bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Qualitative Study of Family Experience With Hospitalization for Neonatal Abstinence Syndrome
Authors: Atwood Emily C. , Sollender Grace , Hsu Erica , Arsnow Christine , Flanagan Victoria , Celenza Joanna , Whalen Bonny , Holmes Alison V. 
Published: November 2021

BACKGROUND AND OBJECTIVES
Although the incidence of neonatal abstinence syndrome (NAS) in the United States quintupled between 2000 and 2012, little is known about the family perspective of the hospital stay. We interviewed families to understand their experiences during the newborn hospitalization for NAS and to improve family-centered care.

METHODS
A multidisciplinary team from 3 hospital units composed open-ended interview questions based on a literature review, clinical experience, and an internal iterative process. Trained investigators conducted semi-structured interviews with 20 families of newborns with NAS at hospital discharge. Interviews were recorded and transcribed verbatim. Two investigators independently analyzed each transcript, identified themes via an inductive qualitative approach, and reached a consensus on each code. The research team sorted the themes into broader domains through an iterative process that required consensus of 4 team members.

RESULTS
Five domains of family experience were identified: parents’ desire for education about the course and treatment of NAS; parents valuing their role in the care team; quality of interactions with staff (supportive versus judgmental) and communication regarding clinical course; transfers between units and inconsistencies among providers; and external factors such as addiction recovery and economic limitations.

CONCLUSIONS
Families face many challenges during newborn hospitalization for NAS. Addressing parental needs through improved perinatal education, increased involvement in the care team, consistent care and communication, and minimized transitions in care could improve the NAS hospital experience. The results of this qualitative study may allow for improvements in family-centered care of infants with NAS.
Risk Stratification for Opioid Misuse in Children, Adolescents, and Young Adults: A Quality Improvement Project
Authors: Thienprayoon Rachel , Porter Kelly , Tate Michelle , Ashby Marshall , Meyer Mark 
Published: November 2021

BACKGROUND
The Pediatric Palliative and Comfort Care Team (PACT) at Cincinnati Children’s Hospital Medical Center (CCHMC) provides opioids to a large population of patients in the ambulatory setting. Before this project, PACT had no reliable system to risk stratify patients for opioid misuse.

METHODS
The global aim was safe opioid prescribing by the palliative care team. The specific, measurable, achievable, realistic, and timely aim was as follows: “In patients who present for follow up with PACT, we will use the “opioid bundle” to increase risk stratification for opioid misuse from 0% to 90% over 5 months.” The opioid bundle includes a urine drug screen, Ohio Automated Rx Reporting System report, pill count, and screening history for drug abuse and mental health disorders. The setting was multiple CCHMC ambulatory clinics. Participants included all PACT members.

RESULTS
Since implementing the new system, we have increased risk stratification for opioid misuse among outpatients from 0% to &gt;90%. Results have been sustained for 12 months. Key processes have become reliable: obtaining informed consent and controlled substance agreements for all new patients and obtaining the opioid bundle to enable risk stratification in a consistent and timely fashion. A total of 34% of patients have been stratified as high risk, and an additional 27% have been stratified as moderate risk.

CONCLUSIONS
A system to ensure safe opioid prescribing practices to all patients is critical for providers. Identifying key processes and executing them reliably has enabled the palliative care team at CCHMC to risk stratify &gt;90% of patients receiving opioids in the ambulatory setting for opioid misuse.
Nonmedical Prescription Opioid and Heroin Use Among Adolescents Who Engage in Sports and Exercise
Authors: Veliz Philip , Boyd Carol J. , McCabe Sean Esteban 
Published: November 2021

OBJECTIVES
Previous research has found that adolescent athletes may be at increased risk of nonmedical prescription opioid use (NPOU) due to injuries. Although adolescent athletes are at an increased risk of engaging in NPOU, it has yet to be determined if they are also at greater risk for heroin use. The major purpose of this study was to examine both the trends in prevalence rates and patterns of initiation in lifetime NPOU and lifetime heroin use among adolescents who engage in sports and exercise.

METHODS
Eighteen cross-sections of eighth and 10th graders were used from the Monitoring the Future study. The sample consisted of 191 682 respondents who answered questions on past-year participation in sports and exercise, lifetime NPOU, lifetime heroin use, age of NPOU onset, and age of heroin onset.

RESULTS
The trends in NPOU and lifetime heroin use among adolescents who engage in sports and exercise has declined between 1997 and 2014. Logistic regression analyses found that adolescents who engage in sports and exercise had lower odds of reporting lifetime NPOU and heroin use compared with adolescents who did not engage in these activities during the past year. Analyses among lifetime heroin users found that adolescents who engage in sports and exercise had lower odds of initiating NPOU before heroin when compared with their peers who did not engage in these activities in the past year.

CONCLUSIONS
Daily participation in sports and exercise may serve as a protective factor with respect to NPOU and heroin use.
Persistent Opioid Use Among Pediatric Patients After Surgery
Authors: Harbaugh Calista M. , Lee Jay S. , Hu Hsou Mei , McCabe Sean Esteban , Voepel-Lewis Terri , Englesbe Michael J. , Brummett Chad M. , Waljee Jennifer F. 
Published: November 2021

BACKGROUND
Despite efforts to reduce nonmedical opioid misuse, little is known about the development of persistent opioid use after surgery among adolescents and young adults. We hypothesized that there is an increased incidence of prolonged opioid refills among adolescents and young adults who received prescription opioids after surgery compared with nonsurgical patients.

METHODS
We performed a retrospective cohort study by using commercial claims from the Truven Health Marketscan research databases from January 1, 2010, to December 31, 2014. We included opioid-naïve patients ages 13 to 21 years who underwent 1 of 13 operations. A random sample of 3% of nonsurgical patients who matched eligibility criteria was included as a comparison. Our primary outcome was persistent opioid use, which was defined as ≥1 opioid prescription refill between 90 and 180 days after the surgical procedure.

RESULTS
Among eligible patients, 60.5% filled a postoperative opioid prescription (88 637 patients). Persistent opioid use was found in 4.8% of patients (2.7%–15.2% across procedures) compared with 0.1% of those in the nonsurgical group. Cholecystectomy (adjusted odds ratio 1.13; 95% confidence interval, 1.00–1.26) and colectomy (adjusted odds ratio 2.33; 95% confidence interval, 1.01–5.34) were associated with the highest risk of persistent opioid use. Independent risk factors included older age, female sex, previous substance use disorder, chronic pain, and preoperative opioid fill.

CONCLUSIONS
Persistent opioid use after surgery is a concern among adolescents and young adults and may represent an important pathway to prescription opioid misuse. Identifying safe, evidence-based practices for pain management is a top priority, particularly among at-risk patients.
National Trends in Pediatricians’ Practices and Attitudes About Breastfeeding: 1995 to 2014
Authors: Feldman-Winter Lori , Szucs Kinga , Milano Aubri , Gottschlich Elizabeth , Sisk Blake , Schanler Richard J. 
Published: November 2021

BACKGROUND AND OBJECTIVES
The American Academy of Pediatrics (AAP) has affirmed breastfeeding as the preferred method of infant feeding; however, there has been little systematic examination of how pediatricians’ recommendations, affiliated hospitals’ policies, counseling practices, and attitudes toward breastfeeding have shifted over the past 2 decades. These trends were examined from 1995 to 2014.

METHODS
Data are from the Periodic Survey (PS) of Fellows, a nationally representative survey of AAP members. PS #30 (1995; response rate = 72%; N = 832), PS #57 (2004; response rate = 55%; N = 675), and PS #89 (2014; response rate = 51%; N = 620) collected demographics, patient and practice characteristics, and detailed responses on pediatricians’ recommendations, affiliated hospitals’ policies, counseling practices, and attitudes toward breastfeeding. By using bivariate statistics and logistic regression models, the analysis investigated changes over time with predicted values (PVs).

RESULTS
From 1995 to 2014, more pediatricians reported their affiliated hospitals applied for “baby-friendly” designation (PV = 12% in 1995, PV = 56% in 2014; P &lt; .05), and more reported that they recommend exclusive breastfeeding (65% to 76% [P &lt; .05]). However, fewer respondents indicated that mothers can be successful breastfeeding (PV = 70% in 1995, PV = 57% in 2014; P &lt; .05) and that the benefits outweigh the difficulties (PV = 70% in 1995, PV = 50% in 2014; P &lt; .05). Younger pediatricians were less confident than older pediatricians in managing breastfeeding problems (P &lt; .01).

CONCLUSIONS
Pediatricians’ recommendations and practices became more closely aligned with AAP policy from 1995 to 2014; however, their attitudes about the likelihood of breastfeeding success have worsened. These 2 divergent trends indicate that even as breastfeeding rates continue to rise, continued efforts to enhance pediatricians’ training and attitudes about breastfeeding are necessary.
Sexual Orientation and Depressive Symptoms in Adolescents
Authors: Luk Jeremy W. , Gilman Stephen E. , Haynie Denise L. , Simons-Morton Bruce G. 
Published: November 2021

OBJECTIVES
Sexual orientation disparities in adolescent depressive symptoms are well established, but reasons for these disparities are less well understood. We modeled sexual orientation disparities in depressive symptoms from late adolescence into young adulthood and evaluated family satisfaction, peer support, cyberbullying victimization, and unmet medical needs as potential mediators.

METHODS
Data were from waves 2 to 6 of the NEXT Generation Health Study (n = 2396), a population-based cohort of US adolescents. We used latent growth models to examine sexual orientation disparities in depressive symptoms in participants aged 17 to 21 years, conduct mediation analyses, and examine sex differences.

RESULTS
Relative to heterosexual adolescents, sexual minority adolescents (those who are attracted to the same or both sexes or are questioning; 6.3% of the weighted sample) consistently reported higher depressive symptoms from 11th grade to 3 years after high school. Mediation analyses indicated that sexual minority adolescents reported lower family satisfaction, greater cyberbullying victimization, and increased likelihood of unmet medical needs, all of which were associated with higher depressive symptoms. The mediating role of cyberbullying victimization was more pronounced among male than female participants.

CONCLUSIONS
Sexual minority adolescents reported higher depressive symptoms than heterosexual adolescents from late adolescence into young adulthood. Collectively, low family satisfaction, cyberbullying victimization, and unmet medical needs accounted for &gt;45% of differences by sexual orientation. Future clinical research is needed to determine if interventions targeting these psychosocial and health care–related factors would reduce sexual orientation disparities in depressive symptoms and the optimal timing of such interventions.
Timing of Puberty Suppression and Surgical Options for Transgender Youth
Authors: van de Grift Tim C. , van Gelder Zosha J. , Mullender Margriet G. , Steensma Thomas D. , de Vries Annelou L.C. , Bouman Mark-Bram 
Published: November 2021

OBJECTIVES
Puberty suppression (PS) is a cornerstone of treatment in youth experiencing gender dysphoria. In this study, we aim to inform prescribing professionals on the long-term effects of PS treatment on the development of sex characteristics and surgical implications.

METHODS
Participants received PS according to the Endocrine Society guideline at Tanner 2 or higher. Data were collected from adolescents who received PS between 2006 and 2013 and from untreated transgender controls. Data collection pre- and post-PS and before surgery included physical examination and surgical information.

RESULTS
In total, 300 individuals (184 transgender men and 116 transgender women) were included. Of these, 43 individuals started PS treatment at Tanner 2/3, 157 at Tanner 4/5, and 100 used no PS (controls). Breast development was significantly less in transgender men who started PS at Tanner 2/3 compared with those who started at Tanner 4/5 and controls. Mastectomy was more frequently omitted or less invasive after PS. In transgender women, the mean penile length was significantly shorter in the PS groups compared with controls (by 4.8 cm [Tanner 2/3] and 2.1 cm [Tanner 4/5]). As a result, the likelihood of undergoing intestinal vaginoplasty was increased (odds ratio = 84 [Tanner 2/3]; odds ratio = 9.8 [Tanner 4/5]).

CONCLUSIONS
PS reduces the development of sex characteristics in transgender adolescents. As a result, transgender men may not need to undergo mastectomy, whereas transgender women may require an alternative to penile inversion vaginoplasty. These surgical implications should inform decision-making when initiating PS.
Mental Health of Transgender Children Who Are Supported in Their Identities
Authors: Olson Kristina R. , Durwood Lily , DeMeules Madeleine , McLaughlin Katie A. 
Published: November 2021

OBJECTIVE
Transgender children who have socially transitioned, that is, who identify as the gender “opposite” their natal sex and are supported to live openly as that gender, are increasingly visible in society, yet we know nothing about their mental health. Previous work with children with gender identity disorder (GID; now termed gender dysphoria) has found remarkably high rates of anxiety and depression in these children. Here we examine, for the first time, mental health in a sample of socially transitioned transgender children.

METHODS
A community-based national sample of transgender, prepubescent children (n = 73, aged 3–12 years), along with control groups of nontransgender children in the same age range (n = 73 age- and gender-matched community controls; n = 49 sibling of transgender participants), were recruited as part of the TransYouth Project. Parents completed anxiety and depression measures.

RESULTS
Transgender children showed no elevations in depression and slightly elevated anxiety relative to population averages. They did not differ from the control groups on depression symptoms and had only marginally higher anxiety symptoms.

CONCLUSIONS
Socially transitioned transgender children who are supported in their gender identity have developmentally normative levels of depression and only minimal elevations in anxiety, suggesting that psychopathology is not inevitable within this group. Especially striking is the comparison with reports of children with GID; socially transitioned transgender children have notably lower rates of internalizing psychopathology than previously reported among children with GID living as their natal sex.
Percepción de los usuarios sobre la calidad del servicio de atención en ventanilla del departamento de registro de la Universidad Nacional
Authors: Acuña Castro Yolanda 
Published: November 2021

Este artículo versa sobre la percepción que tiene el usuario sobre la calidad del servicio que se brinda en el área de atención al público en el Departamento de Registro de la Universidad Nacional. Es importante destacar que se concluye que el servicio que se brinda es bueno, no obstante se determina que existen serios problemas en cuanto al apoyo logístico se refiere. Así mismo se presenta una propuesta de capacitación para los funcionarios de dicho Departamento.
IMPLEMENTASI KARAGUL-SAHIN APPROXIMATION METHOD UNTUK MEMINIMALISASI BIAYA PENDISTRIBUSIAN AIR PADA MASALAH TRANSPORTASI
Authors: Basriati Sri , Safitri Elfira , Nusantoro Dinda Kurniyawan 
Published: November 2021

Transportation problems such as transportation activities and allocation to reach consumers is one of the factors that determine the level of satisfaction. To find the level of customer satisfaction, it requires an appropriate and efficient transportation model. One of which is in the Air Minum Mata Air Sikumbang business owned by Mr. Zulfikar, located in Rumbio, Kampar. Based on the results of the study the cost of distributing drinking water is still not efficient because it still uses estimation and there is no separate technique used to allocate water distribution. The solution made in this study using the Karagul-Sahin Approximation Method for the initial basic feasible solution and Stepping Stone for the optimal solution value so as to obtain the distribution of water at a minimum cost. Based on research using the method of Karagul-Sahin Approximation and Stepping Stone, a weekly cost savings of Rp.469.515,00 is obtained.
Curva de aprendizaje del ingeniero en comunicaciones y electrónica del espacio aéreo
Authors: Martínez Gutiérrez Rodolfo , Landero Mada Antonio Alfonso , Carey Raygoza Carmen Esther , Hurtado Sánchez Carlos 
Published: November 2021

Este estudio tiene como finalidad la investigación sobre el desarrollo de los ingenieros en comunicaciones y electrónica (ICE) que laboran en Servicios a la Navegación en el Espacio Aéreo Mexicano (SENEAM). Con el propósito de determinar cuáles han sido las transiciones y sus proyecciones en el entorno laboral durante su permanencia en dicho organismo, y conocer y desarrollar la curva de aprendizaje desde sus inicios profesionales como ICE en el área de Ingeniería de Servicios IDS, comunicaciones, radio ayudas o radar. Las curvas de aprendizaje son modelos empíricos que permiten estudiar las transformaciones tecnológicas como resultado del aprendizaje. Partiendo de esto, el aprendizaje es comprendido como la sabiduría adquirida por la repetición de un proceso (learning-by-doing) (Arrow, 1962). Wright (1996) publicó un artículo donde afirma que la curva de aprendizaje se observó por primera vez en 1920. Al respecto, Hirschmann (1964) comenta “que la práctica hace la perfección, que las cosas se pueden hacer mejor no solo la segunda vez, sino cada vez que lo intente”; la curva de aprendizaje es la que se encarga de cuantificar y representar gráficamente este rendimiento (Hirschmann, 1964). La SENEAM cuenta con más de 40 años en México; proporcionando servicios de ayuda a la navegación aérea para la seguridad, fluidez y orden en el espacio aéreo mexicano; garantizando calidad y eficiencia conforme a la normatividad nacional e internacional aplicable. Se espera que esta investigación dé a conocer los factores que determinan la curva de aprendizaje de los ingenieros en comunicaciones y electrónica, caso SENEAM.
HUBUNGAN GRANDPARENTING STYLE TERHADAP KESEJAHTERAAN PSIKOLOGIS LANSIA DI GABUNGAN ORGANISASI LANSIA
Authors: Suci Saraswati Latifah , Hamiyati  , Mulyati  
Published: November 2021

ABSTRAK

Latifah Suci Saraswati. Hubungan Grandparenting Style terhadap Kesejahteraan Psikologis Lansia di Gabungan Organisasi Wanita (GOW) Kota Magelang, Jawa Tengah, skripsi, Jakarta; Program Studi Pendidikan Kesejahteraan Keluarga, Fakultas Teknik, Universitas Negeri Jakarta, 2021. Dosen Pembimbing Dr. Hamiyati, M.Si., Mulyati, M.Si.

Penelitian ini bertujuan untuk mengetahui hubungan grandparenting style dengan kesejahteraan psikologis lansia di Gabungan Organisasi Wanita (GOW) Kota Magelang, Jawa Tengah. Pengumpulan data pada bulan Januari 2020 dengan metode survei dengan pendekatan korelasional. Populasi pada penelitian ini adalah lansia yang berusia 64-74 tahun dengan jumlah sampel sebanyak 54 responden yang terdiri dari lansia wanita (nenek). Penentuan sampel pada penelitian ini menggunakan metode non probability sampling dengan teknik pengambilan data menggunakan teknik sampling jenuh. Pengumpulan data menggunakan skala Grandparenting Style (32 aitem) dan skala Kesejahteraan Psikologis (16 aitem). Uji hipotesis data yang digunakan adalah korelasi koefisien product moment. Hasil analisis data menunjukkan rhitung > rtabel yaitu sebesar (rhitung 0,452 > rtabel 0,2262). Hasil uji t dengan taraf signifikan 0,05 diperoleh thitung>ttabel yaitu (thitung 3,65 > ttabel 1,675) dapat disimpulkan bahwa terdapat hubungan yang kuat dan signifikan antara grandparenting style dengan kesejahteraan psikologis lansia.
Kata Kunci : Grandparenting Style, Kesejahteraan Psikologis, Lansia
Developing the First Iranian Guideline for Management of Poor Prognosis Infants
Authors: Nayeri Fatemeh Sadat , Asghari Fariba , Arani Mahmoud Motevasel , Vigeh Mohsen , Kheyri Maryam , Shamsi-Gooshki Ehsan , Parsapoor Alireza , Shariat Mamak , Farrokhzad Nahid 
Published: November 2021

Abstract
Background: Significantly improvements in the medical science and advanced in medical equipment and hospital facilities have increased the survival rate of poor prognosis infants (PPIs), including premature/extremely low birth weight, asphyxiated, and born with potentially lethal congenital disorders. However, availability of medical resources was not at the same levels across Iran’s cities. Thus, the country health care system encounters to a challenging question about providing advanced care to PPIs. Methods: The present study aimed to develop a national guideline for management of PPIs. We reviewed 120 articles, protocols, and guidelines, and held 15 sessions with 42 active participants. Semi-structured interviews were performed separately with medical specialist teams, medical ethicists, religious masters (Shia clerics), and parents of PPIs. Results & Conclusions: This guideline is the first nationwide attempt to prepare a comprehensive framework that can support prenatal counseling in Iranian hospitals with various medical facilities to achieve more homogeneity in newborn medical care. In addition, we collected an extensive list of lethal congenital malformations, genetic disorders, inborn errors of metabolism and covers the main areas of concern with a clearly states of responsibilities for decision-making regarding prenatal counseling for PPIs across Iran.