID-19: Impact on Health Supply Chain and Lessons to Be Learnt
Authors: Sharma Anu , Gupta Pankaj , Jha Rishabh 
Published: August 2020

Before the imposition of the strict lockdowns and the spread of COVID-19, the disruptions in China caused a ripple effect on the global supply chains. Emphasis has been laid on minimisation of costs and timely delivery of essential products. In India, as the situation worsens due to the outbreak, we have seen disruptions in the logistics supply chain. There are several reasons attributed to the increase in demand and slowing of the supply. There are several workable solutions available to look into this situation. We should work towards promoting Indian markets and amend policies to help the local workforce lessen the interdependencies of imports on other countries. This will help in strengthening the logistics supply chain in India. This will create employment opportunities and increase the GDP growth.
Outcome After Modified Grice-Green Procedure (SAMBB) for Arthritic Acquired Adult Flatfoot
Authors: Mosca Massimiliano , Caravelli Silvio , Vocale Emanuele , Massimi Simone , Fuiano Mario , Grassi Alberto , Ceccarelli Francesco , Zaffagnini Stefano 
Published: August 2020

Background: Adult acquired flatfoot deformity is a well-known and recognized cause of pain and disability. The purpose of this retrospective study was to describe radiographic and clinical outcomes of the modified mini bone block distraction subtalar arthrodesis (SAMBB) in adult patients affected by adult flatfoot with subtalar joint osteoarthritis at a midterm mean follow-up. Methods: A retrospective review of our database identified patients. Radiological imaging was used to evaluate angular corrections (Meary’s angle [MA], talar coverage angle [TC], and calcaneal pitch angle [CP]) to assess the rate of union and highlight the possible progression of arthritis in nearby joints. Clinical evaluation was performed at the time of surgery and at the final follow-up using the American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score. Sixty-two feet were evaluated at a mean follow-up of 6.2 ± 4.2 years. Results: The AOFAS score improved from a mean value of 48.1 ± 6.1 to a postoperative average score of 87.7 ± 5. CP, TC, and MA showed a postoperative improvement to 17.7 ± 2.1, 2.9 ± 0.7, and 0.6 ± 0.6 degrees, respectively, at the final follow-up, and all deformities were corrected. Five complications (8%) were reported: 1 major and 4 minor. No graft reabsorption, sural nerve neuralgia, or donor site morbidity was recorded. Conclusion: To our knowledge, this study is the first report of a modified Grice-Green technique (SAMBB) that is a safe and effective treatment of flatfoot in the adult with subtalar arthritis. Level of evidence: Level IV, retrospective case series.
Nonvascularized Toe Joint Transfers to the Hand in Young Children: Technique Revisited
Authors: Trost Jeffrey G. , Kaufman Matthew , Netscher David T. 
Published: August 2020

Background: Small joint reconstruction of the hand poses a significant challenge, especially in children where both functional motion and preservation of the epiphysis are desired. Auto-transplantation of whole joints is the only way to reconstruct a functional joint that maintains growth potential. Historically, nonvascularized toe-to-finger joint transfer has been criticized for high rates of avascular necrosis and joint dissolution, while vascularized transfers seemingly resulted in increased durability of the joint space and epiphysis. However, certain populations remain poor candidates for microvascular reconstruction, such as those with congenital deformities or sequelae from trauma or infection. In our case series, we demonstrate that a simplified nonvascularized surgical technique and careful patient selection can produce stable, functional joints. Methods: Nonvascularized toe-to-finger joint transfer was performed in 3 children between the ages of 4 and 6. Reconstructed joints included 2 proximal interphalangeal (PIP) joints and 1 metacarpophalangeal (MCP) joint. Donor grafts consisted of second toe PIP joints harvested en bloc to include the epiphysis of the middle phalanx, collateral ligaments, volar plate, and a diamond-shaped island of extensor tendon with its central slip attachment. Results: Follow-up ranged from 7 to 29 months. Each patient demonstrated functional improvements in joint motion and stability. Postoperative radiographs confirmed adequate joint alignment and persistence of the joint spaces. Epiphyseal closure was observed in 1 patient as early as 25 months postoperatively. Conclusions: Nonvascularized joint transfer should remain a practical consideration for small joint reconstruction of the hand in certain pediatric patients.
Assessment of Key Performance Indicators of the Primary Health Care in Oman: A Cross-Sectional Observational Study
Authors: Al Rashidi Badria , Al Wahaibi Ahmed H. , Mahomed Ozayr , Al Afifi Zainab , Al Awaidy Salah 
Published: August 2020

Objective Effective primary health care (PHC) is the key to attaining universal health coverage. The key performance indicators (KPIs), is a component of quality improvement in the PHC service sector that provides feedback to inform and better public service delivery and promoting accountability. We assessed the current performance of PHC service by using KPIs to identify the possible challenges that necessitate being confronted, highlight the lessons learnt, and propose steps towards improvements. Methods We conducted a cross-sectional observational study across 12 PHC centers in 6 governorates in Oman during the period of June 2017 to June 2018. Secondary data from the computerized medical records of the PHC centers on six key indicators, accessibility, workload, outcomes, timeliness, satisfaction, and safety were analysed to assess the performance of PHC service and to identify challenges confronted and propose steps towards further service improvement. Results The mean overall KPIs scores across the ten PHC centers were 174.5 (SD: 9.80) or 67.01%. The overall scores were normally distributed with a median score of 175 (IQR: 171-181). The lowest percentage score was obtained by Al Qabil (61.35%) with the highest mark being at Wadi Kabir (70.54%). The mean score across all KPIs was 3.84 (SD:0.94) with a median score of 3.9 (IQR: 3.43-4.5). Of the six KPI components, safety (4.85), satisfaction (4.67), timeliness (4.44), and accessibility (4.31) had the highest performance scores, whilst workload (4.15) and outcomes (3.75) lagged behind. Conclusions Performance across the KPIs exhibited a considerable variation between facilities, with workload and outcome performing lower than other components. The findings of this study offered a measure of internal strengths that need to be sustained, challenges that require quality improvement initiatives, and external factors such as social determinants that impact overall performance PHC.
Reproductive Health Issues
Authors: Hunt Patricia E. 
Published: August 2020

Occupational health nurses and other health professionals are at the forefront of the issues of reproductive health in the workplace. Many complexities are involved, and the best information available may be inconclusive. Thus, these issues represent a challenging area where occupational health nurses can make important contributions. A great accountability for communication about reproductive toxins falls on occupational health professionals. They must make every effort to be knowledgeable, to control workplace risks for everyone, and to educate and counsel employees on reproductive issues in the workplace.
Educating Blue Collar Workers
Authors: Pugh Nancy S. 
Published: August 2020

The nurse who meets with workers to share practical information about safe work practices, health maintenance, and home safety has the privilege of working to make a difference in their lives. On each return visit to the workplace, the messages can be strengthened and reinforced by using appropriate intervention strategies. The workplace offers a fertile field for effective health education for blue collar workers. Health education can provide useful information and develop within blue collar workers a sense of empowerment that they have the capacity to develop and use improved health behaviors. Education based on workers’ value system, interests, and strengths will be the most likely to influence lifestyle choices.
Occupational Health Nursing in Finland
Authors: Komulainen Pirkko 
Published: August 2020

In Finland occupational health services are stipulated by the law. The services are primarily directed at preventive measures and the achievement of a better working environment. The coverage of occupational health services is about 90%. Occupational health nurses are public health nurses in Finland. Moreover, they have the opportunity to have 4 weeks’ complementary schooling and postgraduate education from universities or nursing colleges. There are about 1,900 occupational health nurses in Finland. On the one hand occupational health nurses work independently; on the other hand, they work as a member of a team. Their work consists of environmental surveys and health education (based on working conditions and health habits), including first aid training, health examination, counseling, and treatment in case of illness.
Faculty Preferences in Clinical Education Recognition: A Survey of Faculty at 3 Institutions
Authors: Ju Connie , Becker Devra B. 
Published: August 2020

Purpose: Innovative studies have created proposals for measuring productivity using Relative Value Unit (RVU) or Educational Value Unit (EVU) systems, but little attention has been given to faculty preferences for rewarding educational activity. This study assesses perceptions of educational value and reward preferences for educational involvement of faculty at 3 different hospital systems affiliated with 1 medical school. Method: A 25-question electronic survey was sent to clinical faculty across 3 distinct hospital systems affiliated with a Midwestern medical school in spring 2015. Results were analyzed using the Kruskal-Wallis test and free text comments were reviewed for common themes. Results: A total of 4325 surveys were distributed and 361/467 (77%) of the surveys opened were completed for an overall response rate of 8%. Of the respondents 55% were employed by the primary affiliate hospital. Most respondents believed some method of recognition for educational activities should be in place at their institution. Overall, clinical faculty believed their own hospital systems valued education less than the school of medicine and their departments did. Most faculty gave highest preference for academic recognition, reduction in RVU requirements, or an adoption of an EVU system. Conclusion: Most faculty preferred reduced RVU requirements, adoption of an EVU system, or some method of academic recognition to reward educational activity. Differences in results between hospital systems suggest institutional climate may influence faculty preferences.
Genetic variants modulate gene expression statin response in human lymphoblastoid cell lines
Authors: Theusch Elizabeth , Chen Yii-Der I. , Rotter Jerome I. , Krauss Ronald M. , Medina Marisa W. 
Published: August 2020

Abstract
Background
Statins are widely prescribed to lower plasma low-density lipoprotein cholesterol levels. Though statins reduce cardiovascular disease risk overall, statin efficacy varies, and some people experience adverse side effects while on statin treatment. Statins also have pleiotropic effects not directly related to their cholesterol-lowering properties, but the mechanisms are not well understood. To identify potential genetic modulators of clinical statin response, we looked for genetic variants associated with statin-induced changes in gene expression (differential eQTLs or deQTLs) in lymphoblastoid cell lines (LCLs) derived from participants of the Cholesterol and Pharmacogenetics (CAP) 40 mg/day 6-week simvastatin clinical trial. We exposed CAP LCLs to 2 μM simvastatin or control buffer for 24 h and performed polyA-selected, strand-specific RNA-seq. Statin-induced changes in gene expression from 259 European ancestry or 153 African American ancestry LCLs were adjusted for potential confounders prior to association with genotyped and imputed genetic variants within 1 Mb of each gene’s transcription start site.

Results
From the deQTL meta-analysis of the two ancestral populations, we identified significant cis-deQTLs for 15 genes (TBC1D4, MDGA1, CHI3L2, OAS1, GATM, ASNSD1, GLUL, TDRD12, PPIP5K2, OAS3, SERPINB1, ANKDD1A, DTD1, CYFIP2, and GSDME), eight of which were significant in at least one of the ancestry subsets alone. We also conducted eQTL analyses of the endogenous (control-treated), statin-treated, and average of endogenous and statin-treated LCL gene expression levels. We identified eQTLs for approximately 6000 genes in each of the three (endogenous, statin-treated, and average) eQTL meta-analyses, with smaller numbers identified in the ancestral subsets alone.

Conclusions
Several of the genes in which we identified deQTLs have functions in human health and disease, such as defense from viruses, glucose regulation, and response to chemotherapy drugs. This suggests that DNA variation may play a role in statin effects on various health outcomes. These findings could prove useful to future studies aiming to assess benefit versus risk of statin treatment using individual genetic profiles.
Multidrug resistant and extensively drug resistant Acinetobacter baumannii hospital infection associated with high mortality: a retrospective study in the pediatric intensive care unit
Authors: Shi Jingyi , Sun Ting , Cui Yun , Wang Chunxia , Wang Fei , Zhou Yiping , Miao Huijie , Shan Yijun , Zhang Yucai 
Published: August 2020

AbstractBackgroundMultidrug resistant (MDR) and extensively drug resistant (XDR)Acinetobacter baumanniipresents challenges for clinical treatment and causes high mortality in children. We aimed to assess the risk factors and overall mortality for MDR/XDRAcinetobacter baumanniiinfected pediatric patients.MethodsThis retrospective study included 102 pediatric patients who developed MDR/XDRAcinetobacter baumanniiinfection in the pediatric intensive care unit (PICU) of Shanghai Children’s Hospital in China from December 2014 to May 2018.Acinetobacter baumanniiclinical isolates were recovered from different specimens including blood, sputum, bronchoalveolar lavage fluid, cerebrospinal fluid, ascites, hydrothorax, and urine. Antibiotic susceptibility test was determined according to the Clinical and Laboratory Standards Institute interpretive criteria. Clinical and biological data were obtained from the patients’ medical records.Results102 patients withAcinetobacter baumanniiinfection were enrolled. The median age was 36 (9.6, 98.8) months, and there were 63 male in the case group. The overall mortality rate was 29.4%, while theAcinetobacter baumannii-associated mortality rate was 16.7% (17/102, 12 bloodstream infections, 4 meningitis and 1 intra-abdominal infection). Bloodstream infections occurred in 28 patients (27.5%), and 10 patients (9.8%) among them had central line-associated bloodstream infections (6 central venous catheters, 2 PICCs, 1 venous infusion port and 1 arterial catheter). Cerebrospinal fluid (CSF) cultures were positive in 4(3.9%) patients. 14(13.7%) patients got positive cultures in ascites and hydrothorax. Lower respiratory isolates (56/102) accounted for 54.9% of all patients. Non-survival patients appeared to have a lower NK cell activity (6.2% ± 3.61% vs. 9.15% ± 6.21%,P = 0.029), higher CD4+ T cell ratio (39.67% ± 12.18% vs. 32.66% ± 11.44%,P = 0.039),and a higher serum level of interlukin-8 (IL-8, 15.25 (1.62, 47.22)pg/mL vs. 0.1 (0.1, 22.99)pg/mL,P = 0.01) whenAcinetobacter baumanniiinfection developed. Multivariate logistic analysis indicated that high serum level of Cr (RR, 0.934, 95%CI, 0.890–0.981;P = 0.007) and high BUN/ALB level (RR, 107.893, 95%CI, 1.425–870.574;p = 0.005) were associated with high risk of mortality in MDR/XDRAcinetobacter baumanniiinfected patients.ConclusionMDR/XDRAcinetobacter baumanniiinfection is a serious concern in pediatric patients with high mortality. Bloodstream and central nervous system infection accounted for high risk of death. Acute kidney injury is associated with high risk of mortality.