bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical course and outcome after kidney transplantation in patients with C3 glomerulonephritis due to CFHR5 nephropathy
Authors: Frangou Eleni , Varnavidou-Nicolaidou Agathi , Petousis Panayiotis , Soloukides Andreas , Theophanous Elena , Savva Isavella , Michael Nicos , Toumasi Elpida , Georgiou Dora , Stylianou Galatia , Mean Richard , Anastasiadou Natasa , Athanasiou Yiannis , Zavros Michalis , Kyriacou Kyriacos , Deltas Constantinos , Hadjianastassiou Vassilis 
Published: January 2019

Abstract

Background
Complement factor H-related protein 5 (CFHR5) nephropathy is an inherited renal disease characterized by microscopic and synpharyngitic macroscopic haematuria, C3 glomerulonephritis and renal failure. It is caused by an internal duplication of exons 2–3 within the CFHR5 gene resulting in dysregulation of the alternative complement pathway. The clinical characteristics and outcomes of transplanted patients with this rare familial nephropathy remain unknown.

Methods
This is a retrospective case series study of 17 kidney transplant patients with the established founder mutation, followed-up over a span of 30 years.

Results
The mean (±SD) age of patients at the time of the study and at transplantation was 58.6 ± 9.9 and 46.7 ± 8.8 years, respectively. The 10- and 15-year patient survival rates were 100 and 77.8%, respectively. Proteinuria was present in 33.3% and microscopic haematuria in 58.3% of patients with a functional graft. Serum complement levels were normal in all. ‘Confirmed’ and ‘likely’ recurrence of CFHR5 nephropathy were 16.6 and 52.9%, respectively; however, 76.5% of patients had a functional graft after a median of 120 months post-transplantation. Total recurrence was not associated with graft loss (P = 0.171), but was associated with the presence of microscopic haematuria (P = 0.001) and proteinuria (P = 0.018). Graft loss was associated with the presence of proteinuria (P = 0.025).

Conclusions
We describe for the first time the clinical characteristics and outcome of patients with CFHR5 nephropathy post-transplantation. Despite the recurrence of CFHR5 nephropathy, we provide evidence for a long-term favourable outcome and support the continued provision of kidney transplantation as a renal replacement option in patients with CFHR5 nephropathy.
Industry Input in Policy Making: Evidence from Medicare*
Authors: Chan David C , Dickstein Michael J 
Published: January 2019

AbstractIn setting prices for physician services, Medicare solicits input from a committee that evaluates proposals from industry. The committee itself comprises members from industry; we investigate whether this arrangement leads to regulatory capture with prices biased toward industry interests. We find that increasing a measure of affiliation between the committee and proposers by one standard deviation increases prices by 10%. We then evaluate whether employing a biased committee as an intermediary may nonetheless be desirable, if greater affiliation allows the committee to extract information needed for regulation. We find industry proposers more affiliated with the committee produce less hard evidence in their proposals. However, on soft information, we find evidence of a trade-off: private insurers set prices that more closely track Medicare prices generated under higher affiliation.
Compact groups in which all elements are almost right Engel
Authors: Khukhro E I , Shumyatsky P 
Published: January 2019

AbstractWe say that an element g of a group G is almost right Engel if there is a finite set R(g) such that for every x∈G, there is a positive integer n(x,g) such that […[[g,x],x],…,x]∈R(g) if x is repeated at least n(x,g) times. Thus, g is a right Engel element precisely when we can choose R(g)={1}. We prove that if all elements of a compact (Hausdorff) group G are almost right Engel, then G has a finite normal subgroup N such that G/N is locally nilpotent. If in addition there is a uniform bound ∣R(g)∣⩽m for the orders of the corresponding sets, then the subgroup N can be chosen of order bounded in terms of m. The proofs use the Wilson–Zelmanov theorem saying that profinite Engel groups are locally nilpotent and previous results of the authors about compact groups in which all elements are almost left Engel.
‘A Double Care’: Prayer as Therapy in Early Modern England
Authors: Mann Sophie 
Published: January 2019

Summary
This article explores three central questions. What did people consider the physical effects of prayer to be? Why were these effects considered to be therapeutic? How did an awareness of prayer’s physiological benefits shape the practices of patients and practitioners? It also presents a wider attempt to incorporate the notion of ‘double care’ into our thinking about early modern medical treatment. To date, early modernists have demonstrated that the sick engaged in prayer in order to elicit the Lord’s mercy and bring about a recovery. What remains underexplored is the way in which prayer was believed to somatically manifest in the devotee’s own body. Exploring this theme will highlight that medical practitioners, clergymen and the laity perceived and invoked prayer as both a spiritual and physical aid. In this way, prayer was not only a central religious exercise but also could be an important component of early modern therapeutics.
Using Clinical Instructor Perceptions to Improve a Pilot Simulation Course
Authors: Woda Aimee , Schnable Theresa , Alt-Gehrman Penny 
Published: January 2019

Abstract
Little is known about clinical instructors’ perceptions of student decision-making in relation to the block sequencing of simulation and traditional clinical experiences. Focus groups were conducted with 12 clinical instructors. Three common threads emerged from the data: right away, anxious but more confident, and scary and unsafe. Instructors noted that the more patient care experiences encountered, the more students developed efficient clinical decision-making skills. Major safety concerns regarding medication administration were identified, resulting in additional safety parameters instituted in the simulated environment.
Practices and Attitudes of Nursing Students Toward Patients With Disordered Eating Behaviors
Authors: Phillips Kathryn E. , LoGiudice Jenna A. 
Published: January 2019

Abstract
Disordered eating (DE) behaviors are associated with obesity and eating disorders. This study describes practices and attitudes of nursing students toward patients exhibiting DE and how personal DE behaviors affect practices and attitudes. Most respondents had a mental health rotation (74.7 percent) and DE education (68 percent); however, only 34.7 percent felt prepared to screen for DE, and only 44 percent were taught to screen. Those scoring high for DE behaviors (n = 7) indicated greater rates of feeling prepared to screen. This knowledge can help nurse educators design curricula to increase the preparation of nurses to address DE behaviors.
Methods for measuring patient preferences: an update and future directions
Authors: Meara Alexa , Crossnohere Norah L. , Bridges John F.P. 
Published: January 2019

Purpose of review
The current review highlights the growing number of available methods used to measure patient preferences and discusses how this impacts preference research in rheumatology. Spurred by the growing role of preferences in regulatory decisions and drug development, researchers have begun applying preference methods to study questions beyond the clinical context. We explore these trends, provide case studies highlighting changes in measuring patient preferences, compare strengths and weaknesses of common stated-preference methods, and discuss considerations for the future use of these methods.

Recent findings
Early literature on patient preferences often mimicked clinical practice, asking whether treatment A is better or worse than treatment B for a patient. Early applications of patient preference methods in rheumatology aimed to value different attributes of treatments, but remained focused on informing clinical questions. Spurred by interest in preferences by regulatory agencies and patient-centeredness throughout the product lifecycle, there are now a wide array of methods available to measure preference.

Summary
Although these different preference methods have strengths and weaknesses, they serve to highlight the broad number of questions that could help rheumatology beyond the clinical context. Researchers in rheumatology now have the opportunity to better serve diverse stakeholders by considering how these methods could aid in clinical trial design, regulatory policy, and other elements of the medical product life cycle.
Cryolipolysis for Noninvasive Contouring of the Periumbilical Abdomen With a Nonvacuum Conformable-Surface Applicator
Authors: Friedmann Daniel P. 
Published: January 2019

BACKGROUND
Although most cryolipolysis treatments are performed with vacuum applicators, some patients may have areas of fibrous, nonpinchable fat or find vacuum suction to be uncomfortable.

OBJECTIVE
This study evaluates a nonvacuum conformable-surface applicator for cryolipolysis of the periumbilical abdomen.

METHODS/MATERIALS
Twenty subjects with periumbilical subcutaneous fat were treated with a nonvacuum cryolipolysis applicator in this prospective, single-center, open-label clinical trial. Each subject underwent a single treatment cycle with an optional second treatment 10 weeks later. Efficacy was evaluated by blinded review of digital photographs. Subject satisfaction was assessed at 10-week follow-up.

RESULTS
Twenty subjects completed one treatment, of which 6 underwent the optional retreatment. Independent review demonstrated 77% correct identification of baseline photographs after one treatment, which improved to 100% after a second treatment. Patient questionnaires after one treatment revealed 50% satisfaction, with 60% willing to recommend the procedure and 60% reporting visible fat reduction. After second treatment, however, 100% were satisfied, 83% were willing to recommend, and 100% reported visible fat reduction.

CONCLUSION
Cryolipolysis with a nonvacuum conformable-surface applicator is safe, effective, and well tolerated for noninvasive reduction of fibrous periumbilical abdominal fat. Efficacy and subject satisfaction is significantly greater with 2 treatments than with a single session.
Life With HIV in a Canadian Suburban Community: A Qualitative Inquiry of Health Care and Social Services Access
Authors: Manis Derek , Gamble Brenda 
Published: January 2019

Abstract
HIV has been examined in urban and rural contexts, but the suburban gradient has not been sufficiently described, despite the fact that many Canadians live in suburbia. Using qualitative description, we investigated how people living with HIV in a suburban community in Ontario, Canada, accessed health care and social services. Posters at the regional AIDS Service Organization and snowball sampling were used to recruit and interview 13 adult participants with various experiences and perspectives. A content analysis identified three meta-themes in the interviews: (a) transportation cost and time: barriers to access, (b) isolation, and (c) defective primary care: unmet and deflected needs. The findings have implications for the (a) development of community-based groups, (b) the role of transportation in health care and social services utilization, (c) community-based, interprofessional health and social care services, and (d) aging with HIV.
A Mindfulness Workshop for Health Science Graduate Students: Preliminary Evidence for Lasting Impact on Clinical Performance
Authors: Willgens Annette , Palombaro Kerstin 
Published: January 2019

Introduction.
Health science graduate students take high stakes examinations and experience stress and burnout, which can negatively influence performance in clinical courses. The intent of this study was to pilot a curriculum in mindful practice for graduate health science students under high levels of perceived stress. The purpose of this study was to determine the effectiveness of an abbreviated mindfulness workshop to determine if it would provide lasting benefit for students during clinical experiences 9 months later.

Methods.
Twenty-three graduate students across 4 health professions participated in a 6-week workshop for stress management in March 2017. Students were executed to practice mindfulness activities for 15 minutes daily over the 6 weeks. Weekly meetings included meditation, mindful movement, and small group discussion. A mixed methods approach incorporated pre- and postworkshop measures exploring students' levels of worry, perceived stress, feelings of isolation, self-judgment, self-kindness, overidentification, and mindfulness. Additional survey data were collected 9 months later to determine if the tools learned in the workshop influenced clinical performance. Qualitative comments were coded using generic qualitative analysis, and member checking confirmed themes.

Results.
Overall, students demonstrated improvements in all measures of stress over the 6-week workshop. Additionally, they reported positive influences on clinical performance in the affective and cognitive domains 9 months later. Four main themes were extracted from the data. These were I Have Tools; Think, Pause, Allow; Silence the Critic; and, I Am Not Alone. Overall, the participants experienced significant improvements in mindfulness scores and self-compassion, and showed improvements in perceived stress and worry (Cognitive-Affective Mindfulness Scale-revised).

Discussion and Conclusion.
Altogether, these data suggest that (1) graduate students can learn to manage worry, feelings of isolation, and self-judgment using tools and strategies from mindful practices; (2) students who practice mindfulness in a 6-week workshop report lasting effects during clinical performance 9 months later; and (3) students benefit from a community of peers and a shared space to share their thoughts and feelings as emerging health professionals. Suggestions are made for integrating mindful practices into graduate health science education.
Nonadherence after pediatric renal transplantation: detection and treatment
Authors: Holmberg Christer 
Published: January 2019

Purpose of review
Nonadherence is a problem in adolescents and young adults. Risk factors are classified as those of the individual, family, health-care-system, or community. I present the latest reports and how to tackle nonadherence.

Recent findings
Nonadherence risk is independent of one's origin in a high-poverty or low-poverty neighborhood or having private or public insurance in respect to African Americans. Females with male grafts have higher graft-failure risks than do males. Female recipients aged 15–24 with grafts from female donors have higher graft-failure risk than do males. In study of nonadherence risks, such findings must be taken into account. Antibody-mediated rejection is seen in nonadherence. The sirolimus and tacrolimus coefficient of variation is associated with nonadherence, donor-specific antibodies, and rejection. Adolescents had electronically monitored compliance reported by e-mail, text message or visual dose reminders and meetings with coaches. These patients had significantly greater odds of taking medication than did controls. Transition programs have an impact on renal function and rejection episodes.

Summary
Individual risk factors are many, and methods for measuring nonadherence exist. Each transplant center should have a follow-up program to measure nonadherence, especially in adolescence, and a transition program to adult care.
Creation and Online Use of Patient-Centered Videos, Digital Storytelling, and Interactive Self-testing Questions for Teaching Pathophysiology
Authors: DeLenardo Samantha , Savory Joanne , Feiner Frank , Cretu Madalina , Carnegie Jacqueline 
Published: January 2019

Background
Nursing students need to not only understand the pathophysiological basis of disease but also acquire insight into its effects on patients and their families.

Purpose
Digital storytelling was used to engage students in self-directed, online learning, allowing them to identify with patients dealing with disease and its consequences.

Methods
Scripts were written and videos created that simulated patient experiences with select diseases of the gastrointestinal and respiratory systems as well as diabetes. Videos plus online self-testing questions were provided to nursing students studying pathophysiology and student outcomes on summative examinations compared before and after introduction of the videos.

Results
Students had improved outcomes on summative examination questions that targeted diseases addressed in the video modules.

Conclusions
Digital storytelling is an effective way to portray illness from a patient perspective, and the addition of this approach to pathophysiology instruction can benefit student learning.
23.4% Hypertonic Saline and Intracranial Pressure in Severe Traumatic Brain Injury Among Children: A 10-Year Retrospective Analysis
Authors: Wu Andrew G. , Samadani Uzma , Slusher Tina M. , Zhang Lei , Kiragu Andrew W. 
Published: January 2019

Objective:
To explore the effect of 23.4% hypertonic saline for management of elevated intracranial pressure in children admitted to our institution for severe traumatic brain injury.

Design:
Single-center, retrospective medical chart analysis.

Setting:
A PICU at a level 1 pediatric trauma center in the United States.

Patients:
Children admitted for severe traumatic brain injury from 2006 to 2016 who received 23.4% hypertonic saline and whose intracranial pressures were measured within 5 hours of receiving 23.4% hypertonic saline.

Interventions:
None.

Measurements and Main Results:
Over the 10-year period, 1,587 children were admitted for traumatic brain injury, 155 of whom were deemed severe per this study’s criteria. Forty of these children received at least one dose of hypertonic saline, but 14 were excluded for insufficient intracranial pressure data. Among the remaining 26 children, one hundred one 23.4% hypertonic saline boluses were used in the analysis. Use of 23.4% hypertonic saline was associated with a decrease in intracranial pressure of approximately 7 mm Hg at both within 1 hour after the bolus (p < 0.01) and 4 hours after the bolus (p < 0.01) when compared with the intracranial pressure measured within 1 hour before the hypertonic saline bolus. These effects remained significant after adjusting for Functional Status Scale score and CT Marshall scores. There was no statistically significant association between adjunctive therapies, such as antiepileptics and analgesics, and changes in intracranial pressure. There was no laboratory evidence of hyperkalemia or renal injury after use of 23.4% hypertonic saline. Across all hospitalizations, 65% of the study population demonstrated an abnormally elevated creatinine at least once, but only three episodes of acute kidney injury occurred in total, all before hypertonic saline administration. Eight of the 26 children in this analysis died during their hospitalization. The Functional Status Scale scores ranged from 6 to 26 with a mean of 12.2 and sd of 5.7.

Conclusions:
Use of 23.4% hypertonic saline with children admitted for severe traumatic brain injury is associated with a statistically significant decrease in intracranial pressure within 1 hour of use.
Does Receiving a Text Message Reminder Increase Follow-up Compliance After Discharge From a Pediatric Emergency Department?
Authors: Salinero Efren A. , Ramirez Jose , Cramm-Morgan Kelly , Papa Linda 
Published: January 2019

Objectives
Compliance with recommended follow-up from the pediatric emergency department (PED) has been shown to be poor. This study evaluated whether a text message reminder to the caregivers after discharge from the PED improved compliance with recommended primary care follow-up.

Methods
This was a blinded randomized control trial conducted at a level 1 pediatric trauma center. The intervention was a text message sent to the caregiver within 24 hours of discharge from the PED reminding them to follow up with their primary care doctor. Patients were eligible if the caregiver had text message capability on their cellular phones, they were currently established patients of the organization's Pediatric Faculty Practice, they were discharged home from the PED, and they were referred for follow-up within 1 week of discharge by the pediatric emergency physician. After informed consent, pediatric patients were randomized to either an intervention group (text message appointment reminder) or a control group (standard scheduling with no reminder). The patient, treating physician, and primary care outpatient center were blinded to the group assignment. Enrollment occurred 24 hours per day and 7 days per week.

Results
There were 123 patients enrolled in the study, 62 patients randomized to the control group (standard scheduling) and 61 randomized to the intervention group (text message appointment reminder). Of the patients, 58% were male and 42% were female, with the average age of the patients being 2.2 years (SD, 2.8). The majority of patients were seen in the PED on a weekday, with 24% presenting on a weekend. Only 28% of patients completed the recommended follow-up, and the average time from PED discharge to follow-up was 6 days (SD, 4.2; range, 0–17 days). There was no significant difference in follow-up in the standard treatment group (19/62, 31%) versus the text message intervention group (16/61, 26%) (P = 0.69; rate ratio, 0.94; 95% confidence interval, 0.75–1.18). When we assessed other variables, we found that parents of younger children were more likely to follow up as recommended by the pediatric ED physician. Of those who were compliant with follow-up, we found a mean age of 1.3 years (SD, 2.0; range, 0.8–9.1) versus 2.6 years (SD, 3.0; range, 0.08–15.3) for those who were not compliant with follow-up (P = 0.02).

Conclusions
In this randomized controlled study, a text message reminder to caregivers did not improve compliance for PED patients. However, caregivers of younger children were more likely to complete follow-up as recommended by the PED physician compared with caregivers of older children.
Distraction Using Buzzy or Handheld Computers During Venipuncture
Authors: Cozzi Giorgio , Crevatin Franca , Dri Veronica , Bertossa Gabriella , Rizzitelli Patrizia , Matassi Daniela , Minute Marta , Ronfani Luca , Barbi Egidio 
Published: January 2019

Objectives
Venipuncture is one of the most frequently performed painful procedures in children. The aim of this study was to investigate the effectiveness of 2 analgesic strategies for venipuncture in children in a specific setting like a blood-drawing center.

Methods
This was a prospective randomized controlled trial. It was conducted in the blood-drawing center of a tertiary level children's hospital in Italy, between November 2014 and February 2015. Eligible patients were children aged from 4 to 12 years referred to the blood-drawing center for venipuncture. Enrolled children were randomized to be distracted by Buzzy device or by playing with a handheld computer. The procedural pain was measured with the faces pain scale-revised by children aged from 4 to 7 years and with a numerical rating scale by children aged from 8 to 12 years.

Results
Two hundred children with a median age of 8 years were enrolled in the study. The self-reported procedural pain was not statistically different between the Buzzy group and the handheld computer group: median (interquartile range) = 3.0 (1.0–4.8) and 2.0 (1.0–4.8), respectively (P = 0.72). Children reported significant pain in 25% of cases with both distraction strategies. The procedural success rate at the first attempt was not significantly different in the 2 groups.

Conclusions
Analgesia provided by Buzzy or by a handheld computer was not significantly different in children undergoing venipuncture in a blood-drawing center, with the great proportion of them reporting no or mild pain during procedure.