bluuebunny/crossref_metadata_2025_split huggingface dataset:
Changing New Graduate Nurse Profiles and Retention Recommendations for Nurse Leaders
Authors: Tyndall Deborah E. , Scott Elaine S. , Jones Lenna R. , Cook Kristy J. 
Published: October 2019

OBJECTIVE
This study compares and contrasts new graduate nurse attributes and perceptions using findings from a 2010 study and a recent analysis of new graduate nurses participating in the same residency program.

BACKGROUND
As millennials saturate the healthcare work environment, their unique views and needs will influence the evolution of new graduate nurse residencies.

METHODS
This study used previously reported data on new graduate nurses between 1999 and 2009 and compared it with a secondary analysis of data collected on new graduate nurses between 2011 and 2016.

Results
This study provides evidence that millennial new graduate nurses' levels of commitment and satisfaction do not moderate turnover intentions in the 1st 2 years of practice as they did in the previous group of new graduate nurses.

Conclusions
Job embeddedness, a construct that measures the likelihood of whether a person is going to stay, may be a better measurement among new graduate nurses than commitment or satisfaction because millennials, a generation that is predominant in current new graduate nurses, are more engaged than loyal.
The Role of Nurse Managers in the Adoption of Health Information Technology
Authors: Strudwick Gillian , Booth Richard G. , Bjarnadottir Ragnhildur I. , Rossetti Sarah (Collins) , Friesen Madison , Sequeira Lydia , Munnery Mikayla , Srivastava Rani 
Published: October 2019

OBJECTIVE
This study aims to investigate the role of nurse managers in supporting point-of-care nurses' health information technology (IT) use and identify strategies employed by nurse managers to improve adoption, while also gathering point-of-care nurses' perceptions of these strategies.

BACKGROUND
Nurse managers are essential in facilitating point-of-care nurses' use of health IT; however, the underlying phenomenon for this facilitation remains unreported.

METHODS
A qualitative descriptive study was conducted with 10 nurse managers and 14 point-of-care nurses recruited from a mental health hospital environment in Ontario, Canada. Inductive and deductive content analyses were used to analyze the semistructured interviews.

RESULTS
Nurse managers adopt the role of advocate, educator, and connector, using the following strategies: communicating system updates, demonstrating use of health IT, linking staff to resources, facilitating education, and providing IT oversight.

CONCLUSIONS
Nurse managers use a variety of strategies to support nurses' use of health IT. Future research should focus on the effectiveness of these strategies.
Experiences With Managing the Workplace Social Environment
Authors: Price Sheri L. , Vine Jocelyn , Gurnham Mary Ellen , Paynter Martha , Leiter Michael 
Published: October 2019

OBJECTIVE
This study aims to examine 1st-line managers' (FLMs') experiences in managing the workplace social environment (WSE).

BACKGROUND
FLMs are responsible for the establishment and maintenance of supportive WSE essential for effective teamwork. Poorly managed WSE and dysfunctional teams hold negative implications for patients, teams, and organizations.

METHODS
This was a qualitative descriptive study, using content analysis of individual and focus group interviews with FLMs and directors.

RESULTS
FLMs play a critical role in the management of the WSE; however, the task is fraught with constraints and challenges including competing demands, lack of support, and insufficient training. Findings explicate how competing demands and communication challenges impede the successful management of the WSE.

CONCLUSIONS
Given the importance of a healthy WSE to patient, professional, and organizational outcomes, FLMs need support, training, and resources to assist them in managing the social environment alongside other competing priorities.
Low Awareness of and Access to Pre-exposure Prophylaxis But High Interest Among Heterosexual Women in Cleveland, Ohio
Authors: Bogorodskaya Milana , Lewis Steven A. , Krakower Douglas S. , Avery Ann 
Published: October 2019

Abstract
Women received <5% of all US pre-exposure prophylaxis (PrEP) prescriptions in 2016. Among 351 heterosexual women surveyed in Cleveland, Ohio, 14.5% were aware of PrEP, 20.5% knew where to access PrEP, 75.9% were willing to try PrEP, and 50.9% expressed interest in more information.
A Standardized Cardiac Protocol for Pediatric Drug Ingestion Hospital Admissions
Authors: Del Grippo Erica L. , Baskar Shankar , Gray Seth , Osakwe Onyekachukwu , Powell Adam W. , Anderson Jeffrey , Spar David , Madsen Nicolas 
Published: October 2019

Objective:
To optimize patient resource utilization and safety, we created a standard-of-care guideline for pediatric drug ingestion hospital admissions.

Methods:
A multidisciplinary committee developed specific telemetry guidelines for pediatric drug ingestion hospital admissions at a tertiary pediatric hospital. The guidelines stipulated inpatient admission with telemetry monitoring for the following criteria: (1) corrected QT interval (interval between the Q wave and T wave on a standard EKG)≥ 500 ms, (2) ingestion of an antiarrhythmic medication, or (3) ingestion of a tricyclic antidepressant. We created guidelines for electrocardiogram frequency for nontelemetry admissions. We implemented these guidelines in November 2015 in partnership with the Emergency Medicine Department and Poison Control Center. We reviewed medical records of all these admissions between January 1, 2015, and July 31, 2016, and divided patients into preintervention (January 1, 2015 to November 30, 2015) and postintervention (December 1, 2015 to July 31, 2016) groups. We used statistical process control charts and methodology to monitor changes over time.

Results:
There were a total of 622 drug ingestion admissions during the study period. We admitted 69 patients (11%) to the cardiac acute care unit (CACU) for telemetry monitoring. The preintervention period included 61 admissions (5.5 CACU admissions per month). The postintervention period included 8 admissions (1.1 CACU admissions per month). This difference reflects an overall absolute decrease of 87%. There was no evidence of an increase in the rate of intensive care unit utilization, rapid response events, or adverse events in the postintervention period.

Conclusions:
A standardized admission protocol for pediatric drug ingestions can safely improve resource utilization.
Next-of-Kin Involvement in Regulatory Investigations of Adverse Events That Caused Patient Death: A Process Evaluation (Part II: The Inspectors’ Perspective)
Authors: Wiig Siri , Schibevaag Lene , Tvete Zachrisen Rannveig , Hannisdal Einar , Anderson Janet E. , Haraldseid-Driftland Cecilie 
Published: October 2019

Objective
The aim of the study was to explore regulatory inspectors’ experiences with a new method for next-of-kin involvement in investigation of adverse events causing patient death. A resilient healthcare perspective is used as the theoretical foundation.

Methods
The study design was a qualitative process evaluation of the new involvement method in 2 Norwegian counties. Next of kin, who had lost a close family member in an adverse event, were invited to a 2-hour face-to-face meeting with the inspectors. Data collection involved 3 focus group interviews with regulatory inspectors and observation (20 hours) of the meetings (2017–2018). Data were analyzed by a thematic content analysis.

Results
Next-of-kin involvement informed the investigations by additional and new information about the adverse events and by different versions of the investigators’ earlier obtained information, such as time sequences, what happened and how, and who were involved. Inspectors considered next of kin as a key source of information that contributed to improve the quality of the investigation. The downside was that the involvement method increased work load and could challenge the principle of equal treatment in regulatory practice.

Conclusions
Involvement of next of kin in regulatory investigation of adverse events causing patient death contributes to a better understanding of work as done in clinical practice and contributes to strengthen the learning potential in resilience.
The Great Mimicker—Tuberculosis Involving Prostate and Vertebrae Posing as Metastatic Prostate Carcinoma on FDG PET/CT
Authors: Joshi Prathamesh Vijay , Shewalkar Balaji , George Thomas , Sahasrabudhe Shrikant , Joshi Sujit , Kulkarni Mukta 
Published: October 2019

Abstract
A 65-year-old man underwent FDG PET/CT for evaluation of vertebral lesions, radiologically suspected to be metastases. The scan showed hypermetabolism in D8 to D9 vertebrae, retroperitoneal lymph nodes, and both the lobes of prostate. Transrectal ultrasound-guided biopsy of prostate was performed with suspicion of prostate malignancy. The biopsy revealed caseating granulomatous lesions in prostate suggestive of tuberculosis. Post antitubercular treatment patient showed excellent clinical response. Possibility of infective pathologies mimicking malignancy should be kept in mind while evaluating hypermetabolic foci seen on PET/CT. Although rare, tuberculosis of prostate needs consideration in differential diagnosis of FDG-avid foci seen in prostate.
Nasal Reconstruction With Two Stages Versus Three Stages Forehead Fap: What is Better for Patients With High Vascular Risk?
Authors: Lo Torto Federico , Redi Ugo , Cigna Emanuele , Losco Luigi , Marcasciano Marco , Casella Donato , Ciudad Pedro , Ribuffo Diego 
Published: October 2019

Abstract
In nasal reconstruction, it is necessary to replace all anatomic layers in order to reinstate correct aesthetics. The most apt donor site to use in order to cover the nose has been recognized as forehead skin. Traditionally 2 phases are required to reconstruct the forehead flap; however, an intermediate third phase was described by Millard which is between transfer of the flap and division of the pedicle. These methods will be compared in this study with regard to both complication rates and aesthetic results in high vascular risk patients.
46 patients were enrolled in the study, all of whom were undergoing either total or subtotal nasal reconstruction from January 2001 to March 2018. The 2-step technique (2S Group) was performed on 30 patients and the 3-step technique (3S Group) was performed on 16. Evaluation questionnaires were completed by patients and a plastic surgeon who was extraneous to the study to evaluate aesthetic satisfaction. Complications other than flap necrosis such as infection, wound dehiscence and hematoma were recorded. VAS and Likert mean values, used to evaluate aesthetic satisfaction, were examined with a Student t test and were discovered to be relevant. Complication rates studied with Fisher exact test showed no statistically significant difference between the 2 groups. The 3-phase method for nose reconstruction using a forehead flap represents a better functional and aesthetic option for patients at high vascular risk.
Study for Cephalometrics of Facial Bone by Computerized Tomography Images
Authors: Yi Chang Ryul , Choi Young Woong 
Published: October 2019

Abstract
Authors tried to investigate the maxillomandibular morphology of Korean nationality with computerized tomography images and establish a series of cephalometric values which should be considered in orthognathic plastic surgery in Korea.
The computerized tomography images of 200 patients were retrospectively reviewed with the computer workstation in Sanggye Paik Hospital, Inje University College of Medicine from 2016 to 2017.
The mean distance between nasion to point A (NA) line and the maxillary central incisor was 5.07 cm. The mean distance from nasion to point B (NB) line to the mandibular central incisor was 7.11 cm. The mean angle between NA line and the long axis of the maxillary central incisor was 20.58 degree. The mean angle between NB line and the long axis of the mandibular central incisor was 26.47 degree. The mean angle between SN (sella to nasion) line and NA line was 83.18 degree. The mean angle between SN line and NB line was 78.83 degree. The mean angle between NA line and NB line was 4.35 degree. There were no any statistically significant differences between age groups. But there were statistically significant difference in the mean of angle between NB line and the long axis of the mandibular central incisor (P = 0.025, between sex groups) and in the mean of angle between NA line and the long axis of the maxillary central incisor between sex groups in the 51 to 60 age group (P = 0.045).
The maxillomandibular profile of Korean adults was established which can be applied for orthognathic surgery of Korean patients.
Learning Impacts of Pretraining Video-Assisted Debriefing With Simulated Errors or Trainees' Errors in Medical Students in Basic Life Support Training
Authors: Li Qi , Lin Jing , Fang Li-Qun , Ma Er-Li , Liang Peng , Shi Ting-Wei , Xiao Hong , Liu Jin 
Published: October 2019

Background
Previous studies demonstrated that pretraining video-assisted debriefing (VAD) with trainees' errors (TE) videotaped in a skills pretest improved skill learning of basic life support (BLS). However, conducting a pretest and preparing TE video examples is resource intensive. Exposing individual trainee's errors to peers might be a threat to learners' psychological safety. We hypothesized pretraining VAD with simulated errors (SE, performed by actors) might have the same beneficial effect on skills learning as pretraining VAD with TE, but avoid drawbacks of TE.

Methods
Three hundred twenty-two third-year medical students were randomized into 3 groups (the control [C], TE, SE). A videotaped BLS skills pretest was conducted in 3 groups. Then, group C received traditional training with concurrent feedback. Video-assisted debriefing with TE in the pretest or SE was delivered in groups TE or SE, respectively, followed by BLS training without any feedback. Basic life support skills were retested 1 week later (posttest). Students completed a survey to express their preference to TE or SE for VAD in the future.

Results
Higher BLS skills scores were observed in groups TE (85.7 ± 7.0) and SE (86.8 ± 7.5) in the posttest, compared with group C (68.7 ± 13.3, P < 0.001). No skills difference was observed between group TE and SE in the posttest. More trainees (65.8%) preferred SE for VAD.

Conclusions
Pretraining VAD with SE had an equivalent beneficial effect as VAD with TE on BLS skills learning in medical students. More trainees preferred SE for VAD with regard to psychological safety.
Cognitive and Physical Factors Affecting High-Speed Driving Ability in Older Adults
Authors: Shih Huei-Yu , Chu I-Hua , Wang Chih-Chung , Liaw Lih-Jiun , Hsu Hsiu-Tao , Wu Wen-Lan 
Published: October 2019

Background and Purpose:
The ability to drive is important for the elderly to maintain their mobility and independence. Therefore, to investigate age-related changes in driving-related functions and their relation to the braking ability of drivers driving at high speeds, subjects were organized by age into study groups (younger, middle-aged, and older).

Methods:
For a correlational comparative study, 36 male participants were recruited and instructed to complete the Assessment of Driving-Related Skills (ADReS), lower limbs muscle test, and driving tasks on a driving simulator under 3 speed conditions. For the driving tasks, 3 event phases were analyzed: perception-reaction time (PRT), brake-movement time, and fast pressing time.

Results:
Older drivers demonstrated a significant decline in certain driving-related cognitive and motor abilities, as well as hip flexion and knee extension muscle strength, and exhibited a significantly longer PRT under moderate- and high-speed conditions compared with younger drivers. A longer PRT under moderate- and high-speed conditions was significantly associated with poor driving-related cognitive and motor abilities.

Conclusion:
The increased PRT for older drivers under moderate- and high-speed conditions might increase their risk of vehicular accidents on highways.
Effectiveness of Chair Yoga for Improving the Functional Fitness and Well-being of Female Community-Dwelling Older Adults With Low Physical Activities
Authors: Yao Ching-Teng , Tseng Chien-Hsing 
Published: October 2019

Objective:
This study investigated the effect of a 12-week chair yoga program on functional fitness and well-being in community-dwelling older women with low physical activities.

Methods:
A total of 31 community-dwelling older women with low physical activity participated in this quasi-experimental study. Two communities of the elderly were allocated to 2 groups through lot drawing. Subjects were randomly assigned to control or intervention groups by community to avoid contamination—the experimental group of 16 people and the control group of 15 people. The participants in the experimental group trained chair yoga exercise for 12 weeks with 2 sessions per week, 110 minutes per session, whereas the control group maintained its regular daily activities. Data collection from multiple variables was conducted using questionnaire (well-being) and examination on functional fitness (handgrip strength, lower limb muscle strength, upper limb muscle strength, static balance, agility and dynamic balance, lower limb flexibility, upper limb flexibility).

Results:
The results showed a significant improvement for the experimental group in the handgrip strength (P = .001), upper limb muscle strength (P = .047), lower limb muscle strength (P = .007), static balance (P = .016), agility and dynamic balance (P = .009), and in the well-being (P = .003) after the intervention. The control group reveals deteriorated result in upper limb muscle strength (P = .016). Among other functional fitness and well-being variables, there is no significant difference.

Conclusion:
The chair yoga training provides a simple and inexpensive exercise program that improves the functional fitness and well-being effectively.
Combining Multifactorial Assessment Tools and Dimensionality Reduction Analysis for Fall Risk Classification in Community-Dwelling Older Adults
Authors: Lin I-Ching , Yang Chia-Chi , Lai Yi-Horng , Guo Lan-Yuen 
Published: October 2019

Background and Purpose:
Optimal approaches in fall risk assessment involve interdisciplinary collaboration of assessment. This current work aimed at screening the fall risk characteristics from the objective balance and mobility tests between older fallers and nonfallers and further assessing the feasibility of 2 statistical dimensionality reduction models, Linear Discriminant Analysis (LDA) and Generalized Discriminant Analysis (GDA) for discriminating older nonspecific fallers. We hypothesized that the high-dimensionality objective sensor-based parameters, followed by a feature selection and dimensionality reduction process, would be able to discriminate older nonspecific fallers.

Methods:
Thirty-one community-living older individuals who were older than 60 years (faller: n = 15; nonfaller: n = 16) were recruited. The measurements include gait, balance, and ankle proprioception performances. LDA and GDA were further applied to obtain more discriminative feature space. Receiver-operating characteristic (ROC) curves were constructed to compare the classification quality in all the features.

Results:
Although some features in single objective measure reached statistical significance, the original features still resulted in high within-class and low between-class variances in the feature space. By further applying LDA and GDA on the original features, the performance of LDA in the feature space was improved. The area under the curve of ROC was GDA dimensionality reduction feature (1), LDA dimensionality reduction feature (0.99), proprioception (0.752), inertial measurement unit (0.745), and center of pressure (0.72), respectively.

Conclusions:
Experimental results showed the GDA feature has the best classification quality and the additional advantage in combination of interdisciplinary multifactorial fall risk assessment.
Spinal Cord Ischemia in Pancreas Transplantation: The UK Experience
Authors: Phillips Benedict L. , Papadakis Georgios , Bell Rachel , Sinha Sanjay , Callaghan Chris J. , Akyol Murat , Watson Christopher J.E. , Drage Martin 
Published: October 2019

Background.
Spinal cord ischemia (SCI) is a rare but devastating condition that can occur in the perioperative period resulting in paraplegia. Although diabetes mellitus is a risk factor for SCI in other types of major surgery, SCI is not widely recognized in transplantation. The aim of this study was to quantify the risk of SCI in pancreatic transplantation.

Methods.
All UK pancreas transplant units were surveyed between 2017 and 2018. The risk of SCI in pancreas transplantation was estimated using the number of radiologically confirmed cases relative to the number of pancreatic transplants from UK registry data during the same time period.

Results.
There have been 6 cases of SCI during pancreas transplantation since 2002. No aortic clamping occurred in any recipient. During or after surgery, all patients experienced episodes of hypotension (systolic blood pressure ≤ 90 mm Hg) before the onset of neurological symptoms. Epoprostenol, epidural anesthesia, and postoperative hemodialysis may have contributed to systemic hypotension. The mainstay of early treatment for SCI for all cases was blood pressure control.

Conclusions.
Based on these findings, there is approximately a 1:440 risk of SCI in pancreas transplantation. Hypotension appears to be a prominent risk factor. Strategies for mitigating the risk of SCI are discussed, drawing on evidence from thoraco-abdominal aortic aneurysm surgery. The risk of long-term neurological deficit should be discussed with prospective pancreas recipients given the potential impact on posttransplant quality of life.
DSA Are Associated With More Graft Injury, More Fibrosis, and Upregulation of Rejection-associated Transcripts in Subclinical Rejection
Authors: Höfer Anne , Jonigk Danny , Hartleben Björn , Verboom Murielle , Hallensleben Michael , Hübscher Stefan G. , Manns Michael P. , Jaeckel Elmar , Taubert Richard 
Published: October 2019

Background.
Subclinical T cell-mediated rejection (subTCMR) is commonly found after liver transplantation and has a good short-term prognosis, even when it is left untreated. Donor-specific antibodies (DSA) are putatively associated with a worse prognosis for recipient and graft after liver transplantation.

Methods.
To assess the immune regulation in subTCMR grafts, gene expression of 93 transcripts for graft injury, tolerance, and immune regulation was analyzed in 77 biopsies with “no histologic rejection” (NHR; n = 25), “clinical TCMR” (cTMCR; n = 16), and subTCMR (n = 36). In addition, all available subTCMR biopsies (n = 71) were tested for DSA with bead assays.

Results.
SubTCMR showed heterogeneous and intermediate expression profiles of transcripts that were upregulated in cTCMR. Graft gene expression suggested a lower activation of effector lymphocytes and a higher activation of regulatory T cells in grafts with subTCMR compared to cTCMR. DSA positivity in subTCMR was associated with histological evidence of more severe graft inflammation and fibrosis. This more severe DSA+ associated graft injury in subTCMR was converged with an upregulation of cTCMR-associated transcripts. In nonsupervised analysis, DSA positive subTCMR mostly clustered together with cTCMR, while DSA negative subTCMR clustered together with NHR.

Conclusions.
T cell-mediated rejection seems to form a continuum of alloimmune activation. Although subTCMR exhibited less expression of TCMR-associated transcript, DSA positivity in subTCMR was associated with an upregulation of rejection-associated transcripts. The identification of DSA positive subclinical rejection might help to define patients with more inflammation in the graft and development of fibrosis.