bluuebunny/crossref_metadata_2025_split huggingface dataset:
Identifying Training Needs and Active Information Opportunities in Primary Care Through the Analysis of Drug Information Requests
Authors: Salgado Teresa M. , Barker Melissa R. , Frerichs Jon D. , Musselman Kerri T. , Dixon Dave L. , Fernandez-Llimos Fernando 
Published: March 2021

Introduction: Drug information (DI) services should work toward efficiency by identifying knowledge gaps and actively creating resources to address those needs. The aim was to identify training needs and active information opportunities in primary care by analyzing DI requests and to calculate labor cost associated with DI requests addressable with training or active information. Methods: DI requests received in 2016 and 2017 by ambulatory care pharmacists were independently classified by 2 authors into: training (i.e., delivery of content meant to be retained as knowledge and used when needed); active information (i.e., resources created preemptively and consulted when needed); or passive information (i.e., not addressable with training or active information). Inter-rater reliability was calculated using Cohen’s Kappa. Median time spent by category and across practice settings/professional types was compared using bivariate analysis. Thematic analysis categorized specific training and active DI requests and labor costs were calculated. Results: Of 2,041 DI requests, 330 (16.2%) were classified as training, 454 (22.2%) active information, and 1257 (61.6%) passive information (kappa = 0.769). Median (IQR) time to resolve requests was 5 (2-10) mins for training, 5 (3-11) active information, and 10 (4-15) passive information. Pharmacists spent 132.1 hrs = $8,956.98 answering questions addressable with training or active information. Areas warranting training or active information included: controlled substances, immunizations, patient assistance programs, policy/regulations, medication preparation/administration, storage/stability, disposal, availability/ordering medications, and patient-related resources. Conclusion: Several opportunities for training and active information were identified. Despite the single-institution nature, the method described can serve as an example for other institutions.
Differences in quality of life in patients with cutaneous lupus erythematosus with varying income levels
Authors: Joseph Adrienne , Prasad Smriti , Hynan Linda S. , Chren Mary-Margaret , Chong Benjamin 
Published: March 2021

Background Cutaneous lupus erythematosus (CLE) is an autoimmune photosensitive skin condition. The impact of income on quality of life has been incompletely characterized in CLE. Objectives We aimed to assess how annual income affects quality of life among CLE patients. Methods In this cross-sectional study of 238 patients with CLE, relationships between predictor variables including annual income and each SKINDEX-29 + 3 subdomain were identified using univariate and multivariable analyses. In addition, answers to individual SKINDEX-29 + 3 questions were compared across income groups. Clinical factors in patients making less than <10,000 USD (N = 85) with worse SKINDEX-29 + 3 scores were also identified by univariate and multivariable analyses. Results Patients making <10,000 USD annually experienced worse quality of life across multiple SKINDEX-29 + 3 subdomains (p < 0.05). These patients specifically experienced poorer quality of life relating to social isolation and self-consciousness. (p < 0.001). Among those making <10,000 USD, predictors for worse quality of life included females, smokers, and those with higher skin disease activity were identified (p < 0.05). Limitations: This is a single center study. Income was also self-reported and could not be verified. Conclusions Lower income is related to poorer quality of life in patients with CLE. Specifically, patients experience limitations regarding social isolation and self-consciousness.
Nurses’ perceptions about the dignity of intubated patients
Authors: Rafiq Nasreen , Arthur David , Rahim Shirin , Amarsi Yasmin , Ndirangu Eunice 
Published: March 2021

Background: The intensive and critical care units are high-dependency areas, with patients requiring complex care. The intubated status of the intensive and critical care patients makes them dependent on healthcare providers not only for acute care, but also for intimate care, imposing a threat to their dignity. Nurses, being the central care providers, become the stakeholders for dignity promotion. The incorporation of dignity in patient care improves the quality of care, and promotes the health and well-being of intubated patients. Objective: The purpose of the study was to explore nurses’ perceptions about the dignity of intubated patients in the intensive and critical care units. Research design: A qualitative descriptive exploratory study design was used to explore the nurses’ perceptions about the dignity of intubated patients. Participants and research context: The intensive and critical care nurses of a tertiary care hospital were recruited using the purposive sampling technique. The data were collected through in-depth individual interviews, using a semi-structured interview guide. The findings were manually analyzed into themes and categories through content analysis. Ethical consideration: The study was conducted after the approval from the Ethical Review Committee of the Aga Khan University. Findings: Four major themes emerged from the data analysis: (1) two sides of the contemporary nursing practice; (2) benefits of dignified nursing care; (3) challenges to the dignity of intubated patients; and (4) strategies for promoting the dignity of intubated patients. Discussion: Dignity incorporates both the science and the art of nursing. The provision of dignified care is the core component of the quality nursing care and patient well-being in the high-dependency units. Conclusion: This is the first exploratory and descriptive study conducted in Pakistan that explored the nurses’ perceptions about the dignity of intubated patients, and also generated contextual understanding about the phenomenon.
Psychoeducation Intervention Effectiveness to Improve Social Skills in Young People with ADHD: A Meta-Analysis
Authors: Powell Lauren Amy , Parker Jack , Weighall Anna , Harpin Valerie 
Published: March 2021

Objective: Attention Deficit Hyperactivity Disorder (ADHD) can be associated with limited understanding of the condition and poor social skills. Some evidence favors a psychoeducational approach, but little is known about the effectiveness of psychoeducation. Methods: Systematic review and meta-analysis of studies assessing psychoeducational interventions that aim to improve social skills of young people with ADHD. Results: Ten studies, including 943 participants, reported across 13 papers met the inclusion criteria. Although effect sizes were small, findings suggest the included interventions significantly improved social skills in young people with ADHD. Conclusions: Results show promise for psychoeducational behavioral interventions . However, the recommendations that can be developed from existing evidence are somewhat limited by the low quality of studies. Further rigorous trials are needed. In addition, future research should consider the long-term outcomes for these interventions, they should be iteratively co-designed and research should consider the context they intend to be delivered in.
Is Screen Time Throughout Adolescence Related to ADHD? Findings from 1993 Pelotas (Brazil) Birth Cohort Study
Authors: Soares Pedro San Martin , de Oliveira Paula Duarte , Wehrmeister Fernando César , Menezes Ana Maria Baptista , Gonçalves Helen 
Published: March 2021

Objective: This study investigated the association between screen time in adolescence and Attention Deficit Disorder (ADHD) at 22 years old. Method: A sample of 2333 participants aged 11 years old without ADHD from the 1993 Pelotas Birth Cohort Study (Brazil) was followed up until the age of 22. Screen time variables included time spent in television, video game and computer at 11, 15, and 18 years old. ADHD was assessed at 22 years. Results: ADHD symptoms at 22 years was positively associated with television time at 11 years, computer time at 18 years and total screen time at ages 11, 15, and 18 years. Television time at 11 years and total screen time at 18 years were associated with diagnosis of ADHD at 22 years of age. Conclusions: Our findings may contribute to future investigations of possible explanatory avenues for these associations.
Adverse Drug Reaction Reporting and Prescribing Trends of Drugs for Attention Deficit Hyperactivity Disorder in Primary Care England, 2010–2019
Authors: Hasan Syed Shahzad , Bal Nimrata , Baker Isabelle , Kow Chia Siang , Khan Muhammad Umair 
Published: March 2021

Objective: We investigated the prescription trends and adverse drug reactions (ADRs) of ADHD drugs in primary care, England between 2010 and 2019. Methods: The Prescription Cost Analysis database presenting the primary care prescriptions data and the Interactive Drug Analysis Profiles presenting all suspected ADRs reported for each drug were screened. The data were analyzed using linear regression analysis to examine the annual average change per year. Results: The prescription items dispensed for ADHD showed an average 11.07% (95% CI 10.54–11.60, p = .001) increase per year and there was a mean 11.54% (95% CI 11.03–12.06, p = .001) increase per year in the costs. The overall reporting of serious and fatal ADR was reduced by 1.79% per year for ADHD drugs. Guanfacine showed a 40% mean increase per year. Conclusion: The increasing use of ADHD drugs within primary care in England could be a result of multiple factors such as growing ADHD prevalence.
Positive Child Personality Factors in Children with ADHD
Authors: Hai Tasmia , Climie Emma A. 
Published: March 2021

Objective: Attention-Deficit/Hyperactivity Disorder (ADHD) is a prevalent neurodevelopmental disorder. While previous studies have shown substantial impact of ADHD across multiple domains, relatively little attention has been devoted to studying positive personality factors in individuals with ADHD. To address this, the current study examined strength-based factors in children with ADHD in relation to their social skills. Method: Sixty-four children (aged 8–12 years) with ADHD completed questionnaires related to their social skills and strength-based factors (e.g., optimism, resilience, self-concept, and coping skills). Results: Findings indicated significant differences between different levels of social skills in children with ADHD, with children with higher social skills reporting higher levels of resiliency, greater behavioral competence, and greater prosocial attitudes than those with lower social skills. Conclusions: The results highlight the importance of fostering strong social skills in children with ADHD, leading them to perceive themselves as competent and resilient.
Blood pressure variability and outcomes after mechanical thrombectomy based on the recanalization and collateral status
Authors: Huang Xianjun , Guo Hongquan , Yuan Lili , Cai Qiankun , Zhang Min , Zhang Yi , Zhu Wusheng , Li Zibao , Yang Qian , Zhou Zhiming , Sun Wen , Liu Xinfeng 
Published: March 2021

Background: Blood pressure (BP), recanalization status, and collateral circulation are important factors for cerebral autoregulation after stroke. We aimed to investigate the association of various BP variability (BPV) parameters with clinical outcomes after mechanical thrombectomy (MT) according to recanalization and collateral status. Methods: We included 502 consecutive patients who underwent MT due to anterior circulation large vessel occlusion stroke at three comprehensive stroke centers. BPV parameters were standard deviation (SD), maximum/minimum BP, coefficient of variation (CV) and successive variation (SV). The clinical outcomes included 90-day functional outcome assessed by modified Rankin Scale score and symptomatic intracranial hemorrhage (sICH). Results: Among the included patients, 219 (43.6%) achieved good functional outcomes and 59 (11.8%) developed sICH. After adjusting for confounders, higher systolic BP (SBP) variability [CV (odds ratio (OR), 1.089, p = 0.035), SV (OR, 1.082, p = 0.004). and SD (OR, 1.074, p = 0.027)] was associated with a lower likelihood of a favorable outcome. In addition, higher SBP [CV (OR, 1.156, p = 0.001) and SD (OR, 1.118, p = 0.001)] were significantly associated with increased odds of sICH. Moreover, the relationship between BPV and the outcomes depended on recanalization status. However, regardless of collateral status, a higher BPV after MT was associated with worse outcomes. Conclusions: Higher SBP SD and CV during the first 24 h after MT was a powerful predictor of worse clinical outcomes, regardless of the collateral status. However, the effects of BPV on outcomes were more substantial among patients with successful reperfusion.
Treatment satisfaction in 5q-spinal muscular atrophy under nusinersen therapy
Authors: Osmanovic Alma , Ranxha Gresa , Kumpe Mareike , Wurster Claudia D. , Stolte Benjamin , Cordts Isabell , Günther René , Freigang Maren , Müschen Lars H. , Binz Camilla , Hermann Andreas , Deschauer Marcus , Lingor Paul , Ludolph Albert C. , Hagenacker Tim , Schreiber-Katz Olivia , Petri Susanne 
Published: March 2021

Background: Nusinersen was the first approved disease-modifying therapy for all 5q-spinal muscular atrophy (SMA) patients regardless of age or disease severity. Its efficacy in adults has recently been demonstrated in a large cohort by motor outcome measures, which were only partially suitable to detect changes in very mildly or severely affected patients. Patient-reported outcome measures (PROs) have been suggested as a valuable addition. Here, we aimed to assess treatment satisfaction and investigate whether it may be a useful PRO to monitor SMA patients. Methods: We enrolled 91 mainly adult 5q-SMA patients treated with nusinersen in a national, multicenter, cross-sectional observational study. 21 patients underwent longitudinal follow up. Patients’ satisfaction with treatment in four dimensions (global, effectiveness, convenience, side effects) was assessed by the Treatment Satisfaction Questionnaire for Medication German version 1.4 (TSQM-1.4©) and related to clinical parameters, motor scores, and treatment duration. Results: More than 90% of SMA patients were consistently satisfied over a median treatment duration of 10 months. Highest mean scores were observed in the dimensions ‘side effects,’ ‘global satisfaction,’ and ‘effectiveness’ (93.5 ± 14.8 versus 73.1 ± 21.0 and 64.8 ± 20.6, respectively). Patients’ satisfaction with the convenience of treatment was considerably lower (43.6 ± 20.2). Interestingly, satisfaction with the effectiveness was higher in ambulatory ( p = 0.014) compared with non-ambulatory patients and directly correlated to motor outcome measures. Five non-ambulatory patients withdrew from therapy. All of them presented with a deterioration of motor outcome measures and reported dissatisfaction with treatment effectiveness and convenience. Conclusion: Most patients were satisfied with nusinersen treatment effectiveness. Less severely affected patients indicated higher satisfaction. The TSQM-1.4© helped to identify therapy non-responders, who mainly addressed dissatisfaction with effectiveness and convenience. We suggest introducing the TSQM-1.4© as an additional PRO in SMA into clinical practice.
How VA Whole Health Coaching Can Impact Veterans’ Health and Quality of Life: A Mixed-Methods Pilot Program Evaluation
Authors: Purcell Natalie , Zamora Kara , Bertenthal Daniel , Abadjian Linda , Tighe Jennifer , Seal Karen H 
Published: March 2021

Purpose To examine the impact of a pilot VA Whole Health Coaching program, including whether and how the program helps veterans improve their health and quality of life. Intervention Whole Health Coaching is a structured program to support veterans in making healthy behavior changes to promote holistic well-being. Design This mixed-methods quality-improvement evaluation combined surveys (pre- and post-coaching) with follow-up qualitative interviews. Setting The setting was a large VA healthcare system, encompassing a medical center and six community-based clinics in Northern California. Participants 65 veterans completed surveys at both time points; 42 completed qualitative interviews. Method Telephone surveys administered at baseline and 3 months assessed global health (PROMIS-10), perceived stress (PSS-4), and perceived health competency (PHCS-2). Pre- and post-scores were compared using t-tests. A subsample of participants completed a qualitative interview evaluating program experience, goal attainment, and the coaching relationship. Results Surveys showed significant improvements over baseline in mental health (p = 0.006; d = 0.36), stress (p = 0.003; d = –0.38), and perceived health competence (p = 0.01; d = 0.35). Interviewees were highly satisfied with their coaching experience, describing both effective program components and improvement opportunities. Conclusion Whole Health Coaching can help participants make meaningful progress toward health goals, reduce stress, and improve quality of life. The Whole Health model’s emphasis on holistic self-assessment; patient-driven goal-setting; supportive, non-judgmental inquiry; and mindful awareness contributed to program success and enhanced participants’ experience.
Individualized blood pressure management during endovascular treatment of acute ischemic stroke under procedural sedation (INDIVIDUATE) – An explorative randomized controlled trial
Authors: Chen Min , Kronsteiner Dorothea , Möhlenbruch Markus A , Kieser Meinhard , Bendszus Martin , Wick Wolfgang , Nagel Simon , Ringleb Peter A , Schönenberger Silvia 
Published: March 2021

Background Optimal blood pressure is not well established during endovascular therapy of acute ischemic stroke. Applying standardized blood pressure target values for every stroke patient might be a suboptimal approach. Aim To assess whether an individualized intraprocedural blood pressure management with individualized blood pressure target ranges might pose a better strategy for the outcome of the patients than standardized blood pressure targets. Sample size: Randomization of 250 patients 1:1 to receive either standard or individualized blood pressure management approach. Methods and design We conduct an explorative single-center randomized controlled trial with a PROBE (parallel-group, open-label randomized controlled trial with blinded endpoint evaluation) design. In the control group, intraprocedural systolic blood pressure target range is 140–180 mmHg. The intervention group is the individualized approach, which is maintaining the intraprocedural systolic blood pressure at the level on presentation (±10 mmHg). Study outcomes: The primary endpoint is the modified Rankin scale assessed 90 days +/− 2 weeks after stroke onset, dichotomized by 0–2 (favorable outcome) to 3–6 (unfavorable outcome). Secondary endpoints include early neurological improvement, infarction size, and systemic physiology monitor parameters. Discussion An individualized approach for blood pressure management during thrombectomy could lead to a better outcome for stroke patients. The trial is registered at clinicaltrials.gov as ‘Individualized Blood Pressure Management During Endovascular Stroke Treatment (INDIVIDUATE)’ under NCT04578288.
Early Outcomes of an Anterior Ankle Fusion Plating System with rhPDGF-BB Beta Tricalcium Phosphate Graft
Authors: Covell Donald J. , McMillen Ryan 
Published: March 2021

Category: Ankle; Ankle Arthritis Introduction/Purpose: Ankle fusion offers a reliable and effective treatment for end-stage ankle arthritis. Biomechanical studies have shown that plating systems may offer an advantage to ankle fusion patients with significant bone loss, bone deformity, or osteoporotic bone by providing a stiffer construct. One potential downside to plating systems is that they have been associated with soft tissue irritation due to their profile height. The objective of this case series was to assess the early patient clinical and radiographic outcomes of an anatomically designed, lower profile anterior ankle fusion plate used in combination with an autograft alternative, recombinant human protein derived growth factor (rhPDGF-BB). Methods: All ankle fusions performed between May 2018 and August 2019 at two centers were retrospectively evaluated. All patients received an anatomically designed, low profile anterior ankle fusion plate (ORTHOLOC 3Di, Wright Medical Group, Memphis, Tennessee, USA) through an anterior surgical approach. All patients also received rhPDGF-BB as part of the surgical procedure. Patients were non-weight bearing for 6 to 8 weeks in a splint or short leg cast, before transitioning to protected partial weight bearing for another 6 to 8 weeks. Patient demographics, time to radiographic fusion, length of follow-up, and adverse events were collected as part of the review. Results: There were 20 patients (12 male, 8 female) included in the analysis. The average age was 60.9 years (range, 42-90) and the average BMI was 31.6 kg/m2 (range, 21-52). There were eight diabetics, four smokers, and two patients who had preoperative ulcers. The average follow-up time was 7.8 months (range, 3-18). The fusion rate was 90%, with two nonunions. One nonunion patient was an obese, diabetic, neuropathic, smoker with a preoperative ulcer and a previous ankle fracture. She was treated with a bone stimulator and showed increased bony consolidation. The second nonunion patient was a neuropathic, diabetic who had previous hindfoot Charcot reconstruction. Her nonunion was stable and fibrous, which allowed her to ambulate pain free without bracing or assistive devices. Conclusion: This case series presents the first clinical results for this anatomically designed anterior ankle fusion plate. Outcomes were positive with a 90% fusion rate despite being used in a series of patients with a high incidence of risk factors and comorbidities. Additional complications were minor as related to wound healing. Further study is needed to confirm these promising initial results.
Arthroscopic Microfracture for Osteochondral Lesions of the Talus in Old Age Patient
Authors: Lee Hong S. , Young Kiwon , Park Tae-Hoon , Lee Hong Seop 
Published: March 2021

Category: Ankle; Arthroscopy Introduction/Purpose: The purpose of the present study was to evaluate the outcomes of arthroscopic microfracture for osteochondral lesions of the talus, in patients of older than 60 years old. Methods: Sixteen patients (16 ankles) with osteochondral lesions of the talus were treated by arthroscopic microfracture from October 2012 to June 2019. As two patients were lost to follow-up, Fourteen patients (14 ankles) participated in the study. There were 6 men (42.9%) and 8 women (57.1%) of average age 67.4years (range 60-77) at the time of surgery. Clinical outcome evaluations were performed using Foot and Ankle Outcome Score (FAOS) and patient’s satisfaction after surgery at a mean follow-up of 50.8 months. Results: Mean FAOS scores improved from SYMPTOM 68.2 points (range 39-86), PAIN 65.1 points (range 36-94), ADL 69.4 points (range 32-99), SPORTS 45.4 points (range 25-80), QOL 47.1 points (range 13-94) preoperatively to SYMPTOM 94.8 points (range 68-100), PAIN 91.1 points (range 48-100), ADL 93.3 points (range 59-100), SPORTS 71.8 points (range 30-100), QOL 79.8 points (range 25-100) at final follow up. Very satisfaction in 4 (29%), Satisfaction in 7 (50%), Fair in 2 (14%), Dissatisfaction in 1 (7%), and reason for dissatisfaction was persistent pain after surgery. Conclusion: Arthroscopic microfracture for osteochondral lesions of the talus is a safe and effective procedure for old age patient.