bluuebunny/crossref_metadata_2025_split huggingface dataset:
Economic evaluations of educational, physical, and psychological treatments for fibromyalgia: a systematic review with meta-analysis
Authors: Cabral Cristina Maria Nunes , Miyamoto Gisela Cristiane , Franco Katherinne Ferro Moura , Bosmans Judith Ekkina 
Published: February 2021

Abstract
Nonpharmacological interventions are recommended for the treatment of fibromyalgia, but there is a lack of knowledge about the cost-effectiveness of these interventions. The aim of this study was to systematically review economic evaluations of educational, physical, and psychological interventions for the treatment of fibromyalgia. The search was performed in PUBMED, EMBASE, CINAHL, Cochrane Library, Physiotherapy Evidence Database, PsycINFO, EconLit, National Health Service Economic Evaluation Database, and Health Technology Assessment. Economic evaluations of educational, physical, and psychological interventions for adult patients with fibromyalgia were included. Primary outcomes were healthcare and societal costs, and quality-adjusted life-years, and secondary outcomes were any disease-specific clinical outcome. Costs and effects were pooled in a meta-analysis, when possible. Eleven studies were included, of which 7 compared a psychological intervention with another intervention or usual care/control. Over a 6-month time horizon, healthcare and societal costs of the psychological intervention were significantly lower than usual care (mean difference: $−2087, 95% confidence interval [CI]: −3061 to −1112; mean difference: $−2411, 95% CI: −3582 to −1240, respectively), and healthcare costs were significantly lower for the psychological intervention compared with a pharmacological intervention (mean difference: $−1443, 95% CI: −2165 to −721). Over a 12-month time horizon, healthcare costs for the psychological intervention were significantly lower than for usual care (mean difference: $−538, 95% CI: −917 to −158). Incremental cost-effectiveness ratios for quality-adjusted life-years and impact of fibromyalgia showed that the psychological intervention was cost-effective compared with other interventions and control conditions. There is a need of more economic evaluations conducted alongside randomized controlled trials with interventions recommended for the treatment of fibromyalgia, such as physical exercise.
Open-label placebo vs double-blind placebo for irritable bowel syndrome: a randomized clinical trial
Authors: Lembo Anthony , Kelley John M. , Nee Judy , Ballou Sarah , Iturrino Johanna , Cheng Vivian , Rangan Vikram , Katon Jesse , Hirsch William , Kirsch Irving , Hall Kathryn , Davis Roger B. , Kaptchuk Ted J. 
Published: February 2021

Abstract
It is commonly believed that blinding to treatment assignment is necessary for placebos to have an effect. However, placebos administered without concealment (ie, open-label placebos [OLPs]) have recently been shown to be effective in some conditions. This study had 2 objectives: first, to determine whether OLP treatment is superior to no-pill control (NPC) in irritable bowel syndrome (IBS) and, second, to compare the efficacy of OLP against double-blind placebo (DBP). In a 6-week, 3-arm, randomized clinical trial, participants were randomized in equal proportions to 3 arms: OLP, DBP, or NPC. Two hundred sixty-two adults (72.9% women), with a mean age of 42.0 (SD = 18.1) years, participated in the primary study. The mean improvement on the IBS Severity Scoring System from baseline to the 6-week end point was significantly greater in OLP compared with that in NPC (90.6 vs 52.3, P = 0.038). Open-label placebo and DBP did not differ significantly on IBS Severity Scoring System improvement (100.3 vs 90.6, P = 0.485). Standardized effect sizes were moderate for OLP vs NPC (d = 0.43) and small for OLP vs DBP (d = 0.10). Participants treated with OLP reported clinically meaningful improvements in IBS symptoms that were significantly greater than those on NPC. Open-label placebo and DBP had similar effects that did not differ significantly, suggesting that blinding may not be necessary for placebos to be effective and that OLP could play a role in the management of patients with refractory IBS.
Effect of back problems on healthcare utilization and costs in Ontario, Canada: a population-based matched cohort study
Authors: Wong Jessica J. , Côté Pierre , Tricco Andrea C. , Watson Tristan , Rosella Laura C. 
Published: February 2021

Abstract
We assessed the effect of back problems on healthcare utilization and costs in a population-based sample of adults from a single-payer health system in Ontario. We conducted a population-based cohort study of Ontario respondents aged ≥18 years of the Canadian Community Health Survey (CCHS) from 2003 to 2012. The CCHS data were individually linked to health administrative data to measure healthcare utilization and costs up to 2018. We propensity score-matched (hard matched on sex) adults with self-reported back problems to those without back problems, accounting for sociodemographic, health-related, and behavioural factors. We evaluated cause-specific and all-cause healthcare utilization and costs adjusted to 2018 Canadian dollars using negative binomial and linear (log transformed) regression models. After propensity score matching, we identified 36,806 pairs (women: 21,054 pairs; men: 15,752 pairs) of CCHS respondents with and without back problems (mean age 51 years, standard deviation = 18). Compared with propensity score matched adults without back problems, adults with back problems had 2 times the rate of cause-specific visits (rate ratio [RR]women 2.06, 95% confidence interval [CI] 1.88-2.25; RRmen 2.32, 95% CI 2.04-2.64), slightly more all-cause physician visits (RRwomen 1.12, 95% CI 1.09-1.16; RRmen 1.10, 95% CI 1.05-1.14), and 1.2 times the costs (women: 1.21, 95% CI 1.16-1.27; men: 1.16, 95% CI 1.09-1.23). Incremental annual per-person costs were higher in adults with back problems than those without back problems (women: $395, 95% CI $281-$509; men: $196, 95% CI $94-$300). This corresponded to $532 million for women and $227 million for men (adjusted to 2018 Canadian dollars) annually in Ontario given the high prevalence of back problems. Given the high health system burden, new strategies to effectively prevent and treat back problems and thus potentially reduce the long-term costs are warranted.
Sufficient conditions for effective psychological treatment of chronic pain: a qualitative comparative analysis
Authors: Batho Anna , Kneale Dylan , Sutcliffe Katy , Williams Amanda C de C. 
Published: February 2021

Abstract
Chronic pain (CP) is the leading cause of years lived with disability globally. Treatment within Western medicine is often multicomponent; the psychological element of treatment varies, yet the optimal conditions for effective reduction of pain-related outcomes remain unclear. This study used qualitative comparative analysis, a relatively new form of evidence synthesis in the field based on set theory to ascertain configurations of intervention components and processes of psychological treatment of chronic pain in adults that lead to more effective interventions. Data were extracted from 38 studies identified in a concurrent Cochrane review and were then subjected to qualitative comparative analysis. Two analyses were conducted: one to examine what is most effective for reducing disability and one to examine what is most effective for reducing distress. Analysis and comparison of the 10 treatments with best outcomes with the 10 treatments with poorest outcomes showed that interventions using graded exposure, graded exercise or behavioural rehearsal (exposure/activity), and interventions aiming to modify reinforcement contingencies (social/operant) reduced disability levels when either approach was applied but not both. Exposure/activity can improve distress levels when combined with cognitive restructuring, as long as social/operant methods are not included in treatment. Clinical implications of this study suggest that treatment components should not be assumed to be synergistic and provided in a single package.
“Here Comes the Junkies,” Opioid Replacement Therapy in Rural Australia
Authors: Opie Cynthia Ann , Wood Penelope , Haines Helen Mary , Franklin Richard C. 
Published: February 2021

Abstract

Background
Opioid replacement therapy (ORT) offers a harm minimization approach and is the mainstay treatment option for opioid dependence in Australia. Recovery is known to be complicated because of service access, cost, workforce availability, privacy, stigma, and discrimination. Rural living is considered to magnify each complication of recovery, yet little is understood about how opioid dependence recovery is experienced in rural Australia. This study aimed to explore the lived experience of people receiving ORT in rural Australia and describe impediments to recovery.

Methods
In this qualitative study design, all outpatients enrolled in ORT at two rural Australian sites were invited to participate. Six volunteers from each site participated in a semistructured interview (eight men, four women; mean age = 44.8 years).

Results
The participants had completed 3 years of secondary school education on average. Four major themes emerged: reinvention, restriction, employment, and reconnection. Small communities increased the likelihood of ORT participants knowing people both directly and indirectly, affecting their ability to reconstruct an identity. Lived distance from prescribers and dosing points dictated daily activity, including opportunities to seek and maintain employment. Rural ORT treatment seekers indicated that geographical displacement and separation from family, the people they needed to reconnect with, were challenging.

Conclusion
Rural people engaged in ORT require positive reinforcement from service providers, enabling identity reinvention and disconnection from the drug-seeking world. Acknowledging underlying trauma and supporting reconnection with loved ones may foster positive social connectedness.
Latent Profiles of Alcohol Consumption Among College Students Exposed to Trauma
Authors: Bountress Kaitlin E. , Hawn Sage E. , Dick Danielle M. ,   Spit for Science Working Group, Amstadter Ananda B. 
Published: February 2021

Abstract

Background
Alcohol use/misuse is a costly public health problem, particularly among college students in the United States. Alcohol use tends to increase during adolescence and peaks in the early/mid-20s; however, there is significant heterogeneity among alcohol use during the college years. Several studies applying a mixture modeling framework to extract latent profiles of alcohol consumption have been conducted. However, none to our knowledge has included only those exposed to trauma, a group known to be at risk for alcohol misuse. The aim of this longitudinal study (n = 1,186) was to identify profiles of alcohol consumption and their associations with demographic and trauma-related constructs.

Method
Data were collected from a larger study of college students attending a large public university. Participants in the current study were, on average, 18.46 years old at study entry, primarily female (69.6%), and of diverse racial/ethnic backgrounds (e.g., 48.8% White, 20.4% Black, 16.8% Asian).

Results
Results suggest evidence for four latent profiles. These classes include an initially high increasing, an initially high decreasing, an initially low decreasing, and an initially low increasing, the last of which had not been found. Using analyses of variance, profile membership was associated with number of traumas, probable posttraumatic stress disorder, broad drinking motives, and trauma-specific drinking-to-cope motives.

Conclusions
Results suggest that drinking motives and trauma-related factors are important correlates of these latent alcohol profiles. Work clarifying the longitudinal interrelations between profile membership and these factors is needed to help inform more effective prevention and intervention efforts.
International Nursing Collaboration to Establish the Philippine Quit Line
Authors: Fildes Elizabeth E. , Campbell Nancy J. , Ong-Cabrera Glynna , Garcia Robert 
Published: February 2021

Abstract
Tobacco use remains the single most preventable cause of death and disability worldwide. In the Philippines, 28.3% of the people are current tobacco smokers, which is one of the highest smoking rates in Asia. The World Health Organization estimates that 10 Filipinos die every day from cancer, stroke, and lung and heart disease caused by cigarette smoke and approximately 24 million Filipinos are exposed to secondhand smoke in the home. Although there are quit lines in all 50 U.S. states and territories, there was no access to this smoking cessation program in the Philippines before the initiation of the international collaboration described in this article. In 2012, a Filipino-American nurse with extensive quit line expertise initiated collaboration between the United States and Philippine smoking cessation experts to plan the creation of a quit line at the Lung Center of the Philippines. The Conceptual Model for Partnership and Sustainability in Global Health was used as a foundation for the planning, implementation, and evaluation of the Philippine Quit Line project, which was funded in 2017 by the World Health Organization and the Philippine Department of Health. This funding and other outcomes related to nursing education about tobacco addictions in the Philippines suggest that the Partnership and Sustainability in Global Health Model can provide a blueprint for international collaboration on health projects that are rooted in real collaborative and sustainable partnerships.
The Influence of Physical Condition on Mental Health and Quality of Life in Patients With Drug Dependence
Authors: Giménez-Meseguer Jorge , Tortosa-Martínez Juan 
Published: February 2021

Abstract

Background
Exercise has been proposed as a good strategy to prevent use and relapse and to improve mental health and quality of life in drug-dependent people. However, it is not known if physical condition per se influences quality of life and mental health.

Objective
The aims of this study were to analyze the relationships between physical condition, mental health, and quality of life in patients with drug dependence and to determine whether physical condition could predict levels of mental health and quality of life.

Method
Levels of physical condition (Timed Get Up and Go test, Chair Stand Test, six-minute walk test), mental health (Depression Anxiety Stress Scales [DASS-21]), and quality of life (Short Form Health Survey) were measured in a sample of 125 patients with drug dependence. A correlation analysis and a stepwise multiple linear regression analysis were performed.

Results
The physical condition tests predicted all DASS-21 variables: stress (F = 26.30, p < .001), anxiety (F = 18.33, p < .001), depression (F = 27.63, p < .001), total DASS-21 (F = 23.91, p < .001), and all the variables of the Short Form Health Survey for quality of life.

Conclusions
Physical condition can predict the levels of mental health and quality of life of patients with drug dependence.
Adolescent Girls and Alcohol Use: Increasing Concern During the COVID-19 Pandemic
Authors: Smith Tedra S. , Bryant Pamela Harris , Fogger Susanne Astrab 
Published: February 2021

Abstract
Adolescence is a time known for risky behaviors and often the initiation of alcohol use. Readily available, alcohol is often one of the drugs of choice for adolescents. Whereas in the past 30 years, the overall consumption of alcohol is down, the data in the past 10 years have shown more girls are binge drinking and meeting criteria for alcohol use disorder (AUD). The alarm of early alcohol use is the association with problems with the substances later in life. Historically, men and male adolescents consumed more alcohol than females. Recent studies indicate girls' alcohol use surpasses boys, whereas women now are developing AUD at the same rate as men. The consequences of early use can result in women's increased risk for multiple cancers, having a more severe form of AUD with less alcohol consumption as well as premature death. To further exacerbate this growing concern, the novel coronavirus (COVID-19) pandemic has created a perfect storm for increased use of alcohol to cope with the stress of living in an uncertain world. Normal daily activities have been halted with the uncertainty of school closures, zoom classroom sessions, and living in mandated social isolation. All nurses need to be screening for how families under their care have been managing stress. The time is opportune to educate and support parents in engaging their children in conversations around substance use. Parents can be supported to increase awareness of their own coping mechanisms and strengthen positive coping. Adolescents need support to strengthen interpersonal skills as well as make informed decisions concerning when and how they engage in alcohol consumption. This article will illuminate the growing need for all healthcare providers to assess and guide adolescents' coping skills during COVID with a focus on mental health, high-risk behavior, and alcohol use.
Substance Abuse Disorder in Nursing
Authors: Mozingo Kimberly D. 
Published: February 2021

Abstract
Outcome measures for individual states' nursing professional alternative-to-discipline (ATD) programs have historically ceased beyond successful fulfillment of active program monitoring, leaving a gap in affirmation of sustained postprogram efficacy. The project objective challenges the absence of profession-specific postmonitoring practice, affording qualitative evaluation of the program's impact to professional nursing. The pilot study's 8-week process improvement PICO(T) seeks validation of incorporating postprogram monitoring to validate program efficacy, conceptualizing framework guidelines established by the Federation of State Physician Health Programs' Performance Enhancement Review. Study efforts encompass identified needs assessment, current practice through outcome recommendations, and access of developed online mixed-methods appraisal with an emphasis on qualitative analysis, questioning the alumni's state of sobriety, perspective related to program participation, workforce contribution to professional practice, and intent to remain in nursing. The proposed alumni graduate status between 2 and 5 years from program completion resulted in an 11% response rate: 90% reported zero relapse since program completion; greater than 50%, willingness to participate as ATD or peer mentors; 90%, nursing licensure in good standing; and 66%, intent to remain working in profession over the next 5 years. Limitations constitute sample size, inception groundwork, and project constraints. Findings offer insight from alumni perspective, validation of literary support, and organizational interest for implementation. Contributions to nursing practice embody care of the caregiver ideology and offer future collaboration with ATD programs at state, national, and global levels to support sustained recovery of professionals affected with substance use disorder.
“Talking Around It”
Authors: DeGroot Lyndsay G. , Bidwell Julie T. , Peeler Anna C. , Larsen Luke T. , Davidson Patricia M. , Abshire Martha A. 
Published: February 2021

Background
Vital components of communicating goals of care and preferences include eliciting the patient and caregiver's definition of quality of life, understanding meaningful activities and relationships, and exploring wishes for care at the end of life. Although current literature suggests framing conversations regarding end of life through the lens of meaning and quality of life, there is limited literature exploring dyadic congruence surrounding these important constructs among patients with ventricular assist devices (VADs) and their caregivers.

Objectives
The purpose of this study was to explore congruence of VAD patient and caregiver perspectives regarding end of life, definitions of quality of life, and meaning in life while managing the uncertainty of living with a VAD.

Methods
We used thematic analysis to analyze semistructured qualitative interviews of 10 patient-caregiver dyads 3 to 12 months after VAD implantation.

Results
Three major themes were identified: (1) differing trajectories of uncertainty and worry, (2) a spectrum of end-of-life perspectives, and (3) enjoying everyday moments and independence. Overall, patients and caregivers had differing perspectives regarding uncertainty and end of life. Within-dyad congruence was most evident as dyads discussed definitions of meaning or quality of life.

Conclusions
Dyadic perspectives on end of life, meaning in life, and quality of life can inform how palliative care and VAD teams approach conversations about planning for the end of life. Findings from this study can inform future shared decision-making interventions for patients living with VADs and their caregivers.
Prognostic Value of the Nutritional Risk Screening 2002 Scale in Patients With Acute Myocardial Infarction
Authors: Li Fanghui , Li Dongze , Yu Jing , Jia Yu , Jiang Ying , Chen Xiaoli , Gao Yongli , Ye Lei , Wan Zhi , Cao Yu , Zeng Zhi , Zeng Rui 
Published: February 2021

Background
The Nutritional Risk Screening 2002 (NRS-2002) scale is a rapid and effective screening instrument that assesses nutritional risk among hospitalized patients.

Objective
The present study aimed to explore the prognostic value of the NRS-2002 scale in acute myocardial infarction (AMI) considering its uncertain role in this particular condition.

Methods
Patients with AMI included in the Retrospective Multicenter Study for Early Evaluation of Acute Chest Pain were investigated. Kaplan-Meier survival analysis and Cox proportional hazards models were used to analyze the association between NRS-2002 and mortality in patients with AMI. The primary and secondary endpoints were all-cause and cardiac mortality during the follow-up period.

Results
A total of 2307 patients were enrolled, among whom 246 (10.7%) died within a median follow-up duration of 10.67 (8.04–14.33) months. Kaplan-Meier analysis revealed that patients with an NRS-2002 score of 3 or higher had poorer cumulative survival than those with an NRS-2002 score lower than 3 (P < .001). In the multivariate Cox regression analysis, patients with an NRS-2002 score of 3 or higher had more than double the risk for all-cause mortality (hazard ratio, 2.25; 95% confidence interval, 1.50–3.40; P < .001) and twice the risk for cardiac-related mortality (hazard ratio, 2.01; 95% confidence interval, 1.29–3.13; P = .002) than did patients with lower scores.

Conclusions
Our results showed that the NRS-2002 screening instrument was an independent prognostic predictor for both all-cause and cardiac mortality in patients with AMI. Nutritional risk assessment based on the NRS-2002 scale may provide useful prognostic information of early nutritional risk stratification in patients with AMI.