bluuebunny/crossref_metadata_2025_split huggingface dataset:
Telehealth Training for Surgeons to Empathetically Deliver Bad News Via Video-Mediated Communication
Authors: Rivet Emily B. , Edwards Cherie , Lange Patricia , Haynes Susan , Feldman Moshe , Cholyway Renee 
Published: July 2021

Background The COVID-19 pandemic resulted in a sudden increase in the need to effectively use telehealth in all realms of health care communication, including the delivery of bad news. Methods A single arm, unblinded, feasibility study was performed at a tertiary care center located in Central Virginia to explore the value and utility of providing a telehealth training program based on SPIKES to teach surgical residents and faculty best practice for disclosing difficult news via video-mediated communication (VMC). Surgical interns (categorical and preliminary), surgical residents, and surgical faculty from General, Neuro, Pediatric, Plastics, Oncology, Urology, and Vascular surgical specialties were recruited via email to voluntarily participate in a telehealth simulation-based workshop, with 33 surgical learners participating in the training and 28 completing evaluation surveys. Results Only six respondents (22%) indicated they had prior formal training on telehealth communication with patients or families, while 13 (46%) said they had prior experience giving bad news via telehealth. Comments about improving the training focused on providing more scenarios to practice and more time for feedback. Overall, 25 learners (86%) agreed the activity was a valuable learning experience and the majority (61%) of responses were positive for future use of telehealth for breaking bad news. Discussion Practicing communication skills with VMC was found to be valuable by surgical interns, residents, and faculty. Formal training should be provided for surgeons at every stage of training and practice to improve skill in the delivery of bad news to patients and their families.
The effects of a multi-disciplinary team on sleep quality assessment in mild-to-moderate Alzheimer's disease patients with sleep disorders
Authors: Chen Zheli , Wang Lan , Chen Ke , Mi Qu , Zu Xin , Xu Qiuxia , Na Wanqiu , He Weiliang , Li Xuefeng , Xu Chunyun , Wang Fei , Shen Chunli , shao Lei , Tang Chenyun , Shen Xinhua 
Published: July 2021

Background and Aims Sleep disturbances are a severe problem among patients with Alzheimer's disease (AD). By evaluating sleep quality in mild-to-moderate AD patients, this study aimed to assess the effects of multi-disciplinary team (MDT) in reducing the incidence of adverse reactions of AD patients. The reduction in the incidence of adverse reactions to predict multi-disciplinary team (MDT) treatment effects. Methods and Results This study included 60 mild-to-moderate AD patients with sleep problems when hospitalized in Huzhou Third Municipal Hospital. The patients were randomly distributed into two groups, routine and MDT treatments. The cognitive functions, sleep conditions, and psycho-behavioral symptoms were compared between both the groups. Cognitive function declined significantly between pretherapy and follow-up in the routine treatment group (MMSE: t = −7.961, P < 0.001; MoCA: t = −4.672, P < 0.001). There was a significant decline in drowsiness in the MDT group compared to that in the routine treatment group (χ2 = 4.320, P = 0.038). Sleep quality improved significantly during the follow-up in the MDT treatment group (t = 6.098, P < 0.001). The results of the Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA) among family caregivers (FCGs) demonstrated that MDT treatment could alleviate caregivers' depression (t = −2.867, P = 0.042), and routine treatment can worsen their anxiety (t = 3.258, P = 0.003). Conclusion The MDT treatment method as an effective and meaningful therapy can help mitigate the suffering of patients with AD and FCGs.
Do Nutrition Education Approaches With Preschoolers and Their Caregivers Influence Retention of Biofortified Orange-Fleshed Sweet Potato on Farms? Evidence From Homa Bay County, Kenya
Authors: Ojwang Sylvester O. , Otieno David J. , Okello Julius J. , Muoki Penina , Nyikal Rose A. 
Published: July 2021

Background: Biofortified staples have been promoted widely in sub-Saharan Africa to combat micronutrient deficiencies. Contemporary projects are increasingly using elementary schools to target households with these foods. Objective: This study assessed the effects of integrated nutrition education approaches, targeting preschoolers and their caregivers, on retention of orange-fleshed sweet potato (OFSP) on farms in the second season after lapse of free vine dissemination initiatives. Methods: Rural farming households, with preschoolers and no prior engagement with OFSP, were targeted. A multistage sample of 431 preschooler–caregiver pairs was recruited for a cluster-randomized controlled trial. After issuing routine OFSP promotion activities, 15 village-level clusters of the pairs were randomized into 1 control group (3 villages) and 3 treatment arms (4 villages each) for the interventions. Baseline and follow-up household-level survey data were collected from the caregivers. The interventions included: (1) OFSP-branded exercise books, posters, and a poem to preschoolers only; (2) OFSP-oriented mobile phone mediated text messages to caregivers only; and (3) both 1 and 2 provided to individual households concurrently. Interventions 1 and 2 were single-channeled, while 3 was multichanneled. We estimated the intention-to-treat (ITT) and treatment-on-the-treated (TOT) effects using a binary logit model and a special regressor method, respectively. Results: Only the multi-channeled nutrition education approach had significant effects (ITT = 0.167, P = .001; TOT = .243, P = .007) on the caregivers’ likelihood to retain OFSP on their farms. Conclusions: The finding implies that multi-channeled agriculture nutrition education interventions through Early Childhood Development institutions can be effective in ensuring sustainable adoption of OFSP.
Length of Stay in Pediatric Neurology Hospital Admissions
Authors: Roliz Annie , Shah Yash D. , Singh Kanwaljit , Talreja Sushil , Kothare Sanjeev 
Published: July 2021

Objective: To describe inpatient length of stay patterns, identify key drivers related to prolonged length of stay, and evaluate the relationship between length of stay and readmission in pediatric neurology Methods: This was a retrospective review of patients <19 years old admitted with a principal neurologic diagnosis to our hospital between January 2017 and July 2019. Scheduled admissions and hospital admissions lasting >30 days were excluded from analysis. Length of stay was obtained in addition to demographic characteristics, principal discharge diagnosis, multispecialty care, use of multiple antiseizure medications, inpatient hospital costs (ie, claims paid), and pediatric intensive care unit (ICU) admission for unplanned admissions and 7- and 30-day readmissions. Results: There were a total of 1579 unplanned admissions. The most common reasons for admission were seizure (n = 942), headache (n = 161), other neurologic diagnosis (n = 121), and psychiatric disorders/functional neurologic disorder (n = 60). Children admitted to the hospital for a neurologic condition have an average length of stay of 2.8±5.0 days for unplanned admissions, 4.5±7.4 days for 7-day readmissions, and 5.2±7.5 days for 30-day readmissions. Average inpatient hospital costs were $44 075±56 976 for unplanned admissions, $60 361±71 427 for 7-day readmissions, and $55 434±56 442 for 30-day readmissions. Prolonged length of stay and increased hospital costs were associated with pediatric ICU admission, multispecialty care, 7- and 30-day readmission, multiple antiseizure medications, and psychiatric disorders / functional neurologic disorders. Conclusions: Pediatric ICU admission, multispecialty care, readmission, multiple antiseizure medications, and psychiatric disorder / functional neurologic disorder prolong length of stay and increase hospital costs.
Impact of pulmonary hypertension on arteriovenous fistula failure of hemodialysis patients: A 10 years follow-up cohort study
Authors: Song Li , Quan Zi-Lin , Zhao Li-Yan , Cui Dong-Mei , Zhong Mi , Zhou Li-Fang , Sun Chun-Yan , Chen Ying-Gui , Mo Ya-Wen , Feng Zhonglin , Tao Yiming , Ye Zhiming , Chen Yuanhan , Liang Huaban , Lin Ting , Liu Shuangxin , Liang Xin-Ling , Fu Xia 
Published: July 2021

Background: Pulmonary hypertension (PH) is common in patients with end-stage renal disease (ESRD). Arteriovenous fistulas (AVF) creation may involve in the pathogenesis of PH. The aim of this study was to explore the impact of PH after AVF creation on the AVF failure rate in maintenance hemodialysis (MHD) patients. Methods: From January 1, 2009, to January 1, 2019, we retrospectively collected data of 578 MHD patients in Guangdong Provincial People’s Hospital Blood Purification Center, China. Patients were followed-up until AVF failure or death or May 25, 2020. According to the systolic pulmonary artery pressure (SPAP) within 1 year after the establishment of AVF, the MHD patients were divided into three groups: SPAP ⩽ 35 mmHg, 35 < SPAP < 45 mmHg, SPAP ⩾ 45 mmHg. The primary outcome was AVF failure defined as AVF cannot complete hemodialysis. The secondary outcomes were all-cause mortality. Results: A total of 578 patients were analyzed. The average age was 60.66 ± 15.34 years (58.1% men). Of these, 26.1% of patients were reported PH. The SPAP exhibited a left-skewed nonparametric distribution and the overall SPAP after the creation of AVF was 39.00 (29.00–52.00) mmHg. The median follow-up was 5.8 (5.5–6.3) years. Overall, 12.8% (74/578) patients were reported AVF failure events. There was no significant difference in AVF failure rate among three groups ( p = 0.070). A total of 111 (19.2%) died during the follow-up period. Compared with the SPAP ⩽35 mmHg group, only the all-cause death rate significantly increased in MHD patients with PH ( p < 0.001). Conclusions: The secondary pulmonary hypertension after AVF creation did not increase the risk of AVF failure in MHD patients, but significantly increased the risk of mortality for this portion of the patients. Future larger sample sizes, multi-center, and prospective trials are needed to make sure which type of access will benefit on their survival for MHD patients with SPAP ⩾35 mmHg.
Impact of the Coronavirus Pandemic on Substance Use Disorder Treatment: Findings from a Survey of Specialty Providers in California
Authors: Henretty Kristen , Padwa Howard , Treiman Katherine , Gilbert Marylou , Mark Tami L 
Published: July 2021

Background: As the coronavirus pandemic public health emergency begins to ebb in the United States, policymakers and providers need to evaluate how the addiction treatment system functioned during the public health emergency and draw lessons for future emergencies. One important question is whether the pandemic curtailed the use of addiction treatment and the extent to which telehealth was able to mitigate access barriers. Methods: To begin to answer this question, we conducted a survey of specialty addiction treatment providers in California from June 2020 through July 2020. The survey focused specifically on provider organizations that served Medicaid beneficiaries. Results: Of the 133 respondents, 50% reported a decrease in patients since the stay-at-home order in March 2020, with the largest decline among new patients, and 58% said more patients were relapsing. Eighty-one percent of providers said that telemedicine use had increased since the stay-at-home order. Most said that telemedicine had moderately (48%) or completely (30%) addressed access barriers. Conclusion: More efforts are needed to ensure that patients, and in particular new patients, receive addiction treatment during public health emergencies.
Evaluating the use of multimedia information when recruiting adolescents to orthodontics research: A randomised controlled trial
Authors: Knapp Peter , Mandall Nicky , Hulse Wendy , Roche Jenny , Moe-Byrne Thirimon , Martin-Kerry Jacqueline , Sheridan Rebecca , Higgins Steven ,   (for the TRECA study group)
Published: July 2021

Objective: To compare two methods of providing information about the Bone Anchored Maxillary Protraction (BAMP) trial: standard printed information and multimedia websites, for their quality and ease of understanding, and impact on decision-making. Design: Randomised controlled trial. Setting: Orthodontic outpatient clinic in the UK. Methods: Participants were 109 adolescents (aged 11–14 years) attending for orthodontic treatment. While awaiting treatment they were asked to imagine being recruited to the BAMP clinical trial. They were individually randomised to receive the printed or the multimedia website information (comprising text, animations and ‘talking head’ videos). After reading or viewing the information, they completed a 9-item Likert scale Decision-Making Questionnaire (DMQ) (score range 0–36) plus three free-text questions on their evaluation of the information. Results: A total of 104 participants completed the questionnaire. Mean total DMQ scores were higher (more positive) in the website group (28.1 vs. 27.0), although the difference was small and not statistically significant ( P = 0.20). Analysis of individual questionnaire items showed two statistically significant differences: the website information had higher ratings on ‘easy to understand’ (Z = 3.03; P = 0.003) and ‘confidence in decision-making’ (Z = 2.00; P = 0.044). On the three free-text questions, more positive and fewer negative comments were made about the websites than the printed information. Conclusion: In this hypothetical trial setting, adolescent patients found that trial information conveyed on a multimedia website was easier to understand and made them more confident in their decision about trial participation. Their subjective evaluations of the website were also more positive and less negative than about the printed information. Multimedia information has the potential to increase the quality of engagement and information exchange when seeking consent for research.
Social workers’ approaches to ethical dilemmas
Authors: Gómez-García Rogelio , Lucas-García Jezabel , Bayón-Calvo Siro 
Published: July 2021

Summary The study objective was the identification of social workers’ ethic profiles in their professional interventions. To conduct this pilot study, we used data from a national survey ( N = 1071) carried out in Spain. The information was collected through an online questionnaire. Findings Results show that social workers face a variety of ethical dilemmas in their professional practice. Through exploratory factor analysis, it was revealed that the underlying structure of the questionnaire consisted of three categories: direct service to individuals and families, design and implementation of social welfare policy and programmes and relationships among professional colleagues. Through latent class analysis, four unique social workers’ ethical profiles were identified: professionals with minimum incidence of experiencing ethical dilemmas, professionals with low incidence of experiencing ethical dilemmas, professionals with a notable incidence of experiencing ethical dilemmas and, finally, professionals with high incidence of experiencing ethical dilemmas. A third of the social workers in the sample showed a very low probability to be conflicted by ethical dilemmas. Applications The pilot study is expected to serve as a catalyst for discussion of social workers’ ethical conduct and professional practice, to promote professional ethics training and education and to support the development of professional guidelines.
Trauma and cervical cancer screening among women experiencing homelessness: A call for trauma-informed care
Authors: Kohler Racquel E , Roncarati Jill S , Aguiar Anastasia , Chatterjee Pritha , Gaeta Jessie , Viswanath Kasisomayajula , Henry Cassis 
Published: July 2021

Objective: Women experiencing homelessness are at increased risk of cervical cancer and have disproportionately low Pap screening behaviors compared to the general population. Prevalence of Pap refusals and multiple kinds of trauma, specifically sexual trauma, are high among homeless women. This qualitative study explored how trauma affects Pap screening experiences, behaviors, and provider practices in the context of homelessness. Methods: We conducted 29 in-depth interviews with patients and providers from multiple sites of a Federally Qualified Health Center as part of a study on barriers and facilitators to cervical cancer screening among urban women experiencing homelessness. The Health Belief Model and trauma-informed frameworks guided the analysis. Results: Trauma histories were common among the 18 patients we interviewed. Many women also had strong physical and psychological reactions to screening, which influenced current behaviors and future intentions. Although most women had screened at least once in their lifetime, many patients experienced anticipated anxiety and retraumatization which pushed them to delay or refuse Paps. We recruited 11 providers who identified strategies they used to encourage screening, including emphasizing safety and shared decision-making before and during the exam, building strong patient–provider trust and communication, and individually tailoring education and counseling to patients’ needs. We outlined suggestions and implications from these findings as trauma-informed cervical cancer screening. Conclusion: Discomfort with Pap screening was common among women experiencing homelessness, especially those with histories of sexual trauma. Applying a trauma-informed approach to cervical cancer screening may help address complex barriers among women experiencing homelessness, with histories of sexual trauma, or others who avoid, delay, or refuse the exam.
Family history of obesity and the influence on physical activity and dietary adherence after bariatric surgery
Authors: Fipps David C , Holder Sharon M , Schmalz Dorothy L , Scott John 
Published: July 2021

Background The causes of obesity are multifactorial, with genetic, environmental, behavioural and societal contributions. These factors also affect adherence to diet and exercise after bariatric surgery. The objective of this study was to evaluate changes in perceived obesity-related stigma, exercise and dietary adherence perioperatively as well as what demographic factors most influence the magnitude of these changes. Methods Validated questionnaires regarding perception of stigma and adherence to diet and exercise regimens were administered to 104 bariatric surgery patients preoperatively and postoperatively at three, six and 12 months. Scoring was compared for improvement, and concomitant factors were analysed for effect on magnitude of improvement. Results Our study found overall improvement in perception of stigma as well as adherence to diet and exercise regimens. Those with a family history of obesity had less robust improvement compared to those without a family history of obesity. Those who were Caucasian also did not have as robust of an improvement in their scores. Conclusions Patient perception of obesity-related stigma and adherence to diet and exercise regimens improve after bariatric surgery. However, a patient with a family history of obesity and/or a Caucasian ethnicity may have a less robust improvement in these facets.
Application of linked color imaging in the diagnosis of early gastrointestinal neoplasms and precancerous lesions: a review
Authors: Wang Shanshan , Shen Lei , Luo Hesheng 
Published: July 2021

Introduction: Minimally invasive endoscopic resection is often effective in the management of early gastrointestinal tumors. However, advanced and more effective methods of endoscopic examination are required to improve the rate of diagnosing early gastrointestinal tumors. Discussion: The development of dye-based image-enhanced endoscopy (d-IEE) and equipment-based image-enhanced endoscopy (e-IEE) has helped improve the diagnostic rate of early gastrointestinal tumor using endoscopy. In some special cases, these methods are still not accurate in diagnosing lesions. On the basis of these e-IEEs, a new endoscopic technique, linked color imaging (LCI), that combines a specific short wavelength narrow band of light with white light, has been developed. Conclusion: In this article, we summarized the characteristics of LCI and the development of research regarding digestive tract examination. Plain language summary Application of linked color imaging in early gastrointestinal neoplasms At present, the complete diagnosis of early gastrointestinal tumors and precancerous lesions can be made by gastrointestinal endoscopy. With the improvement of therapeutic instruments and operators’ experience, endoscopic therapy can often achieve significant effect in the treatment of early gastrointestinal tumors. The development and spread of equipment-based image-enhanced endoscopy (e-IEE) mode has helped improve the diagnosis rate of early gastrointestinal tumors under endoscopy. However, in some special cases, these methods are still not accurate for the diagnosis of lesions. On the basis of these E-IEEs, a new endoscopic technique, linked color imaging (LCI), has been developed, which combines a specific short wavelength narrow band of light with white light. LCI can significantly improve the diagnostic rate of all types of gastrointestinal mucosal lesions. Tumor lesions and inflammatory lesions can be distinguished by observing the mucosal microvascular structure and color difference. LCI helps detect early gastrointestinal mucosal lesions by taking advantage of the differences in light absorption of different wavelengths and contrast of enhanced colors in the later stage.
A Glucose-Only Model to Extract Physiological Information from Postprandial Glucose Profiles in Subjects with Normal Glucose Tolerance
Authors: Eichenlaub Manuel M. , Khovanova Natasha A. , Gannon Mary C. , Nuttall Frank Q. , Hattersley John G. 
Published: July 2021

Background: Current mathematical models of postprandial glucose metabolism in people with normal and impaired glucose tolerance rely on insulin measurements and are therefore not applicable in clinical practice. This research aims to develop a model that only requires glucose data for parameter estimation while also providing useful information on insulin sensitivity, insulin dynamics and the meal-related glucose appearance (GA). Methods: The proposed glucose-only model (GOM) is based on the oral minimal model (OMM) of glucose dynamics and substitutes the insulin dynamics with a novel function dependant on glucose levels and GA. A Bayesian method and glucose data from 22 subjects with normal glucose tolerance are utilised for parameter estimation. To validate the results of the GOM, a comparison to the results of the OMM, obtained by using glucose and insulin data from the same subjects is carried out. Results: The proposed GOM describes the glucose dynamics with comparable precision to the OMM with an RMSE of 5.1 ± 2.3 mg/dL and 5.3 ± 2.4 mg/dL, respectively and contains a parameter that is significantly correlated to the insulin sensitivity estimated by the OMM ( r = 0.7) Furthermore, the dynamic properties of the time profiles of GA and insulin dynamics inferred by the GOM show high similarity to the corresponding results of the OMM. Conclusions: The proposed GOM can be used to extract useful physiological information on glucose metabolism in subjects with normal glucose tolerance. The model can be further developed for clinical applications to patients with impaired glucose tolerance under the use of continuous glucose monitoring data.