bluuebunny/crossref_metadata_2025_split huggingface dataset:
Isolated Increased Intracranial Pressure and Unilateral Papilledema in an Infant With Traumatic Brain Injury and Nondepressed Basilar Skull Fracture
Authors: Dunnick Jennifer , Gesteland Per 
Published: November 2019

Abstract
Traumatic brain injury is one of the most common pediatric injuries; totaling more than 500,000 emergency department visits per year. When the injury involves a skull fracture, sinus venous thrombosis and the risk of resultant increased intracranial pressure (ICP) are a concern. We describe a previously healthy 11-month-old female infant with nondepressed skull fracture who developed increased ICP in the absence of intracranial changes on imaging. Funduscopic examination revealed unilateral papilledema, and opening pressure on lumbar puncture was elevated at 35 cm of H2O. Computed tomography scan demonstrated a nondepressed occipital bone fracture. However, further imaging, including magnetic resonance imaging with angiogram/venogram, did not reveal any intracranial abnormalities. In particular, there was no evidence of sinus venous thrombosis. Given her presentation and signs of increased ICP, she was started on acetazolamide and improved dramatically. A thorough literature search was completed but yielded no information on infants with increased ICP after nondepressed skull fracture in the absence of radiographic findings to suggest a cause for the increase in pressure. Trauma alone can lead to increased ICP secondary to several processes, although this is expected in moderate to severe head trauma. Our case demonstrates that increased ICP can be present in infants with mild traumatic brain injury in the absence of intracranial pathology. This should be considered in patients who present with persistent vomiting that is refractory to antiemetics.
A Novel Approach for Workforce Surveillance at the US Department of Health and Human Services
Authors: Abeysekara Purni , Coronado Fátima , Glynn M. Kathleen , Simone Patricia M. 
Published: November 2019

Background:
Expert groups have recommended ongoing monitoring of the public health workforce to determine its ability to execute designated objectives. Resource- and time-intensive surveys have been a primary data source to monitor the workforce. We evaluated an administrative data source containing US Department of Health and Human Services (HHS) aggregate federal civil service workforce-related data to determine its potential as a workforce surveillance system for this component of the workforce.

Methods:
We accessed FedScope, a publicly available online database containing federal administrative civilian HHS personnel data. Using established guidelines for evaluating surveillance systems and identified workforce characteristics, we evaluated FedScope attributes for workforce surveillance purposes.

Results:
We determined FedScope to be a simple, highly accepted, flexible, stable, and timely system to support analyses of federal civil service workforce-related data. Data can be easily accessed, analyzed, and monitored for changes across years and draw conclusions about the workforce. FedScope data can be used to calculate demographics (eg, sex, race or ethnicity, age group, and education level), employment characteristics (ie, supervisory status, work schedule, and appointment type), retirement projections, and characterize the federal workforce into standard occupational categories.

Conclusions:
This study indicates that an administrative data source containing HHS personnel data can function as a workforce surveillance system valuable to researchers, public health leaders, and decision makers interested in the federal civil service public health workforce. Using administrative data for workforce development is a model that can be applicable to federal and nonfederal public health agencies and ultimately support improvements in public health.
Changing Leadership Behaviors in a Public Health Agency Through Coaching and Multirater Feedback
Authors: Dean Hazel D. , Myles Ranell L. , Porch Tichelle , Parris Stephanie , Spears-Jones Crystal 
Published: November 2019

Context:
Public health managers' leadership skills can be improved through multirater feedback and coaching.

Objective:
To explore to what extent participation in a coaching intervention influences leadership behaviors of first- and second-level leaders in a federal public health agency.

Design:
Team leads and branch chiefs in the Centers for Disease Control and Prevention's (CDC's) National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP) were invited to participate in the Coaching and Leadership Initiative (CaLI), which incorporates the US Office of Personnel Management (OPM) Leadership 360 assessment, 6 coaching sessions, and 2 in-depth interviews.

Setting:
NCHHSTP is one of 16 CDC national centers, institute, and offices.

Participants:
Staff serving as team leads or branch chiefs.

Main Outcome Measures:
Two in-depth interviews explored CaLI's influence on leadership behaviors regarding the government-wide Leading People executive core qualification.

Results:
A total of 103 (93%) CaLI participants completed the OPM 360 feedback, 82 (80%) completed leadership coaching; 71 of 82 (87%) completed phase 1 interview, and 46 of 71 (65%) completed phase 2 interview. Eighty unique participants completed 1 or more interviews; all indicated that CaLI helped provide new perspectives, practices, and approaches that led to better communication and relationships, different approaches to conflict resolution, and awareness of individual leadership practices. Of the 71 participants who completed phase 1 evaluation, 66 (93%) said they made changes in developing others, 56 (79%) completed conflict management and team building, and 16 (23%) completed leveraging diversity. Of the 46 participants who completed both phase 1 and phase 2 interviews and among those who made changes post-CaLI, 23 of 26 (88%) sustained those leadership changes in developing others, 21 of 27 (78%) in team building; 24 of 34 (71%) in conflict management; and 5 of 10 (50%) in leveraging diversity.

Conclusions:
This study demonstrates the benefits and effectiveness of using multirater feedback and leadership coaching for first- and midlevel public health leaders.
Risk Factors for and Trends in Isoniazid Monoresistance at Diagnosis of Tuberculosis—United States, 1993-2016
Authors: Iqbal Shareen A. , Armstrong Lori R. , Kammerer J. Steve , Truman Benedict I. 
Published: November 2019

Context:
Resistance to isoniazid (INH) only (monoresistance), with drug susceptibility to rifampin, pyrazinamide, and ethambutol at diagnosis of tuberculosis (TB) disease, can increase the length of treatment.

Objective:
To describe US trends in INH monoresistance and associated patient characteristics.

Design:
We performed trend and cross-sectional analyses of US National Tuberculosis Surveillance System surveillance data. We used Joinpoint regression to analyze annual trends in INH monoresistance and logistic regression to identify patient characteristics associated with INH monoresistance.

Participants:
Culture-positive cases reported to National Tuberculosis Surveillance System during 1993-2016 with drug susceptibility test results to INH, rifampin, pyrazinamide, and ethambutol.

Main Outcome Measures:
(1) Trends in INH monoresistance; (2) odds ratios for factors associated with INH monoresistance.

Results:
Isoniazid monoresistance increased significantly from 4.1% of all TB cases in 1993 to 4.9% in 2016. Among US-born patients, INH monoresistance increased significantly from 2003 onward (annual percentage change = 2.8%; 95% confidence interval: 1.4-4.2). During 2003-2016, US-born persons with INH-monoresistant TB were more likely to be younger than 65 years; to be Asian; to be human immunodeficiency virus–infected; or to be a correctional facility resident at the time of diagnosis. Among non–US-born persons, INH resistance did not change significantly during 1993-2016 (annual percentage change = −0.3%; 95% confidence interval: –0.7 to 0.2) and was associated with being aged 15 to 64 years; being Asian, black, or Hispanic; or having a previous history of TB.

Conclusions:
INH-monoresistant TB has been stable since 1993 among non–US-born persons; it has increased 2.8% annually among US-born persons during 2003-2016. Reasons for this increase should be further investigated.
Core Competency Gaps Among Governmental Public Health Employees With and Without a Formal Public Health Degree
Authors: Taylor Heather L. , Yeager Valerie A. 
Published: November 2019

Objectives:
To examine the role of a formal public health degree as it relates to core competency needs among governmental public health employees.

Design:
This cross-sectional study utilizes the 2017 Public Health Workforce Interests and Needs Survey (PH WINS). Bivariate relationships were analyzed by conducting χ2 tests of respondents' supervisory level and reported skill gaps. Multivariate logistic regressions of reported skill gaps were performed holding gender, age, race/ethnicity, highest degree attained, current employer, role type, tenure in current agency, and public health certificate attainment constant.

Setting:
Nationally representative sample of government public health employees.

Participants:
A total of 30 276 governmental public health employees.

Main Outcome Measure:
Self-reported competency skills gaps.

Results:
Among nonsupervisors, those with a public health degree had significantly lower odds of reporting a competency gap for 8 of the 21 skills assessed. Among supervisors/managers, those who had a formal public health degree had significantly lower odds of reporting a competency gap in 3 of the 22 skills assessed. Having a degree in public health was not significantly related to an executive's likelihood of reporting a skill gap across any of the 22 skills assessed. Regardless of supervisory level, having a public health degree was not associated with a reduced likelihood of reporting skill gaps in effective communication, budgeting and financial management, or change management competency domains.

Conclusions:
Possessing a formal public health degree appears to have greater value for skills required at the nonsupervisor and supervisor/manager levels than for skills needed at the executive level. Future work should focus on longitudinal evaluations of skill gaps reported among the public health workforce as changes in public health curricula may shift over time in response to newly revised accreditation standards. In addition, public health education should increase emphasis on communication, budgeting, systems thinking, and other management skills among their graduates.
A Surveillance Data-Based Model System for Assessing the Effects of HIV Intervention and Prevention Strategies
Authors: Song Ruiguang , Green Timothy A. , Hall H. Irene 
Published: November 2019

Objective:
Build a dynamic model system to assess the effects of HIV intervention and prevention strategies on future annual numbers of new HIV infections, newly diagnosed cases of HIV infection, and deaths among persons infected with HIV.

Design and Setting:
Model parameters are defined to quantify the putative effects of HIV prevention strategies that would increase HIV testing, thereby diagnosing infection earlier; increase linkage to care and viral suppression, thereby reducing infectiousness; and increase the use of preexposure prophylaxis, thereby protecting persons at risk of infection. Surveillance data are used to determine the initial values of the model system's variables and parameters, and the impact on the future course of various outcome measures of achieving either specified target values or specified rates of change for the model parameters is examined.

Participants:
A hypothetical population of persons with HIV infection and persons at risk of acquiring HIV infection.

Main Outcome Measures:
HIV incidence, HIV prevalence, proportion of persons infected with HIV whose infection is diagnosed, and proportion of persons with diagnosed HIV infection who are virally suppressed.

Results:
A model system based on the basic year-to-year algebraic relationships among the model variables and relying almost exclusively on HIV surveillance data was developed to project the course of HIV disease over a specified time period. Based on the most recent HIV surveillance data in the United States—which show a relatively high proportion of infections having been diagnosed but a relatively low proportion of diagnosed persons being virally suppressed—increasing the proportion of diagnosed persons who are virally suppressed and increasing preexposure prophylaxis use appear to be the most effective ways of reducing new HIV infections and accomplishing national HIV prevention and care goals.

Conclusions:
Both having current and accurate information regarding the epidemiologic dynamics of HIV infection and knowing the potential impact of prevention strategies are critical in order for limited HIV prevention resources to be optimally allocated.
Pain from torture: assessment and management
Authors: Amris Kirstine , Jones Lester E. , Williams Amanda C de C. 
Published: November 2019

Abstract

Introduction:
Survivors of torture are for many reasons at particularly high risk for inadequate assessment and management of pain. Among the many health problems associated with torture, persistent pain is frequent, particularly pain in the musculoskeletal system. The pathophysiology underlying post-torture pain is largely unknown, but pain inflicted in torture may have profound effects on neurophysiology and pain processing.

Methods:
A narrative review of assessment and treatment studies, informed by clinical experience, was undertaken.

Results:
The clinical presentation in survivors of torture shares characteristics with other chronic primary pain syndromes, including chronic widespread pain. Unfortunately, such pain is often misunderstood and dismissed as a manifestation of psychological distress, both in specialist psychosocially oriented torture services and in mainstream health care. This means that pain is at risk of not being recognized, assessed, or managed as a problem in its own right.

Conclusions:
The available research literature on rehabilitation for torture survivors is predominantly targeted at mental health problems, and studies of effectiveness of pain management in torture survivors are lacking. Rehabilitation is identified as a right in the UN Convention on Torture, aiming to restore as far as possible torture survivors' health and capacity for full participation in society. It is therefore important that pain and its consequences are adequately addressed in rehabilitative efforts. This article summarizes the current status on assessment and management of pain problems in the torture survivor.
The Impact of Plastic Surgery Training on Family Planning and Prenatal Health
Authors: Bourne Debra A. , Chen Wendy , Schilling Benjamin K. , Littleton Eliza Beth , Washington Kia M. , De La Cruz Carolyn 
Published: November 2019

Background:
Plastic surgery trainees who wish to start a family face challenges. This is the first study to collect data directly from residents and fellows to understand issues surrounding childbearing and to propose solutions.

Methods:
Following institutional review board approval, an anonymous survey was distributed to all current plastic surgery residents and fellows in the United States. Data regarding demographics, obstetrical complications, parental leave, breastfeeding, and use of assisted reproductive technology were collected.

Results:
The survey was completed by 307 trainees, for a resident response rate of 27.0 percent. Mean age of the respondents was 31.7 ± 3.8 years, 58.6 percent were married, and 35.3 percent reported at least one pregnancy for themselves or for their partner. Both male (67.4 percent) and female (76.5 percent) respondents intentionally postponed having children because of career. Women were significantly more likely to report negative stigma attached to pregnancy (70.4 percent versus 51.1 percent; p = 0.003) and plan to delay childbearing until after training. Fifty-six percent of female trainees reported an obstetrical complication. Assisted reproductive technology was used by 19.6 percent of trainees. Mean maternity leave was 5.5 weeks, with 44.4 percent taking less than 6 weeks. Mean paternity leave was 1.2 weeks. Sixty-two percent of women and 51.4 percent of men reported dissatisfaction with leave. Sixty-one percent of female trainees breastfed for 6 months and 19.5 percent continued for 12 months. Lactation facilities were available near operating rooms for 29.4 percent of respondents.

Conclusions:
Plastic surgery training may negatively impact fertility, obstetrical health, and breastfeeding practices. The data presented in this article provide the groundwork for identifying areas of concern and potential solutions.
Outcomes of Breast Reduction Surgery Using the BREAST-Q: A Prospective Study and Comparison with Normative Data
Authors: Crittenden Tamara A. , Watson David I. , Ratcliffe Julie , Griffin Philip A. , Dean Nicola R. 
Published: November 2019

Background:
This study aimed to assess breast-related satisfaction and well-being in women with breast hypertrophy before and after breast reduction surgery, and to compare these scores with Australian general population norms, using the BREAST-Q Reduction module.

Methods:
A prospective cohort study was conducted between March of 2010 and February of 2016. Participants self-completed the BREAST-Q preoperatively and 12 months postoperatively. Normative BREAST-Q data were generated from women aged 18 years and older for comparison. Statistical analysis was performed and values of p < 0.05 were considered significant.

Results:
The BREAST-Q was completed by 132 participants preoperatively and 12 months postoperatively. Statistically significant improvements were found following surgery in Satisfaction with Breasts, Psychosocial Well-being, Sexual Well-being, and Physical Well-being. In comparison with normative data, patients with breast hypertrophy had significantly lower scores preoperatively, with scores significantly increasing postoperatively to levels representative of the general population. Satisfaction with outcome was not significantly different between patients who were eligible by traditional insurance requirements (Schnur sliding scale/500-g minimum rule) and those who were not. The presence of surgical complications did not affect change in BREAST-Q scores or postoperative satisfaction with outcome. Differences were observed in mean BREAST-Q scores when comparing generated Australian norms to published U.S. norms.

Conclusions:
Breast reduction surgery significantly improves the satisfaction and quality of life in women with breast hypertrophy to a level that is at least equivalent to that of the normative population. Surgery is of benefit to all women, including those who do not meet traditional insurance requirements.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.
Breast-Related Quality of Life in Young Reduction Mammaplasty Patients: A Long-Term Follow-Up Using the BREAST-Q
Authors: Krucoff Kate B. , Carlson Anna R. , Shammas Ronnie L. , Mundy Lily R. , Lee Hui-Jie , Georgiade Gregory S. 
Published: November 2019

Background:
Reduction mammaplasty is the most effective means of improving symptoms of macromastia. Although studies have shown lasting benefits in adult patients, there is a paucity of data that explore this topic in young patients. In this study, the long-term satisfaction and well-being of young reduction mammaplasty patients was assessed.

Methods:
A retrospective review was performed for all female patients younger than 25 years who underwent reduction mammaplasty performed by a single surgeon from 1980 to 2003. Demographic characteristics, comorbidities, surgical details, and length of follow-up were recorded. Participants completed the postoperative version of the BREAST-Q Reduction module. Responses were scored on a scale of 0 to 100. Scores were summarized with descriptive statistics and compared to normative values.

Results:
Thirty-seven of 52 eligible participants completed the survey (response rate, 71.2 percent). Median age at surgery was 21 years (range, 12.4 to 24.6 years), and median follow-up was 21.4 years (range, 11.4 to 32.4 years). Overall, participants demonstrated high satisfaction and well-being. Mean Q-Scores for Satisfaction with Breasts and Sexual Well-being were significantly higher than normative values (p = 0.0012 and p < 0.0001, respectively), and were as follows: Satisfaction with Breasts, 66.6 ± 16.5 (normative, 57 ± 16); Psychosocial Well-being, 75.9 ± 21.3 (normative, 68 ± 1 9); Sexual Well-being, 72 ± 18.2 (normative, 55 ± 19); and Physical Well-being, 81.1 ± 13.6 (normative, 76 ± 11).

Conclusions:
Young reduction mammaplasty patients experience excellent breast-related quality of life decades after surgery. Compared with normative values, young reduction mammaplasty patients reported higher satisfaction with breasts and sexual well-being. Surgeons and third-party payers should be aware of these data and advocate for young patients to gain access to care.
The Effects of Facial Lipografting on Skin Quality: A Systematic Review
Authors: van Dongen Joris A. , Langeveld Mirte , van de Lande Lara S. , Harmsen Martin C. , Stevens Hieronymus P. , van der Lei Berend 
Published: November 2019

Background:
Autologous lipografting for improvement of facial skin quality was first described by Coleman in 2006. The current dogma dictates that adipose tissue–derived stromal cells that reside in the stromal vascular fraction of lipograft contribute to skin rejuvenation (e.g., increased skin elasticity), a more homogenous skin color, and softening of skin texture. Nowadays, many studies have been reported on this “skin rejuvenation” effect of autologous fat grafting. This systematic review was undertaken to assess the efficacy of autologous lipografting on skin quality.

Methods:
The MEDLINE, Embase, Cochrane Central, Web of Science, and Google Scholar databases were searched for studies evaluating the effect of autologous lipografting on facial skin quality (May 11, 2018). Outcomes of interest were skin texture, color, and elasticity in addition to histologic outcomes and number of complications.

Results:
Nine studies were included, with 301 patients treated in total. No meta-analysis could be performed because of heterogeneity of the metrics and outcomes. Eight studies reported increased skin elasticity; improvement in skin texture; and a more homogeneous skin color after treatment with lipografting, cellular stromal vascular fraction, or nanofat. One study reported no increased skin elasticity after lipografting. Histologic improvement was seen after lipografting and adipose tissue–derived stromal cell injections. However, in general, the level of evidence of the included studies was low. No serious complications were reported.

Conclusion:
Autologous facial lipografting and cellular stromal vascular fraction and adipose tissue–derived stromal cell injections hardly seem to improve facial skin quality but can be considered a safe procedure.