bluuebunny/crossref_metadata_2025_split huggingface dataset:
Conflict resolution between physicians and nurse practitioners
Authors: Blackwell Christopher W. , Faraci Nicholas 
Published: September 2020

ABSTRACT

Background:
In the United States health care system, nurse practitioners (NPs) and physicians work very closely in the delivery of high-quality patient care across lifespans and acuities. In fact, advanced practice nurses work closer with physicians in their day-to-day care delivery than with any other group of professionals. This remains true even in states with independent practice for NPs. Because of the significant relationships between physicians and NPs, assessment of how these professionals resolve conflict is essential.

Purpose:
The purpose of this study was to determine the style of conflict resolution employed by NPs and physicians.

Methods:
Nurse practitioners (n = 57) and physicians (n = 58) were randomly sampled from the Florida Department of Health—Health Care Practitioner Data Portal (N = 115). Participants completed a demographic questionnaire assessing experience in conflict resolution training and the Rahim Organizational Conflict Inventory—II, Form C, which defined the style of conflict resolution they most used and preferred.

Results:
Results showed that 29.8% of physicians and 40.4% of NPs received formal conflict resolution/management education/training (p = .24). The dominant style of conflict resolution used for 78% of physicians and 74% of NPs was the integrating style, with no statistical difference between the two professions (p = .87).

Implications for practice:
Physicians and NPs lack formal education on conflict resolution in their graduate studies. In addition, both professionals tend to use similar styles of conflict resolution among one another in clinical practice, which affects their collaboration and ultimately how optimal care is delivered to patients.
Evaluation of an electronic clinical algorithm to improve screening and evaluation of college students for depressive symptoms
Authors: Webb Chris , Owens Heather , Hager Kathy , Lindsay Ta'Neka , Steinbock Stacie 
Published: September 2020

ABSTRACT

Background:
Depression is higher among college students compared with the general population, and lesbian, gay, bisexual, transgender and questioning/queer (LGBTQ+) persons have higher rates than heterosexuals. Evidence supports the implementation of automated depressive symptoms screenings to improve provider compliance.

Local problem:
A student health clinic at a private, catholic university did not consistently collect Patient Health Questionnaire 2 (PHQ-2) and Patient Health Questionnaire 9 (PHQ-9) depressive screening scores or sexual orientation and gender identity (SOGI) data.

Methods:
The Plan-Do-Study-Act method of quality improvement was used to improve depressive symptom screenings and SOGI data collection. Baseline assessment included a review of patient medical records during a 10-week period before the intervention.

Interventions:
Patient Health Questionnaire 2 data were collected electronically and PHQ-9 data were collected automatically when indicated. Sexual orientation and gender identity data were added to the electronic intake form. The project was evaluated by: (1) comparing preimplementation and postimplementation compliance of PHQ-2 and PHQ-9 screenings; (2) assessing SOGI data collection; and (3) comparing LGBTQ+ and heterosexual student's PHQ-2 scores.

Results:
Preimplementation data revealed a PHQ-2 compliance rate of 44.3%, with 0% PHQ-9 compliance, and no self-reported SOGI data collection. Postimplementation, PHQ-2 and PHQ-9 compliance increased to 93.2% and 100%, respectively. Patient Health Questionnaire 2 scores did not differ between LGBTQ+ and heterosexual students.

Conclusions:
The electronic clinical algorithm increased PHQ-2 and PHQ-9 data collection, supporting automated screenings for depressive symptoms. Collection of SOGI data also improved, thus potentially improving health outcomes. No differences between LGBTQ+ and heterosexual student's depressive symptoms were identified.
Use of an educational intervention to increase screening for antenatal depression in an obstetrics and gynecology practice
Authors: VanderWall Rachel , Haefner Judy , Wehbe-Alamah Hiba 
Published: September 2020

ABSTRACT

Background:
Depression affects approximately 12% of pregnant women and increases maternal and fetal risk during pregnancy and the postpartum period. The United States Preventative Services Task Force and the American College of Obstetricians and Gynecologists recommend that all prenatal care include depression screening. This study assessed the effectiveness of an educational intervention to increase screening for depression during prenatal care.

Local problem:
The clinical site serves a socioeconomically and culturally high-risk population. Prior to the intervention, prenatal depression screening was not incorporated into prenatal care.

Methods:
Health records of patients presenting for prenatal care to an obstetrics and gynecology clinic were analyzed before an educational intervention on prenatal depression was delivered to providers at the practice site. Data for prenatal depression screening rates, treatment plans, and patient demographic information were extracted and compared to determine compliance with antenatal depression screening guidelines.

Interventions:
The primary intervention of this initiative is the provision of education on the importance of and techniques for prenatal depression screening, diagnosis, and treatment.

Results:
Prenatal depression screening increased from 0% to 27% of patients following the intervention. No significant correlation was found between factors of age, gestational age, gravidity, parity, or marital status. A total of 2.8% of screened patients scored positive for severe depression, 5.7% indicated moderate depression, and 51% indicated mild depression.

Conclusions:
Education and training improves provision of prenatal depression screening, but further work is needed to improve the accurate and timely identification of depression, as well as its appropriate treatment, referral, and follow-up.
Communication, leadership and organizational support facilitate successful transition into practice for nurse practitioners in the emergency department
Authors: Soco Cheryl , Simonovich Shannon D. , Dillon Deborah , Bishop-Royse Jessica , Lattner Christina 
Published: September 2020

ABSTRACT

Background:
Postgraduate programs, specialized academic programs, and national health organizations such as the Institute of Medicine (IOM) have identified and begun addressing the gap in knowledge, skills, and factors for successful transition into practice.

Purpose:
The purpose of this study is to examine the relationships and differences among the personal and community resources that promote successful transition for nurse practitioners (NP) who practice in the emergency department (ED) and the skills or procedures they find difficult to perform independently.

Methods:
A descriptive, correlational, comparative study design was conducted using an online survey administered to a convenience sample of NPs with 6 months to 5 years of experience as an NP.

Results:
Findings from this study identified factors associated with successful and unsuccessful transition into practice and help support positive outcomes for health care institutions, ED patients, and NPs practicing in this specialty area.

Implications for practice:
Support in transition recognizes recommendations set by health care organizations in promoting professional development, safe clinical practice, job satisfaction, and retention. Further study will provide clarity in financial gains and improved patient health outcomes during a time in which complex disease processes and provider shortages continue to weigh heavily on society.
Preparing nurse practitioners to combat the opioid epidemic: A survey of nurse practitioner academic programs in the United States
Authors: Kameg Brayden N. , Fradkin Dina , Mitchell Ann M. 
Published: September 2020

ABSTRACT
Between 1999 and 2017, nearly 400,000 individuals died from opioid-related overdoses in the United States. Nurse practitioners (NPs) can be instrumental in providing care for those with opioid use disorders (OUDs) but must be adequately prepared to do so. Currently, there is limited evidence regarding how NP programs are preparing their graduates to address opioid use. The purpose of this study was to evaluate how NP programs have addressed the opioid epidemic within their curricula, and to evaluate barriers to and facilitators of curricular modifications. Electronic surveys were distributed to all 444 NP program directors in the United States. The survey consisted of 10 questions and inquired about curricular modifications made in regard to OUDs, barriers and facilitators of such modifications, and perceived importance of addressing the opioid epidemic within NP programs. A total of 130 (29.3%) of program directors responded to the survey. Of the program directors who responded, 89 (76.1%) reported that curricular modifications were made to address OUDs. Barriers to curricular modification included limited time, lack of faculty expertise or confidence, and stigma in regard to opioid use. Facilitators included faculty champions, availability of external educational resources, student interest, and financial incentives. Nurse practitioners can treat patients with OUDs, mitigating significant barriers to care reported in light of the opioid epidemic. Graduate NP programs should assure that curricula adequately cover opioid use and related management.
Mastoid Obliteration Using Autologous Bone Dust Following Canal Wall Down Mastoidectomy
Authors: Sioshansi Pedrom C. , Alyono Jennifer C. , Blevins Nikolas H. 
Published: September 2020

Objective:
To describe a technique for mastoid obliteration following canal wall down (CWD) mastoidectomy for chronic otitis media with cholesteatoma, and review its early results in producing a dry, safe ear, and a small mastoid cavity.

Study Design:
Retrospective review.

Setting:
Tertiary referral center.

Patients:
Forty-three consecutive CWD procedures using bone dust obliteration for chronic otitis media.

Intervention:
All patients underwent CWD mastoidectomy and, if indicated, concurrent tympanoplasty and ossicular chain reconstruction. Bone dust harvested from healthy mastoid cortex was used to obliterate selected portions of the tympanomastoid defect. Temporalis fascia and/or an inferiorly-based periosteal flap were used for coverage of the bone dust.

Main Outcome Measures:
Postoperative infection, need for mastoid bowl cleaning, incidence of recurrent cholesteatoma, need for revision surgical intervention.

Results:
At mean follow-up of 29 months, 95% of ears have remained dry and safe since mastoid obliteration, with a lack of symptoms and no evidence of recurrent disease. Cholesteatoma recurrence rate was 5%. Postoperative otorrhea, while rare, was managed successfully with topical medication in all affected patients. Clinical, radiographic, and surgical appearance of grafted bone dust suggests good take with long-term viability.

Conclusions:
The described technique used for mastoid obliteration using autologous bone dust and cartilage is simple, effective, and safe to reduce the size of the mastoid cavity in patients undergoing CWD mastoidectomy. It might help to reduce morbidity by improving the surgeon's control over mastoid bowl size and shape.
Perioperative safety of simultaneous off-pump coronary artery bypass grafting with non-cardiac surgery of moderate-to-severe severity
Authors: Dong Shiyong , Wang Jin , Xiao Feng 
Published: September 2020

Background
To evaluate the perioperative safety of simultaneous off-pump coronary artery bypass grafting (OPCABG) with non-cardiac surgery.

Methods
From September 2013 to January 2019, patients who underwent OPCABG surgery in the Department of Cardiology, Peking University First Hospital were included in this retrospective study. A total of 54 patients who underwent simultaneous surgery were defined as simultaneous surgery group. A total of 108 patients who had recently undergone isolated OPCABG surgery, and had similar vascular reconstruction methods were selected for matching, and these patients were defined as the OPCABG group. The general data and laboratory indicators were detected and were used as baseline data, and the EuroSCORE II scoring system was used to evaluate the surgical risk of patients based on these data. During surgery, intraoperative indicators were assessed and evaluated during surgery. In addition, evaluation of postoperative indicators was performed, including mechanical ventilation time, residence time in ICU, and proportion of perioperative myocardial infarction, perioperative stroke, postoperative renal failure, and surgical wound infection.

Results
All the combined non-cardiac surgeries were assessed to be of moderate-to-severe grade by operative severity scoring system. The analysis of intraoperative indicators showed that there were no significant differences in proportion of emergency or urgent surgery, cases of arterial and venous anastomosis, and proportion of intraoperative blood transfusion between two groups (P > 0.05). Meanwhile, the values of operation time and intraoperative blood loss of patients in simultaneous surgery group were significantly higher than that in OPCABG group (P < 0.05). No perioperative death events occurred in this study. In terms of postoperative indicators, the values of operation duration and intraoperative blood loss of patients in simultaneous surgery group were significantly higher than that in OPCABG group (P < 0.05).

Conclusions
Simultaneous OPCABG surgery with non-cardiac surgeries of moderate-to-severe severity may not be associated with increased postoperative risks when compared with isolated OPCABG.
Characterization of mucosal cytokine profile in ulcerative colitis patients under conventional and anti-TNF-a treatment
Authors: Lopetuso Loris Riccardo , Corbi Maddalena , Scaldaferri Franco , Petito Valentina , Graziani Cristina , Castri Federica , Neri Matteo , Gasbarrini Antonio , Sgambato Alessandro , Papa Alfredo 
Published: September 2020

Objectives
Cytokines play a pivotal role in inflammatory bowel disease (IBD). We investigated the expression of inflammatory and regulatory cytokines in inflamed and uninflamed mucosal samples of ulcerative colitis patients.

Methods
Twenty-five ulcerative colitis patients were enrolled. Bioptic samples from inflamed and not inflamed intestinal areas were obtained. Multiplex analysis for inflammatory and regulatory cytokines was performed. Serum C-reactive protein (CRP) was assessed. Endoscopic Mayo score and histological simplified Geboes score were calculated.

Results
Interleukin (IL)-1Ra, IL-6, IL-8, IL-17, induced Protein (IP)-10, monocyte chemoattractant protein (MCP)-1, macrophage inflammatory protein (MIP)-1a, MIP-1b resulted increased in ulcerative colitis inflamed vs ulcerative colitis not inflamed areas. No differences were registered between conventional and anti-tumor necrosis factor-a regimens. No difference with CRP levels was found. IL-7 resulted reduced in patients with endoscopic Mayo score ≥2. All the not inflamed samples had a Geboes score <2A, while all the inflamed specimens had a Geboes score ≥2B. IL-1Ra resulted increased in the group with a Geboes score ≥4.

Conclusions
Inflamed and adjacent not inflamed mucosal areas in ulcerative colitis patients share detailed inflammatory molecular pathways, but can be differentiated endoscopically and histologically on the basis of specific cytokines levels. This underlines the complexity of the mucosal cytokine network in ulcerative colitis and highlights the major limitations of a single proinflammatory target therapeutic strategy in IBD.
The impact of acute kidney injury on mortality and clinical outcomes in patients with alcoholic cirrhosis in the USA
Authors: Makar Michael , Reja Debashis , Chouthai Abhishek , Kabaria Savan , Patel Anish Vinit 
Published: September 2020

Introduction
Acute kidney injury (AKI) is associated with increased morbidity and mortality in patients with chronic liver disease. Although the impact of AKI on patients with liver disease has been established, its impact on alcoholic cirrhosis has not been studied.

Methods
Our study utilized data from the National Inpatient Sample for the year 2016 for all patients with a diagnosis of alcoholic cirrhosis and AKI. Primary outcomes were mortality, length of stay (LOS) and hospitalization cost were compared. Secondary outcomes were complications of cirrhosis and its impact on mortality. Multivariate logistic regression analysis and propensity-score matching were used to compare the two groups.

Results
A total of 29 906 patients were included and 6733 (22.5%) had AKI. Propensity-matched multivariate analysis demonstrates that AKI was associated with a significant increase risk of mortality [odds ratio (OR): 8.09; 95% confidence interval (CI), 6.68–9.79; P < 0.0001]. AKI prolonged the hospital stay by 3.68 days (95% CI, 3.42–3.93; P < 0.0001) and increased total hospital charges by $50 284 (95% CI, 45 829–54 739; P < 0.0001). AKI increased the risk of complications of cirrhosis, including hepatorenal syndrome (OR: 19.15; 95% CI, 16.1–22.76), ascites (OR: 2.27; 95% CI, 2.11–2.44), hepatic encephalopathy (OR: 2.54; 95% CI, 1.87–3.47) and portal hypertension (OR: 1.08; 95% CI, 1.01–1.16).

Conclusion
AKI in alcoholic cirrhosis significantly increases the risk of mortality, hospitalizations costs and LOS. Further studies are needed on addressing renal failure and treatment options for patients with alcoholic cirrhosis.
Increased Burden of Concordant and Sequential Anogenital Human Papillomavirus Infections Among Asian Young Adult Women With Perinatally Acquired HIV Compared With HIV-Negative Peers
Authors: Sohn Annette H. , Chalermchockcharoenkit Amphan , Teeraananchai Sirinya , Hansudewechakul Rawiwan , Gatechompol Sivaporn , Chokephaibulkit Kulkanya , Dang Hanh Le Dung , Tran Dan Ngoc Hanh , Achalapong Jullapong , Teeratakulpisarn Nipat , Thamkhantho Manopchai , Phanuphak Nittaya , Ananworanich Jintanat , Reiss Peter , Kerr Stephen J. 
Published: September 2020

Background
Youth with perinatally acquired HIV (YPHIV) are at higher risk for anogenital human papillomavirus (HPV) infection.

Methods
We enrolled a cohort of YPHIV and HIV-negative youth in Thailand and Vietnam, matched by age and lifetime sex partners, and followed them up for 144 weeks (to 2017). Participants had annual pelvic examinations with samples taken for HPV genotyping. Concordant infection was simultaneous HPV detection in multiple anogenital compartments (cervical, vaginal, anal); sequential infection was when the same type was found in successive compartments (cervicovaginal to/from anal). Generalized estimating equations were used to assess factors associated with concordant infection, and Cox regression was used to assess factors associated with sequential infection.

Results
A total of 93 YPHIV and 99 HIV-negative women were enrolled, with a median age of 19 years (interquartile range, 18–20 years). High-risk anogenital HPV infection was ever detected in 76 (82%) YPHIV and 66 (67%) HIV-negative youth during follow-up. Concordant anogenital high-risk HPV infection was found in 62 (66%) YPHIV versus 44 (34%) HIV-negative youth. Sequential cervicovaginal to anal high-risk HPV infection occurred in 20 YPHIV versus 5 HIV-negative youth, with an incidence rate of 9.76 (6.30–15.13) versus 2.24 (0.93–5.38) per 100 person-years. Anal to cervicovaginal infection occurred in 4 YPHIV versus 0 HIV-negative women, with an incidence rate of 1.78 (0.67–4.75) per 100 person-years. Perinatally acquired HIV was the one factor independently associated with both concordant and sequential high-risk HPV infection.

Conclusions
Children and adolescents with perinatally acquired HIV should be prioritized for HPV vaccination, and cervical cancer screening should be part of routine HIV care for sexually active YPHIV.
Brief Enhanced Partner Notification and Risk Reduction Counseling to Prevent Sexually Transmitted Infections, Cape Town, South Africa
Authors: Kalichman Seth , Banas Ellen , Kalichman Moira , Dewing Sarah , Jennings Karen , Daniels Johann , Berteler Marcel , Mathews Catherine 
Published: September 2020

Background
Evidence-based interventions are needed to stem sexually transmitted infections (STIs). Clinic-delivered counseling remains an important avenue for effective STI prevention.

Methods
A 3-arm randomized clinical trial compared (a) STI health education control condition, (b) risk reduction counseling, and (c) enhanced partner notification counseling. Men and women (n = 1050) were recruited from an STI clinic in Cape Town, South Africa. After baseline assessments, participants were randomly allocated to receive 1 of the 3 single-session counseling interventions and were followed up for 9 months of behavioral assessments and 12 months of electronic medical records abstraction for STI clinic services.

Results
Sexual risk reduction counseling reported greater condom use than did the other 2 conditions during the 3 and 6 months follow-ups. In addition, women receiving risk reduction counseling were significantly less likely to have returned for STI clinic services but did not differ in the number of STI clinic visits over the year.

Conclusions
Brief single-session STI prevention counseling demonstrates significant targeted outcomes. The findings suggest that counseling approaches to both increase condom use and enhance partner notification may offer more robust and sustained outcomes and should be tested in future research.
Barriers, Facilitators, and Cost of Integrating HIV-Related Activities Into Sexually Transmitted Disease Partner Services in Jackson, Mississippi
Authors: Digre Peder , Avoundjian Tigran , Johnson Kendra , Peyton David , Lewis Christie , Barnabas Ruanne V. , Golden Matthew R. , Khosropour Christine M. 
Published: September 2020

Background
Many US health departments now integrate HIV-related outcomes (e.g., relinkage to HIV care and preexposure prophylaxis [PrEP]) into sexually transmitted disease (STD) partner services (PS) programs. We sought to determine the barriers, facilitators, and cost of integrating these activities into PS.

Methods
From 2016 to 2018, the Mississippi State Department of Health integrated 3 new activities into STD PS: HIV testing for partners of HIV-negative men who have sex with men with gonorrhea/chlamydia, relinkage to HIV care for STD PS recipients previously diagnosed with HIV, and PrEP referrals. We conducted direct observations and interviews with disease intervention specialists (DIS) in Jackson to assess barriers and facilitators to implementing these activities. We completed time and motion studies with 8 DIS and case tracking forms for 90 unique cases to estimate the incremental staff time and associated personnel cost of added services compared with a standard PS case.

Results
Disease intervention specialists were optimistic about integrating HIV-related activities but noted disparate data systems, nonsystematic documentation, and lack of training as barriers. The mean time for a standard STD PS case without HIV-related activities was 195 minutes (cost, $77.69/case). The cost to conduct PS for HIV-negative men who have sex with men with gonorrhea/chlamydia was 36% higher than a standard case. Integrating relinkage to care and PrEP referrals resulted in a 44% and 20% increase in cost, respectively.

Conclusions
Integrating HIV care relinkage and PrEP referrals into STD partner services was generally acceptable by DIS and added marginal cost per case. Coupling these cost metrics with an assessment of the effectiveness of these activities can inform prioritization of partner services activities.