bluuebunny/crossref_metadata_2025_split huggingface dataset:
Using Multisite Process Mapping to Aid Care Improvement: An Examination of Inpatient Suicide-Screening Procedures
Authors: Holleran Lori , Baker Samantha , Cheng Caleb , Wilson Jaime , Mickelson Robin , Kazana Izabela , Messinger-Rapport Barbara , Shahin Jacquelene , Cully Jeffrey , Naik Aanand D. , Godwin Kyler M. 
Published: January 2019

ABSTRACT
Although most suicides occur outside of medical settings, a critical and often overlooked subgroup of patients attempt and complete suicide within general medical and inpatient units. The purpose of this quality improvement initiative was to perform a baseline assessment of the current practices for suicide prevention within medical inpatient units across eight Veterans Affairs medical centers throughout the nation, as part of the VA Quality Scholars (VAQS) fellowship training program. In conjunction with the VAQS national curriculum, the authors and their colleagues used multisite process mapping and developed a heuristic process to identify best practices and improvement recommendations with the hopes of advancing knowledge related to a key organizational priority—suicide prevention. Findings demonstrate a multitude of benefits arising from this process, both in relation to system-level policy change as well as site-based clinical care. This interprofessional and multisite approach provided an avenue for process literacy and consensus building, resulting in the identification of strengths including the improvement of prevention efforts and accessibility of supportive resources, the discovery of opportunities for improvement related to risk detection and response and the patient centeredness of current prevention efforts, and the provision of solutions that aim to achieve sustained change across a complex health system.
Moving to Another World: Understanding the Impact of Clinical Trial Closure on Research Participants Living With HIV in Uganda
Authors: Nalubega Sylivia , Cox Karen , Mugerwa Henry , Evans Catrin 
Published: January 2019

Abstract
Despite an increasing need for clinical trials involving people living with HIV (PLWH), little is known about how PLWH experience trial closure, particularly in low-income countries, where the majority of trials take place. We sought to explore the impact of trial closure on PLWH in Uganda. This was an interpretive, grounded theory study using in-depth interviews, conducted between October 2014 and August 2015. Adult participants (N = 23) from 3 trials were included. The findings indicated that trial closure was represented as “moving to another world” and was an emotional transition, linked to a loss of quality care in the research environment, the need to find alternative health facilities, fear of experiencing unwanted side effects, a desire to receive trial feedback, and difficulties linking to posttrial care. We concluded that PLWH leaving trials in a resource-limited setting required holistic care to facilitate their transition back to “usual care.”
Factors Associated With Depressive Symptoms in Female Victims of Intimate Partner Violence in Southern Taiwan
Authors: Hsieh Hsiu-Fen , Shu Bih-Ching 
Published: January 2019

ABSTRACTBackgroundIntimate partner violence (IPV) is known to cause physical suffering and psychological problems, which burden society. In addition, IPV-related psychological problems such as depressive symptoms may lead to disabilities, chronic mental illness, and an increased risk of suicide.PurposeThis study was designed to explore the factors associated with depressive symptoms in women who were physically abused by intimate partners.MethodsThis cross-sectional study recruited 72 physically abused women from two domestic violence prevention centers in southern Taiwan. The questionnaires that were used to collect data included the Eysenck Personality Questionnaire, the Conflict Tactic Scale, and the Center for Epidemiologic Studies Depression Scale.ResultsSixty-six of the participants (91.67%) met the inclusion criteria and completed all questionnaires. Fifty-five (83.3%) of the participants were found to have depressive symptoms. Depressive symptoms were positively associated in this sample with younger age, a lower level of extraversion, and a higher level of neuroticism. These three factors explained 59.5% of the total variance in depressive symptoms.Conclusions/Implications for PracticeYouth and neuroticism were found to be significant risk factors for developing depressive symptoms in female victims of IPV, whereas extraversion was found to be a related protective factor. The results of this study indicate that clinical workers should provide female victims of IPV, especially relatively young victims, with services that help ameliorate neuroticism to reduce the risk of depressive symptoms.
Sport Concussion Assessment Tool: Fifth Edition Normative Reference Values for Professional Rugby Union Players
Authors: Fuller Gordon W. , Raftery Martin 
Published: January 2019

Objective:To describe distributions and establish normative ranges for new or changed subcomponents of the Sports Concussion Assessment Tool (SCAT)-5.Design:Cross-sectional study.Setting and Participants:Professional Rugby Union players performing 2017 preseason baseline SCAT-5 testing.Independent Variables:Subcomponent tests newly introduced or changed in the SCAT-5.Main Measurements:The 10-word immediate and delayed recall tests and the rapid neurological screen.Results:Thousand two hundred three players were included in complete case analyses. The 10-word immediate recall test [median score 15, interquartile range (IQR) 15-22, range 3-30] showed an asymmetrical, bimodal distribution. The delayed recall test (median score 7, IQR 5-9, range 0-10) demonstrated a left skewed distribution. The diplopia and reading/following instruction tests of the neurological screen were performed normally by virtually all participants (98.5% and 99.6%, respectively). Normative classification ranges for each SCAT-5 subcomponents of interest were determined.Conclusions:The increased spread of scores, with improved midrange centering, suggests that the increase to 10-word list lengths should improve the performance of immediate and delayed recall tests. Normative ranges will provide a distribution against which postinjury SCAT-5 scores can be compared and interpreted.
Integration of Safe Patient Handling and Mobility Principles in Professional Physical Therapist Education: A Case Report
Authors: Haines Jamie , Arnold Margaret 
Published: January 2019

Background and Purpose.
Safe patient handling and mobility (SPHM) programs are being used across the country to safely transport and mobilize patients while at the same time reducing injury risk to caregivers, including physical therapists (PT) and physical therapist assistants (PTA). The American Physical Therapy Association has called PTs and PTAs to not only use the concepts of SPHM in clinical practice, but also be leaders in utilization, development, and implementation of SPHM programs, including training and education of other health care team members. Perlow, et al have recommended that SPHM content be integrated into Doctor of Physical Therapy (DPT) education. This case report outlines 1 current module used to deliver such content.

Case Description.
A neurologic interventions course within the DPT curriculum was selected using a framework that linked content, objectives, and learning activities with relevant Normative Model criteria and Physical Therapist Code of Ethics to improve student self-efficacy with SPHM content. Primary goals were to improve student awareness about risk and impact of work-related musculoskeletal disorders, expose students to the expected role of the PT as an advocate for and educator in SPHM programs, and provide hands-on experience with SPHM technologies. The 6-hour session was completed in 1 day with a 1-hour lecture and 5 hours with a variety of hands-on activities.

Outcomes.
Student learning was assessed through a pre–post class questionnaire, documentation/discussion of experiences, and presentations of student-generated neurologic interventions using SPHM equipment. Awareness of increased risk of injury, limits of 'good' body mechanics, and feasibility of using SPHM technologies to improve the quality of physical therapy practice dramatically increased.

Discussion.
Students should participate in a variety of learning activities threaded through the curriculum to provide sufficient hands-on opportunities to improve self-efficacy in using SPHM principles in rehabilitation. By developing a basic level of competency with SPHM principles, students may be more likely to adopt SPHM as a professional value once graduated. Improvements to this model, recommendations for SPHM integration into DPT curricula, and research opportunities are discussed.

Conclusion.
We have provided 1 model that embeds SPHM content into entry-level physical therapist education. In doing so, educators are advancing physical therapy skills needed to apply evidenced-based therapeutic principles in difficult to move patients while reducing risk of injury to students and new graduates of the profession.
The Development and Implementation of a Faculty Development Residency Within Physical Therapist Education
Authors: Salamh Paul , Roll Marcus , Figuers Carol , Covington Kyle 
Published: January 2019

Background.
Over the past decade, there has been a significant proliferation of physical therapist (PT) programs within the United States. Along with these more accredited PT programs come vacant faculty positions and the need for well qualified candidates to fill core faculty rolls. The Faculty Residency Ad Hoc Group (FRAHG) of the American Board of Physical Therapy Residency and Fellowship Education was established to discuss the growing demand for qualified faculty within PT programs. A faculty development residency (FDR) was created based on the work of the FRAHG.

Method.
A 2-year full-time FDR was established at Duke University Doctor of Physical Therapy (DPT) Program. The program consists of didactic modules covering various facets of academia, teaching responsibilities, mentorship, and scholarly projects. The 2-year progressive curriculum builds on foundational knowledge and skillsets in order to move toward greater independence as a faculty member.

Discussion.
The FDR within the Duke DPT program has demonstrated the ability to identify and foster the knowledge and skills deemed valuable from the perspective of the residency directors, core faculty members, learners, and the residents themselves.

Conclusion.
Moving forward, the FDR appears to be a viable and meaningful option for the increasing demand for well-prepared core faculty within a DPT program. The model proposed has successfully led to the prior residents' ability to be competitive and successfully secure faculty positions upon completion.
The Integration of TeamSTEPPS Into Interprofessional Education Curricula at 3 Academic Health Centers
Authors: Davis Beth P. , Jernigan Stephen D. , Wise Holly H. 
Published: January 2019

Background and Purpose.
The need for developing collaborative practice–ready health care providers, along with new interprofessional education (IPE) accreditation standards, highlights the importance of IPE in physical therapist education curriculum. As we strive to meet the goal of preparing students for collaborative practice and team-based care, the TeamSTEPPS system can be integrated into IPE programs to assist in the provision of quality health care and in the prevention of medical errors. Emory University (Emory), Kansas University Medical Center (KUMC), and the Medical University of South Carolina (MUSC) have integrated TeamSTEPPS into their IP classroom- and practice-based curricula. The purpose of this paper is to describe how these academic health centers have embedded TeamSTEPPS into their IP curricula, with the goal of assisting academic and clinical faculty with the development and implementation of learning activities directed toward the development of IP competency.

Method/Model Description and Evaluation, Outcomes.
The IPE models used by Emory, KUMC, and MUSC use the TeamSTEPPS framework and are described with select evaluation measures and outcomes. The Emory and KUMC models are primarily classroom based, whereas the MUSC uses a combined classroom- and clinic-based model. Although each institution's model for IP training and assessment is different, all have shown positive results.

Discussion and Conclusion.
With new IPE accreditation standards for most health professions programs, using TeamSTEPPS is a strategy to assist in meeting the standards for IPE training and a larger goal of improving the quality and safety of patient care.
A model of successful DNP and PhD collaboration
Authors: Cowan Linda , Hartjes Tonja , Munro Shannon 
Published: January 2019

ABSTRACT

Background and purpose:
Within nursing education, the existence of two graduate-level programs has created some challenges. Role confusion between the practice-focused Doctor of Nursing Practice (DNP) and the research-focused Doctor of Philosophy (PhD) is compounded by competition for similar positions. Collaboration between DNP and PhD nurses, however, benefits the health care system and patients.

Methods:
The complementary skills of these two groups of nurses are detailed, and a model for building PhD-DNP partnerships is presented based on a collaborative PhD-DNP project that resolved a negative trend in outcomes from cardiac surgery. The clinical pathway created by the project met national benchmarks, improved interprofessional staff communication, and resulted in uniform and improved patient care.

Conclusions:
Although role differentiation for doctoral nurses can be challenging, role integration is critical. Building collaborative partnerships between these groups of nurses benefits the health care system, as well as patients, and this partnership is sustainable through successful collaborative projects.

Implications for practice:
Doctoral-prepared nurses must understand each other's background and education and focus on what each can contribute. In the beginning, as with any collaborative relationship, collaborators must discuss and agree on ground rules, team roles, responsibilities, and time line for projects.
Lesbian, Gay, Bisexual, and Transgender health: Creating safe spaces and caring for patients with cultural humility
Authors: Kuzma Elizabeth K. , Pardee Michelle , Darling-Fisher Cynthia S. 
Published: January 2019

ABSTRACT

Background and purpose:
This article provides foundational information about 1) the significant health disparities LGBT individuals face, which are associated with persistent discrimination, oppression, and stigmatization in both societal and healthcare settings; and 2) how cultural humility can help nurses to create safe spaces and provide optimal care for all patients.

Methods:
CINAHL, Medline, PsychInfo, and GoogleScholar databases were searched to identify theoretical and empirical literature regarding LGBT health, health disparities, barriers to accessing care, unconscious bias, cultural humility, and creating safe spaces to better meet the healthcare needs of the LGBT population.

Conclusions:
LGBT patients' health needs are not being adequately met in many healthcare settings due to inadequate education and preparation of healthcare providers, including nurses. Lack of access to safe, appropriate, and affirming healthcare services increases the risk of poor health and persistent health disparities.

Implications for practice:
As the largest professional healthcare workforce, nurses can have a significant role in reducing the health disparities LGBT patients face. When armed with the tools to care for LGBT patients with cultural humility, nurses can lead clinical change within their institutions to create safe, accepting, affirming, inclusive, and welcoming environments for all patients.
Challenges faced by Canadian primary health care nurse practitioners in chronic disease management: A qualitative study among key informants
Authors: Pelletier Jérôme , Vermette Sarah , Lauzier Sophie , Bujold Mathieu , Bujold Louise , Martin Élisabeth , Guillaumie Laurence 
Published: January 2019

ABSTRACT

Background and purpose:
The increasing prevalence of chronic diseases is driving health care systems to rethink their operations. Despite numerous studies supporting the advantages of primary health care nurse practitioners (PHCNPs) in chronic disease management, implementing practices that fully use the skills of these practitioners seems impeded in the Canadian province of Québec. This study explores the views of leaders involved in primary health care regarding the contributions PHCNPs can make in chronic disease management and the challenges they face in doing so.

Methods:
Through semistructured interviews, an exploratory descriptive qualitative study was conducted with 20 key informants across Québec who hold a variety of professional positions connected to PHCNPs.

Conclusions:
Primary health care nurse practitioners were perceived to be able to improve self-management support for chronic diseases. In reality, however, PHCNPs are mainly devoting their time to clientele in acute care, and current regulations governing their practices limit their involvement in chronic disease management.

Implications for practice:
Integrating PHCNPs offers a unique opportunity for health care settings to redefine the roles of family physicians and registered nurses and to restructure practices toward a chronic disease–oriented system. A clinical manager should be designated to monitor this restructuring process and ensure its success.
Progression of Peripheral Vestibular Dysfunctions in Patients With a Mitochondrial A3243G Mutation
Authors: Inoue Aki , Iwasaki Shinichi , Fujimoto Chisato , Kinoshita Makoto , Yamasoba Tatsuya 
Published: January 2019

Objective:
To evaluate the progression of peripheral vestibular dysfunction in patients with an A-to-G point mutation at nucleotide pair 3243 in mitochondrial DNA (A3243G mutation).

Study Design:
Retrospective patient series.

Setting:
Tertiary referral center.

Patients:
Six unrelated patients with an A3243G mutation (four mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes; and two maternally inherited diabetes and deafness; five females and one male; average age 41 ± 11.3 yr old), who underwent repeated vestibular examinations, were included (average interval between the first and second examinations: 5.7 ± 2.1 yr).

Intervention:
Diagnostic.

Main Outcome Measure:
Results of caloric testing and cervical vestibular evoked myogenic potential testing in response to air-conducted sound were analyzed.

Results:
All the patients except one, who was already completely deaf in both ears at the first examination, showed progression of hearing loss (average 4.0 ± 6.3 dB per year). Five of the six patients had vestibular symptoms at the first examination. The other patient developed dizziness later. Caloric responses were abnormal in four patients at the first examination and in five patients at the second examination. Cervical vestibular evoked myogenic potential responses were bilaterally absent in three patients at the first examination and in five patients at the second examination.

Conclusions:
The A3243G mutation causes progression of peripheral vestibular dysfunction as well as that of hearing loss.
Long-term Changes in Musical Perception in Korean Cochlear Implant Patients
Authors: Ahn Jungmin , Ryu Gwanghui , Cho Yang-Sun 
Published: January 2019

Objective:
The purpose of this study was to assess the long-term changes in music perception among cochlear implant (CI) patients using the Korean version of the Clinical Assessment of Music Perception test and questionnaires for music listening.

Methods:
Twenty-seven CI patients participated in this study. Their music perception ability was evaluated using the Korean version of the Clinical Assessment of Music Perception test, which consisted of pitch discrimination, melody, and timbre identification. The test was conducted at least twice after CI. A questionnaire was also used to quantify listening habits (LH) and level of musical experience (LE).

Results:
The participants were divided into two groups according to the average of each test result from the first test. In the pitch discrimination test, the just-noticeable-difference limen values increased as the base frequency increased, and significant differences were observed between the results of 262 and 391 Hz (p = 0.006). In the good performance group, pitch discrimination in the second test did not significantly differ from the first test, but the pitch discrimination score significantly improved in the poor performance group. Similarly, timbre test results were significantly improved in the poor performance group. Neither group exhibited changes in the second test for melody identification. The scores for LH and LE significantly decreased postoperatively and did not recover during the follow-up period.

Conclusions:
Pitch discrimination and timbre identification improved in CI listeners who exhibited poor musical performance shortly after surgery. However, melody identification did not improve over time. LH and LE scores decreased after CI surgery without time-dependent improvement.
Cochlear FLAIR Signal Changes in Hearing Preservation Vestibular Schwannoma Surgery
Authors: Tu Nathan Chin-yau , Bobarnac Dogaru Gabriela , Huang Polly , Kim Jeehong , Diegnan Bernadette , Go John Louie , Friedman Rick Adam 
Published: January 2019

Objective:
Cochlear fluid-attenuated inversion recovery (FLAIR) magnetic resonance imaging (MRI) signal intensity has been shown to be elevated in patients with vestibular schwannomas (VS). This study evaluated the preoperative and postoperative cochlear signal on FLAIR sequences in patients undergoing hearing preservation surgery.

Study Design:
Retrospective chart review.

Setting:
Tertiary referral center.

Patients:
All patients undergoing middle cranial fossa or retrosigmoid craniotomy for VS at a single institution from September 2013 to January 2017 were screened.
Hearing was graded according to the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) hearing classification. Inclusion criteria included preoperative AAO-HNS class A or B hearing and available preoperative and postoperative FLAIR sequences.

Main Outcome Measure:
Signal intensity of cochlear FLAIR signal was measured in the affected cochlea and normalized to the contralateral cochlea. Hearing preservation was defined as AAO-HNS class A or B postoperatively.

Results:
Eighteen patients met all inclusion criteria, and 12/18 experienced hearing preservation. There was no difference in preoperative FLAIR ratio between hearing preserved and nonpreserved groups (2.02 vs 2.32, p = 0.52). Postoperatively, FLAIR ratio was lower in the hearing preserved group compared to the nonpreserved group (1.19 vs 1.87, p = 0.033).

Conclusions:
The current study is the first to examine postoperative cochlear FLAIR changes in VS patients undergoing hearing preservation surgery. In our study population, abnormal hyperintense FLAIR signal normalized in patients experiencing successful hearing preservation, while those who lost hearing maintained abnormal signal. Future studies may investigate the role of FLAIR in guiding optimal timing of operative intervention in VS patients.