bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative Matched-Pair Analysis of Open-Wedge High Tibial Osteotomy With Versus Without an Injection of Adipose-Derived Mesenchymal Stem Cells for Varus Knee Osteoarthritis: Clinical and Second-Look Arthroscopic Results
Authors: Kim Yong Sang , Koh Yong Gon 
Published: August 2018

Background:High tibial osteotomy (HTO) is reported to be an effective treatment for varus knee osteoarthritis (OA) by redistributing the load line within the knee joint. The cell-based tissue engineering approach using mesenchymal stem cells (MSCs) has addressed the issue of articular cartilage repair in knee OA.Purpose:This study aimed to compare the clinical, radiological, and second-look arthroscopic outcomes of open-wedge HTO with versus without an MSC injection and to identify the association between cartilage regeneration and HTO outcomes.Study Design:Cohort study; Level of evidence, 3.Methods:Among 271 patients treated with HTO for varus knee OA from September 2009 to April 2014, patients treated with HTO alone (conventional group; n = 50) were pair-matched with those who underwent HTO with an MSC injection (injection group; n = 50) based on sex, age, and lesion size. Clinical outcomes were evaluated using the International Knee Documentation Committee (IKDC) score and Lysholm score. Radiological outcomes evaluated were the femorotibial angle and posterior tibial slope. At second-look arthroscopic surgery, cartilage regeneration was evaluated using the International Cartilage Repair Society (ICRS) grade.Results:At the time of second-look arthroscopic surgery (mean, 12.4 months [conventional group] and 12.7 months [injection group]), the mean IKDC and Lysholm scores in each group significantly improved: conventional group, from 38.4 ± 9.2 to 55.2 ± 15.0 and from 56.7 ± 12.2 to 79.6 ± 13.5, respectively; and injection group, from 36.5 ± 4.7 to 62.7 ± 14.1 and from 55.7 ± 11.9 to 80.6 ± 15.6, respectively ( P < .001 for all). Clinical outcomes at final follow-up (mean, 38.8 months [conventional group] and 37.2 months [injection group]) further improved from 62.7 ± 14.1 to 64.8 ± 13.4 (IKDC) and from 80.6 ± 15.6 to 84.7 ± 16.1 (Lysholm) ( P < .001 and P = .034, respectively) only in the injection group when compared with the values at second-look arthroscopic surgery. At final follow-up, there was a significant difference in the mean IKDC and Lysholm scores between groups ( P = .049 and P = .041, respectively). Overall ICRS grades, which significantly correlated with clinical outcomes, were better in the injection group than in the conventional group. Radiological outcomes at final follow-up showed improved knee joint alignment relative to patients’ preoperative conditions but showed no significant correlation with clinical outcomes or ICRS grade in either group ( P > .05 for all).Conclusion:The group that received an MSC injection scored better on the IKDC and Lysholm scales at final follow-up than the group that did not, although these differences were relatively small. When performing HTO for patients with varus knee OA, an MSC injection should be considered as an additional procedure for improved cartilage regeneration with better clinical outcomes.
Self-Concept in the Context of Diabetes Prevention: Development of the Lifestyle Health-Related Self-Concept Questionnaire
Authors: Thomas Jenifer J. , Lutes Lesley , Smirnova Ekaterina , Das Bhibha M. , Huzurbazar Snehalata , Aldrich Lisa , Lee Mariah 
Published: August 2018

Purpose: Understanding psychosocial factors in the context of lifestyle change is important to recognize distinctions in type 2 diabetes prevention behaviors. A relatively stable psychosocial feature, such as health-related self-concept (HRSC), may indicate factors that promote or repress positive health behaviors. The present study created a questionnaire specific to lifestyle change activities by modifying the Generalized Health-Related Self-Concept Questionnaire (G-HRSC). Design: A modified lifestyle health-related self-concept (Lifestyle-HRSC) questionnaire was developed through creation of new items, context expert review of new items, and small and large sample test of new items. Participants: 101 college students completed the Lifestyle-HRSC. Analysis: Kaiser-Meyer-Olkin (0.64) and Bartlett sphericity tests (χ2 = 6350.7 [ df = 3081], P < .01) indicated the sample met criteria for factor analysis. Principle component factor analysis was performed using varimax rotation with Kaiser normalization. Results: Six factors were revealed: nutrition, social support, avoiding diabetes, physical activity, problem solving, and challenges related to being healthy. Item analysis was conducted to remove correlated and conceptually redundant items and to create the 31-item final questionnaire. Conclusion: The Lifestyle-HRSC provides additional knowledge regarding the relationship between self-concept and health as well as insights into the role of psychosocial factors in the context of diabetes prevention.
Collective Well-Being to Improve Population Health Outcomes: An Actionable Conceptual Model and Review of the Literature
Authors: Roy Brita , Riley Carley , Sears Lindsay , Rula Elizabeth Y. 
Published: August 2018

Objectives: To propose collective well-being as a holistic measure of the overall “health” of a community. To define collective well-being as a group-level construct measured across 5 domains (vitality, opportunity, connectedness, contribution, and inspiration) and introduce an actionable model that demonstrates how community characteristics affect collective well-being. To review the literature describing each domain’s association with health outcomes and community characteristics’ associations with collective well-being. Methods: We came to consensus on topics describing each component of our conceptual model. Because “well-being” is not indexed in MEDLINE, we performed topic-specific database searches and examined bibliographies of papers retrieved. We excluded articles that were limited to narrow subtopics or studies within small subpopulations. Preference was given to quasi-experimental or randomized studies, systematic reviews, or meta-analyses. Consensus was reached on inclusion or exclusion of all articles. Results: Reviewed literature supported each of the proposed domains as important aspects of collective well-being and as determinants of individual or community health. Evidence suggests a broad range of community characteristics support collective well-being. Conclusions: The health and quality of life of a community may be improved by focusing efforts on community characteristics that support key aspects of well-being. Future work should develop a unified measure of collective well-being to evaluate the relative impact of specific efforts on the collective well-being of communities.
Association of Perceived Futile or Potentially Inappropriate Care With Burnout and Thoughts of Quitting Among Health-Care Providers
Authors: Lambden Jason P. , Chamberlin Peter , Kozlov Elissa , Lief Lindsay , Berlin David A. , Pelissier Latrice A. , Yushuvayev Elina , Pan Cynthia X. , Prigerson Holly G. 
Published: August 2018

Background: Futile or potentially inappropriate care (futile/PIC) has been suggested as a factor contributing to clinician well-being; however, little is known about this association. Objective: To determine whether futile/PIC provision is associated with measures of clinician well-being. Design: Cross-sectional, self-administered, online questionnaire. Setting: Two New York City Hospitals. Participants: Attending physicians, residents, nurses, and physician assistants in the fields of internal medicine, surgery, neurology, or intensive care. Exposure(s): Provision of perceived futile/PIC. Measurements: Main outcomes included (1) clinician burnout, measured using the Physician Worklife Study screen; (2) clinician depression, measured using the Patient Health Questionnaire; and (3) intention to quit, measured using questions assessing thoughts of quitting and how seriously it is being considered. Results: Of 1784 clinicians who received surveys, 349 participated. Across all clinicians, 91% reported that they either had or had possibly provided futile/PIC to a patient. Overall, 43.4% of clinicians screened positive for burnout syndrome, 7.8% screened positive for depression, and 35.5% reported thoughts of leaving their job as a result of futile/PIC. The amount of perceived futile/PIC provided was associated with burnout (odds ratio [OR] 3.8 [16-30 patients vs 1-2 patients]; 95% confidence interval [CI]: 1.1-12.8) and having thoughts of quitting (OR, 7.4 [16-30 patients vs 1-2 patients]; 95% CI: 2.0-27), independent of depression, position, department, and the number of dying patients cared for. Conclusions: A large majority of clinicians report providing futile/PIC, and such care is associated with measures of clinician well-being, including burnout and intention to quit.
Physicians’ Religious Characteristics and Their Perceptions of the Psychological Impact of Patient Prayer and Beliefs at the End of Life: A National Survey
Authors: Thompson Kathryn , Tak Hyo Jung , El-Din Magdy , Madani Syed , Brauer Simon G. , Yoon John D. 
Published: August 2018

Background: Physicians who are more religious or spiritual may report more positive perceptions regarding the link between religious beliefs/practices and patients’ psychological well-being. Methods: We conducted a secondary data analysis of a 2010 national survey of US physicians from various specialties (n = 1156). Respondents answered whether the following patient behaviors had a positive or negative effect on the psychological well-being of patients at the end of life: (1) praying frequently, (2) believing in divine judgment, and (3) expecting a miraculous healing. We also asked respondents how comfortable they are talking with patients about death. Results: Eighty-five percent of physicians believed that patients’ prayer has a positive psychological impact, 51% thought that patients’ belief in divine judgment has a positive psychological impact, and only 17% of physicians thought the same with patients’ expectation of a miraculous healing. Opinions varied based on physicians’ religious and spiritual characteristics. Furthermore, 52% of US physicians appear to feel very comfortable discussing death with patients, although end-of-life specialists, Hindu physicians, and spiritual physicians were more likely to report feeling very comfortable discussing death (adjusted odds ratio range: 1.82-3.00). Conclusion: US physicians hold divided perceptions of the psychological impact of patients’ religious beliefs/practices at the end of life, although they more are likely to believe that frequent prayer has a positive psychological impact for patients. Formal training in spiritual care may significantly improve the number of religion/spirituality conversations with patients at the end of life and help doctors understand and engage patients’ religious practices and beliefs.
Treatment of Proximal Fifth Metatarsal Fractures and Refractures With Plantar Plating in Elite Athletes
Authors: Bernstein Derek T. , Mitchell Ronald J. , McCulloch Patrick C. , Harris Joshua D. , Varner Kevin E. 
Published: August 2018

Background: Fractures of the proximal fifth metatarsal are relatively common foot injuries in elite athletes. Acute fixation with intramedullary screws is the most common operative treatment. However, the rate of nonunion and refracture after this procedure remains a concern. The purpose of this study was to determine rates of clinical and radiographic fracture healing, return to sport, and patient-reported clinical outcomes of elite athletes with proximal fifth metatarsal fracture or refracture treated with plantar plating. Methods: An institutional review board–approved retrospective single-surgeon case series investigation assessed athletes (competing at college, Olympic, or professional levels) with proximal fifth metatarsal fracture or refracture, treated with open reduction internal fixation and calcaneal autogenous bone grafting using a plantar plate with a minimum 2-year follow-up. Demographic data, radiographic evaluation, and the time until return to unrestricted sporting competition were collected and analyzed. Means with standard deviations were calculated for continuous data, and frequencies of categorical data were calculated in percentages. Results: Four refractures and 4 primary fractures were treated in 8 male athletes with a mean age of 21.9 ± 1.9 years at a mean follow-up of 3.2 ± 0.4 years. Two patients experienced temporary neuropraxia of the sural nerve that resolved within 6 weeks. There were no incisional complications, delayed unions or nonunions, refractures, hardware loosening, or complaints of hardware prominence. Clinically asymptomatic radiographic union was observed in 100% of the athletes at 6.5 ± 1.1 weeks and full release given at 12.3 ± 1.9 weeks. All athletes returned to sport at the same level of competition. Conclusion: With minimum 2-year follow-up, plantar plating of proximal fifth metatarsal fractures was an effective and safe technique that was used in both primary and revision settings. Level of Evidence: Level IV, case series.
Patient monitoring programs in oncology pharmacy practice: A survey of oncology pharmacists in Atlantic Canada
Authors: Edwards Scott , Abbott Rick , Dranitsaris George 
Published: August 2018

Background There has been a dramatic increase in new drug approvals in oncology, consisting of both small molecule inhibitors and monoclonal antibodies. However, Health Canada approval for many of the new agents was based on single randomized trials consisting of only a few hundred patients. As more patients get treated with these newer agents, there is the potential for new and discrete toxicities. Pharmacists are in an ideal position to identify, monitor, manage, and even preempt future events, given their close proximity to the patient. However, the extent of pharmacists’ involvement in formal patient programs is unknown. To address this knowledge gap, a survey of oncology pharmacists practicing in Atlantic Canada was conducted. Methods A structured mailing strategy was adopted as recommended by Dillman (1978). Standardized data collection forms were electronically mailed to 60 oncology pharmacists. Survey items consisted of respondent demographic information, practice setting, the existence of a formal patient monitoring program managed, and if patients are contacted by telephone following the completion of their anticancer cycle. Results Overall, 31 completed surveys were received, for an overall response rate of 50%. Respondents had a median age of 42 and a median of 18 years’ (range 1 to 25) professional experience as a pharmacist. Only 18 of the 31 (58%) respondents indicated that there was a formal monitoring and call back program managed by pharmacy available at their institution. For those without such programs, the main reasons were due to staffing issues and lack of adequately trained clinical personnel. Overall, 100% of respondents would favor the development of a formal monitoring program in hospitals with a high volume of anticancer drug prescribing. Conclusions Even though the number of new anticancer drugs being introduced into clinical pharmacy practice is increasing, formal patient monitoring and patient call back programs are not universal in Atlantic Canada hospitals.
Social media platforms as a photo-elicitation tool in research on alcohol intoxication and gender
Authors: Laws Ryan , Hunt Geoffrey , Antin Tamar M. J. 
Published: August 2018

Aim: This methodological article aims to describe the use of comparative social media platforms within a photo-elicitation (PE) activity as part of a multi-method interview-based study on the gendered meanings of alcohol intoxication among young adults (aged 18–25 years, n = 200). Method: Early interviews revealed social media as a particularly engaging topic for participants, and discussions of social media exposed relevant issues that often were not discussed in other sections of the interview guide. By embedding photos of young people drinking within three social media platforms with photo-sharing capabilities – Instagram, SnapChat and Facebook – we elicited narrative data revealing important aspects of the meanings of intoxication and providing information on how participants manage and judge drinking behaviours shared through online social networking systems (SNS). Conclusions: Given that social media use and photo-sharing are so common, familiar, and endemic among young people, to ignore this feature of contemporary social interaction would have limited our exploration of meanings of intoxication. We suggest that embedding existing methods, such as photo-elicitation, into social media contexts that are salient for youth may be a valuable strategy for providing a more comprehensive approach for investigating contemporary social issues.
Governance of substance use as a by-product of policing in Norway
Authors: Johansen Kenneth Arctander , Debaere Virginie , Vandevelde Stijn , Vandenbroeck Michel 
Published: August 2018

Aim: The aim of this article was to study governance of drug use in Norway through a historical account. Method: A genealogy was conducted through the study of documentation and legal texts from the 1600s until contemporary times. Findings: Based on legal texts addressing people using substances (both drugs and alcohol) various strategies for governance of drug use appears. The first section describes the emergence of institutions where people with alcohol problems were confined in a system originating the Dutch discipline houses. The second section describes the poor laws of the 1800s and the practice of the local poorhouses. The third section takes a look at the Vagrancy Act of 1900 and the state-owned labour camp at Opstad. The fourth section discusses the establishment of the sobriety boards and their role in confining alcoholics at cure homes. The fifth section describes developments in post-world-war Norway, with increased attention to illicit substances. Conclusions: The terminology justifying interventions is increasingly medicalised. Descriptions of the “drunkard” that appeared in 18th-century legal texts as immoral and free are contrasted by a positioning of this character as being a slave to his drinking in 20th-century political discourses, or as substance-dependent patients in the 21st century, alongside concerted efforts to dissolve open drug scenes.
Progression-free survival as a surrogate endpoint for overall survival in modern ovarian cancer trials: a meta-analysis
Authors: Sjoquist Katrin M. , Lord Sarah J. , Friedlander Michael L. , John Simes Robert , Marschner Ian C. , Lee Chee Khoon 
Published: August 2018

Background: Progression-free survival (PFS) has been adopted as the primary endpoint in many randomized controlled trials, and can be determined much earlier than overall survival (OS). We investigated whether PFS is a good surrogate endpoint for OS in trials of first-line treatment for epithelial ovarian cancer (EOC), and whether this relationship has changed with the introduction of new treatment types. Methods: In a meta-analysis, we identified summary data [hazard ratio (HR) and median time] from published randomized controlled trials. Linear regression was used to assess the association between treatment effects on PFS and OS overall, and for subgroups defined by treatment type, postprogression survival (PPS) and established prognostic factors. Results: Correlation between HRs for PFS and OS, in 26 trials with 30 treatment comparisons comprising 24,870 patients, was modest ( r2 = 0.52, weighted by trial sample size). The correlation diminished with recency: preplatinum/paclitaxel era, r2 = 0.66; platinum/paclitaxel, r2 = 0.44; triplet combinations, r2 = 0.22; biologicals, r2 = 0.30. The median PPS increased over time for the experimental ( Ptrend = 0.03) and control arms ( Ptrend = 0.003). The difference in median PPS between treatment arms strongly correlated with the difference in median OS ( r2 = 0.83). In trials where the control therapy had median PPS of less than 18 months, correlation between PFS and OS was stronger ( r2 = 0.64) than where the median PPS was longer ( r2 = 0.48). Conclusions: In EOC, correlation in the relative treatment effect between PFS and OS in first-line platinum-based chemotherapy randomized controlled trials is moderate and has weakened with increasing availability of effective salvage therapies.
Career choices for nephrology and factors influencing them: surveys of UK medical graduates
Authors: Barat Atena , Goldacre Michael J , Lambert Trevor W 
Published: August 2018

Objectives To study early and eventual career choices for nephrology among UK medical graduates and investigate factors which influenced career preferences. Design Self-completed survey questionnaires mailed to medical graduates 1, 3, 5 and 10 years after graduation. Setting United Kingdom. Participants UK medical graduates in 15 year-of-qualification cohorts between 1974 and 2015. Main outcome measures Early career specialty choices, career specialty destinations at 10 years and ratings of factors affecting career choices. Results Around 0.4%–1.1% of these junior doctors expressed a career preference for nephrology, varying by year of qualification and years after qualification. Among all graduates of 1993–2002 combined, 0.4% expressed a career preference for nephrology 1 year after qualification rising to 1.0% in year 5. Among graduates of 2005–2008, the corresponding figures were 1.0% in year 1 falling to 0.7% in year 5. Only 18% of doctors who chose nephrology in year 1 eventually became nephrologists. Of doctors who were practising as nephrologists for 10 years and more after qualification, 74% of the women and 56% of the men had decided to pursue a career in nephrology by year 5 after qualification. ‘Enthusiasm/commitment’ had a great deal of influence on those who chose nephrology, for all cohorts and all years studied. Conclusions The most recent data suggest that the proportion of young doctors who sustain an interest in nephrology through the early postgraduate training years may be lower than among their predecessors. Efforts are needed to reverse the declining trend and increase interest in nephrology.