bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of the COVID-19 pandemic on participants in pragmatic clinical trials for chronic pain: implications for trial outcomes and beyond
Authors: Sellinger John J , Gilstad-Hayden Kathryn , Lazar Christina , Seal Karen , Purcell Natalie , Burgess Diana J , Martino Steve , Heapy Alicia , Higgins Diana , Rosen Marc I 
Published: November 2024

Abstract

Objective
The COVID-19 pandemic had profound effects on society, including those living with chronic pain. This study sought to examine pandemic impacts on individuals enrolled in pragmatic clinical trials focused on nonpharmacological treatments for chronic pain.

Methods
We evaluated responses to a questionnaire on COVID-19 impacts that had been administered to participants (n=2024) during study enrollment in 3 pragmatic clinical trials for chronic pain treatment. All trials were part of the National Institutes of Health (NIH)–Department of Veterans Affairs (VA)–Department of Defense (DOD) Pain Management Collaboratory. COVID-19–related impacts on access to health care, mental health, finances, ability to meet basic needs, and social support were assessed.

Results
Pandemic impacts were found in all domains assessed, including access to health care, mental and emotional health, ability to meet basic needs, finances, and social support. Impacts varied by demographic and clinical characteristics. The participants most negatively impacted by the pandemic were younger, Black or Latino, female, more educated, and unemployed and had screened positive for depression. No impact differences were found with regard to alcohol use disorder screenings or a prior history of COVID-19. Higher levels of pain were associated with worse pandemic impacts, and negative impacts declined over time.

Conclusions
Negative impacts of the pandemic on individuals living with chronic pain cut across aspects of life that are also central to effective pain management, including access to health care, social support, and mental and emotional health, with differential impacts found across key demographic and clinical factors. These findings should yield consideration of pandemic impacts in clinical practice and as moderating effects of treatment outcomes in clinical trials conducted during the pandemic.
Screening, brief intervention, and referral to treatment for pain management for veterans separating from military service: study protocol of a hybrid type 2 study testing implementation facilitation versus training-as-usual
Authors: Sellinger John J , Rosen Marc I , Lazar Christina M , Gilstad-Hayden Kathryn , Dziura James , Li Fang-Yong , Mattocks Kristin , Weede Adrienne , Sullivan-Tibbs Michael , Rose Liam , Garcia Vassallo Gabriela , Manhapra Ajay , Turner Amos , Vogt Dawne , Woodward Eva N , Hartmann Christine W , Haskell Sally G , Mohammad Amir , Martino Steve 
Published: November 2024

Abstract

Background
Veterans transitioning to civilian life often have chronic pain from service-related musculoskeletal disorders (MSD) with higher risk for substance misuse. Many seek VA (Department of Veterans Affairs) compensation for MSD. Use of Screening, Brief Intervention, and Referral to Treatment for Pain Management (SBIRT-PM) by VA Post-9/11 Military2VA (M2VA) case managers presents an opportunity to engage these veterans in VA pain care and address substance misuse. Implementation facilitation might help case managers use SBIRT-PM and engage veterans in services to improve outcomes.

Design
This study is a 2-cohort multisite cluster-randomized hybrid type 2 effectiveness-implementation trial. Within 2 separate cohorts of 14 VA sites each, sites will be allocated to receive an implementation strategy through the use of a constrained randomization procedure: virtual implementation facilitation or training-as-usual. Sites and M2VA case managers will receive the assigned implementation strategy to support use of SBIRT-PM. Recently discharged veterans (n = 1848) claiming service-connected MSD will be recruited, with case managers blind to veterans’ study enrollment. The proportion of participants who receive any SBIRT-PM will be the primary implementation outcome. Veteran participants will complete baseline, 12-week, and 36-week assessments, irrespective of whether case managers conduct SBIRT-PM with them (intent-to-treat). Pain intensity and interference will be the primary clinical outcomes. The study emphasizes pragmatic over explanatory methodological features.

Summary
This pragmatic trial will examine implementation facilitation versus training-as-usual in implementing SBIRT-PM to promote veteran engagement in nonpharmacological pain services. Using innovative methods to train and support VA case managers in SBIRT-PM, study outcomes could have broad implications for case management systems of care across the VA.
The implementation of a pain navigator program in the department of Veterans Affairs' (VA) health care systems: a cluster randomized pragmatic clinical trial
Authors: France Courtni , Cook Chad E , Coffman Cynthia J , Tumminello Christa , Choate Ashley , George Steven Z , Lentz Trevor A , Hastings Susan N 
Published: November 2024

Abstract

Objective
This manuscript describes the uptake of the AIM-Back Pain Navigator Pathway (PNP) designed to encourage use of non-pharmacologic care options within the Veterans Health Administration (VHA).

Design
This manuscript describes the implementation of a telehealth intervention from one arm of a multisite, embedded, cluster-randomized pragmatic trial comparing the effectiveness of two novel clinical care pathways that provide access to non-pharmacologic care for Veterans with low back pain (LBP).

Setting
Ten VHA clinics

Subjects
19 pain navigators, &gt;200 primary care physicians, and over 1000 Veterans were involved in the PNP implementation

Methods
Data were generated within the VHA electronic health record (EHR) for the ongoing AIM-Back trial to describe PNP implementation for system-level findings in terms of number of visits, and type of care received

Results
Over a 3-year period, 9 of 10 clinics implemented the PNP within the context of the AIM-Back trial. The most frequent care recommended in the PNP included physical therapy, chiropractic, acupuncture, and yoga/tai chi. During follow-up at six-weeks, ∼50% of Veterans elected to receive a different care choice than what was initially prescribed. Notable variation across clinics was documented for PNP based on time to initiation of care and follow-up rates.

Conclusions
Implementation of the telehealth delivered PNP provides a nuanced understanding of the introduction of novel care programs within diverse clinical settings. These findings are most applicable to care programs that are delivered remotely and involve facilitation of existing care options.
Tele-collaborative outreach to rural patients with chronic pain: pragmatic effectiveness trial protocol for the CORPs study
Authors: Morasco Benjamin J , Pal Natassja , Ono Sarah S , McPherson Sterling M , Lynch Frances L , Dickerson John F , Dobscha Steven K , Krebs Erin E , Makris Una E , Mixon Amanda S , Maloy Patricia , Davis Melinda M , Lovejoy Travis I 
Published: November 2024

Abstract

Background
Despite the increased availability of evidence-based treatments for chronic pain, many patients in rural areas experience poor access to services. Patients receiving care through the VA may also need to navigate multiple systems of care.

Objective
To examine the effectiveness of a remotely delivered collaborative care intervention for improving pain interference among veterans with high-impact chronic pain living in rural areas.

Design
We will conduct a four-site pragmatic effectiveness trial of remotely delivered collaborative care for high-impact chronic pain. Participants (n = 608) will be randomized to the Tele-Collaborative Outreach to Rural Patients (CORPs) intervention or to minimally enhanced usual care (MEUC). Participants randomized to CORPs will complete a biopsychosocial assessment and five follow-up sessions with a nurse care manager (NCM), who will collaborate with a consulting clinician to provide personalized recommendations and care management. CORP participants will also be invited to a virtual 6-session pain education group class. Participants randomized to MEUC will receive a one-time education session with the NCM to review available pain services. All participants will complete quarterly research assessments for one year. The primary study outcome is pain interference. This trial will oversample veterans of female birth sex and minoritized race or ethnicity to test heterogeneity of treatment effects across these patient characteristics. We will conduct an implementation process evaluation and incremental cost-effectiveness analysis.

Discussion
This pragmatic trial will test the real-world effectiveness of a remotely delivered collaborative care intervention for chronic pain. Study findings will inform future implementation efforts to support potential uptake of the intervention.
Regional Differences in Job Satisfaction among Chinese Social Workers: The Mediating Effect of Attitudinal Professionalism
Authors: Tang Ning , Zhang Donghang , Sun Fei , Xia Yihong 
Published: November 2024

Abstract
Job satisfaction is a vital factor associated with better physical health and subjective well-being among social workers. This study aims to explore the job satisfaction of social workers from China’s Mainland and Macao and the role of attitudinal professionalism on regional differences. A cross-sectional survey collected data from 292 social workers in Mainland and 108 from Macao one year after the outbreak of COVID-19; 72 percent were female, less than half were married (44.8 percent), the average age was 32.64 years old, and the average working time was 6.07 years. Data were analyzed using descriptive statistics, independent t tests, and mediation analysis. Results indicated that Mainland social workers reported a significantly higher level of job satisfaction and attitudinal professionalism than Macao social workers. Moreover, attitudinal professionalism helped explain the regional difference in job satisfaction. The evidence from this study highlights the need to nurture professional beliefs and values among social workers, especially for Macao social workers, and also underscores the importance of developing continuing education programs to enhance social workers’ identification with and commitment to the profession. We also need to improve financial compensation and social status for Mainland social workers to sustain their professionalism.
Disparities in Buprenorphine Administration for Opioid Use Disorder in the Emergency Department
Authors: Koerber Samantha N. , Huynh David , Farrington Sydney , Springer Kylie , Manteuffel Jacob 
Published: November 2024

Study Objective
Although buprenorphine is an effective treatment for opioid use disorder (OUD), this treatment is often not universally provided in the emergency department (ED). We aimed to determine whether patient characteristics, particularly race and ethnicity, were associated with buprenorphine administration.

Methods
This was a retrospective cross-sectional study of adult patients who had a positive screening result for opioid misuse in the ED at a single urban hospital. Univariate and multivariable logistic regressions were used to assess the association of patient characteristics (race, ethnicity, age, sex, insurance type, and Area Deprivation Index) with buprenorphine administration.

Results
Of 1082 patients who screened positive for opioid misuse, 133 (12%) were treated with buprenorphine and 949 (88%) were not. Despite representing over half the patient sample, Black patients (n = 682) were less likely than White patients (n = 310) to be treated with buprenorphine (multivariable: OR, 0.56; 95% CI, 0.35–0.88; P = 0.023). Age, sex, insurance type, ethnicity, and Area Deprivation Index were not associated with buprenorphine administration.

Conclusions
Patient race was associated with buprenorphine administration, even after controlling for multiple other social determinants of health. These data suggest racial disparities in care that should be investigated through further research to optimize equitable administration of buprenorphine.
Occipital Vascularized Bone Graft for Reconstruction of a C3-C7 Defect
Authors: Riasa I. Nyoman P. , Reece Edward M. , Mahadewa Tjokorda G. B. , Kawilarang Bertha , Jeger Jonathan L. , Awyono Steven , Putra Made Bhuwana , Putra Kevin Kristian , Suadnyana I. Putu Ramanda 
Published: November 2024

Summary:
The number of spinal reconstruction cases is growing, as are the accompanying complications. Wound complications after spinal reconstruction can be fatal and can affect up to 19% of patients undergoing major spine surgery. The discipline of spinoplastic surgery is characterized by the use of vascularized bone grafts to reconstruct spinal defects, which provide better results compared with nonvascularized and allogenic equivalents, owing to their superior blood supply. We present a 49-year-old man with spinal defect in the C3-C7 region treated with spinoplastic reconstruction. A 5 × 6 cm occipital VBG was designed with a centrally located muscular pedicle and successfully inset into the osseous defect. Radiographs taken 15 months postoperatively demonstrated overall excellent bony fusion, and the patient made an appropriate clinical recovery. In difficult spine procedures, the use of this occipital vascularized bone graft may lead to higher fusion rates without the need for free tissue transfer or allograft placement, which may not be available at all surgical centers around the world.
Enhanced Recovery Protocol Decreases Postoperative Opioid Use after Penile Inversion Vaginoplasty
Authors: Rios Sanchez Maria V. , Sanchez Figueroa Nicole , Zheng Eugene , Sotelo Leon Dan , Martinez-Jorge Jorys , Fahradyan Vahe 
Published: November 2024

Background:
Penile inversion vaginoplasty (PIV) entails considerable soft-tissue dissection to the perineal region and involves complex tissue rearrangement. This study examines the role of an enhanced recovery after surgery (ERAS) pathway after PIV in reducing opioid use and controlling postoperative pain.

Methods:
A retrospective study of 50 transfemale patients who underwent PIV at a single institution from June 2021 to January 2023 was completed. The study compared 2 groups of patients who were given different postoperative pain management regimens: group A received standard postoperative analgesics and group B received ERAS. Variables such as postoperative pain scores on the numeric pain rating scale (0–10), use of opioid medication, length of hospital stay, and patient comorbidities were recorded and compared across the 2 groups.

Results:
The average hospital stay length was 4.92 (±0.85) days. Group A had a slightly longer average stay compared with group B. The average pain level in both groups was 4.25 (SD ±1.51). Group A exhibited a slightly higher average pain level of 4.31 (±1.53), whereas group B exhibited 4.16 (SD±1.51) (P = 0.77). Although pain levels did not significantly vary between the 2 groups, there was a statistically significant decrease in the amount of opioid medication used in group B with a P value of 0.009.

Conclusions:
ERAS protocol is effective in decreasing opioid usage in the immediate postoperative setting after PIV.
Influence of Mental Model-derived Themes on the Quality of Radiological Emergency Response by HAZMAT Technicians: Insights from a Case Study
Authors: Leek Angela E. , Keren Nir , Shelley Mack C. , Franke Warren , Mosher Gretchen A. , Simpson Stephen A. , Rice Timothy , Lawson Andrew 
Published: November 2024

Abstract
This paper investigates the link between gaps in emergency responders' notions of mental model regarding radiation and risk and their effectiveness in responding to radiological incidents. Particularly, this work focused on exploring themes that emerged in prior work related to improper understanding and application of knowledge concepts related to radiation risks and Radiological Dispersal Device (RDD) scenarios (Leek et al., 2024b). The research uses a quantitative approach to correlate various thematic elements, such as responders’ confidence levels, comprehension, and application of radiation risk principles, with the quality of the emergency response score gained through a virtual reality simulation. The results underscore a strong effect of responders' confidence level on response quality scores. Additionally, the study identifies that improper understanding of knowledge concepts and incorrect application of radiation risk and RDD concepts are factors that detract from the quality of response, especially the tendency to overestimate health risks associated with a 25-rem (0,25 Sv) dose and to misapply principles of radiation risk. The implications of this research are significant for the development and refinement of training programs for hazardous materials (HAZMAT) technicians and other emergency responders. The findings suggest the need for a comprehensive review of current training methodologies to address the identified deficiencies that had impacts on the quality of response. The findings provide a foundation for reshaping training priorities and operational readiness, driving the development of training that is both grounded in empirical evidence and that directly addresses the knowledge gaps influencing response quality. The methodological framework developed and employed, including the quality scoring system and the Expected Mental Model State (EMMS) Diagnostic Matrix, also hold potential for broader application in future investigations, extending to diverse types of responders and emergency scenarios.
Knowledge and Adherence to Radiation Protection among Non-radiation Health Care Workers at Two Operating Theatres in Windhoek, Namibia
Authors: Shivute Panduleni , Shilumba Moneni 
Published: November 2024

Abstract

Background: In operating theatres, diagnostic radiography is used to capture images during surgical operations. With the growing use of fluoroscopy, there are concerns about increased radiation exposure to healthcare workers such as doctors and nurses. Thus, assessing HCWs’ knowledge and adherence to radiation protection is crucial to prevent overexposure, radiation-related health issues, and ensure patient safety. Objective:The study aimed to assess the knowledge of non-radiation HCWs regarding radiation protection and determine the level of adherence to radiation protection in two theaters. Methods: A quantitative descriptive research methodology was used. Data collection involved a questionnaire, and participants were selected through a simple random sampling method. Data were analyzed using SPSS version 26. Results: Fifty-eight non-radiation HCWs participated. Most (77.6%) were female with nurses comprising the largest demographic (62.1%). Most participants (53.4%) lacked prior education in radiation protection. Concerningly, 70.7% did not use dosimeters during theater radiography, which is a requirement for radiation protection. No significant association was found between participants’ allocated hospital and the level of knowledge, but a significant association (p = 0.027) was found between participants’ allocated hospital and adherence levels. Conclusion: The findings suggest inadequate knowledge and adherence to radiation protection. Therefore, education on radiation protection must be mandated, and measures should be taken to enforce adherence.
Cariprazine and Cognition in Patients with Schizophrenia and Bipolar Disorder: A Systematic Review
Authors: García-Fernández Lorena , Romero-Ferreiro Verónica , Peñuelas-Calvo Inmaculada , Álvarez-Mon Miguel A. , Scala Mauro , Romero-Ferreiro Carmen , López Estela Jiménez , Santos José Luis , Rodriguez-Jimenez Roberto 
Published: November 2024

Abstract

Background
Cariprazine (CAR), an antipsychotic with partial agonism at the D3 receptor and higher affinity than dopamine, has shown significant procognitive effects in preclinical animal studies. This study systematically reviews CAR's effects on cognitive measures in patients with schizophrenia and bipolar disorder.

Methods
Two independent reviewers systematically searched PubMed, Web of Science, Scopus, and the Cochrane Library up to May 2024, following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Additional studies were found by hand searching the references of included studies. Eligible studies were randomized controlled trials (RCTs) in English that assessed CAR's effects on cognition in patients with schizophrenia or bipolar disorder. Quality was assessed using the Jadad scale.

Results
Out of 139 reports, 5 studies (involving 6,104 patients with schizophrenia or bipolar disorder) were included. In schizophrenia, CAR showed better cognitive outcomes (mainly indirect measures) than placebo (PBO) in both early and late stages. It also outperformed risperidone and aripiprazole in attention-related cognitive tests. In bipolar disorder, CAR improved cognition compared to PBO (also using indirect measures). Most studies found the greatest cognitive benefits with low doses of CAR (1.5–3 mg/d).

Conclusions
CAR improved cognitive measures compared to PBO and other D2 antagonists or partial agonists in RCTs, especially in patients with greater baseline impairment. Thus, CAR may be a promising option for enhancing cognition in schizophrenic and bipolar patients; though, more trials using specific cognitive assessment tools are needed.

Systematic review registration
PROSPERO CRD42023485028
Incorporating Lifestyle Medicine Into Occupational Medicine Practice
Authors: Hymel Pamela A. , Stave Gregg M. , Burton Wayne N. , Schultz Alyssa B. , Jones Nathan , Liva Jeffrey , Price Richard D. , Loeppke Ron , Stout Ronald , Saito Kenji ,   ACOEM Presidential Task Force on Lifestyle Medicine and OEM Practice
Published: November 2024

Abstract
Lifestyle medicine (LM) utilizes evidence-based therapeutic lifestyle changes to address lifestyle factors that impact health, performance, and injury risk and recovery. By integrating LM principles into clinical care, workplace policies, and programs, along with other evidence-based methods, occupational and environmental medicine clinicians and medical directors can enhance worker health and performance, manage chronic disease, and facilitate faster recovery from injury and illness. This guidance addresses approaches that can be used in the clinic and workplace to address tobacco, substance misuse, nutrition, physical activity, overweight/obesity, sleep, mental well-being, and social connectedness.