bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Deep-Rooted Culture Evolves to Support Healthcare Heroes
Authors: Dunn Jim 
Published: August 2021

Summary
Enhancing employee well-being and creating a distinct employee experience are crucial to the success of Atrium Health. Our strategies for listening, well-being, and experience have always been deep-rooted in our culture, and the COVID-19 pandemic brought extraordinary opportunities to refresh those strategies as we carried out our mission during a time of uncertainty, crisis, and disruption to our everyday lives. From the start of the pandemic, we have deliberately anticipated the needs of our employees to provide support when they need it most. As the pandemic eases, we continue to make relevant and timely resources available to increase resilience and overall well-being. Our efforts have evolved to support our heroes—including our nonclinical workers—and to better position Atrium Health for future challenges that come our way. Although we are constantly changing, our primary focus remains the same. Employee well-being and experience are a significant part of who we are and an essential element of the care we all provide at Atrium Health.
Learning from the Past to Face the Worst with Our Best
Authors: Berdan Barclay E. 
Published: August 2021

SUMMARY
At Texas Health Resources, the well-being of our patients, our workforce, and our communities has long been at the core of who we are and the driving force behind business decisions, employee interactions, programs, practices, and the patient care we deliver. It is in our DNA, from our vision “to partner with you for a lifetime of health and well-being” to Our Texas Health Promise: Individuals Caring for Individuals, Together. That solid foundation—always the basis of our business preparations—made it possible for us to weather the challenges brought by the COVID-19 pandemic and to prepare ourselves for what comes next, emerging stronger and with sustained energy to transform the enterprise on the other end.
Pandemic Hastens Cleveland Clinic’s Unified Well-Being Strategy
Authors: Hancock K. Kelly , Minor Chad V. 
Published: August 2021

SUMMARY
Across the healthcare landscape, the COVID-19 pandemic has been incredibly challenging. It also has been a catalyst for change. It has ignited a redesign of the US health system and presented opportunities in areas such as caregiver and patient communication, digital practice, telehealth and virtual care, and more. Notably, the pandemic also has shined a new light on caregiver well-being. As executive leaders of Cleveland Clinic’s Caregiver Office, our top priority throughout the pandemic has been to support our caregivers professionally and personally—to help them be their best for themselves and for their fellow caregivers, our patients, our organization, and our communities. Today, Cleveland Clinic is realizing the profound impact of many of the strategies put in place during the pandemic and seeing how COVID-19 accelerated our organization’s unified vision for caregiver well-being. This article offers insight into Cleveland Clinic’s commitment to caregiver well-being, highlights actions we undertook during the pandemic, shares the resulting lessons we learned, and showcases how those lessons are shaping our future caregiver well-being strategy.
Enhancing Quality Supervision for the Delivery of Mental Health Care Through Nonspecialist Clinicians in Resource-Limited Settings
Authors: Collier Stephanie , Meyen Rachel , Smith Stephanie L. , Valentin Cidna , Eustache Fr. Eddy 
Published: August 2021

Abstract
Supervision of nonspecialist clinicians by trained mental health professionals is integral to developing capacity for providing mental health care in low-resource settings. Current supervision efforts in low-resource settings, however, are often variable in quality. Scant published literature addresses how supervision practices affect treatment outcomes; only a few studies have been published on evidence-based supervision methods. Additionally, in low-resource settings many systems-level obstacles exist in providing adequate mental health supervision to nonspecialist clinicians. This article seeks to address psychiatrists’ role in providing supervision and promoting quality of care in low-resource settings. We review the literature on evidence-based supervision practices, address obstacles and current practices of providing high-quality mental health supervision in low-resource settings, and weave this knowledge with our experiences learning from the clinicians at Partners in Health in Haiti. We also discuss feasible strategies and provide recommendations for strengthening the supervision process in resource-limited settings.
Overactive bladder syndrome is associated with detrusor overactivity and abnormal voiding pattern in nulliparous women
Authors: Fang Jessica Jay , Wu Ming-Ping , Yen Yu-Chun , Wu Jeng-Cheng , Chin Hung-Yen 
Published: August 2021

Background:
Pregnancy and childbirth are frequently associated with overactive bladder syndrome (OAB). However, the role of parous effects in OAB among nulliparous (NP) women remains controversial.

Methods:
This study investigated abnormal voiding patterns and detrusor overactivity (DO) among NP women with OAB in comparison with parous women. From August 2011 to December 2018, 906 patients met the inclusion criteria for participation and were divided into three groups: 221 patients in the NP group, 571 patients in the normal spontaneous delivery (NSD) group, and 114 patients in the cesarean section (CS) group. Urodynamic study examinations were performed, and the presence of DO, abnormal voiding patterns, and maximum urethral closure pressure (MUCP) was recorded. Data were analyzed using analysis of variance, χ2 tests, and independent t tests.

Results:
Compared with parous women in the NSD and CS groups, patients in the NP group had a significantly higher prevalence of abnormal voiding patterns, DO, and MUCP. Furthermore, abnormal voiding patterns were significantly associated with DO and MUCP, respectively, especially in the NP group.

Conclusion:
We hypothesized that hypertonicity or poor relaxation of the pelvic muscle in NP women may cause functional BOO, which is related to their OAB.
Upper airway muscles: influence on obstructive sleep apnoea pathophysiology and pharmacological and technical treatment options
Authors: Perger Elisa , Taranto-Montemurro Luigi 
Published: August 2021

Purpose of review
Obstructive sleep apnoea (OSA) is highly prevalent with numerous deleterious effects on neurocognitive and cardiovascular health. It is characterized by collapse of the upper airway during sleep, due to the decrease in both basal and compensatory UA muscle activities. However, the leading treatment, continuous positive airway pressure, is often poorly tolerated. This review presents latest works focusing on novel interventions targeting upper airway muscles to alleviate OSA severity.

Recent findings
In the last years, researchers have focused on the development of alternative treatment strategies targeting UA muscle activation, including pharmacological and nonpharmacological interventions.

Summary
Among the nonpharmacological treatments, hypoglossal nerve stimulation aims to increase upper airway muscle phasic activity during sleep through electrical stimulation, while myofunctional therapy improves the activity and coordination of upper airway dilator muscles.
Regarding OSA pharmacotherapy, recent findings strongly suggest that selective norepinephrine reuptake inhibitors such as atomoxetine and reboxetine, when administered with antimuscarinics such as oxybutynin, can alleviate OSA in most patients increasing pharyngeal dilator muscles activity during sleep. New combinations of norepinephrine reuptake inhibitors and antimuscarinics have further been explored with variable success and animal models showed that leptin, thyrothropin releasing hormone analogues and gene therapy hold potential for the future of OSA pharmacotherapy.
Telehealth and virtual health monitoring in cystic fibrosis
Authors: Vagg Tamara , Shanthikumar Shivanthan , Morrissy David , Chapman Wendy W. , Plant Barry J. , Ranganathan Sarath 
Published: August 2021

Purpose of review
At many institutions, the Covid-19 pandemic made it necessary to rapidly change the way services are provided to patients, including those with cystic fibrosis (CF). The purpose of this review is to explore the past, present and future of telehealth and virtual monitoring in CF and to highlight certain challenges/considerations in developing such services.

Recent findings
The Covid-19 pandemic has proven that telehealth and virtual monitoring are a feasible means for safely providing services to CF patients when traditional care is not possible. However, both telehealth and virtual monitoring can also provide further support in the future in a post-covid era through a hybrid-model incorporating traditional care, remote data collection and sophisticated platforms to manage and share data with CF teams.

Summary
We provide a detailed overview of telehealth and virtual monitoring including examples of how paediatric and adult CF services adapted to the need for rapid change. Such services have proven popular with people with CF meaning that co-design with stakeholders will likely improve systems further. In the future, telehealth and virtual monitoring will become more sophisticated by harnessing increasingly powerful technologies such as artificial intelligence, connected monitoring devices and wearables. In this review, we harmonise definitions and terminologies before highlighting considerations and limitations for the future of telehealth and virtual monitoring in CF.
Sleep medicine and coronavirus disease 2019
Authors: Gill Cara M. , Piggott Laura M. , Kent Brian D. 
Published: August 2021

Purpose of review
To evaluate the impact of the COVID-19 pandemic on the care of people with sleep disorders, to explore relationships between OSA and COVID-19, and to describe current knowledge of the effect of the pandemic on sleep globally.

Recent findings
COVID-19 has led to significant changes in the practice of sleep medicine, including the care of patients with OSA. An OSA diagnosis may portend a worse prognosis with COVID-19, whilst prior COVID-19 may have an impact on sleep breathing.

Summary
The pandemic has caused marked difficulties with access to diagnostic sleep studies and reduced capacity for CPAP initiation. Conversely, adherence to CPAP therapy may have improved, and use of remote consultations and telemonitoring has increased. An OSA diagnosis may be associated with increased risk of severe COVID-19, although any apparent relationship may be attributable to confounding factors, such as obesity and metabolic disease. Small studies have reported some increase in CPAP requirements in OSA patients following COVID-19 infection. More generally, the pandemic has been associated with a deterioration in subjective sleep quality across the population; much of this appears because of increased anxiety and stress. Finally, studies assessing putative links between COVID-19 and REM sleep issues are ongoing.
Novel predictors for liver transplantation or death in drug-induced acute liver failure
Authors: Weber Sabine , Woischke Christine , Denk Gerald , Gerbes Alexander L. 
Published: August 2021

Objective
Drug-induced liver injury (DILI) is a leading cause of acute liver failure (ALF). Predictors for orthotopic liver transplantation (OLT) or death in drug-induced ALF (DI-ALF) are scarce.

Methods
In total 33 of 346 patients recruited for our prospective study on potentially hepatotoxic drugs had ALF. DILI diagnosis was based on Roussel Uclaf Causality Assessment Method (RUCAM) score and expert opinion. Area under the receiver operating characteristic (AUROC) curve, Youden’s index and positive and negative likelihood ratios were calculated to identify the best performing predictive markers and scores for OLT or death.

Results
Poor outcome was associated with lower baseline platelet counts and cholinesterase (CHE) levels, higher International Normalized Ratio (INR) levels and Model for End-Stage Liver Disease (MELD) scores. Yet, AUROC reached a maximum of only 0.71–0.75 for either of those laboratory markers or the MELD score. Notably however, combinations of those scores were highly discriminatory, in particular INR/(CHE*platelet count) and MELD/(CHE*platelet count), showing an AUROC of 0.91, a positive likelihood ratios of 13.78 and a negative likelihood ratios of 0.08.

Conclusion
While baseline MELD score, INR, CHE, and platelet counts had limited potential to discriminate between DI-ALF with survival or poor outcome, their combinations were highly associated with OLT or death in patients with DI-ALF.
Trends in Cancer Treatment Service Availability Across Critical Access Hospitals and Prospective Payment System Hospitals
Authors: Hung Peiyin , Shi Kewei , Probst Janice C. , Zahnd Whitney E. , Zgodic Anja , Merrell Melinda A. , Crouch Elizabeth , Eberth Jan M. 
Published: August 2021

Background:
Rural residents experience worse cancer prognosis and access to cancer care providers than their urban counterparts. Critical access hospitals (CAHs) represent over half of all rural community hospitals. However, research on cancer services provided within CAHs is limited.

Objective:
The objective of this study was to investigate trends in cancer services availability in urban and rural Prospective Payment System (PPS) hospitals and CAHs.

Design:
Retrospective, time-series analysis using data from 2008 to 2017 American Hospital Association Annual Surveys. Multivariable logistic regressions were used to examine differential trends in cancer services between urban PPS, rural PPS, and CAHs, overall and among small (<25 beds) hospitals.

Subjects:
All US acute care and cancer hospitals (4752 in 2008 to 4722 in 2017).

Measures:
Primary outcomes include whether a hospital provided comprehensive oncology services, chemotherapy, and radiation therapy each year.

Results:
In 2008, CAHs were less likely to provide all cancer services, especially chemotherapy (30.4%) and radiation therapy (2.9%), compared with urban (64.4% and 43.8%, respectively) and rural PPS hospitals (42.0% and 23.3%, respectively). During 2008–2017, compared with similarly sized PPS hospitals, CAHs were more likely to provide oncology services and chemotherapy, but with decreasing trends. Radiation therapy availability between small PPS hospitals and CAHs did not differ.

Conclusions:
Compared with all PPS hospitals, CAHs offered fewer cancer treatment services and experienced a decline in service capability over time. These differences in chemotherapy services were mainly driven by hospital size, as small urban and rural PPS hospitals had lower rates of chemotherapy than CAHs. Still, the lower rates of radiotherapy in CAHs highlight disproportionate challenges facing CAHs for some specialty services.
How to assess quality of life in persons with chronic kidney disease
Authors: Lightfoot Courtney J. , Howell Martin , Smith Alice C. 
Published: August 2021

Purpose of review
Chronic kidney disease (CKD) significantly impacts many aspects of life, health, and wellbeing. People with CKD have individual priorities for their care which may differ from those valued by clinicians and policy makers. The patient experience is broadly captured by the concept of quality of life (QoL) which is increasing assessed in research and used to guide clinical and policy decision making. Appropriate selection and application of QoL assessment tools are essential for high-quality research and patient care. This article summarises the current approaches to QoL assessment in CKD and outlines aspirations for future improvement.

Recent findings
Commonly used tools for assessment of QoL in CKD include the Short Form-36 and -12 and extended versions adapted for specific use in kidney patients (KD-QoL), and the EQ-5D. However, a wide range of other instruments are also reported, making comparisons between research findings challenging. Few of the tools are adequately validated for use in CKD, and relevance to patient values are unclear. Instruments suitable for use in a routine clinical setting are lacking.

Summary
QoL instruments developed and validated with meaningful CKD stakeholder input are required. The Standardised Outcomes in Nephrology initiative is working to address this need.
Using Data from a 360° Leadership Assessment to Enhance Nurse Manager Transformational Leadership Skills
Authors: Heuston Melanie M. , Leaver Cynthia , Harne-Britner Sarah 
Published: August 2021

OBJECTIVE
The aim of this study was to compare self-perception of leadership practices among nurse managers (NMs), day shift nurses, and night shift nurses (NSNs).

BACKGROUND
Nurse managers have complex roles in healthcare, with clinical, administrative, and 24-hour accountability for unit activities. Transformational leadership inspires performance beyond expectations, while transcending self-interest for the good of the organization.

METHODS
A comparative, secondary data analysis study of the Leadership Practices Inventory (LPI) 2018.

RESULTS
Day shift nurses' and NSNs' mean scores had lower perceptions of leadership practices than NMs' self-assessment. Day shift nurses, NSNs, and NMs identified the highest mean scores in “enable others to act” (8.57, 8.62, and 8.82, respectively).

CONCLUSIONS
The LPI assessment, the defined observer groups, and unique data visualization informed development of a comprehensive follow-up plan supporting individual and group leadership development. Research examining differences in perceptions of LPI practices across observer groups, particularly direct report staff nurses, is warranted.
The Relationship Between Staff Nurses' Perceptions of Nurse Manager Caring Behaviors and Patient Experience
Authors: Kostich Kelley , Lasiter Sue , Duffy Joanne R. , George Vicki 
Published: August 2021

OBJECTIVE
The objective of this study was to explore the relationship between staff nurses' perceptions of nurse manager caring behaviors and patient experience.

BACKGROUND
Despite numerous interventions aimed at changing the provision of patient care to improve care quality, patient experience scores have remained moderate. Little research has been conducted exploring how caring relationships in the professional practice environment might play a role in the patient experience of care.

METHODS
A cross-sectional, correlational design was used to examine the relationship between staff nurses' perceptions of nurse manager caring behaviors as measured by the Caring Assessment Tool–Administration (CAT-Adm) and acute-care patient experience using the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores.

RESULTS
There was a positive relationship between the staff nurses' perceptions of nurse manager caring behaviors and patients' HCAHPS overall hospital rating. There also was a positive relationship between the CAT-Adm scores and nurse manager visibility.

CONCLUSION
Departments had higher HCAHPS overall hospital rating when the staff nurses perceived their unit manager as caring. In addition, the more staff nurses actually visualized their nurse manager during a shift, the more they perceived their nurse manager as caring.
Peripartum Cardiomyopathy
Authors: Farrell Amanda S. , Kuller Jeffrey A. , Goldstein Sarah A. , Dotters-Katz Sarah K. 
Published: August 2021

Importance
Peripartum cardiomyopathy is a rare form of heart failure due to left ventricular systolic dysfunction that affects women late in pregnancy and the postpartum period. A diagnosis of exclusion, peripartum cardiomyopathy can be difficult to diagnose in the context of the normal physiologic changes of pregnancy and requires a high index of suspicion.

Evidence Acquisition
Original research articles, review articles, and guidelines on peripartum cardiomyopathy were reviewed.

Results
The etiology of peripartum cardiomyopathy remains poorly defined, but theories include genetic predisposition, as well as myocardial inflammation and angiogenic dysregulation. Risk factors for this condition include hypertensive disorders of pregnancy, Black race, and maternal age older than 30 years. Patients with peripartum cardiomyopathy are at increased risk of acute clinical decompensation, cardiac arrhythmias, thromboembolic complications, and death. Primary treatment modalities include initiation of a medication regimen aimed at the optimization of preload and reduction of afterload. Maternal clinical status is the primary determinant for timing of delivery.

Conclusions and Relevance
Prompt diagnosis and medical management by an interdisciplinary care team are vital for improving outcomes in patients with peripartum cardiomyopathy.

Target Audience
Obstetricians and gynecologists, family physicians

Learning Objectives
After participating in this activity, the provider should be better able to describe the incidence, proposed etiologies, and risk factors for peripartum cardiomyopathy; outline diagnostic tools and evidence-based clinical management of peripartum cardiomyopathy; and identify the disparities in outcomes and existing knowledge gaps.
COVID-19 in Pregnancy: A Current Review of Global Cases
Authors: Chae Sung Y. , Bhattacharyya Adity , Mendoza Rosa 
Published: August 2021

ABSTRACT

Importance
There is great concern about the impact of COVID-19 in pregnancy due to the high morbidity and mortality associated with prior coronavirus infections.

Objective
The objective of this review is to summarize the current literature on the impact of COVID-19 on pregnant women and their newborns.

Evidence Acquisition
The search terms COVID-19 and pregnancy were used in Medline and Clinical Key databases. Only articles written in English with outcome data on both mothers and their newborns were incorporated.

Results
Pregnant women generally experience COVID-19 as a mild-moderate illness. However, approximately 5% become critically ill. Women with underlying comorbidities seem more likely to experience severe morbidity. Newborns also generally have a favorable course.
Vertical transmission in the intrauterine period is possible but rare. Infection control measures need to be taken to prevent transmission during the peripartum period. There is a paucity of data on infections in the first and second trimesters, but research from those infected in the third trimester indicates a possible link with preterm birth. There is a significant percentage of asymptomatic cases. Racial disparities are also being noted with disproportionate numbers of racial/ethnic minorities being affected.

Conclusions
COVID-19 is generally experienced by pregnant women and their newborns as a mild to moderate illness, although a minority become critically ill and mortality does occur. This is more likely among those with underlying comorbidities, as in the general population. Asymptomatic cases heighten the need for increased testing and infection control measures. Racial disparities highlight underlying vulnerabilities and the need for increased research and policy changes.

Target Audience
Obstetricians and gynecologist, family physicians

Learning Objectives
After completing this activity, the reader should be better able to describe clinical presentations of pregnant women who contract COVID-19; explain the risks associated with maternal morbidity and mortality with COVID-19 infections; outline the risks of vertical transmission and neonatal outcomes of pregnant women with COVID-19 infections; and identify racial/ethnic disparities among pregnant women with COVID-19.
Outcomes of Women Undergoing Excision of the Retained Cervix After Supracervical Hysterectomy
Authors: McHale Melissa P. , Smith Anna Jo B. , Fader Amanda N. , Wethington Stephanie L. 
Published: August 2021

(Abstracted from Obstet Gynecol 2021;137(5):831–836)
Supracervical hysterectomy accounted for approximately 7% of all hysterectomies from 2012 to 2016. Supracervical hysterectomy is often desired because of belief that there is superior sexual and urinary function with retention of the cervix as well as decreased operative complexity.