bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Development of a Situation-Specific Nurse-Led Culturally Tailored Self-Management Theory for Chinese Patients With Heart Failure
Authors: Jin Yuanyuan , Peng Youqing 
Published: June 2021

Introduction: Self-management is essential for treating heart failure (HF). Culture influences the ability to cope, negotiate, and adopt self-management behaviors. However, current HF self-management interventions for Chinese patients do not take culture into consideration. The aim of this article is to describe the development of a situation-specific nurse-led culturally tailored self-management theory for Chinese patients with HF. Methodology: An integrative approach was used as theory development strategy for the situation-specific theory. Results: Based on theoretical and empirical evidence, and theorists’ experiences from research and practice, a nurse-led culturally tailored self-management theory for Chinese patients with HF was developed. Discussion: Researchers addressing health phenomena often have difficulty defining, conceptualizing, and operationalizing culture. The situation-specific theory developed in this study has the potential to increase specificity (i.e., logical adequacy and usefulness) of existing theories while informing the application to nursing practice. Further critique and testing of the situation-specific theory is warranted.
Comparison of Early Versus Late Initiation of Hydrocortisone in Patients With Septic Shock in the ICU Setting
Authors: Ragoonanan David , Allen Bryan , Cannon Chad , Rottman-Pietrzak Kathleen , Bello Abdel 
Published: June 2021

Background: Multiple publications demonstrate an association between time to initiation of corticosteroids and outcomes such as mortality and reversal of shock. However, the optimal time to initiate hydrocortisone remains unknown. Objective: To evaluate the impact of early versus late initiation of hydrocortisone in septic shock patients. Methods: A retrospective, multicentered, observational study was conducted. Adults admitted from July 1, 2014, to August 31, 2019, diagnosed with septic shock receiving vasopressors and low-dose hydrocortisone were evaluated. Participants were divided into the “early” group if hydrocortisone was initiated within 12 hours or “late” group if initiated after 12 hours of vasopressor initiation. The primary outcome was time to vasopressor discontinuation. Secondary outcomes included in-hospital mortality, intensive care unit (ICU) and hospital length of stay (LOS), vasopressor utilization, fluids administered, and need for renal replacement therapy. Results: A total of 198 patients were identified for inclusion in this propensity score–weighted cohort: 99 in the early group and 99 in the late group. Early initiation was associated with shorter time to vasopressor discontinuation compared with late initiation (40.7 vs 60.6 hours; P = 0.0002). There was also a reduction in ICU LOS (3.6 vs 5.1 days; P = 0.0147) and hospital LOS (8.9 vs 10.9 days; P = 0.0220) seen in the early group. There was no difference in mortality between groups. Conclusion and Relevance: In this propensity-matched cohort, administration of hydrocortisone within 12 hours from the onset of septic shock was associated with improved time to vasopressor discontinuation and reduced ICU and hospital LOS.
Characterization of Psychotropic PRN Medications in a Canadian Psychiatric Intensive Care Unit
Authors: Casol Marina , Tong Angela , Ng Joan C. Y. , McGloin Rumi 
Published: June 2021

BACKGROUND: Pro re nata (PRN) antipsychotics and benzodiazepines are routinely used for the rapid stabilization of acutely agitated patients. Despite the popular use of PRN medications in mental health units, primary literature supporting efficacy and safety is poor, and there is no single universally accepted practice guideline. PRN psychotropic medications have the potential to cause adverse effects when used inappropriately. AIMS: Our objective was to characterize the prescribing, administration, and documentation practices of PRN psychotropic medications in a psychiatric intensive care unit. METHODS: We conducted a retrospective chart review of patients admitted to a 12-bed psychiatric intensive care unit between June and September 2018. All PRN antipsychotic and benzodiazepine orders, administrations, documentation practices, and attempted nonpharmacological strategies were assessed for each order and patient. Descriptive statistics were used to analyze data. RESULTS: Thirty-two patients with a total of 123 physicians’ orders and 1,179 PRN administrations of antipsychotics and benzodiazepines were reviewed. Of the total administrations, 720 (61%) were combinations with at least two psychotropic agents. Forty-one (33%) physicians’ orders had a prescribed indication, and 559 (47%) administrations had an attempted nonpharmacological method prior to PRN administration. Eight patients (25%) had antipsychotic PRN orders, which exceeded the total daily maximum dose. Three adverse drug effects were attributed to PRN administration. CONCLUSIONS: Areas of improvement that we identified included documentation practices of effectiveness of administered PRNs, prescriptions to include clear indications and dosage within the 24-hour maximum limits, and documentation of nonpharmacological methods utilized.
Does body position, age, and heart rate induce IOP’s changes?
Authors: Sobczak Marcelina , Asejczyk Magdalena , Geniusz Malwina 
Published: June 2021

Objectives: The main goal of this research was to determine the differences between the values of intraocular pressure (IOP) in the supine and sitting positions, and to assess the effect of age and cardiovascular parameters. Methods: Seventy-two healthy adults were enrolled and classified into age groups: 20–30 years (group A), 31–40 years (group B), and 41–71 years (group C). Corneal biometry and cardiovascular parameters, such as heart rate (HR), were measured. IOP measurements were taken in the sitting position (IOPS) and in the supine position (IOPL) using the iCare® Pro tonometer. Results: A significant difference between the IOPS and IOPL in the entire cohort was found ( p < 0.001). Regarding the age subgroups, a significant difference ( p < 0.001) between the IOPS and IOPL was obtained in group A (2.6 ± 1.6 mmHg) and group C (1.5 ± 1.3 mmHg). There were no significant differences in the IOPS between groups. The highest IOP values were obtained for group A. The correlations between HR and IOPS are statistically significant for group A and group B, and for HR and IOPL-S for group B only. Multivariate analysis showed that HR has a significant influence on the difference in IOP in the two body positions. Conclusion: A statistically significant difference between the effect of age and the values of IOPS and IOPL was shown. Cardiovascular parameters showed some relevant statistical dependencies, but with a rather marginal significance in young people. The influence of body position for the measurement of IOP for healthy subjects does not seem to matter, despite the fact that there are some dependencies that are statistically significant.
Neuronal and glial cell number is altered in a cortical layer-specific manner in autism
Authors: Falcone Carmen , Mevises Natalie-Ya , Hong Tiffany , Dufour Brett , Chen Xiaohui , Noctor Stephen C. , Martínez Cerdeño Verónica 
Published: June 2021

Autism spectrum disorder is a neurodevelopmental condition characterized by impaired social communication and repetitive behaviors. Changes in the number of specific cell types in the cerebral cortex could produce a dramatic alteration in the regulation of cortical circuits, and thus an alteration of behavior. We investigated whether there are layer-specific changes in the number of neurons, astrocytes, and oligodendrocytes in the prefrontal cortex in postmortem human brains from autism spectrum disorder subjects. We quantified the number of specific cell types in the prefrontal cortex (Brodmann areas 9, 46, and 47) of 10 cases with autism spectrum disorder and 10 age-matched control cases. We found that the number of neurons was increased and the number of astrocytes was decreased in layer II of all three prefrontal areas. Area BA47 was most widely affected presenting with an increased number of neurons and a decreased number of astrocytes in layer II and deeper layers of the cortex. Among other possibilities, the alterations in neuron and glial cell number we report here are consistent with a failure of radial glial cells to shift daughter cell production from neurons to astrocytes during prenatal cortical development in autism spectrum disorder. The data provided here are key anatomical findings that shed light on autism spectrum disorder pathogenesis. Lay abstract The cerebral cortex affected with autism spectrum disorder presents changes in the number of neurons and glia cells, possibly leading to a dysregulation of brain circuits and affecting behavior. However, little is known about cell number alteration in specific layers of the cortex in autism spectrum disorder. We found an increase in the number of neurons and a decrease in the number of astrocytes in specific layers of the prefrontal cortex in postmortem human brains from autism spectrum disorder cases. We hypothesize that this may be due to a failure in neural stem cells to shift differentiation from neurons to glial cells during prenatal brain development. These data provide key anatomical findings that contribute to the bases of autism spectrum disorder pathogenesis.
An examination of prosody and second language sentence processing through pause insertion
Authors: Fang Lan , Xie Yiyang , Yu Keke , Wang Ruiming , Schwieter John W. 
Published: June 2021

Objectives: Research on second language (L2) sentence comprehension often has examined reliance on semantic and syntactic information but has left aside for the most part the role of prosodic cues. In the present study, we compare less- and more-proficient L2 learners’ integration of prosody and syntax structure during auditory L2 sentence comprehension. Design: Two group Chinese learners of L2 English learners (A2 and C1 levels) participated in an auditory comprehension task, which included sentences that had artificial pauses inserted either between or within syntactic boundaries. After hearing each sentence, learners were asked to judge the translation as ‘identical’ or ‘not identical’ on the keyboard. Data Analysis: We conducted t-tests and an analysis of variance to examine prosodic effects among the two learner groups. Findings: The results showed that both A2 and C1 learners were sensitive to pauses. However, the direction and magnitude of this sensitivity was significantly different for the two groups. A2 learners were faster to respond to auditory sentences in which a brief pause was placed within syntactic phrases. Contrarily, C1 learners responded faster when the brief pause was placed between syntactic phrases. Originality: Unique to the present study is the inclusion of the pause-insertion paradigm to examine the role of prosody in L2 auditory sentence processing. Implications: The results imply that the two groups of learners do not rely on prosodic and syntactic cues in the same manner when processing L2 sentences. We argue that the processing mechanisms involved in L2 sentence comprehension evolve hand-in-hand with L2 proficiency development. We discuss the implications of these findings for future research.
Nonmedical use of prescription drugs: A comparison between intoxication-oriented and other nonmedical users
Authors: Piispa Ilona , Karjalainen Karoliina , Karttunen Niina 
Published: June 2021

Aims: Nonmedical use of prescription drugs (NMUPD) is a major public health concern. The aim of the study was to compare intoxication-oriented users to those who utilised prescription drugs nonmedically for other purposes. The characteristics of the study groups, prescription drugs used, motivations for their use and sources of prescription drugs were also examined. Methods: Data were derived from the population-based Drug Survey 2014 which was conducted in Finland. The respondents were divided into intoxication-oriented users ( n = 118) and other nonmedical users ( n = 74) according to the motivation behind their NMUPD. The reference population ( n = 3277) did not report any NMUPD. Pearson’s chi square test was used to compare the distributions. A multinomial logistic regression model was used to estimate the association of sociodemographic background and intoxicant use with NMUPD. Results: Low education level and illegal drug use were associated with intoxication-oriented and other nonmedical use of prescription drugs. Intoxication-oriented use was associated also with younger age and current smoking. Sedatives were the most commonly used prescription drugs among intoxication-oriented users, and opioids among other nonmedical users. Experimentation and facilitating social interactions as a motivation for use were emphasised among intoxication-oriented users. Friends and relatives were the most common sources of prescription drugs for nonmedical use, especially among intoxication-oriented users. Conclusion: The characteristics, motivations and sources of nonmedically used prescription drugs differed in intoxication-oriented and other nonmedical users. These findings may help to identify those at risk for NMUPD. More attention should be paid to the motivations of NMUPD when new prevention and intervention methods are developed.
Assessment of the educational competencies for the Hypertension Canada Professional Certification Program (HC-PCP) designed for implementation of hypertension guidelines into primary care
Authors: Watson Kaitlyn E. , Tsuyuki Ross T. , Beahm Nathan P. , Sedore Rebecca , Bell Alan 
Published: June 2021

Background: The uptake of clinical practice guidelines into practice is limited for many chronic conditions, including hypertension. The aim of this study was to ascertain the importance of the educational competencies for the development of the Hypertension Canada Professional Certification Program (HC-PCP) among frontline, primary care professionals (e.g., pharmacists, physicians, nurses). Methods: A group of hypertension experts developed 15 competencies believed to be important for primary care professionals to master when providing hypertension management. These competencies were surveyed for consensus by frontline clinicians through the Hypertension Canada e-newsletter in 2018. Clinicians were asked to rank the importance of each competency for a primary care provider to acquire when undertaking a certification in hypertension management, using a Likert scale from 1 (not important) to 5 (very important). Results: A total of 121 clinicians responded to the survey. Of these, 38% were pharmacists, 31.4% were registered nurses, 10.7% were physicians and 7% were nurse practitioners. There was at least 1 respondent from each Canadian province and territory, except for the Northwest Territories. All 15 competencies received a mean rank of at least 4. The competency with the highest ranking was Competency 6: Ability to screen and identify hypertension (mean 4.83 [0.04]). The competencies with the lowest average ranks were Competency 1: Demonstrates a sound knowledge of the epidemiology of hypertension (mean 4.07 [0.85]) and Competency 5: Demonstrates an understanding of the validation process for blood pressure devices (mean 4.15 [0.08]). Conclusions: Clinicians generally ranked all 15 competencies to be of high importance for a provider who is certified in hypertension management to possess. These competencies and the current Hypertension Canada guidelines were used as the foundation for the development of an education program called the Hypertension Canada Professional Certification Program. Can Pharm J (Ott) 2021;154:xx-xx.
Correlation Between the Glasgow Prognostic Score and the Serum Cytokine Profile in Taiwanese Patients with Colorectal Cancer
Authors: Yu Yen-Lin , Fan Chung-Wei , Tseng Wen-Ko , Chang Pei-Hung , Kuo Hsuan-Chih , Pan Yi-Ping , Yeh Kun-Yun 
Published: June 2021

Background: The Glasgow Prognostic Score and circulating cytokine levels are related to the prognosis of colorectal cancer and the severity of chronic inflammation. The association between the Glasgow Prognostic Score and circulating cytokines in colorectal cancer remains unclear. Methods: The levels of 10 circulating cytokines (TNF-α, TGF-β, IFN-γ, IL-1β, IL-4, IL-6, IL-10, IL-12, IL-13, and IL-23) were measured in 128 patients with colorectal cancer. The relationship between the Glasgow Prognostic Score, clinicopathologic variables, and cytokine levels was assessed by univariate and multivariate logistic regression analyses. The correlation among cytokines was also examined. Results: Patients with advanced stage colorectal cancer had lower levels of albumin ( P = 0.003), higher levels of C-reactive protein (CRP; P < 0.001), carcinoembryonic antigen (CEA; P < 0.001), interferon (IFN)-γ ( P < 0.001), and interleukin (IL)-10 ( P = 0.006), and shorter survival outcomes ( P < 0.001). Patients with a high Glasgow Prognostic Score (1 or 2) had lower 5-year progression-free survival and poor overall survival (log-rank P < 0.001). A high Glasgow Prognostic Score was significantly correlated with abnormal CEA levels (CEA > 5 ng/mL, P = 0.033), and higher levels of tumor necrosis factor (TNF)-α (TNF-α ⩾ 53.9 pg/mL, P = 0.035) and IL-10 (IL-10 ⩾ 75.95 pg/mL, P = 0.008). TNF-α, IFN-γ, IL-1β, IL-4, IL-6, IL-10, IL-13, and IL-23 were significantly correlated with each other (all P < 0.05). Only IL-10 was correlated with abnormal CEA levels ( P < 0.001). Conclusion: The Glasgow Prognostic Score and level of circulating cytokines have an intergroup correlation, and there is a close association among cytokines in colorectal cancer.
Functional cortical changes associated with shoulder instability – a systematic review
Authors: Livett Morissa F , Williams Deborah , Potter Hayley , Cairns Melinda 
Published: June 2021

Background Glenohumeral joint instability is associated with structural deficits and/or alterations in sensory and motor processing; however, a proportion of patients with glenohumeral joint instability fail to respond to surgical and rehabilitative measures. This systematic review aimed to establish if functional cortical changes occur in patients with glenohumeral joint instability. Methods AMED, CINAHL, Cochrane Central Register of Controlled Trials, Embase, Medline, PEDro, Pubmed, PsychINFO and Scopus were searched from inception to 17 March 2021. Randomised controlled trials and non-randomised trials were included and quality was appraised using the Downs and Black tool. Results One thousand two hundred seventy-nine records were identified of which five were included in the review. All studies showed altered cortical function when comparing instability patients with healthy controls and included areas associated with higher cortical functions. Discussion The findings of this systematic review offer some insight as to why interventions addressing peripheral pathoanatomical factors in patients with glenohumeral joint instability may fail in some cases due to functional cortical changes. However, data are of moderate to high risk of bias. Further high-quality research is required to ascertain the degree of functional cortical changes associated with the type and duration of glenohumeral joint instability.
Shoulder electromyography activity during push-up variations: a scoping review
Authors: Kowalski Katie L , Connelly Denise M , Jakobi Jennifer M , Sadi Jackie 
Published: June 2021

Background Push-ups (PU) are a common closed chain exercise used to enhance shoulder girdle stability, with variations that alter the difficulty or target specific muscles. To appropriately select and prescribe PU exercises, an understanding of muscle activity during variations of the PU is needed. The purpose of this scoping review was to identify common PU variations and describe their muscle activation levels. Methods Databases searched included PubMed, CINAHL, Scopus, and SPORTDiscus for articles published between January 2000 and November 2019. Results Three hundred three articles were screened for eligibility with 30 articles included in the analysis. Six PU types and five muscles met the criteria for analysis. Weighted mean electromyography (EMG) amplitude was calculated for each muscle across PU types and for each PU type as a measure of global muscle activity. Triceps and pectoralis major had the highest EMG amplitude during unstable, suspension, incline with hands on a ball and the standard PU. Serratus anterior had the highest EMG amplitude during PU plus and incline PU. The greatest global EMG amplitude occurred during unstable surface PU. Discussion These results provide clinicians with a framework for prescribing PU to target specific muscles and scale exercise difficulty to facilitate rehabilitation outcomes.
An Economic Evaluation of Disallowing Body Checking in 11- to 12-Year-Old Ice Hockey Leagues
Authors: Currie Gillian R. , Lee Raymond , Black Amanda M. , Palacios-Derflingher Luz , Hagel Brent E. , Emery Carolyn A. , Marshall Deborah A. 
Published: June 2021

Background: After a national policy change in 2013 disallowing body checking in Pee Wee ice hockey games, the rate of injury was reduced by 50% in Alberta. However, the effect on associated health care costs has not been examined previously. Hypothesis: A national policy removing body checking in Pee Wee (ages 11-12 years) ice hockey games will reduce injury rates, as well as costs. Study Design: Cost-effectiveness analysis alongside cohort study. Level of Evidence: Level 3. Methods: A cost-effectiveness analysis was conducted alongside a cohort study comparing rates of game injuries in Pee Wee hockey games in Alberta in a season when body checking was allowed (2011-2012) with a season when it was disallowed after a national policy change (2013-2014). The effectiveness measure was the rate of game injuries per 1000 player-hours. Costs were estimated based on associated health care use from both the publicly funded health care system and privately paid health care cost perspectives. Probabilistic sensitivity analysis was conducted using bootstrapping. Results: Disallowing body checking significantly reduced the rate of game injuries (−2.21; 95% CI [−3.12, −1.31] injuries per 1000 player-hours). We found no statistically significant difference in public health care system (−$83; 95% CI [−$386, $220]) or private health care costs (−$70; 95% CI [−$198, $57]) per 1000 player-hours. The probability that the policy of disallowing body checking was dominant (with both fewer injuries and lower costs) from the perspective of the public health care system and privately paid health care was 78% and 92%, respectively. Conclusion: Given the significant reduction in injuries, combined with lower public health care system and private costs in the large majority of iterations in the probabilistic sensitivity analysis, our findings support the policy change disallowing body checking in ice hockey in 11- and 12-year-old ice hockey leagues.