bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk factors for persistent pain after breast and thoracic surgeries: a systematic literature review and meta-analysis
Authors: Lim Joshua , Chen Dili , McNicol Ewan , Sharma Lokesh , Varaday Grihith , Sharma Anshuman , Wilson Elizabeth , Wright-Yatsko Tiffany , Yaeger Lauren , Gilron Ian , Finnerup Nanna B. , Haroutounian Simon 
Published: April 2021

Abstract
Persistent postsurgical pain (PPSP) is common after breast and thoracic surgeries. Understanding which risk factors consistently contribute to PPSP will allow clinicians to apply preventive strategies, as they emerge, to high-risk patients. The objective of this work was to systematically review and meta-analyze the literature on risk factors of PPSP after breast and thoracic surgeries. A systematic literature search using Ovid Medline, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, Embase, PsycINFO, and Scopus databases was conducted. Study screening with inclusion and exclusion criteria, data extraction, and risk of bias assessment was performed independently by 2 authors. The data for each surgical group were analyzed separately and meta-analyzed where possible. The literature search yielded 5584 articles, and data from 126 breast surgery and 143 thoracic surgery articles were considered for meta-analysis. In breast surgery, younger age, higher body mass index, anxiety, depression, diabetes, smoking, preoperative pain, moderate to severe acute postoperative pain, reoperation, radiotherapy, and axillary lymph node dissection were the main factors associated with higher risk of PPSP. In thoracic surgery, younger age, female sex, hypertension, preoperative pain, moderate to severe acute postoperative pain, surgical approach, major procedure, and wound complications were associated with PPSP. This systematic review demonstrated certain consistent risk factors of PPSP after breast and thoracic surgeries, as well as identified research gaps. Understanding the factors that increase susceptibility to PPSP can help selectively allocate resources to optimize perioperative care in high-risk patients and help develop targeted, risk-stratified interventions for PPSP prevention.
Relationship between gait complexity and pain attention in chronic low back pain
Authors: Homs Alexis F. , Dupeyron Arnaud , Torre Kjerstin 
Published: April 2021

Abstract
Clinical models of chronic low back pain (cLBP) highlight the role of excessive attention to pain and kinesiophobia on the origin of disability. At the motor control level, various mechanisms are involved in the impairments observed in patients with cLBP. We aimed to assess the role of maladaptative attentional behaviors by using a complex systems approach and a visual display as a distraction during walking. Sixteen patients with cLBP with no previous surgery or significant leg pain and 16 healthy matched controls were included. Patients walked on a treadmill at preferred walking speed with and without distraction. Stride time (ST) fractal complexity was assessed using detrended fluctuation analysis. A two-way analysis of variance with repeated measures on distraction was performed on fractal exponents. We found a significant group × distraction interaction effect on fractal complexity of ST series (F(1,30) = 9.972, P = 0.004). Post hoc analysis showed that, without distraction, patients with cLBP had significantly lower ST complexity than controls, but when distracted, they regained gait complexity, recovering the level of controls. Our results suggest that excessive attention to pain causes loss of complexity and adaptability in cLBP and explain alterations of motor control with pain. Fractal analysis seems to be a promising method to explore movement variability and individual adaptability in musculoskeletal disorders.
Short-term impact of combining pain neuroscience education with exercise for chronic musculoskeletal pain: a systematic review and meta-analysis
Authors: Siddall Benjamin , Ram Adrian , Jones Matthew D. , Booth John , Perriman Diana , Summers Simon J. 
Published: April 2021

Abstract
Exercise and pain neuroscience education (PNE) have both been used as standalone treatments for chronic musculoskeletal pain. The evidence supporting PNE as an adjunct to exercise therapy is growing but remains unclear. The aim of this systematic review and meta-analysis was to evaluate the effect of combining PNE and exercise for patients with chronic musculoskeletal pain, when compared with exercise alone. A systematic search of electronic databases was conducted from inception to November 6, 2020. A quality effects model was used to meta-analyze outcomes where possible. Five high-quality randomized controlled studies (n = 460) were included in this review. The PEDro scale was used to assess the quality of individual studies, and Grading of Recommendations, Assessment, Development, and Evaluation analysis was conducted to determine the quality of evidence for each outcome. Meta-analyses were performed for pain intensity, disability, kinesiophobia, and pain catastrophizing using data reported between 0 and 12 weeks postintervention. Long-term outcomes (>12 weeks) were only available for 2 studies and therefore were not suitable for meta-analysis. Meta-analysis revealed a significant difference in pain (weighted mean differences, −2.09/10; 95% confidence interval [CI], −3.38 to −0.80; low certainty), disability (standardized mean difference, −0.68; 95% CI, −1.17 to −0.20; low certainty), kinesiophobia (standardized mean difference, −1.20; CI, −1.84 to −0.57; moderate certainty), and pain catastrophizing (weighted mean differences, −7.72; 95% CI, −12.26 to −3.18; very low certainty) that favoured the combination of PNE and exercise. These findings suggest that combining PNE and exercise in the management of chronic musculoskeletal pain results in greater short-term improvements in pain, disability, kinesiophobia, and pain catastrophizing relative to exercise alone.
Olorinab (APD371), a peripherally acting, highly selective, full agonist of the cannabinoid receptor 2, reduces colitis-induced acute and chronic visceral hypersensitivity in rodents
Authors: Castro Joel , Garcia-Caraballo Sonia , Maddern Jessica , Schober Gudrun , Lumsden Amanda , Harrington Andrea , Schmiel Shirdi , Lindstrom Beatriz , Adams John , Brierley Stuart M. 
Published: April 2021

Abstract
Abdominal pain is a key symptom of inflammatory bowel disease and irritable bowel syndrome, for which there are inadequate therapeutic options. We tested whether olorinab—a highly selective, full agonist of the cannabinoid receptor 2 (CB2)—reduced visceral hypersensitivity in models of colitis and chronic visceral hypersensitivity (CVH). In rodents, colitis was induced by intrarectal administration of nitrobenzene sulfonic acid derivatives. Control or colitis animals were administered vehicle or olorinab (3 or 30 mg/kg) twice daily by oral gavage for 5 days, starting 1 day before colitis induction. Chronic visceral hypersensitivity mice were administered olorinab (1, 3, 10, or 30 mg/kg) twice daily by oral gavage for 5 days, starting 24 days after colitis induction. Visceral mechanosensitivity was assessed in vivo by quantifying visceromotor responses (VMRs) to colorectal distension. Ex vivo afferent recordings determined colonic nociceptor firing evoked by mechanical stimuli. Colitis and CVH animals displayed significantly elevated VMRs to colorectal distension and colonic nociceptor hypersensitivity. Olorinab treatment significantly reduced VMRs to control levels in colitis and CVH animals. In addition, olorinab reduced nociceptor hypersensitivity in colitis and CVH states in a concentration- and CB2-dependent manner. By contrast, olorinab did not alter VMRs nor nociceptor responsiveness in control animals. Cannabinoid receptor 2 mRNA was detected in colonic tissue, particularly within epithelial cells, and dorsal root ganglia, with no significant differences between healthy, colitis, and CVH states. These results demonstrate that olorinab reduces visceral hypersensitivity through CB2 agonism in animal models, suggesting that olorinab may provide a novel therapy for inflammatory bowel disease– and irritable bowel syndrome–associated abdominal pain.
Sexual Activity After Acute Coronary Syndrome
Authors: Boothby Célina A. , Santana Maria J. , Norris Colleen M. , Campbell Tavis S. , Rabi Doreen M. 
Published: April 2021

Background
Little is known about how best to support both patients and their partners in the reengagement of sexual activity (SA) after acute coronary syndrome (ACS), with sparse direct data from the partner on their needs and concerns in the area of SA support.

Objectives
We undertook a qualitative study to address this gap in the literature through 3 objectives from a patient and partner perspective: (1) to characterize the experience of reengaging in SA post ACS, (2) to identify needs and priorities in the area of SA support post ACS, and (3) to determine whether cardiac rehabilitation (CR) could be an acceptable point of intervention for SA support.

Methods
Semistructured qualitative interviews were conducted with 6 male patients who were post ACS and their partners (age range, 47–81 years). Patients were criterion sampled from the Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease database. Inductive thematic data analysis was conducted.

Results
Four themes were identified: “importance,” “support received,” “on their own,” and “wanting support.” Couples reaffirmed the importance of SA pre and post ACS, reported SA support as currently insufficient but articulated ways it could be improved, and reported CR as a current source of SA support but thought there could be room for improvement on the content and delivery of such information.

Conclusions
This study illustrates the potential value of promoting SA support for both patients who are post ACS and their partners and reports that SA support provided at CR would be viewed as important, needed, and acceptable.
Mononitrate Isosorbide as an Adjunctive Therapy in Schizophrenia
Authors: Guimarães Tiago M. , Guimarães Mara R. C. , Oliveira Ícaro A. F. , Leoni Renata F. , Santos Antonio C. , Dursun Serdar M. , Crippa Jose A.S. , Bressan Rodrigo A. , Machado-de-Sousa João Paulo , Lacerda Acioly L. T. , Hallak Jaime E. Cecílio 
Published: April 2021

Abstract

Background
Schizophrenia is a complex disabling mental disorder, and many patients present poor response to available treatments. Accumulating evidence about the role of the glutamate/nitric oxide pathway in mediating the positive and negative symptoms of schizophrenia suggests potential benefits of drugs that modulate this system. The aim of this study was to test the efficacy of isosorbide mononitrate (ISMN) as an adjunctive therapy for symptomatic outpatients with schizophrenia.

Methods
This was a 2-month randomized, double-blind, placebo-controlled trial with 24 schizophrenia patients. Participants were treated with ISMN 50 mg for 1 month and placebo for another month in a crossover design. The Positive and Negative Syndrome Scale (PANSS), Clinical Global Impression Scale, Global Assessment of Functioning, and MATRICS Cognitive Consensual Battery were used for symptom assessment and arterial spin labeling was used to assess brain activation patterns.

Results
We found significant differences in the total, general, and positive subscales of the PANSS, Global Assessment of Functioning scores, and Clinical Global Impression scores during treatment with ISMN relative to placebo. No treatment effects were found comparing scores in the MATRICS Cognitive Consensual Battery and the negative subscale of the PANSS between the active and placebo conditions. A post hoc analysis of neuroimaging data showed reduced activity in the thalamus in subgroup of patients with severe psychopathology.

Conclusions
Schizophrenia patients with persistent symptoms showed significant improvement after 4 weeks of treatment with ISMN 50 mg/d compared with placebo. Isosorbide mononitrate added beneficial effects to antipsychotic treatment in terms of positive symptoms and functioning.
A Review of the State of HIV Nursing Science With Sexual Orientation, Gender Identity/Expression Peoples
Authors: Phillips J. Craig , Hidayat Jufri , Clark Kristen D. , Melisek Julia , Balthazar Monique S. , Beck Albert G. D. , Moore Scott E. , Dawson-Rose Carol 
Published: April 2021

Abstract
Throughout the HIV pandemic, nurses have contributed to or led approaches to understanding the effects of HIV disease at individual and societal levels. Nurses have advocated for socially just care for more than a century, and our efforts have created a foundation on which to further build the state of HIV nursing science with sexual orientation and gender identity/expression (SOGI) Peoples. Nurses have also participated in the development of approaches to manage HIV disease for and in collaboration with populations directly affected by the disease. Our inclusive approach was guided by an international human rights legal framework to review the state of nursing science in HIV with SOGI Peoples. We identified articles that provide practice guidance (n = 44) and interventions (n = 26) to address the health concerns of SOGI Peoples and our communities. Practice guidance articles were categorized by SOGI group: SOGI People collectively, bisexual, transgender, cisgender lesbian, women who have sex with women, cisgender gay men, and men who have sex with men. Interventions were categorized by societal level (i.e., individual, family, and structural). Our review revealed opportunities for future HIV nursing science and practices that are inclusive of SOGI Peoples. Through integrated collaborative efforts, nurses can help SOGI communities achieve optimal health outcomes that are based on dignity and respect for human rights.
The Effect of High-Fidelity Simulation–Based Learning in Acute Cardiorespiratory Physical Therapy—A Mixed-Methods Systematic Review
Authors: Brown Laura , Ilhan Emre , Pacey Verity , Hau Wendy , Van Der Kooi Veronica , Dale Marita 
Published: April 2021

Background and Purpose.
Simulation-based learning is commonly used in physical therapy education. However, given the financial cost and resources required to provide high-fidelity simulation (HFS)-based learning, it is necessary to determine its effectiveness. Therefore, the purpose of this study was to investigate the effect of HFS-based learning using computerized mannequins on clinical performance and preparedness of physical therapy students and physical therapists in acute cardiorespiratory physical therapy.

Methods.
We undertook a mixed-methods systematic review and meta-analysis. Search strategies were used to find articles in electronic databases. Reference lists of studies were also searched. Included studies investigated the effect of HFS-based learning on physical therapy students' and physical therapists' clinical performance and preparedness in acute cardiorespiratory physical therapy and included the use of computerized mannequins. Both quantitative and qualitative studies were considered.

Results.
A total of 12 trials from 11 articles were included. Quantitative findings of pooled studies indicated a small, but not statistically significant, effect of simulation training on clinical performance of physical therapy students' when compared with traditional learning methods (Hedges' g = 0.18; 95% confidence interval, −0.18 to 0.64; P = .07; I
2 = 57%). Qualitative data were synthesized into 4 themes in which HFS positively impacted students' preparedness: familiarization with the clinical setting, real-world learning in a controlled environment, learning about patient safety, and self-efficacy and confidence. Only the theme of self-efficacy and confidence were able to be integrated with quantitative data, demonstrating a positive effect of HFS on students' and physical therapists' self-efficacy and confidence.

Discussion and Conclusion.
High-fidelity simulation involving the use of computerized mannequins improves students' preparedness for clinical practice but does not improve students' clinical performance, although limited evidence exists for physical therapists' preparedness and clinical performance, indicating that further research of physical therapy clinicians is required.
Organizational empowerment and practice outcomes of acute care nurse practitioners in Taiwan: A national survey
Authors: Luo Pei-Ying , Tung Heng-Hsin , Huang Sheng-Shiung , Kau Kevin , Chang Shu-Chen , Shiu Shu-Ying , Tsay Shiow-Luan 
Published: April 2021

ABSTRACT

Background:
Nurse practitioners (NPs) play an important role in addressing growing health care needs. Among NPs, organizational empowerment is positively associated with overall practice outcomes. Therefore, efforts to promote organizational empowerment in practice are necessary to increase job satisfaction among NPs as well as decrease the stress and intention to leave.

Purpose:
This study investigated the relationships of organizational empowerment and practice outcomes of job satisfaction, work stress, and intention to leave in acute care practices.

Methodological orientation:
This study was conducted as a cross-sectional design with a national survey of 946 acute care NPs. Questionnaires contained demographic and practice characteristics, Misener Nurse Practitioner Job Satisfaction Scale, Condition for Work Effectiveness Questionnaire II, and the work stress VAS scale. Hierarchical Linear Model (HLM) was used to investigate individual NP-level or organization-level effects on job satisfaction. The factors associated with job satisfaction were examined by stepwise multiple regression.

Results:
The organizational empowerment was low, work stress was moderately high, and job satisfaction was between slightly unsatisfied and slightly satisfied. The HLM results indicated that organization-level effects did not affect the job satisfaction of NPs. Nurse practitioners with greater formal power, resources, and informal power had higher job satisfaction. Conversely, NPs with an intention to leave and a higher level of stress showed lower job satisfaction.

Conclusions:
Organizational empowerment, intention to leave, and stress affect job satisfaction of acute care NPs in Taiwan.

Implications for practic:
To enhance the job satisfaction of NPs, health care administrators should empower NPs by providing access to opportunity, support, information, and resources in the health care delivery system.
Drivers for seeking the doctor of nursing practice degree and competencies acquired as reported by nurses in practice
Authors: Kesten Karen S. , Moran Katherine , Beebe Sarah L. , Conrad Dianne , Burson Rosanne , Corrigan Catherine , Manderscheid Amy , Pohl Elizabeth 
Published: April 2021

ABSTRACT

Background:
The American Association of Colleges of Nursing introduced the Doctor of Nursing Practice (DNP) degree in 2004. To date, few publications examine the competencies and impact of nurses with practice doctorates.

Purpose:
The purpose of this study was to examine reasons for seeking a DNP degree, assess knowledge and competencies acquired from DNP programs, and to inform stakeholders about the skills acquired by nurses with practice doctorates.

Methods:
A cross-sectional design was used to administer a self-report survey to a convenience sample of DNP-prepared nurses in practice, recruited from a national membership organization. The electronic survey was designed using constructs developed from the literature, national organization position statements, and standards of doctoral nursing education.

Results:
A total of 306 participants responded to the survey, 270 were used after data review. The majority of respondents did not seek a DNP degree because it was required for a job, to gain additional supervised practice, or to receive additional training with a specialty population. The majority strongly agreed that they gained competency in translating and synthesizing research evidence into practice, designing and implementing quality improvement, and identifying, measuring, and evaluating outcomes.

Conclusions:
Primary reasons for seeking a DNP degree were seeking knowledge, skills, competencies, confidence, and job opportunities.

Implications for practice:
Doctor of Nursing Practice–prepared nurses hold unique, advanced knowledge, competencies and skills to affect health care across multiple settings. Study results suggest that highly skilled DNP-prepared nurses are equipped to lead quality improvement, engage in practice scholarship, and improve clinical outcomes.
Diabetes management among underserved older adults through telemedicine and community health workers
Authors: Marsh Zyrene , Nguyen Yen , Teegala Yamini , Cotter Valerie T. 
Published: April 2021

ABSTRACT

Background:
Diabetes mellitus (DM) disproportionately affects older adults from marginalized communities. In the United States, the prevalence of DM in ages ≥65 years is twofold higher than the national average for adult populations. Telemedicine and community health workers (CHWs) are emerging diabetes care models but their impact on older adults with limited resources are relatively neglected within the medical literature.

Objectives:
The purpose of this systematic review was to explore the impact of telemedicine and CHW interventions for improving A1C levels and self-management behaviors among underserved older adults with DM.

Data sources:
A systematic literature search was performed in PubMed, CINAHL, Embase, and Cochrane databases using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses as a reporting guideline.

Conclusions:
Diabetes self-management education (DSME) administered through telemedicine and CHW interventions were effective for improving A1C levels, self-care adherence, and patient and provider satisfaction among adults aged ≥50 years. Common barriers to diabetes care include inadequate resources, lack of transportation, inconsistent means of communications, social isolation, and low motivation. Community health workers and telemedicine were effective in improving disease management and optimizing care coordination within the vulnerable adult populations.

Implications for practice:
Well-coordinated, evidence-based, and population-centered interventions can overcome the unique disparities experienced by underserved older adults with diabetes. Incorporating DSME-guided telemedicine and CHW interventions into primary care can mitigate diabetes-related complications in older populations. The lack of evidence specific to adults aged ≥65 years calls for a universally accepted age range when referring to older adults in future research.