bluuebunny/crossref_metadata_2025_split huggingface dataset:
Inter-Rater Reliability of the Phase of Illness Tool in Pediatric Palliative Care
Authors: Burke Kimberley , Coombes Lucy H. , Petruckevitch Ann , Anderson Anna-Karenia 
Published: March 2020

Background: Phase of Illness is used to describe the stages of a patient’s illness in the palliative care setting. Categorization is based on individual needs, family circumstances, and the adequacy of a care plan. Substantial (κ = .67) and moderate (κ = .52) inter-rater reliability is demonstrated when categorizing adults; however, there is a lack of similar studies in pediatrics. Objective: To test the inter-rater reliability of health-care professionals when assigning pediatric palliative care patients to a Phase of Illness. Furthermore, to obtain user views on phase definitions, ease of assignment, feasibility and acceptability of use. Method: A prospective cohort study in which up to 9 health-care professionals’ independently allocated 80 pediatric patients to a Phase of Illness and reported on their experiences. This study took place between June and November 2017. Results: Professionals achieved a moderate level of agreement (κ = 0.50). Kappa values per phase were as follows: stable = 0.63 (substantial), unstable = 0.26 (fair), deteriorating = 0.45 (moderate), and dying = 0.43 (moderate). For the majority of allocations, professionals report that the phase definitions described patients very well (76.1%), and they found it easy to assign patients (73.5%). However, the unstable phase caused the most uncertainty. Conclusion: The results of this study suggest Phase of Illness is a moderately reliable, acceptable, and feasible tool for use in pediatric palliative care. Current results are similar to those found in some adult studies. However, in a quarter of cases, users report some uncertainty in the application of the tool, and further study is warranted to explore whether suggested refinements improve its psychometric properties.
Factors affecting superficial vein visibility at the upper limb in healthy young adults: A cross-sectional observational study
Authors: Mukai Kanae , Fujii Taiga , Nakajima Yukari , Ishida Asami , Kato Moeka , Takahashi Mao , Tsuda Mihiro , Hashiba Nanami , Mori Namiko , Yamanaka Ayaka , Nakatani Toshio 
Published: March 2020

Objective: Venipuncture is an invasive procedure, and repeated puncture attempts may be uncomfortable or even traumatic for patients. Vein visibility is one of the most influential variables for the failure of venipuncture; however, the factors affecting vein visibility remain unclear. The present study was conducted to identify the factors influencing vein visibility at the upper limb in healthy young adults. Methods: Twenty-seven healthy volunteers were included. All measurements were performed at the right arm, right cubital fossa, and right forearm. The depth and cross-sectional area of superficial veins were measured by ultrasonography. Skin color was assessed by a spectrophotometer and quantified according to Commission International d’Eclairage L*a*b* values. Results: Invisible superficial veins were significantly deeper and had a larger cross-sectional area than visible superficial veins. Skin color b* of invisible superficial veins was significantly higher than that of visible superficial veins. Vein depth, skin color b*, and gender markedly affected superficial vein visibility at the upper limb. The cutoff for vein depth was 2.3 mm (area under the curve = 0.91). Conclusion: The present results confirmed that vein depth, skin color b*, and gender strongly influenced vein visibility at the upper limb. The cutoff for vein depth was 2.3 mm.
Exploring the role of lay and professional patient navigators in Canada
Authors: Reid Amy E , Doucet Shelley , Luke Alison 
Published: March 2020

Objectives To explore the roles of patient navigators in different settings and situations for various patient populations and to understand the rationale for implementing lay and professional models of patient navigation in a Canadian context. Methods A qualitative descriptive design was applied, using interviews with 10 patient navigators from eight Canadian provinces, and Braun and Clarke’s six phases of thematic analysis to guide the analysis of interview transcripts. Results Findings indicate that a patient navigator’s personality and experience (personal and work-related) may be more important than their specific designation (i.e. lay or professional). Conclusions Lay and professional navigators in Canada appear to be well suited to provide navigational services across populations. This study has the potential to inform future research, policy, and the delivery of navigation programmes in Canada.
Socio-emotional determinants of depressive symptoms in adolescents and adults with autism spectrum disorder: A systematic review
Authors: Smith Isaac C , White Susan W 
Published: March 2020

Co-occurring problems with mood and anxiety among adolescents and adults on the autism spectrum are highly prevalent and contribute to poor outcomes and diminished quality of life. The current study’s principal aim was to evaluate variation in the presentation of depression symptomatology among adolescents and adults with autism spectrum disorder, specifically to determine if social motivation may be implicated in an autism spectrum disorder–specific subtype of depression. A systematic review was conducted, with an initial search conducted in February 2018 and a search update conducted in November 2019, yielding 48 articles which met inclusion criteria. Results support other recent work indicating that symptoms of depression are highly prevalent among adolescents and adults with autism spectrum disorder. Coding of study variables related to core autism spectrum disorder symptoms provided initial evidence for the proposition of a conceptual model implicating social motivation in the etiology of depression among a subset of individuals with autism spectrum disorder. Lay abstract Many adolescents and adults with autism spectrum disorder experience difficulty with symptoms of depression. These symptoms can contribute to poor quality of life and lack of independence for adolescents and adults. To better understand these symptoms, we conducted a review of articles that examined the presentation of depression specific to autism spectrum disorder. Our goals in conducting this study were (1) to examine whether depression may be associated with symptoms that are common among people with autism spectrum disorder, such as loneliness or poor social motivation; (2) to determine whether people with autism spectrum disorder experience depression in a different way than the general population; and (3) to add to other recent studies that have examined how common depression is in autism spectrum disorder and how it is typically measured. Our study reviewed 48 papers on this topic. Results showed that a substantial proportion of people with autism spectrum disorder experience significant symptoms of depression. We related our results to social factors commonly studied in this field (i.e. social motivation) and proposed a new model for the development of depression in this population.
Organizational justice, burnout, and turnover intention of social workers in China
Authors: Wang Yean , Jiang Nan , Zhang Huan , Liu Ziyu 
Published: March 2020

Summary High turnover rate among Chinese social work practitioners is a big challenge facing the nation’s social work profession. Turnover intention, the determinant predictor of actual turnover, has been widely used instead of the actual turnover. Among many predictors, burnout (exhaustion, cynicism, and professional efficacy) was recognized as a key predictor of turnover intention. In addition, recently, organizational justice is getting more and more attention by social work scholars in affecting employees’ intention to leave the organization. This article aims to empirically test how different dimensions of organizational justice influence social workers’ turnover intention, regarding burnout as a mediator, and including the development and validation of a new organizational justice scale in Chinese context. Findings In total, 616 social workers (223 from Beijing for Study 1 and 393 from Jiangmen for Study 2) participated in the study. The results revealed that interpersonal justice is the most important dimension for predicting social workers’ turnover intention, whereas cynicism plays a mediator role in that relationship. Application Turnover is an organizational behavior. Therefore, it is more important for organization managers and policy makers to consider the factors from organizational conditions that are influencing turnover. This study provides the field of social work in China with solid evidence that more attention should be paid to management issues in solving the challenge of a high turnover rate.
The cluster randomized crossover trial: The effects of attrition in the AB/BA design and how to account for it in sample size calculations
Authors: Moerbeek Mirjam 
Published: March 2020

Background/Aims: This article studies the effect of attrition in the cluster randomized crossover trial. The focus is on the two-treatment two-period AB/BA design where attrition occurs during the washout period. Attrition may occur at either the subject level or the cluster level. In the latter case, clusters drop out entirely and provide no measurements in the second period. Subject attrition can only occur in the cohort design, where each subject receives both treatments. Cluster attrition can also occur in the cross-sectional design, where different subjects are measured in the two time periods. Furthermore, this article explores two different strategies to account for potential levels of attrition: increasing sample size and replacing those subjects who drop out by others. Methods: The statistical model that takes into account the nesting of subjects within clusters, and the nesting of repeated measurements within subjects is presented. The effect of attrition is evaluated on the basis of the efficiency of the treatment effect estimator. Matrix algebra is used to derive the relation between efficiency, the degree of attrition, cluster size and the intraclass correlations: the within-cluster within-period correlation, the within-cluster between-period correlation and (in the case of a cohort design) the within-subject correlation. The methodology is implemented in two Shiny Apps. Results: Attrition in a cluster randomized crossover trial implies a loss of efficiency. Efficiency decreases with an increase of the attrition rate. The loss of efficiency due to attrition of subjects in a cohort design is largest for small number of subjects per cluster-period, but it may be repaired to a large degree by increasing the number of subjects per cluster-period or by replacing those subjects who drop out by others. Attrition of clusters results in a larger loss of efficiency, but this loss does not depend on the number of subjects per cluster-period. Repairing for this loss requires a large increase in the number of subjects per cluster-period. The methodology of this article is illustrated by an example on the effect of lavender scent on dental patients’ anxiety. Conclusion: This article provides the methodology of exploring the effect of attrition in cluster randomized crossover trials, and to repair for attrition. As such, it helps researchers plan their trial in an appropriate way and avoid underpowered trials. To use the methodology, prior estimates of the degree of attrition and intraclass correlation coefficients are needed. It is advocated that researchers clearly report the estimates of these quantities to help facilitate planning future trials.
Can Syndesmosis Screws Displace the Distal Fibula?
Authors: Vance Nicholas G. , Vance Robert C. , Chandler William T. , Panchbhavi Vinod K. 
Published: March 2020

Background. There has been historical debate as to whether the distal tibiofibular syndesmosis can be overtightened during operative fixation. We used finite-element analysis to determine if overtightening of syndesmotic screws can cause widening of the lateral gutter clear space in the ankle joint. Methods. A 3D finite-element model was constructed and analyzed using geometries from a computed tomography scan of a cadaveric lower leg. Starting 2 cm from the plafond, screw fixation was simulated at 5-mm increments to a distance of 5 cm from the plafond. The fibula was compressed 2 mm toward the tibia at each interval, and the change in distance between the lateral talus and distal fibula was measured. Results. Medial deflection of the fibula resulted in widening of the lateral clear space, which was proportional to the amount of deflection. The effect increased as screws were placed closer to the plafond, with 1.5 mm of widening at 2 cm (0.76 mm/mm) versus 0.7 mm at 5 cm (0.34 mm/mm). Conclusion. Our finite-element model demonstrated that overtightening of the distal tibiofibular syndesmosis with medial fibular displacement can cause widening of the lateral clear space. Clinical relevance. The results suggest that screws placed farther from the plafond widen the lateral clear space to a lesser degree, which may be advantageous during surgical fixation to prevent clear space widening and increased tibiotalar contact forces. Levels of Evidence: Level I
Eustachian Tube Quality of Life and Severity of Disease in Patients With Chronic Rhinosinusitis
Authors: Wu Arthur W. , Walgama Evan S. , Higgins Thomas S. , Borrelli Michela , Vardanyan Narine , Hopp Stephanie , Shamsian Arash , Hopp Martin L. 
Published: March 2020

Background Chronic rhinosinusitis (CRS) has long been a suspected risk factor for Eustachian tube dysfunction (ETD). However, there have been few studies quantifying the presence of ETD in CRS patients. We sought to determine the prevalence of ETD symptoms in patients undergoing functional endoscopic sinus surgery (FESS) for CRS using the validated 7-item Eustachian Tube Dysfunction Questionnaire (ETDQ-7) and to correlate the ETDQ-7 scores with scores of CRS symptom severity based on the 22-item Sino-Nasal Outcome Test (SNOT-22). Methods Patients for FESS were preoperatively administered both the ETDQ-7 and the SNOT-22 validated quality of life instruments. Pearson and Spearman correlation coefficients were calculated. Changes in ETDQ-7 were measured at 3 months and differences were compared via paired t test. Results A total of 82 patients completed the surveys. Thirty-nine (47.6%) patients had ETDQ-7 score ≥14.5, signifying clinically significant ETD symptoms. The mean ETDQ-7 score of the study population was 15.8 ± 8.8, and the mean SNOT-22 score was 37.5 ± 19.7. The Pearson and Spearman correlation coefficients between ETDQ-7 and the total SNOT-22 score were 0.52 ( P > .0001) and 0.51 ( P < .0001), respectively. There was significant improvement in ETDQ-7 scores postoperatively. Conclusion While the association between ETD and CRS has long been known, this is one of the few prospective patient studies evaluating otologic symptoms in a CRS population. We found that a significant percentage of CRS patients suffer from ETD symptoms based on patient-reported subjective outcome measures. This study demonstrates that otologic symptoms increase with CRS severity and improve after FESS.
Surgical management of adverse events associated with deep brain stimulation: A single-center experience
Authors: Nonaka Masani , Morishita Takashi , Yamada Kazumichi , Fujioka Shinsuke , Higuchi Masa-aki , Tsuboi Yoshio , Abe Hiroshi , Inoue Tooru 
Published: March 2020

Objectives: Deep brain stimulation is widely used to treat movement disorders and selected neuropsychiatric disorders. Despite the fact, the surgical methods vary among centers. In this study, we aimed to evaluate our own surgical complications and how we performed surgical troubleshooting. Methods: A retrospective chart review was performed to evaluate the clinical data of patients who underwent deep brain stimulation surgery and deep brain stimulation–related procedures at our center between October 2014 and September 2019. We reviewed surgical complications and how surgical troubleshooting was performed, regardless of where the patient underwent the initial surgery. Results: A total of 92 deep brain stimulation lead implantation and 43 implantable pulse generator replacement procedures were performed. Among the 92 lead implantation procedures, there were two intracranial lead replacement surgeries and one deep brain stimulation lead implantation into the globus pallidus to add to existing deep brain stimulation leads in the bilateral subthalamic nuclei. Wound revision for superficial infection of the implantable pulse generator site was performed in four patients. There was neither intracerebral hemorrhage nor severe hardware infection in our series of procedures. An adaptor (extension cable) replacement was performed due to lead fracture resulting from a head trauma in two cases. Conclusion: We report our experience of surgical management of adverse events associated with deep brain stimulation therapy with clinical vignettes. Deep brain stimulation surgery is a safe and effective procedure when performed by a trained neurosurgeon. It is important for clinicians to be aware that there are troubles that are potentially manageable with optimal surgical treatment.
Urethral obstruction and urolithiasis associated with patent urachus in a 12-week-old kitten
Authors: Lavin Lindsey E , Amore Amanda R , Shaver Stephanie L 
Published: March 2020

Case summary A 12-week-old intact male domestic shorthair kitten presented for dysuria. The patient had a urethral obstruction that was relieved with urinary catheter placement. A cutaneous opening at the umbilicus was identified. Three-view abdominal radiographs and a contrast study revealed a patent urachus with no evidence of urine leakage into the abdomen. An exploratory laparotomy was performed that confirmed a patent urachus, which was excised, and cystic and urethral calculi, which were removed via cystotomy. The patient recovered well from surgery, with a 12 h period of stranguria occurring 2 days postoperatively, attributed to residual inflammation. Calculi analysis revealed struvite stones, likely secondary to infection and inflammation. At the time of writing, 3 months postoperatively, the kitten had one episode of hematuria and inappropriate urination, which resolved with a short course of non-steroidal anti-inflammatory drugs, but had been otherwise been asymptomatic and healthy. Relevance and novel information To our knowledge, this is the first report of urolithiasis and patent urachus in a pediatric feline patient. Based on the occurrence of struvite stones in the presence of a patent urachus in an animal of this age, we suspect that chronic infection and inflammation led to the development of urolithiasis. Correction of the patent urachus resulted in almost complete resolution of clinical signs and no crystal formation was appreciated on recheck urinalysis.
Unusual presentation of vitamin D3-dependent rickets type II in a kitten
Authors: Duplan Florent , Maunder Christina 
Published: March 2020

Case summary A 15-week-old kitten presented with a 1-month history of intermittent generalised tremors and abdominal distension. Hypocalcaemia associated with increased 1,25-vitamin D3 was consistent with vitamin D3-dependent rickets type II. The bone appearance on CT scan was most consistent with the changes typically seen with nutritional secondary hyperparathyroidism and less typical of the changes seen with rickets. Our patient had a positive response to high vitamin D3 therapy as it remained normocalcaemic 16 months after diagnosis, supporting the diagnosis of rickets. Relevance and novel information This case report is an unusual and interesting presentation of rickets in a kitten. Despite the characteristic vitamin D3 disturbance for rickets type II, the atypical radiographic changes have not been previously reported. In the literature, a positive response to treatment is not commonly seen or follow-up is short. Our case responded well to treatment and was followed for 16 months from the time of diagnosis. This emphasises that the pathophysiology of the condition is not well understood, and that different types of vitamin D3-dependent rickets type II may exist. Although the genetic defects responsible for some cases of rickets type I have been identified, this has still not been determined for rickets type II.
Policy-Driven Development and the Strategic Initiative of One-Million Enrollment Expansion in China’s Higher Vocational Education
Authors: Fan Xiaoxian 
Published: March 2020

Purpose: This article explores the relationship between governmental policy and the development of higher vocational education in China. Design/Approach/Methods: The article begins with a textual analysis of dozens of policy documents on higher vocational education issued by the Chinese government since 1999. Findings: The article argues that the development of higher vocational education in China has been largely policy-driven. This development can be divided into four stages: scale development, quality improvement, capacity building, and systemwide enhancement. The transition between each of these developmental stages was marked by new policy initiatives undertaken by the Chinese government. Originality/Value: The government’s recent efforts to expand higher vocational education enrollment by one million students have significant implications for China’s higher vocational education. Additionally, the proposed “1 + X” model—which attaches equal importance to academic education and skill training—may represent the beginning of a new stage in the development of higher vocational education in China.
Learning Experience: An Alternative Understanding Inspired by Thinking Through Confucius
Authors: You Yun 
Published: March 2020

Purpose: This article aims to provide an alternative understanding of learning experience in contrast to the dominant constructivist interpretation, and discuss its implication for pedagogy. Design/Approach/Methods: The aim is specifically achieved in the comparison between a review of how experience is understood in constructivism and its philosophical underpinnings and an exploration of how it can be understood alternatively inspired by Confucius’ educational thought and premised on his ontology. Drawing on this philosophical discussion, learning experience is reinterpreted. Findings: Beyond rationally translating experience into knowledge or gaining knowledge on the basis of experience, learning leads students to immediately and consistently experience dao in which tian and ren harmoniously unit. This experience renders aesthetics and religiousness in learning and moral transformation in life events. Originality/Value: By illustrating this ontological alternative of learning experience, this article is an attempt to fundamentally decolonize thinking about pedagogy.
Downstream River Dialogues: An Educational Journey Toward a Planetary-Scaled Ecological Imagination
Authors: Taylor Affrica 
Published: March 2020

Purpose: This article aims to subvert the nature/culture and subject/object divides that structure the dominant Western educational research paradigm by stepping beyond an exclusively human conversation and activating our ecological imaginations in the face of intensifying anthropogenic climate change. Design/Approach/Methods: Informed by animist ecofeminist philosophies, the river dialogues emerged from a climate action research field trip to the Athabasca oil sand mines in Alberta, Canada. They perform a “more-than-human” mode of narrative engagement with “nature in the active voice.” Findings: Despite the epistemological separations of Western-style education, I conclude that we can still find ways to dialogue and learn with the nonhuman world and thereby to stimulate our ecological imaginations. Originality/Value: This article showcases innovative more-than-human narrative methods and offers a collaborative alternative to the human-centric conventions of educational research and pedagogy.