bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outpatient Follow-up Care After Hospital Discharge of Children With Complex Chronic Conditions at a Rural Tertiary Care Hospital
Authors: Brown Andrew , Quaile Mary , Morris Hannah , Tumin Dmitry , Parker Clayten L. , Warren Lana , Wall Bennett , Crickmore Kim , Ledoux Matthew , Eldridge David Lewis , Aikman Inga 
Published: September 2021

Objective To determine factors associated with completion of recommended outpatient follow-up visits in children with complex chronic conditions (CCCs) following hospital discharge. Methods We retrospectively identified children aged 1 to 17 years diagnosed with a CCC who were discharged from our rural tertiary care children’s hospital between 2017 and 2018 with a diagnosis meeting published CCC criteria. Patients discharged from the neonatal intensive care unit and patients enrolled in a care coordination program for technology-dependent children were excluded. Results Of 113 eligible patients, 77 (68%) had outpatient follow-up consistent with discharge instructions. Intensive care unit (ICU) admission ( P = .020) and prolonged length of stay ( P = .004) were associated with decreased likelihood of completing recommended follow-up. Conclusions Among children with CCCs who were not already enrolled in a care coordination program, ICU admission was associated with increased risk of not completing recommended outpatient follow-up. This population could be targeted for expanded care coordination efforts.
Does food and health education in school influence students’ everyday life?
Authors: Beinert Cecilie , Sørlie Anne Cathrine , Åbacka Gun , Palojoki Päivi , Vik Frøydis Nordgård 
Published: September 2021

Objective: The Norwegian National Action Plan for a Healthier Diet calls for discussion of new ways to communicate health information. An already established and important arena in which to do so is school, in the Food and Health (FH) subject in particular. The aim of this study was to investigate how Norwegian students experience the FH subject, and how they believe it impacts on their everyday lives. Design: Qualitative study using focus group discussions Setting: Three public schools in Norway Methods: Focus group discussions were audio-recorded, transcribed verbatim and thematically analysed. Results: The students reported the relevance of the school subject FH to their everyday life. However, how much FH was experienced as having impacted on their everyday lives with respect to cooking at home, food choice and food hygiene varied. Conclusions: More research is needed to explore how FH can have a stronger impact on students’ actual food choices and cooking practices. This is important in order to tackle contemporary dietary challenges among children and adolescents. Rather than discussing new channels of health education, we suggest that the FH subject area should be strengthened in schools by increasing teachers’ competence and focusing more strongly on how best to influence students’ food choices.
Evaluation of Neurotoxin and Filler Injection Training in Otolaryngology Residency
Authors: Cristel Robert T. , Caniglia Alexander J. 
Published: September 2021

Introduction: Residency training courses are fundamental to an Otolaryngology (ENT) residency curriculum. Neurotoxin and filler injections have become common during ENT residency, and the outcomes of training courses have not been previously evaluated. We hypothesize that after participating in the course, resident knowledge, skill, and likelihood of using neurotoxin and filler injections in future practice will significantly improve. Materials and Methods: A prospective study was designed among ENT residents undergoing neurotoxin and filler injection educational training courses from April 2019 to November 2020. After the completion of the course and injections, residents completed a self-evaluation to assess their level of knowledge and skill level with neurotoxin and filler injections. Results: The mean number of neurotoxin and filler injections besides within the course was 1.67 and 0.33, whereas during the course was 3.39 ( P = .008) and 1.39 ( P = .0009), respectively. Resident knowledge, skill, and likelihood of using neurotoxin and filler injections in future practice all significantly improved ( P < .05). This study found that a biannual training course for neurotoxin and injectable fillers was an effective strategy at improving resident knowledge, skill, and likelihood of use in future practice.
Apixaban and Rivaroxaban Anti-Xa Level Monitoring Versus Standard Monitoring in Hospitalized Patients With Acute Kidney Injury
Authors: Towers William , Nguyen Steffany N. , Ruegger Melanie C. , Salazar Eric , Donahue Kevin R. 
Published: September 2021

Background: Oral direct factor Xa inhibitors (FxaIs) are renally eliminated; thus, acute kidney injury (AKI) may increase the risk for drug accumulation and bleeding. There is minimal data describing the effects of AKI on FxaI anti-Xa levels or clinical outcomes. Objective: To compare anti-Xa level monitoring with standard monitoring in patients who experience AKI on apixaban or rivaroxaban. Methods: This retrospective study included patients admitted within a large hospital system from May 2016 to October 2020. Patients were included if they received apixaban or rivaroxaban prior to AKI. Patients were stratified into 1 of 2 groups: those with anti-Xa level monitoring or those who received standard monitoring. The primary outcome was major bleeding as defined by the International Society of Thrombosis and Haemostasis. Results: A total of 196 patients were included in the final analysis. Major bleeding occurred in 2 patients who received anti-Xa level monitoring, compared with 14 patients who received standard monitoring (2.1% vs 14%; P < 0.01). Variables identified as predictors of major bleeding included a documented history of liver disease (adjusted odds ratio = 3.17; 95% CI = 1.04-9.67; P = 0.04) and antiplatelet use (adjusted odds ratio = 4.18; 95% CI = 1.28-13.7; P = 0.02). Conclusion and Relevance: This is the first study to demonstrate that anti-Xa level monitoring was associated with a significant reduction in major bleeding compared with standard monitoring in patients with AKI who received apixaban or rivaroxaban. The optimal management of antithrombotic medications in patients with AKI and recent exposure to an FxaI requires further investigation.
A Review of Selumetinib in the Treatment of Neurofibromatosis Type 1–Related Plexiform Neurofibromas
Authors: Anderson Mary Kate , Johnson Meredith , Thornburg Lauren , Halford Zachery 
Published: September 2021

Objective: To evaluate the safety and efficacy of selumetinib, a novel MEK inhibitor, for the treatment of plexiform neurofibromas (PN) in patients with neurofibromatosis type 1 (NF1). Data Sources: An English-based literature search of PubMed, EMBASE, and ClinicalTrials.gov was conducted using the terms selumetinib AND neurofibromatosis from inception to August 1, 2021. Study Selection and Data Extraction: Relevant prescribing information, abstracts, and articles identified through the search were considered for inclusion in this review. Data Synthesis: The open-label, multicenter, single-arm, phase II SPRINT trial demonstrated clinically significant improvements in PN-related complications. Of 50 symptomatic patients, 68% experienced a partial response, with a median change in tumor volume of −27.9% from baseline. Estimated progression-free survival at 3 years was 84%. Additionally, clinically meaningful improvements were seen on patient- and parent-reported assessments evaluating pain, range of motion, disfigurement, and quality of life. Overall, the adverse effect profile for selumetinib appears mild and manageable. Relevance to Patient Care and Clinical Practice: Selumetinib is the first FDA-approved treatment for inoperable PN in patients with NF1, demonstrating that MEK inhibition is a promising therapeutic strategy. Studies are ongoing to assess the effect of selumetinib on other NF1-associated tumor types and to determine the optimal dosing schedule and treatment duration. Cost and treatment burden must be considered when selecting selumetinib therapy. Conclusion: Selumetinib exhibits impressive antitumor activity and sustained clinical benefit in patients lacking other viable treatment options. Further studies are warranted to determine the optimal age of initiation, treatment duration, and overall cost-effectiveness of selumetinib.
Developments in National Cancer Control Programmes in Europe – Results From the Analysis of a Pan-European Survey
Authors: Jelenc Marjetka , Weiderpass Elisabete , Fitzpatrick Patricia , Albreht Tit 
Published: September 2021

Introduction National Cancer Control Programmes (NCCPs) provide a country’s policy framework for the development of cancer control, focussing on the reduction of cancer morbidity and mortality and improving quality of life of cancer patients. Objective Exploring and analysing to which extent some of the key elements of the European Guide for Quality National Cancer Control Programmes (Guide) are implemented in NCCPs in the EU. Methods Survey carried out through 30 countries, EU members, Iceland, Montenegro, Norway and Turkey, focussing on stakeholders’ participation, inclusion of all the envisaged chapters from the Guide as well as implementation and dissemination. Results The results of the policy survey on European NCCPs carried out within Cancer Control Joint Action (CANCON JA) are presented. The response was 30 out of 35 countries. In total, 28 out of 30 countries, which completed the survey, had an NCCP or another cancer document. Cancer documents were mostly single documents, managed and supervised by the respective Ministries of Health and communicated to the public via websites and press. Nine documents were defined as programmes, eight as plans and six as strategies; in five countries, terminology was mixed. Regarding the content, recommended by the Guide from 2015, comprising ten chapter areas in three parts. Only 10 countries included in their NCCPs all elements suggested in the Guide. Conclusion Based on our results, we can see that a more comprehensive approach in the process of NCCPs is needed. Policy should focus on the development of instruments for efficient cancer management, which would encompass the entire trajectory of the cancer care from diagnosis to survivorship and supportive care.
Nursing Staff Attitude, Subjective Norms, Perceived Behavior Control, and Intention to Provide Tobacco Treatment in a Psychiatric Hospital
Authors: Abufarsakh Bassema , Okoli Chizimuzo T.C. 
Published: September 2021

BACKGROUND: Although the nursing staff is fundamental in assisting individuals with mental illnesses (MI) to stop tobacco use, they often have mixed feelings about providing tobacco treatment (TT) services to people with MI in inpatient psychiatric settings. AIMS: Therefore, this study aimed to understand factors associated with nursing staff’s intentions to provide TT interventions for individuals diagnosed with MI in a psychiatric facility using the constructs of the theory of planned behavior (TPB). METHOD: Secondary data analysis was performed using cross-sectional data collected from 98 nursing staff who worked in a state inpatient psychiatric facility. A 15-item questionnaire was used to assess nursing staff intentions to provide TT services based on TPB constructs, including attitudes (four items), subjective norms (four items), perceived behavioral controls (four items), and intentions (three items) toward providing TT. The mean scores of each subscale ranged from 1 to 7. A logistic regression analysis was used to examine the relationship between TBP constructs and nursing staff intentions to provide TT for people with MI. RESULTS: Nursing staff had an acceptable mean score in the intentions subscale (4.34 ± 2.01). Only two constructs of TPB explained nursing staff intentions to provide TT: subjective norms (OR = 2.14, 95% CI [1.46, 3.13]) and perceived behavioral control (OR = 2.33, 95% CI [1.32, 4.12]). CONCLUSIONS: The constructs of the TPB, the subjective norms, and the perceived behavior control were able to predict nurses’ intentions to provide TT for inpatients in a psychiatric setting. Accordingly, we suggest implementing policies that make TT a normative practice while supporting the confidence and competence of nurses to deliver TT in psychiatric facilities.
Reactivation of varicella zoster infection presenting as acute retinal necrosis post COVID 19 vaccination in an Asian Indian male
Authors: Mishra Sai Bhakti , Mahendradas Padmamalini , Kawali Ankush , Sanjay Srinivasan , Shetty Rohit 
Published: September 2021

Purpose: To present the clinical features of a rare case of varicella zoster infection following one dose of Coronavirus Disease 2019 (COVID-19) vaccination in an elderly Asian Indian male. Methods: Retrospective observational case report. Results: A 71-year-old gentleman presented to us with complaints of reduced vision associated with redness and pain in his right eye for 1 week. On examination he revealed a right eye pan uveitis picture with circumcorneal congestion, multiple fine keratic precipitates, anterior chamber cells and flare, vitritis and widespread areas of acute retinal necrosis. His left eye was within normal limits. Ten days prior to the presentation he had received the first dose of COVID-19 vaccine following which he had developed fever for 2 days that preceded the red eye. The patient’s aqueous sample tested positive for varicella zoster virus (VZV) by nested polymerase chain reaction (PCR) method. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in reverse transcriptase polymerase chain reaction (RT-PCR) assay from the aqueous and also from the nasopharyngeal swab was negative. Conclusion and significance: To the best of our knowledge this is the earliest description of a case that has a viral reactivation following COVID-19 vaccination. Elderly people with pre-existing comorbidities, may be at a risk of both primary coronavirus infection and unconceivable risk of aberrant immune reactions leading to a different virus infection or reactivation need to be kept in mind. We present a possible link between SARS-CoV-2 virus vaccination and varicella zoster reactivation in this patient.
Safe disconnection of 5-fluorouracil elastomeric pumps: The benefit of a closed-system-transfer device designed for cytotoxic drug administration/perfusion
Authors: Raphaëlle Pesqué , Elodie Peyrilles , Nathalie Jourdan , Odile Albert , Paul Sessink , Isabelle Madelaine , Hélène Levert 
Published: September 2021

Background: Occupational exposure to cytotoxic drugs can lead to significant health problems. This study was designed to evaluate the risk of 5-fluorouracil (5-FU) contamination for nurses when disconnecting the infusion line of an elastomeric pump from a non-coring needle, by comparing three configurations: the first one using standard Male and Female Luer lock (Group 1), the second one using a needle-free connector (NFC) and a Male Luer lock (Group 2) and the third one using a closed-system transfer device (CSTD), Qimono® (Group 3). Methods: In this in vitro study, 10 elastomeric pumps for each of the three groups were filled with 5-FU and a tissue mimicking the patient’s arm was placed below the connection between the infusion line and the tubing of non-coring needle. After 48 h of infusion, disconnection was performed by a nurse with a wipe soaked in a mix of chlorhexidine and isopropyl alcohol in order to mimic care practices. For each pump, the tissue, the pair of gloves and the wipes used during the disconnection were collected for analysis. Results: Median level of overall 5-FU contamination (gloves + wipes + tissues) in group 3 was significantly lower than in group 1 ( p = 0.018) and group 2 ( p = 0.036). There was no difference between groups 1 and 2. Results per sample type showed no difference in contamination between the three configurations for the gloves as well as for the tissues. Concerning the wipes, the lowest contamination was observed in group 3, representing a mean reduction of 61% compared to group 1 and a mean reduction of 43% compared to group 2. Conclusion: The use of Qimono® appears to significantly reduce 5-FU contamination when disconnecting infusion lines of an elastomeric pump unlike NFC and standard Luer lock.
Analysis of influencing factors on the duration of pediatric peripheral intravenous catheter
Authors: Peng Yanxian , Zhou Yawei 
Published: September 2021

Background: The application of peripheral intravenous catheter has been an effective guarantee for the success of pediatric therapy. We aimed to investigate the correlative factors that impacting the duration of pediatric peripheral intravenous catheter. Methods: From January 2017 to October 2017, 370 cases of pediatric patients in the First Hospital of Hunan University of Chinese Medicine were collected as the research object. Based on the indwelling time, the collected cases were divided into two groups, namely long time group (>72 h) and short time group (<72 h). The general data and laboratory test results of two groups were collected, and the correlation factors of indwelling time were analyzed by single factor and Logistic multiple factors. Results: As the results revealed that compared with short time group, patients in long time group had statistically significant differences in puncture site, phlebitis, extravasation of blood vessels, hemoglobin, white blood cells, platelets, and 75% ethanol sterilization ( p < 0.05). Logistic multivariate analysis indicated that scalp puncture was the independent protective factors that affecting the duration of pediatric peripheral intravenous catheter. Moreover, phlebitis represented the independent risk factor that influencing the indwelling time of pediatric peripheral intravenous catheter. And the differences were statistically significant ( p < 0.05). Conclusions: Analyze factors influencing indwelling time of pediatric peripheral intravenous catheter and enhance the management of relevant factors are of great significance to prolong the indwelling time, reduce the pain of pediatric patients, and facilitate the clinical medication.
Which illicit drugs are injected in Oslo? A study based on analysis of drug residues in used injection equipment and self-reported information
Authors: Gjerde Hallvard , Bretteville-Jensen Anne Line , Bache-Andreassen Lihn , Hanoa Kristin , Furuhaugen Håvard , Brochmann Gerd-Wenche , Vindenes Vigdis 
Published: September 2021

Background People who inject drugs (PWID) have a high risk of premature death due to fatal overdoses. Newly emerged fentanyls, much more potent than heroin and other opioids, may increase this risk further. Therefore, precise information on injected drugs is critical to improving prevention strategies. Aims This study aimed to analyse drug residues in used injection equipment in order to determine drug and drug combinations and compare and complement findings with self-reported information. Methods Used syringes and needles ( n=766) were collected at the supervised drug consumption facilities, the needle exchange service and two low-threshold health services for problem drug users in Oslo, Norway. The material was collected every third month from June 2019 to June 2020 and analysed for 64 substances using highly specific analytical methods (ultra–high performance liquid chromatography tandem mass spectrometry). Additionally, a street-recruited sample of PWID was interviewed from 2017 to 2019 regarding their drug injection habits ( n=572). Results Heroin (65.5%) or amphetamines (59.8%), often in combination (30.5%), were commonly detected in drug residues. Other opioids, stimulants or benzodiazepines were rarely detected (6.1%). Fentanyl was detected in only one syringe. Heroin was the most reported drug (77.6% during the past four weeks, 48.3% daily/almost daily), followed by amphetamines (57.5% during the past four weeks, 23.1% daily or almost daily). Injection of methadone, buprenorphine and dissolved tablets was self-reported more frequently than determined in drug residue findings. Conclusions Analysis of the injection equipment proved useful as a non-invasive, rapid and accurate means to obtain detailed information on injected drugs in Oslo and supplement traditional PWID survey information.
Evaluating the Quality of Life and Sleep Quality in Saudi Women with Breast Cancer-Related Lymphedema: A Cross-Sectional Correlational Study
Authors: Tamam Nissren , Al-mugren K. S. , Alrebdi H. I. , Sulieman Abdelmoneim , Abdelbasset Walid Kamal 
Published: September 2021

Background Among the different cancers found in women, breast cancer is the most common. Breast cancer-related lymphedema is a serious health complication affecting the quality of life and sleep quality. This study evaluates the quality of life and sleep quality among Saudi women with different stages of lymphedema following the treatment of breast cancer. Methods This cross-sectional correlational study included 163 Saudi women with breast cancer-related lymphedema (Stages I-III), aged 28 to 56 years. From the patients identified for this study, women who suffered from mental and psychological dysfunctions or other malignant disorders were excluded. Copies of structured questionnaires were given to each participant during their visits to outpatient physiotherapy clinics. Quality of life was assessed using a valid questionnaire (EORTC QLQ-C30), while sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). The differences between the different lymphedema stages have been assessed. Results Of the total number of participants 27 women had been diagnosed with stage I lymphedema, 84 women had been diagnosed with stage II lymphedema, and 52 women had been diagnosed with stage III lymphedema. All participants have shown low scores on both EORTC QLQ-C30 and PSQI. While analyzing the differences between the 3 stages of lymphedema with the Kruskal–Wallis test, noteworthy statistical differences between the 3 stages of lymphedema ( P < .05) have been found. The Stage III lymphedema patients have been shown the lowest quality of life values in all scales when compared with the stage I and stage II lymphedema patients. For PSQI scores, the stage III lymphedema patients worse values than the stage I and stage II lymphedema patients ( P < .05). Conclusion and Recommendations Both quality of life and quality of sleep have significantly decreased in Saudi women with different stages of breast cancer-related lymphedema. Quality of life and quality of sleep are the worst in stage III lymphedema patients. Future research should consider repeat and enlarge these results as well as assess the risk factors that affect the quality of life and quality of sleep among Saudi women suffering from breast cancer-related lymphedema.