bluuebunny/crossref_metadata_2025_split huggingface dataset:
Adolescent Dating Violence: Results of a Mixed Study in Quito, Ecuador
Authors: Medina-Maldonado Venus , del Mar Pastor-Bravo María , Vargas Elka , Francisco Judith , Ruiz Ismael Jiménez 
Published: March 2021

Dating violence is a public health problem affecting people worldwide. This study evaluated the occurrence of different types of adolescent dating violence using a mixed analysis of each data source. The present study addresses the following research questions: does the occurrence of the types of violence analyzed in the quantitative phase match with the narratives obtained in the qualitative phase? and does the additional information obtained in the qualitative phase improve the understanding of the analyzed phenomenon? In the quantitative phase, 410 participants (aged 13 to 19 years) answered a questionnaire based on the Modified Conflict Tactics Scale, while in the qualitative phase, 26 participated in two focus groups. Data were collected from May to June 2019. Written informed consent was obtained from the parents or legal guardians of those who had agreed to participate. The present research was approved by the Human Research Ethics Committee of the Pontifical Catholic University of Ecuador. The results were divided on: prevalence of dating violence based on age groups and gender, management and resolution of dating conflicts, victimization and perpetration of intimate partner violence, factors favoring intimate partner violence and acceptance of abuse. The results were analyzed via triangulation and indicated that adolescents were involved in the perpetration and victimization of psychological as well as mild and severe physical violence. An analysis of the contributing factors revealed a strong tendency toward the acceptance of the traditional gender model. Challenging these models is crucial to deconstruct hierarchical models, develop conflict resolution skills, and promptly identify abusive behaviors that affect emotional development. The combination of different methodological approaches improved the understanding of the phenomenon studied.
Factors associated with sexually transmitted infection/HIV diagnosis among a predominantly university population in Brazil
Authors: Bomfim Isabella GO , dos Santos Sigrid DS , Ruggiero Cíntia M , Napoleão Anamaria A ,   SANCAHIV
Published: March 2021

In Brazil, the increasing prevalence of HIV infection in young people makes it critical to know its distribution in university communities. In this cross-sectional study, we evaluated the impact of STI/HIV testing campaigns on university campuses from 2013 to 2017. The participants took part in rapid testing for HIV, syphilis, hepatitis B and C, and counseling sessions. A total of 2691 people participated in the campaigns. Of these, 79.4% were single, and 50.3% were women. The median age was 24 years old, and 77.9% of participants had ≥12 years of formal education. Most reported having unprotected sex in the last year (87.4%). The positivity rates for HIV, syphilis, hepatitis B virus, and hepatitis C virus were 0.56%, 1.20%, 0.19%, and 0.11%, respectively. The characteristics associated with HIV infection were being men who have sex with men (MSM) (aOR = 12.06; 95% CI = 3.83–37.99) and having <12 years of schooling (aOR = 3.28; 95% CI = 1.03–10.38). Factors associated with syphilis seropositivity were older age (aOR = 1.06; 95% CI = 1.03–1.09), multiple partners (aOR = 2.44; 95% CI = 1.08–5.50), and being MSM (aOR = 5.40; 95% CI = 2.49–11.72). Positivity for hepatitis B tended to decrease with the years of testing ( p = 0.023) and for hepatitis C to increase with age ( p = 0.035). Our study observed a high vulnerability to HIV and syphilis infection in a university community, which needs an early prevention strategy, including regular testing, continuing sexual education, easy access to condoms, and pre- and postexposure HIV prophylaxis.
Recent Attitudes toward ADHD in the Broader Community: A Systematic Review
Authors: Bisset Matthew , Winter Leanne , Middeldorp Christel M. , Coghill David , Zendarski Nardia , Bellgrove Mark A. , Sciberras Emma 
Published: March 2021

Objective: This review aimed to understand the broader community’s attitudes toward ADHD, which could facilitate public health interventions to improve outcomes for individuals with ADHD. Methods: A standardized protocol identified peer-reviewed studies focusing on attitudes of broader community samples, published from January 2014 to February 2020 (inclusive). Results: A total of 1,318 articles were screened and 10 studies were included, examining attitudes of broader community samples from Australia, Sweden, Germany, Finland, Korea, Indonesia, and the United States. Findings revealed that broader community samples displayed varying degrees of ADHD-related knowledge, negative attitudes (that ADHD is over-diagnosed; that pharmacological treatment is not acceptable; that those with ADHD are more likely to exhibit poor behavior), and a desire for maintaining social distance from individuals with ADHD. Conclusion: Findings suggest that community attitudes are generally negative toward those with ADHD. Targeted mental health literacy could provide an important avenue for improving the broader community’s attitudes toward those with ADHD.
Effects of Implementation and Enforcement Differences in Prescription Drug Monitoring Programs in 3 States: Connecticut, Kentucky, and Wisconsin
Authors: Dickson-Gomez Julia , Christenson Erika , Weeks Margaret , Galletly Carol , Wogen Jennifer , Spector Antoinette , McDonald Madelyn , Ohlrich Jessica 
Published: March 2021

Background and aims: Prescription Drug Monitoring Programs (PDMPs) were designed to curb opioid misuse and diversion by tracking scheduled medications prescribed by medical providers and dispensed by pharmacies. The effects of PDMPs on opioid prescription, misuse and overdose rates have been mixed due in part to variability in states’ PDMPs and difficulties measuring this complexity, and a lack of attention to implementation and enforcement of PDMP components. The current study uses qualitative interviews with key informants from 3 states with different PDMPs, Connecticut, Kentucky and Wisconsin to explore differences in the characteristics of the PDMPs in each state; how they are implemented, monitored and enforced; and unintended negative consequences of these programs. Methods: We conducted in-depth interviews with key informants from each state representing the following sectors: PDMP and pain clinic regulation agencies, Medicaid programs, state licensing boards, pharmacies, emergency medicine departments, pain management clinics, first responders, drug courts, drug treatment programs, medication assisted treatment (MAT) providers, and harm reduction organizations. Interview guides explored participants’ experiences with and opinions of PDMPs according to their roles. Data analysis was conducted using a collaborative, constant comparison method. Results: While all 3 states had mandated registration and reporting requirements, the states differed in the implementation and enforcement of these and the extent to which provider prescribing was monitored. These, in turn, influenced how medical providers perceived the PDMP and changed how providers prescribed opioids. Unintended consequences of state PDMPs included under-prescribing for pain and “dumping” patients who were long term users of opioids or who had developed opioid use disorders and may explain the increase in illicit heroin or opioid use. Conclusion: State PDMPs with similar mandates may differ greatly in implementation and enforcement. These differences are important to consider when determining the effects of PDMPs on opioid misuse and overdose.
Using Co-Design to Create Community Advocacy for Biosecurity Behavior Change
Authors: Sherring Phill 
Published: March 2021

Background: New Zealand’s Ministry for Primary Industries (MPI) manages the “declare or dispose” biosecurity border compliance social marketing program. Its aim is to protect the country’s important horticulture and agriculture industries from imported pests and diseases, and its environment. The program encourages visitors to New Zealand to leave potential biosecurity risk items at home or dispose in specially marked bins on arrival. An important part of this is having New Zealand ethnic communities advocate on MPI’s behalf to friends and family overseas to follow the biosecurity rules. To fully engage the community to be advocates, it was felt that the community should be involved in the creation of this aspect of the program. Focus of the article: The article is a case study explaining how MPI used co-design methodology to create an advocacy program with a local community to assist behavior change in overseas visitors. The article focusses on the process and planning (including following a six-step co-design model) from a practitioners’ perspective to develop a program co-created with the target audience, rather than the final interventions developed. Program design/approach: The “declare or dispose” program had been solely “expert led” and designed by social marketers and researchers. The program is heavily influenced by a mix of quantitative and ethnographic research. These feed into customer journey mapping where interventions are inserted to influence audiences’ behavior. To assist in advocacy from the New Zealand Indian community to friends and family overseas, a customer led co-design process was developed to create community engagement and advocacy. Methods: MPI ran three co-design sessions involving members of local Indian community groups. The sessions used a mixture of card sorting and open discussion within small groups. The card sorting was used to review, and rate current interventions used in the behavior change program (including interventions both overseas direct to visitors and locally to community members). The open discussion asked participants to generate new ideas for potential new interventions to reach visitors. Results: Through the ranking of existing tools and participant suggestions of new ideas—MPI has developed an advocacy program that spans expert-led and user-led interventions. As hoped, the user-led suggestions were at a community-based level, resulting in a stronger buy-in from the community to deliver advocacy messages to overseas friends and family. Recommendations for practice: The article is useful for practitioners by detailing how to not only use co-design for creating new ideas, but also to evaluate existing ones to create a program blending both expert- and user-led interventions. MPI followed a six-step co-design process to organize its co-design program. This ensured that the right preparation was followed, sessions were effective, and the desired results of the program were achieved.
Patient Satisfaction Following Hallux Rigidus Treatment With a Synthetic Cartilage Implant
Authors: Lee Wonyong , Wang Carol , Prat Dan , Wapner Keith L. , Chao Wen , Farber Daniel C. 
Published: March 2021

Background There remains no clear consensus on patient satisfaction and functional outcomes following synthetic cartilage implant (SCI) implantation for hallux rigidus. The purpose of this study was to review our experience at a single academic institution using an SCI for treatment of hallux rigidus. Methods A retrospective review was performed of patients who underwent the SCI procedure for treatment of hallux rigidus between January 2017 and May 2019. Functional outcomes were evaluated using Patient-Reported Outcome Measures Informational System (PROMIS)-10 scores as well as a survey investigating patient satisfaction, self-reported clinical improvement, and changes in sporting ability. Patients were divided into satisfied versus unsatisfied subgroups, and between-group differences in preoperative variables and complications were reviewed. A total of 90 patients (96 implants) were included in this study. The mean follow-up time was 26.4 months. Results In all, 81.2% of patients reported that their foot was “much improved” (55.2%) or “improved” (26.0%) since undergoing the SCI procedure, whereas a slightly lower percentage, 74.0%, stated that they were “extremely satisfied” (41.7%) or “satisfied” (32.3%) at final follow-up. Patients were able to tolerate higher impact sporting activities after the procedure, and 75.0% of patients stated they would have the same surgery again. PROMIS-10 T-scores averaged 54.2 points for physical health and 57.4 points for mental health. Only 2.1% of patients required conversion to arthrodesis. Significant differences between the satisfied versus unsatisfied subgroups were found in preoperative corticosteroid injection use (21.1% vs 41.1%, respectively; P = .029) and preoperative VAS pain score (8.2 vs 7.1, respectively; P = .036). Conclusion The SCI procedure can be a viable option for treating hallux rigidus with high satisfaction overall, increased sport activity levels, and a very low revision rate. However, maximizing patient satisfaction may require more careful consideration of preoperative prognosticators and extensive patient counseling to ensure realistic expectations for recovery time and individual outcome. Level of Evidence: Level IV: Retrospective case series
Surgical treatment of a distal oesophageal stricture by mucosal radial incision and dilation in a kitten with secondary megaoesophagus
Authors: Kurtz Maxime , Paulin Mathieu V , Fournet Alexandre , Decambron Adeline , Fabrès Virginie , Freiche Valérie 
Published: March 2021

Case summary A 7-month-old intact female Maine Coon cat was presented with a 2-month history of regurgitations. Contrast radiographic and endoscopic examinations revealed a diffuse megaoesophagus secondary to a severe lower oesophageal stricture. An epiphrenic diverticulum was noted. Endoscopic balloon dilation was unsuccessful. Gastrotomy was thus performed in order to incise the oesophageal wall radially along the stricture site, and then to dilate the stricture. A diameter of 20 mm was reached. With the aim of preventing stricture recurrence, submucosal injections of triamcinolone acetonide were performed. An 18 Fr oesophagogastric feeding tube was placed and a left gastropexy was performed in order to exert some traction on the gastroesophageal junction, with the aim of reducing the oesophageal diverticulum. Twelve months postoperatively, clinical signs had completely resolved and follow-up radiographs revealed marked improvement of the oesophageal dilatation. Relevance and novel information Lower oesophageal strictures should be considered when evaluating regurgitations or megaoesophagus in a kitten. Surgical mucosal radial incision is a therapeutic option in cases of lower oesophageal stricture refractory to balloon dilation, and can lead to a marked improvement of clinical signs and of the oesophagus diameter leading to clinical success.
Preoperative Cognitive Impairment as a Perioperative Risk Factor in Patients Undergoing Total Knee Arthroplasty
Authors: Krishnan Sindhu , Brovman Ethan Y. , Urman Richard D. 
Published: March 2021

Background: The study assessed whether pre-existing cognitive impairment (CI) prior to elective total knee arthroplasty (TKA) is associated with worse postoperative outcomes such as delirium, in-hospital medical complications, 30-day mortality, hospital length of stay and non-home discharge. Methods: A retrospective database analysis from the NSQIP Geriatric Surgery Pilot Project was used. There was an initial cohort of 6350 patients undergoing elective TKA, 104 patients with CI were propensity score matched to 104 patients without CI. Results: Analysis demonstrated a significantly increased incidence of post-operative delirium (POD) in the cohort with pre-op CI (p = < .001), a worsened functional status (p = < .001) and increased nonhome discharge postoperatively compared to the group without CI (p = 0.029). Other post-operative outcomes included 30-day mortality of 0% in both groups, and low rate of complications such as infection (2.88% vs 0.96%), pneumonia (1.92% vs 0%), failure to wean (0.96% vs 0%), and reintubation (0.96% vs 0%). Some other differences between the CI group and non-CI group, although not statistically significant, included increased rate of transfusion (10.58% vs 6.73%), and sepsis (1.92% vs 0%). The length of stay was increased in the non-CI group (4.28% vs 2.32%, p = 0.122). Conclusion: CI in patients undergoing TKA is associated with an increased risk of POD, worsened postoperative functional status, and discharge to non-home facility.
The Development of a Mobile Application for Older Adults for Rehabilitation Instructions After Hip Fracture Surgery
Authors: Ko YoungJi , Hwang Jong-Moon , Baek Seung-Hoon 
Published: March 2021

Introduction: Older patients with hip fractures require a long time to rehabilitate and recover after surgery. Although effective discharge instructions for long-term recovery are important, the discharge instructions of most acute-care hospitals are often presented as a brochure, which is difficult for older adults to follow. The purpose of this study was to develop rehabilitation instructions in the form of a mobile application for the physical recovery of older adults after hip fracture surgery. Materials and Methods: A mobile application for rehabilitation instructions after hip fracture surgery was developed in ADDIE order of analysis, design, development, implementation, and evaluation. The contents of the mobile application composed of rehabilitative exercises, activities of daily living, pain and nutrition management, fall prevention, and hospital visits. Nine experts evaluated the application and SPSS version 23.0 program was used for data analysis. Results: In the mobile application evaluation by the experts, the average score of the contents was 2.22 out of 3 points. The average score of understanding was the highest at 2.42, while accuracy was the lowest at 2.00 in the contents. The average score of the interface design was 2.32 out of 3 points. The average score of consistency was the highest at 2.42, while design suitability was the lowest at 2.25 in the interface design. The experts perceived the mobile application as simple and easy to understand while also suggesting some improvements. Conclusion: The average scores were highest for understanding of contents and consistency of the interface design and lowest for accuracy of contents and design suitability of the interface design. The mobile application was easy to understand and had consistency in design.
A Systematic Scoping Review on Portfolios of Medical Educators
Authors: Hong Daniel Zhihao , Lim Annabelle Jia Sing , Tan Rei , Ong Yun Ting , Pisupati Anushka , Chong Eleanor Jia Xin , Quek Chrystie Wan Ning , Lim Jia Yin , Ting Jacquelin Jia Qi , Chiam Min , Chin Annelissa Mien Chew , Lee Alexia Sze Inn , Wijaya Limin , Cook Sandy , Krishna Lalit Kumar Radha 
Published: March 2021

Background: Heralded as a teaching, assessment and reflective tool, and increasingly as a longitudinal and holistic perspective of the educator’s development, medical educator’s portfolios (MEP)s are increasingly employed to evaluate progress, assess for promotions and career switches, used as a reflective tool and as a means of curating educational activities. However, despite its blossoming role, there is significant dissonance in the content and structure of MEPs. As such, a systematic scoping review (SSR) is proposed to identify what is known of MEPs and its contents. Methods: Krishna’s Systematic Evidenced Based Approach (SEBA) was adopted to structure this SSR in SEBA of MEPs. SEBA’s constructivist approach and relativist lens allow data from a variety of sources to be considered to paint a holistic picture of available information on MEPs. Results: From the 12 360 abstracts reviewed, 768 full text articles were evaluated, and 79 articles were included. Concurrent thematic and content analysis revealed similar themes and categories including: (1) Definition and Functions of MEPs, (2) Implementing and Assessing MEPs, (3) Strengths and limitations of MEPs and (4) electronic MEPs. Discussion: This SSR in SEBA proffers a novel 5-staged evidence-based approach to constructing MEPs which allows for consistent application and assessment of MEPs. This 5-stage approach pivots on assessing and verifying the achievement of developmental milestones or ‘micro-competencies’ that facilitate micro-credentialling and effective evaluation of a medical educator’s development and entrust-ability. This allows MEPs to be used as a reflective and collaborative tool and a basis for career planning.
Risk perception on the labour ward: A mixed methods study
Authors: McCarthy Claire , Meaney Sarah , Rochford Marie , O’Donoghue Keelin 
Published: March 2021

Healthcare providers commonly experience risky situations in the provision of maternity care, and there has been increased focus on the lived experience in recent years. We aimed to assess opinions on, understanding of and behaviours of risk on the LW by conducting a mixed methods study. Staff working in a LW setting completed a descriptive questionnaire-based study, followed by qualitative structured interviews. Statistical analysis was performed with SPSS on quantitative data and thematic analysis performed on qualitative data. Nearly two thirds of staff (64%; 73/114) completed the questionnaire, with 56.2% (n = 47) experiencing risk on a daily basis. Experiencing risk evoked feelings of apprehension (68.4%; n = 50) and worry (60.2%; n = 44) which was echoed in the qualitative work. Structured clinical assessment was utilised in risky situations, and staff described “ going on autopilot” to manage these situations. A large number of respondents reflected on their provision of care following an adverse event (87.7%; n = 64). Debriefing was mentioned as an important practice following such events by all respondents. This study describes the negative terminology prevailing in emergency obstetric care. These experiences can have a profound impact on staff. Risk reduction strategies and the provision of increased staff support and training are crucial to improve staff wellbeing in stressful scenarios.