bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictors of Success in Selective Laser Trabeculoplasty: Data From the Lausanne Laser Trabeculoplasty Registry
Authors: Elahi Sina , Rao Harsha L. , Dumitru Alina , Mansouri Kaweh 
Published: May 2020

Purpose:
The purpose of this study was to determine the factors associated with the outcomes of selective laser trabeculoplasty (SLT).

Patients and Methods:
This was a database analysis (Lausanne Laser Trabeculoplasty Registry) of patients who had SLT between 2015 and 2017. Exclusion criteria were age below 40 years and diagnosis other than ocular hypertension and open-angle glaucoma. Intraocular pressure (IOP) and number of medications were recorded before and at various follow-ups after laser treatment. Success was defined as “complete” if an IOP reduction of at least 20% was observed at a given time, and “qualified” if any reduction of IOP was observed with either at least a 20% difference from baseline or a reduction in IOP-lowering medications. Associations of complete and qualified success with patients’ baseline characteristics, laser settings, and clinical examination findings were studied using multivariate regression and survival analysis.

Results:
A total of 170 eyes (126 patients) were included. Mean age was 68.3±12.2 years and 57.9% of the study cohort were female individuals. Average baseline IOP was 18.7±4.8 mm Hg, and average IOP reduction was 3.3±4.3 (−17.6% from baseline) and 3.5±3.9 mm Hg (−18.7% from baseline) at years 1 and 2, respectively. Male sex [odds ratio (OR)=2.79, P=0.02], baseline IOP (OR=1.15, P<0.01), and medical treatment before SLT (OR=2.57, P=0.03) were positive predictors of success. Total energy was associated with the duration of success. SLT outcome was strongly correlated to the outcome of the fellow eye, which represented the strongest predictor (OR=17.33, P<0.01).

Conclusions:
SLT achieved good IOP-lowering in a majority of patients with mild-to-moderate glaucoma, while it was inefficient in up to 35% of eyes. SLT success in the fellow eye was a strong predictive factor.
Day-Case Admission for External Dacryocystorhinostomy in Preschool Children
Authors: Juniat Valerie , Rose Geoffrey E. , Timlin H. , Wagh V.J. , Abou-Rayyah Y. , Uddin J. , Verity David H. 
Published: May 2020

Purpose:
Epistaxis during or after dacryocystorhinostomy may present a risk of circulatory compromise, particularly in young children. In view of this concern, we reviewed the outcome and complications of external dacryocystorhinostomy in preschool children, aged less than 4½ years.

Design:
Retrospective noncomparative series.

Patients and Methods:
A case-note review for a series of preschool children undergoing external dacryocystorhinostomy as a day-case admission at Moorfields Eye Hospital between 1992 and 2018; all surgery was consultant-led. Details were taken of the type of surgery, any intraoperative or postoperative complications (surgical or anesthetic), any unplanned admissions after surgery, and the functional outcome. To assess the veracity of the medical records, the parents for a sample of 67 children were contacted to check whether there had been any unrecorded events or concerns.

Outcome Measures:
Anesthetic or surgical complications, unplanned admissions, and postoperative events.

Results:
One-hundred and eighty-seven children (117 boys; 63%) underwent 228 external dacryocystorhinostomies during 201 admissions, the average admission age being 36.8 months (median, 37.5; range, 5.5–53.5 months). Forty-one children (20%) underwent bilateral dacryocystorhinostomy: the 27 having simultaneous bilateral surgery dacryocystorhinostomy were operated at a mean age of 38.2 months (median, 37.5; range, 15.5–53.5 months), this being significantly different from the average age at first operation in 14 children undergoing sequential admission for bilateral dacryocystorhinostomy (mean, 24.9 months; median, 27.0; range, 5.5–42.5) (p = 0.0023). No adverse anesthetic events were recorded, 2 children (2 dacryocystorhinostomies) required temporary nasal packing at the end of surgery for epistaxis, and one further child was admitted for overnight observation because of persistent mild epistaxis after bilateral dacryocystorhinostomy. Three children (3 dacryocystorhinostomies) had a mild, self-limiting secondary epistaxis, and there were no unplanned emergency admissions. The telephone survey did not reveal any disparity in the medical records.

Conclusion:
With experienced surgeons and anesthetists in a suitable specialist hospital, external dacryocystorhinostomy in preschool children would appear to be a safe and effective procedure, with few and minor complications. Although facilities for overnight observation should be available, the surgery can typically be planned as a day-case admission, and simultaneous bilateral surgery is also possible in this age-group.
Associations Among Perceived Control, Depressive Symptoms, and Well-being in Patients With Heart Failure and Their Spouses
Authors: Strömberg Anna , Liljeroos Maria , Ågren Susanna , Årestedt Kristofer , Chung Misook L. 
Published: May 2020

Background
High levels of perceived control and lower levels of depressive symptoms are associated with better well-being in both patients with heart failure and their spouses at an individual level. However, there is a knowledge gap about how these individual factors have reciprocal influences on partners' well-being within the patient-spouse dyads.

Objective
The aims of this study were to examine dyads of patients with heart failure and their spouses on whether the patients' perceived control over the management of heart failure and depressive symptoms predicts their own and their spouses' physical and emotional well-being and to examine whether patients' perceived control predicts their own and their spouses' depressive symptoms.

Methods
A total 155 patient-spouse dyads (patients: 75% male, mean age of 71 years, 53% classified as New York Heart Association III; spouses: 75% female, mean age of 69 years) were recruited from 2 hospital-based outpatient heart failure clinics. Participants completed the Control Attitude Scale, the Beck Depression Inventory, and the Short-Form 36. Dyadic data were analyzed using multilevel regression of the actor-partner interdependence model.

Results
Perceived control had an actor effect on emotional well-being only for patients, and there were partner effects of perceived control on emotional well-being for both patients and their spouses. Depressive symptoms exhibited an actor effect on physical and emotional well-being for patients and spouses, but there were no partner effects of depressive symptoms on emotional well-being. Perceived control had partner effects on depressive symptoms for patients and spouses, but an actor effect of depressive symptoms was only found for patients.

Conclusion
In an interdependent relationship within the patient-spouse dyads, each dyad member's perceived control influenced their partner's emotional well-being as well as depressive symptoms. The findings suggest development of dyadic interventions that can increase perceived control over the heart condition.
Perceived Control Predicts Symptom Status in Patients With Heart Failure
Authors: Lin Chin-Yen , Miller Jennifer L. , Lennie Terry A. , Biddle Martha J. , Mudd-Martin Gia , Hammash Muna , Moser Debra K. 
Published: May 2020

Background
Symptom status is an important indicator of disease progression in patients with heart failure (HF). Perceived control is a target of most self-care interventions and is associated with better outcomes in HF; however, little is known about the relationship between perceived control and symptom status in patients with HF.

Objective
The aims of this study were to (1) determine the relationship of perceived control to HF symptom status and (2) examine the associations of perceived control to self-care and of self-care to symptom status.

Methods
A total of 115 patients with HF were included. Data on symptom status (Memorial Symptom Assessment Scale-HF), perceived control (Control Attitudes Scale-Revised), and self-care (Self-Care of Heart Failure Index) were collected. Other covariates included were age, gender, New York Heart Association class, comorbidity burden, and depressive symptoms. Multiple regression analyses were performed to analyze the data.

Results
Lower perceived control predicted worse symptom status after controlling for covariates (P = .009). Other covariates predictive of worse symptom status were younger age, New York Heart Association class III/IV, and higher levels of depressive symptoms. Higher levels of perceived control were associated with better self-care (P = .044). Better self-care was associated with better symptom status (P = .038).

Conclusions
Lower levels of perceived control were independently associated with worse symptom status in patients with HF. Intervention strategies targeting perceived control should be tested to determine whether they could improve symptom status.
Associations Between Sleep and Personality Factors Among Patients Living With Coronary Artery Disease
Authors: Kjellsdotter Anna , Edéll-Gustafsson Ulla , Yngman-Uhlin Pia 
Published: May 2020

Background
Insomnia symptoms have become increasingly common in patients with coronary artery disease (CAD). Increasing evidence suggests comorbidity between personality traits and health status. Considering personality traits may act as a predisposition for future illness; this state may influence sleep quality and it appears to precipitate cardiac events in high-risk patients.

Objective
The aim of this study was to investigate self-reported sleep deficiency in relation to vicious cycle of sleeplessness (VCS) behavior, hyperarousal behavioral trait (H-personality), and type D personality traits in patients with CAD and in a population-based group. Furthermore, our aim was to explore the association of VCS behavior with H-personality trait and type D personality. Finally, we investigated to what extent type D personality can explain self-reported too little sleep in patients with CAD.

Methods
An observational case-control design was applied comprising 859 patients in cardiac outpatient care and 859 participants from a population-based group. Questionnaires assessing VCS behavior, H-personality, type D personality, and perceptions of too little sleep were used.

Results
Statistically significant higher scores of a hyperarousal and sleeplessness behavior were revealed for those with too little sleep compared with those with sufficient sleep in both the patient and the population-based group. Age, female gender, or sleeplessness behavior significantly predicted too little sleep (P < .001).

Conclusions
The current study highlights the advantage of studying heterogeneity in patients with CAD from a person-centered perspective with focus to identify distressed individuals in order to prevent or treat sleep deficiency. A cluster of factors may be a more accurate predictor of patient-reported outcomes than a single psychosocial factor.
The Effect of Semirecumbent and Right Lateral Positions on the Gastric Residual Volume of Mechanically Ventilated, Critically Ill Patients
Authors: FARSI Zahra , KAMALI Maa'soumeh , BUTLER Samantha , ZAREIYAN Armin 
Published: May 2020

ABSTRACT

Background
Delay in stomach discharge is a challenge for patients who are tube fed and may result in serious side effects such as pneumonia and malnutrition.

Purpose
This study was designed to determine the respective effects of the semirecumbent (SR) supine and right lateral (RL) with a flatbed positions on the gastric residual volume (GRV) of mechanically ventilated, critically ill adult patients.

Methods
A randomized, crossover clinical trial design was used to investigate GRV in 36 critically ill, ventilated adult patients who were hospitalized in the intensive care unit. GRV was measured at 3 hours after three consecutive feedings. GRV was first measured in all of the participants in the supine position; after which, participants were randomly assigned into one of two therapeutic positioning groups (Group A: assessment in the SR position and then the RL position; Group B: assessment in the RL position and then the SR position).

Results
GRV was significantly lower in both the SR and RL positions than in the supine position. GRV in the SR and RL positions did not vary significantly. The in-group measurements for GRV did not significantly differ for any of the three positions. In Group A, GRV was significantly lower at each subsequent measurement point.

Conclusion/Implications for Practice
Positioning patients in the RL and SR positions rather than in the supine position is an effective strategy to reduce GRV. Furthermore, placing patients in either the RL or SR position is an effective intervention to promote faster digestion and feedings.
Patients With Type 2 Diabetes Mellitus: Obstacles in Coping
Authors: FİDAN Özlem , TAKMAK Şenay , ZEYREK Arife Şanlialp , KARTAL Asiye 
Published: May 2020

ABSTRACT

Background
Diabetes mellitus is a major global threat to public health. Reducing the daily obstacles of coping with the disease for patients with diabetes may improve management.

Purpose
The aim of this study was to investigate daily obstacles to coping with Type 2 diabetes mellitus (T2DM) and related factors.

Methods
A descriptive and cross-sectional design was used. Data were collected from 186 patients with T2DM who were hospitalized in an endocrinology clinic in Turkey. The Hospital Anxiety and Depression Scale and the Diabetes Obstacles Questionnaire were used to collect data. Multiple linear regression analysis was performed to explore the predictors of obstacles to coping in patients with T2DM.

Results
The highest mean score was achieved on the obstacles to coping with diabetes (2.57 ± 3.78) among the subscales of the Diabetes Obstacles Questionnaire. After regression analysis, level of treatment compliance was identified as the most significant predictor (β = .289, p < .001). Anxiety, depression, smoking status, and highest level of education were also identified as significant predictors.

Conclusions
On the basis of these results, nurses should plan and implement interventions to improve treatment compliance and assist patients to overcome obstacles to disease management. Moreover, patient anxiety, depression, and lifestyle behaviors should be addressed.
The Relationship Between Positive Perceptions Toward Organizational Politics and the Work-Related Outcomes of Nurses
Authors: MOVAHEDI Ali , BIDKHORI Mohammad , ARAZI Tajmohammad , KHALEGHIPOUR Mostafa , AMINI Fatemeh 
Published: May 2020

ABSTRACT

Background
Organizational politics (OP) exists to varying degrees in all organizations. OP plays an important role in creating synergy between employees and the goals of the organization.

Purpose
We aimed to investigate the relationship between positive perceptions toward OP and work-related outcomes in nurses, including stress level, burnout level, turnover intention, and job satisfaction.

Methods
This descriptive, analytical study was conducted from April to June 2018 on nurses at Neyshabur University of Medical Sciences Hospitals in Neyshabur, northeastern Iran. The study included 280 nurses working in two teaching hospitals. Five standardized tools were used, including the Perception of Organizational Politics Scale, the Nursing Stress Scale, the Burnout Measure Scale, the Turnover Intention Inventory Scale, and the Minnesota Satisfaction Questionnaire.

Results
The results indicate that the participants did not hold positive perceptions toward OP. The mean Perception of Organizational Politics Scale score was 2.63 ± 0.55. Multiple linear regression analyses showed a significant and positive relationship between positive perception toward OP and job satisfaction and a negative relationship between positive perception toward OP and turnover intention, burnout, and job stress.

Conclusions
Nurses who perceive the work environment to be political will experience greater levels of stress, turnover intention, and burnout and lower levels of job satisfaction. Politics is an issue that should be handled by all levels of management. Managers should use supportive, nonpolitical workplace strategies to improve the work-related outcomes of employees.
Twenty-eight years of experience measuring autonomy using the Dempster Practice Behavior Scale
Authors: Goolsby Mary Jo , Pierson Charon A. , Sheer Barbara 
Published: May 2020

ABSTRACT

Background:
Autonomy in practice is an important attribute of all professions and a cornerstone of advanced nursing practice. The Dempster Practice Behavior Scale was conceptualized, constructed, and psychometrically tested to make available a generalizable, empirically sound, and useful tool capable of measuring previously unrecognized dimensions of autonomy in practice. Nurse practitioner (NP) practice continues to evolve as new models of care emerge, requiring more autonomy in the NP role.

Purpose:
The purpose was to describe the development and psychometric testing of the Dempster Practice Behavior Scale (DPBS), review the extant research on its use in research on nursing and other professions, and determine where future research is needed on the concept of autonomy in professional practice with a focus on advanced practice registered nurses (APRNs).

Methods:
Research articles, theses, dissertations using the DPBS as an instrument to measure practice autonomy were reviewed.

Results:
Twenty-one unique publications were examined for reports of psychometric properties in various populations. For the APRN population (total N = 1,669 in 10 studies), psychometrics for the DPBS support the reliability of the instrument for research. The remaining 11 studies included 2,285 participants who were not APRNs.

Implications for practice:
Questions remain about the relationships between autonomy and external factors such as regulatory environment, practice setting, models of care, years of experience, and practice mix.
Implementation of a new cardiology hospital service leveraging nurse practitioners to improve patient access and outcomes
Authors: Horne Michael P. , Estes Krista R. 
Published: May 2020

ABSTRACT

Background:
Delays in patient access due to excessive wait times for clinic consult appointments impair timely diagnosis and treatment, resulting in worse outcomes.

Local problem:
Average days wait (ADW) for clinic consult appointments for the cardiology group of a regional managed care organization was too long. A quality improvement project (QIP) was undertaken to improve efficiency/efficacy of patient coverage and reduce ADW by implementing a new cardiology hospital service with expanded roles for nurse practitioners (NPs).

Methods and intervention:
The QIP used the Institute for Healthcare Improvement's Model for Improvement. The new cardiology hospital service deployed a group of 11 cardiologists and three cardiology NPs who rotated between hospital and clinic service. Two cardiologists and one NP covered all cardiology inpatients, alleviating the need for clinic-assigned cardiologists to also see hospitalized patients, thus improving capacity. The primary measure was ADW, whereas secondary measures included patient satisfaction with access, hospital readmissions, clinic cancellations, and provider job satisfaction.

Results:
All measures were assessed on pre/post 6-month averages. Average days wait reduced from 28 to 14; patient satisfaction improved from 39% to 52%; readmissions reduced from 13.2% to 9.7%, and provider job satisfaction with the intervention was 91% positive. There were no significant changes in potential confounding factors and no identified negative consequences.

Conclusions:
Implementation of a cardiology hospital service leveraging NPs was feasible, increased capacity to improve patient access and associated outcomes, and did not manifest any known adverse impacts.
Extracorporeal shockwave therapy combined with alginate dressing for treatment of sacroiliac decubital necrosis in older adults
Authors: Duan Haoyang , Li He , Liu Hongying , Zhang Hong , Liu Na , Dong Qingjun , Li Zhenlan 
Published: May 2020

Abstract

Rationale:
Pressure sores are major clinical problems with limited treatment options.

Patient concern:
A 62-year-old man, admitted with unresponsive, indifferent mood, and malnutrition. A noval-shaped skin lesion deeping into the fascia was found in the sacrococcygeal region.

Diagnosis:
The patient was diagnosed with delayed carbon monoxide poisoning encephalopathy and stage IV sacrococcygeal pressure sores.

Intervention:
The patient received neurologic rehabilitation therapy and simple debridement dressing care followed by extracorporeal shockwave therapy.

Outcomes:
The scores for the pressure ulcer healing scale were 17 points, 13 points, 9 points, and 5 points, respectively, before treatment and at the 4-, 8-, and 12-week follow-ups. At 2 weeks after discharging the total pressure ulcer healing scale score was 0, which signifies that the sacroiliac decubital necrosis healed without adverse reactions and side effects.

Lessons:
This study presents a therapeutic solution for treating older adults with pressure ulcers by using extracorporeal shockwave with alginate dressing, which proved effective and safe.
In vivo investigation on bio-markers of perimenopausal panic disorder and catgut embedding acupoints mechanism
Authors: Chen Guizhen , Wang Xue , Zhang Shuo , Xu Xiaokang , Liang Junquan , Xu Yunxiang 
Published: May 2020

Abstract

Background:
Panic disorder (PD), defined by repeated and unexpected panic attacks, severely affects patients’ living quality and social function. Perimenopausal women are high-risk group of PD and suffer greatly from it. Modern medicine therapies for this disorder have many side reactions and poor effects, so nonpharmacological modality is an urgent need. Although acupoint catgut embedding is widely used in clinical practice, there is no persuasive evidence of its effect for perimenopausal PD. The aim of this study is to investigate the effectiveness and safety of acupoint catgut embedding for perimenopausal PD and to elucidate the correlations among brain neural activation, bio-markers (amino acids) and clinical outcomes with radiographic evidence, thus to explore its neural mechanism.

Methods:
The parallel designed, exploratory randomized controlled trial will include 70 outpatients with perimenopausal PD recruited from two hospitals of Chinese Medicine. These subjects will be randomly allocated to an intervention group (Group Embedding) and a control group (Group Medication) in a 1:1 ratio. The subjects in the intervention group will receive acupoint catgut embedding treatment two weeks a time in the following predefined acupuncture points: Shenshu (BL23), Sanyinjiao (SP6), Guanyuan (RN4), Ganshu (BL18), Zusanli (ST36) and Pishu (BL20). The included women of the control group will take 0.4 mg Alprazolam tablet orally, 1 tablet a time, 3 times a day. There is a study period of 3 months and a follow-up period of 1 month for each group. The primary outcomes will be the following therapeutic indexes: the frequency of panic attack, Panic Disorder Severity Score (PDSS), and Panic-associated Symptoms Score (PASS) during the observation period and follow-up period. The changes in Hamilton Anxiety Scale (HAMA) Score and Symptom Checklist 90 (SCL-90) Score will also be compared between these two groups. Additionally, functional magnetic resonance imaging (fMRI) and proton magnetic resonance spectroscopy (1H-MRS) scans will be done before and after the observation period to show cranial neuroimaging changes.

Discussion:
We present a study design and rationale to explore the effectiveness and neural mechanism of acupoint catgut embedding for perimenopausal PD. There are still several factors restrict our research such as no unified standard of diagnostic criteria and curative effect evaluation.

Trial registration:
Chinese Clinical Trial Registry, ChiCTR-INR-16009724, registered in November 2016.