bluuebunny/crossref_metadata_2025_split huggingface dataset:
Faculty Descriptions of Simulation Debriefing in Traditional Baccalaureate Nursing Programs
Authors: Waznonis Annette R. 
Published: October 2018

Abstract

AIM
A study was conducted to describe simulation debriefing practices of faculty in accredited, traditional, baccalaureate nursing programs in the United States.

BACKGROUND
Best debriefing practices include debriefing by a competent facilitator in a safe environment using a structured framework. Yet, structured frameworks and evaluation of debriefing are lacking in nursing education.

METHOD
This article reports the interview findings from the qualitative component of a large-scale mixed-methods study.

RESULTS
Twenty-three full-time faculty members with an average of 6 years of simulation debriefing experience participated in interviews. Three themes emerged with subthemes: a) having the student’s best interest at heart, b) getting over the emotional hurdle, and c) intentional debriefing evolves into learning. Gaps were found in faculty development, use of a structured framework, and evaluation.

CONCLUSION
Research is warranted on use of video, postdebriefing assignments, cofacilitation, and debriefing effectiveness.
Video-Enhanced Simulation in Pediatric End-of-Life Care
Authors: Gotwals Beth A. , Scholtz Susan 
Published: October 2018

Abstract
Pediatric end-of-life care is a challenge for nursing education. Until recently, there was little evidence of pedagogical approaches to meet the educational needs of nursing students. Based on End-of-Life Nursing Education Consortium guidelines and recent literature, a clinical simulation was developed using the documentary “A Lion in the House.” Learning objectives were developed along with presimulation student learning activities. Reflection and dialogue were guided postsimulation. This simulation provided a novel approach to student-centered learning and a context for resolving the problem of providing clinical learning experiences to educate nursing students to care for the child and family experiencing the end of life.
Interprofessional Research Guidelines for Health Care Students
Authors: Poling Deborah B. , Wilson Meg , Finke Linda K. , Bokhart Gordon , Buchanan Jeb 
Published: October 2018

Abstract
Although there has been a substantial increase in published research about interprofessional education for future health care providers in recent years, little has been published about students conducting interprofessional research using an interprofessional model. To help address this gap, a community research consortium developed a set of interprofessional research guidelines to enhance both the learning experiences of health care providers and students and provide a strong research foundation for future interprofessional projects. The guidelines were adapted from the Interprofessional Education Collaborative Core Competencies.
Using the Evidence-Based Practice Knowledge Assessment in Nursing Instrument to Evaluate Exposure Effects in Baccalaureate Nursing Students
Authors: Wonder Amy Hagedorn , Spurlock Darrell R. , Ironside Pamela M. 
Published: October 2018

Abstract
To prepare nursing students for evidence-based practice (EBP), it is essential to evaluate the exposure effects of courses and pedagogy on EBP knowledge development. Secondary analysis of cross-sectional, descriptive, correlational study data focused on identifying relationships between completion of undergraduate research and statistics courses and EBP knowledge of baccalaureate nursing students. There were statistically significant differences in EBP knowledge scores when comparing subjects recently exposed versus unexposed to statistical coursework. Research course exposure effects were nonsignificant. Further study of exposure effects is needed to clarify the role of research and statistical coursework in developing EBP knowledge.
Rising from the Rubble: A Capstone Simulation Integrating Leadership and Clinical Skills
Authors: Wiles Lynn L. , Isibel Denise 
Published: October 2018

Abstract
This novel simulation approach incorporates assessment, prioritization, patient care, and clinical reasoning with leadership and ethical principles when teaching disaster preparedness content in a prelicensure BSN curriculum. Using a combination of live actors and simulation equipment, 10 patients arrive in the skills lab seeking help for a variety of illnesses and injuries in the aftermath of a severe storm. The patients’ ages and conditions represent each of the clinical courses in the nursing curriculum. Students are assigned to assume the role of nurse, triage nurse, or incident commander and plan, prioritize, and provide patient care.
Meeting a Growing Need: An Online Approach to Cultural Competence Education for Health Professionals
Authors: Utley-Smith Queen E. 
Published: October 2018

Abstract
Prelicensure education may inadvertently lead to a belief that learning about different cultures is an end point, whereas cultural competency is an ongoing process. An online cultural competency education module incorporating organizational cultural assessment was developed for graduate nursing education. After completion, nurses have reported intent to continue career-long cultural competence learning and expressed determination to promote cultural competence in organizations where they work and lead.
Evaluating the Need for Organ Donation and Transplant-Related Education in Nursing Curricula
Authors: Cerrato Annette , Ea Emerson , Flom Peter 
Published: October 2018

Abstract
Transplant education has been historically unstructured and inconsistent. The purpose of this study was to measure nursing students’ knowledge and attitudes toward organ donation, allocation, and preparation for practice using a modified version of the Organ Donation Attitude Questionnaire II-Student Version. Scores were low, particularly regarding brain death and organ allocation. Preparedness for practice was related to knowledge of brain death (z = 2.05, p = .04); knowledge (t = 2.24, p = .03) and attitude (t = 7.55, p < .0001) were related to signing a driver’s license. Results support including organ donation and transplant education in nursing curricula.
Technology Use and Technological Self-Efficacy Among Undergraduate Nursing Faculty
Authors: Roney Linda N. , Westrick Susan J. , Acri Mary C. , Aronson Barbara S. , Rebeschi Lisa M. 
Published: October 2018

Abstract

AIM
This study explored faculty responses to a survey about using technology to teach undergraduate nursing students.

BACKGROUND
Little is known regarding faculty confidence, technology use, or supports for integrating technology into nursing education.

METHOD
A descriptive correlational design was utilized to explore the relationship between technology use and technological self-efficacy in faculty (N = 272) who teach at Commission on Collegiate Nursing Education–accredited nursing programs. Instruments used were a sociodemographic questionnaire, the Roney Technology Use Scale, and the Technology Self-Efficacy Scale.

RESULTS
Participants who taught didactic content had moderate technology use as compared to those teaching didactic and clinical/laboratory who reported high levels of technology use. A weak relationship between age and technological self-efficacy (ρ = .127, p < .05) was also found.

CONLUSION
This research was an initial step in understanding levels of technology use and responses to this challenge by undergraduate nursing faculty.
Reflective Responses Following a Role-play Simulation of Nurse Bullying
Authors: Ulrich Deborah L. , Gillespie Gordon Lee , Boesch Maura C. , Bateman Kyle M. , Grubb Paula L. 
Published: October 2018

Abstract
A qualitative exploratory design was used for this study to evaluate role-play simulation as an active learning strategy. The context for the role-play was bullying in nursing practice. Following a simulation, 333 students from five college campuses of three universities completed a reflection worksheet. Qualitative thematic findings were personal responses, nonverbal communications exhibited, actions taken by participants, and the perceived impact of bullying during the simulation. Role-play simulation was a highly effective pedagogy, eliciting learning at both the cognitive and affective domains.
Long-term outcomes of adolescents with juvenile-onset fibromyalgia into adulthood and impact of depressive symptoms on functioning over time
Authors: Kashikar-Zuck Susmita , Cunningham Natoshia , Peugh James , Black William R. , Nelson Sarah , Lynch-Jordan Anne M. , Pfeiffer Megan , Tran Susan T. , Ting Tracy V. , Arnold Lesley M. , Carle Adam , Noll Jennie , Powers Scott W. , Lovell Daniel J. 
Published: October 2018

Abstract
Juvenile-onset fibromyalgia (JFM) is typically diagnosed in adolescence and characterized by widespread pain and marked functional impairment. The long-term impact of JFM into adulthood is poorly understood. The objectives of this study were to describe physical and psychosocial outcomes of youth diagnosed with JFM in early adulthood (∼8-year follow-up), examine longitudinal trajectories of pain and depressive symptoms from adolescence to young adulthood, and examine the impact of pain and depressive symptoms on physical functioning over time. Participants were 97 youth with JFM enrolled in a prospective longitudinal study in which pain symptoms, and physical and psychosocial functioning were assessed at 4 time points over approximately 8 years. At the time 4 follow-up (Mage = 24.2 years), the majority continued to suffer from pain and impairment in physical, social, and psychological domains. However, trajectories of pain and emotional symptoms showed varying patterns. Longitudinal analysis using growth mixture modeling revealed 2 pain trajectories (Steady Improvement and Rapid Rebounding Improvement), whereas depressive symptoms followed 3 distinct trajectories (Low-Stable, Improving, and Worsening). Membership in the Worsening Depressive symptoms group was associated with poorer physical functioning over time (P < 0.001) compared with the Low-Stable and Improving groups. This study offers evidence that although JFM symptoms persist for most individuals, pain severity tends to decrease over time. However, depressive symptoms follow distinct trajectories that indicate subgroups of JFM. In particular, JFM patients with worsening depressive symptoms showed decreasing physical functioning and may require more intensive and consistent intervention to prevent long-term disability.
Increased pain sensitivity and decreased opioid analgesia in T-cell-deficient mice and implications for sex differences
Authors: Rosen Sarah F. , Ham Boram , Haichin Michael , Walters Ilana C. , Tohyama Sarasa , Sotocinal Susana G. , Mogil Jeffrey S. 
Published: October 2018

Abstract
The processing of pain in the central nervous system is now known to have an important immune component, including T cells of the adaptive immune system. T cells have been shown to release endogenous opioids, and although it is well known that opioids have effects on T-cell populations, very little attention has been given to the converse: how T cells may affect opioid regulation. We find here that, in addition to displaying significantly increased baseline pain sensitivity across various pain modalities, T-cell-deficient mice (CD-1 nude, Rag1 null mutant, and Cd4 null mutant) exhibit pronounced deficiencies in morphine inhibition of thermal or inflammatory pain. Nude mice are also deficient in endogenous opioid-mediated analgesia, exhibiting no stress-induced analgesia from restraint. The relevant T-cell subpopulation seems to be CD4+ T cells because adoptive transfer of them but not CD8+ cells into nude mice rescues both the pain and morphine analgesia phenotypes. As previously reported, we also observe a sex difference in CD-1 mice, with females requiring 2- to 3-fold more morphine than males to produce equal analgesia. Nude mice display no sex differences in morphine analgesia, and the sex difference is restored in nude mice of either sex receiving CD4+ T cells from CD-1 donor male or female mice. These results suggest that CD4+ T cells play an as yet unappreciated role in opioid analgesia and may be a driver of sex differences therein.
Outcome Measures in Interventions That Enhance Breastfeeding Initiation, Duration, and Exclusivity
Authors: Wood Natsuko K. , Woods Nancy F. 
Published: October 2018

Abstract

Objective:
The purpose of this review was to examine outcome measures used in interventions focusing on enhancement of breastfeeding initiation, duration, and exclusivity.

Methods:
A literature search guided by search terms on outcome measures of breastfeeding interventions was conducted using PubMed, CINAHL Plus, & PsycINFO databases on publications between 2006 and 2017.

Results:
Nine studies were included in this review, using PRISMA guidelines. Rates of breastfeeding initiation, duration, and exclusivity were measured during specific points in time. Data collection methods involve interviews, self-report, observations, and/or feeding logs. Although breastfeeding types (exclusive breastfeeding, predominant breastfeeding, and complementary breastfeeding) were measured, methods of infant feeding (breastfeeding and bottle feeding) were rarely assessed, ignoring significant mediators or moderators of breastfeeding.

Conclusions:
There were methodological limitations to the reviewed studies: (1) a 24-hour recall bias, (2) misclassification of breastfeeding categories, (3) lack of consistency in breastfeeding definitions, and (4) few reports of the reason for breastfeeding discontinuation. Future studies should focus on the modifiable cause of the problem: outcome measures attributed to the targets of the intervention, followed by breastfeeding initiation, duration, and/or exclusivity.
Pediatric Major Vascular Injuries
Authors: Perea Lindsey L. , Hazelton Joshua P. , Fox Nicole , Gaughan John P. , Porter John , Goldenberg Anna 
Published: October 2018

Objectives
Vascular injury in pediatric trauma patients is uncommon but associated with a reported mortality greater than 19% in some series. The purpose of this study was to characterize pediatric major vascular injuries (MVIs) and analyze mortality at a high-volume combined adult and pediatric trauma center.

Methods
A retrospective review (January 2000 to May 2016) was conducted of all pediatric (<18 years old) trauma patients who presented with a vascular injury. A total of 177 patients were identified, with 60 (34%) having an MVI, defined as injury in the neck, torso, or proximal extremity. Patients were then further analyzed based on location of injury, mechanism, age, and race. P ≤ 0.05 was deemed significant.

Results
Of the 60 patients with MVI, the mean age was 14.3 years (range, 4–17 years). Mean intensive care unit length of stay (LOS) was 5.4 days, and mean hospital LOS was 12.5 days. Blunt mechanism was more common in patients 14 years or younger; penetrating trauma was more common amongst patients older than 14 years. Overall, blunt injuries had a longer intensive care unit LOS compared with penetrating trauma (7.8 vs 3.1 days; P = 0.016). A total of 33% (n = 20) of MVIs occurred in the torso, with 50% (n = 10) of these from blunt trauma. Location of injury did correlate with mortality; 45% (n = 9) of torso MVIs resulted in death (penetrating n = 7, blunt n = 2). Overall mortality from an MVI was 15.3% (n = 9); all were torso MVIs. Higher Injury Severity Score and Glasgow Coma Scale score were found to be independently associated with mortality.

Conclusions
Our experience demonstrates that MVIs are associated with a significant mortality (15.3%), with a majority of those resulting from gunshot wounds, more than 9-fold greater than the overall mortality of pediatric trauma patients at our institution (1.6%). Further research should be aimed at improving management strategies specific for MVIs in the pediatric trauma patient as gun violence continues to afflict youth in the United States.
Mesh OR Patch for Hernia on Epigastric and Umbilical Sites (MORPHEUS-Trial)
Authors: Ponten Jeroen E. H. , Leclercq Wouter K. G. , Lettinga Tanja , Heemskerk Jeroen , Konsten Joop L. M. , Bouvy Nicole D. , Nienhuijs Simon W. 
Published: October 2018

Objective:
The objective of this trial was to identify a superior method for umbilical and epigastric hernia repair in terms of complications. Complications such as an extended operation duration, additional use of painkillers, reoperation, infection, seroma, extended wound care, extended hospitalization, and early recurrence were reported according to the Clavien–Dindo grading system.

Summary Background Data:
Over the years mesh repair is proven the gold standard for umbilical and epigastric hernias. The question remains, which mesh should be used?

Methods:
In this randomized controlled, multicenter trial, all patients ≥ 18 years with a single, symptomatic, and primary small umbilical or epigastric hernia qualified for inclusion. Flat preperitoneal polypropylene mesh repair was compared with patch repair (PROCEED Ventral Patch) (PVP).

Results:
A total of 352 patients were randomized; 348 patients received the intervention (n = 177 PVP vs n = 171 mesh). One out of 4 suffered from any kind of complication within 2 years postoperative (27.6%). A significant difference in complications was seen, in favor of polypropylene mesh repair (P = 0.044, 22.1% mesh vs 32.5% PVP). Reoperation was performed in 19 PVP operated patients (10.7%) versus 7 patients with polypropylene mesh repair (4.0%, P = 0.021).
No significant differences were seen in recurrences (n = 13, 8.4% PVP vs n = 6, 4.1% mesh, P = 0.127).

Conclusions:
In small epigastric and small umbilical hernia repair a flat polypropylene mesh repair was associated with a lower complication rate than PVP repair. No differences in recurrence rates were seen. Combining all complications, the preperitoneal positioned flat polypropylene mesh performed better.
Repatriation of Patients to Referral Centers and Outcomes After Kidney Transplantation: A Single-center Analysis From the United Kingdom
Authors: Khalil Khalid , Hodson James , Anderson Benjamin , Nath Jay , Sharif Adnan 
Published: October 2018

Background
The aim of this study was to compare posttransplant outcomes of kidney allograft recipients between those followed up at transplant centers and those that were repatriated back to referral renal units.

Methods
We analyzed data for 1375 consecutive patients transplanted in a single center in the United Kingdom. Patients were stratified into 3 groups: (1) externally referred patients with repatriation back for external follow-up (repatriated, n = 463), (2) externally referred patients not repatriated and followed-up internally at transplant center (nonrepatriated, n = 365), and (3) internally referred patients within transplant center with continued internal transplant center follow-up (internal, n = 547). Patient and death-censored graft survival were compared between groups on both univariable and multivariable analyses.

Results
Baseline comparisons found that the nonrepatriated group had increased risk for prolonged length of stay and delayed graft function compared with repatriated patients. The nonrepatriated group had significantly shorter survival compared to the repatriated patients (90.2% vs 94.1% at 5 years, P = 0.013), which persisted after adjustment for confounders on multivariable analysis (hazard ratio, 1.86; 95% confidence interval, 1.06-3.28; P = 0.032). Death-censored graft survival was not found to differ significantly between the 3 groups (P = 0.192).

Conclusions
Our results provide reassurance regarding repatriation of care after kidney transplantation for the United Kingdom. Nonrepatriated patients are identified as a high-risk group for increased mortality, but further investigation is warranted to probe this heterogeneous group and validate in a non-United Kingdom cohort.
Mutation detection in thousands of acute myeloid leukemia cells using single cell RNA-sequencing
Authors: Petti Allegra A. , Williams Stephen R. , Miller Christopher A. , Fiddes Ian T. , Srivatsan Sridhar N. , Chen David Y. , Fronick Catrina C. , Fulton Robert S. , Church Deanna M. , Ley Timothy J. 
Published: October 2018

AbstractVirtually all tumors are genetically heterogeneous, containing subclonal populations of cells that are defined by distinct mutations1. Subclones can have unique phenotypes that influence disease progression2, but these phenotypes are difficult to characterize: subclones usually cannot be physically purified, and bulk gene expression measurements obscure interclonal differences. Single-cell RNA-sequencing has revealed transcriptional heterogeneity within a variety of tumor types, but it is unclear how this expression heterogeneity relates to subclonal genetic events – for example, whether particular expression clusters correspond to mutationally defined subclones3,4,5,6-9. To address this question, we developed an approach that integrates enhanced whole genome sequencing (eWGS) with the 10x Genomics Chromium Single Cell 5’ Gene Expression workflow (scRNA-seq) to directly link expressed mutations with transcriptional profiles at single cell resolution. Using bone marrow samples from five cases of primary human Acute Myeloid Leukemia (AML), we generated WGS and scRNA-seq data for each case. Duplicate single cell libraries representing a median of 20,474 cells per case were generated from the bone marrow of each patient. Although the libraries were 5’ biased, we detected expressed mutations in cDNAs at distances up to 10 kbp from the 5’ ends of well-expressed genes, allowing us to identify hundreds to thousands of cells with AML-specific somatic mutations in every case. This data made it possible to distinguish AML cells (including normal-karyotype AML cells) from surrounding normal cells, to study tumor differentiation and intratumoral expression heterogeneity, to identify expression signatures associated with subclonal mutations, and to find cell surface markers that could be used to purify subclones for further study. The data also revealed transcriptional heterogeneity that occurred independently of subclonal mutations, suggesting that additional factors drive epigenetic heterogeneity. This integrative approach for connecting genotype to phenotype in AML cells is broadly applicable for analysis of any sample that is phenotypically and genetically heterogeneous.