bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Systematic Review of the Diagnostic Accuracy of Depression Questionnaires for Cardiac Populations
Authors: González-Roz Alba , Gaalema Diann E. , Pericot-Valverde Irene , Elliott Rebecca J. , Ades Philip A. 
Published: March 2019

Purpose:
Depression is overrepresented in patients with cardiovascular disease and increases risk for future cardiac events. Despite this, depression is not routinely assessed within cardiac rehabilitation. This systematic review sought to examine available depression questionnaires to use within the cardiac population. We assessed each instrument in terms of its capability to accurately identify depressed patients and its sensitivity to detect changes in depression after receiving cardiac rehabilitation.

Methods:
Citation searching of previous reviews, MEDLINE, PsycInfo, and PubMed was conducted.

Results:
The Beck Depression Inventory-II (BDI-II) and the Hospital Anxiety and Depression Scale (HADS-D) are among the most widely used questionnaires. Screening questionnaires appear to perform better at accurately identifying depression when using cut scores with high sensitivity and specificity for the cardiac population. The BDI-II and the HADS-D showed the best sensitivity and negative predictive values for detecting depression. The BDI-II, the HADS-D, the Center for Epidemiological Studies—Depression Scale, and the 15-item Geriatric Depression Scale best captured depression changes after cardiac rehabilitation delivery.

Conclusions:
The BDI-II is one of the most validated depression questionnaires within cardiac populations. Health practitioners should consider the BDI-II for depression screening and tracking purposes. In the event of time/cost constraints, a briefer 2-step procedure (the 2-item Patient Health Questionnaire, followed by the BDI-II, if positive) should be adopted. Given the emphasis on cut scores for depression diagnosis and limited available research across cardiac diagnoses, careful interpretation of these results should be done. Thoughtful use of questionnaires can help identify patients in need of referral or further treatment.
Bridging worldviews
Authors: Garman Andrew N. , Standish Melanie P. , Wainio Joyce Anne 
Published: March 2019

Background
As the pace of health sector transformation accelerates, the importance of leadership continues to grow across all health professions. Advances in a variety of disciplines can inform effective leadership development. However, at present, most health sector leadership competency models do not incorporate these advances and are instead developed using consensus-based methods within specific professions. An interprofessional approach to leadership competencies could help incorporate these advances and support better interdisciplinary leadership development.

Purpose
This study was pursued to revise and revalidate a widely used health sector leadership competency model and assess its potential for providing greater interoperability across the professions.

Methodology/Approach
Using the National Center for Healthcare Leadership’s interprofessional competency model Version 2.1 as the starting point, we developed a revised and revalidated model in four phases: (a) we completed a future scan using methods described in Garman et al. [Garman, A. N., Johnson, T. J., & Royer, T. (2011). The future of healthcare: Global trends worth watching. Chicago, IL: Health Administration Press.]; (b) we collected behavioral event interview data from pairs of leaders representing different organizational and performance levels, using methods developed by Boyatzis [Boyatzis, R. E. (1982). The competent manager: A model for effective performance. New York, NY: John Wiley & Sons.]; (c) we conducted a validity study via electronic survey of 145 working managers and calculated content validity ratios using methods described by Lawshe [Lawshe, C. H. (1975). A quantitative approach to content validity. Personnel Psychology, 38(4), 563–575.]; and (d) we used natural language processing to assess the extent to which existing leadership models in the health professions will crosswalk to the new model.

Findings
All competencies in the revised model successfully met criteria for validity. The revised model also successfully crosswalked against, on average, 85% of the competencies in the other five health professions leadership models.

Practice Implications
Based on the results of this research, we conclude the revised model can provide a “common language” framework in support of interdisciplinary leadership development. The availability of such a model may also assist human resource and development executives in better aligning learning resources with organizational goals.
Spectrum and Yield to Dose Conversion Coefficients for Beta Skin Doses Linked to the Q System
Authors: Frosio Thomas , Bertreix Philippe , Köster Ulli , Theis Christian , Magistris Matteo 
Published: March 2019

Abstract
Monte Carlo simulations are a state-of-the-art method to calculate dose coefficients and could be used with the Q system for radioactive material packaging. These simulations often take a long time to converge with sufficient precision. Furthermore, if multiple sources have to be taken into account, many weeks of calculations may be needed. In order to reduce the calculation time, this paper proposes a new method based on a transfer function to instantly compute Q values associated with beta skin doses. The method developed in this paper can be applied to compute beta skin dose and easily could be extended to other particles and different depths in organs with various kinds of shielding configurations between source and target.
Primary Open-angle Glaucoma With Initial Visual Field Damage in the Superior and Inferior Hemifields: Comparison in a Population-based Setting
Authors: Iwase Aiko , Araie Makoto 
Published: March 2019

Purpose:
To study differences in systemic and ocular factors between eyes with primary open-angle glaucoma (POAG) with an initial visual field defect (VFD) starting in the superior hemifield and those starting in the inferior hemifield in a population-based setting.

Subjects and Methods:
The data were analyzed from eyes with definitive category-1 POAG based on the International Society of Geographic and Epidemiological Ophthalmology criteria with VFD constriction in the superior or inferior hemifield (superior and inferior VFD groups, respectively) found in 2 Japanese population-based glaucoma surveys. The visual fields were tested using the Humphrey Field Analyzer Central 30-2 or 24-2 Swedish Interactive Thresholding Algorithm Standard program.

Results:
Of 336 eyes of 214 patients with POAG with reliable visual fields results, 36 and 37 eyes with 36 and 37 POAG patients were classified into the superior and inferior VFD groups, respectively. The superior VFD group had significantly greater disc ovality, entire and inferior-half β-peripapillary atrophy (PPA) area, and lower mean total deviation value in the corresponding superior hemifield (P=0.004 to 0.048 after Bonferonni correction) than the inferior VFD group. Multivariate logistic regression analysis showed that the superior VFD group was associated with greater ovality, larger β-PPA area, and thinner central cornea thickness (P=0.013 to 0.035).

Conclusions:
In POAG, greater disc ovality and β-PPA and thinner central cornea thickness were associated significantly with the initial VFD starting in the superior hemifield, suggesting some difference in the glaucomatous damaging process between the superior and inferior halves of the disc.
Quantitative Analysis of Retinal and Choroidal Vascular Parameters in Patients With Low Tension Glaucoma
Authors: Tepelus Tudor C. , Song Sheena , Borrelli Enrico , Nittala Muneeswar G. , Baghdasaryan Elmira , Sadda SriniVas R. , Chopra Vikas 
Published: March 2019

Précis:
By using OCT-A, we observed a reduction of the superficial macular, peripapillary, and optic nerve, as well as the choriocapillaris in eyes with low tension glaucoma, compared with normal controls.

Purpose:
The purpose of this study was to investigate macular and optic disc vascular parameters in patients with low tension glaucoma (LTG) using optical coherence tomography angiography (OCTA).

Methods:
In this cross-sectional study, images were prospectively acquired from both eyes of 26 patients with clinically diagnosed LTG and 22 age-matched volunteers with normal healthy eyes using the Zeiss swept-source (SS) OCTA (Plex Elite 9000, Carl Zeiss Meditec). Perfusion density (PD) and vessel length density (VLD) within a 5 mm diameter circle centered over the macula and optic nerve head were analyzed.

Results:
The final analysis cohort included 49 eyes with LTG and 40 healthy control eyes. Mean age was 60±10 years in the LTG group and 60±17 years in the control group. The LTG group had a statistically significant reduction in PD of the choriocapillaris (CC) compared with normal controls (71.74±8.37% vs. 80.48±3.84%; P<0.001). There was no statistically significant difference in PD between the LTG and control groups for the superficial vascular plexus (SVP), deep capillary plexus (DCP) or the optic nerve head and peripapillary area (ONH+PP) (P>0.05). The LTG group did show statistically significant reductions in VLD compared with normal controls for the SVP (2083.64±153.76 mm/mm2 vs. 2154.63±144.18 mm/mm2; P=0.03) and ONH + PP (1813.76±271.69 mm/mm2 vs. 1950.23±169.33 mm/mm2; P=0.03), whereas the DCP VD was similar between the 2 groups (P>0.05).

Conclusions:
Eyes with low tension glaucoma seems to show a lower CC perfusion density, as well as a lower SVP and ONH+PP vessel length density compared to normal eyes.
A Quality Improvement Project to Improve Sepsis-Related Outcomes at an Integrated Healthcare System
Authors: Hughes M. Courtney , Roedocker Andrea , Ehli Jessica , Walz Danaka , Froehlich Kim , White Landon , Binder Bill 
Published: March 2019

ABSTRACT
Hospitals are encouraged to take steps to improve outcomes for patients with sepsis, a leading cause of morbidity and mortality. A retrospective analysis examined data (n = 4,475) from three health systems to better determine the impact of a 10-month sepsis quality improvement program that consisted of clinical alerts, audit and feedback, and staff education. Compared with the control group, the intervention group significantly decreased length of stay and costs per stay. The intervention group increased sepsis bundle compliance by more than 40%. A sepsis quality improvement program may improve sepsis health outcomes and decrease costs.
Occupational Stress and Burnout Among Health Care Workers Caring for People Living With HIV in Eswatini
Authors: Bhembe Lomthandazo Queeneth , Tsai Feng-Jen 
Published: March 2019

Abstract
We used the Effort-Reward Imbalance Questionnaire and Copenhagen Burnout Inventory in our cross-sectional study to examine associations between occupational stress and burnout among 368 health care workers (HCW) who cared for people living with HIV (PLWH) in Eswatini. Chi-square and logistic regression analyses were conducted. HCW caring for PLWH reported high efforts, imbalanced effort-reward ratios, overcommitment, and low rewards. Health care managers, physicians, and nurses reported higher work efforts, effort-reward ratios, overcommitment, and personal, work-related, and client-related burnout than laboratory staff or peer counselors. HCW with high work efforts, effort-reward ratios, and overcommitment had significantly higher risks of having personal (odds ratio [OR] = 4.60), work-related (OR = 3.96), and client-related burnout (OR = 2.20). HCW with low rewards had a significant risk of having personal (OR = 3.13) and work-related (OR = 2.08) burnout. Our results suggested the need for policies to reduce work stress for HCW caring for PLWH.
Does treatment of urinary tract infections reflect the antibiotic stewardship program guidelines?
Authors: Bista Bhawana , Champion Jane Dimmitt 
Published: March 2019

ABSTRACT
Protocols are required for antibiotic use for treatment of urinary tract infections (UTIs) in long-term care facilities (LTCFs). This project assessed antibiotic prescribing practices for UTI in three LTCFs to elucidate practice and its relationship to protocols in these settings. A retrospective chart review of UTI cases occurring between February 1, 2017, and July 30, 2017, was conducted to describe provider management in three LTCFs. Sixty-three cases with compelling urinary symptoms potentially suggestive of UTI were included in the review. Urine culture findings indicated that a more than 100,000 CFU/ml colony count was present in 46% (n = 29) of the cases; however, 63.5% (n = 40) of the cases received antibiotics. Eleven cases (17.4%) received antibiotics based on symptoms without UTI diagnosis. Empirical treatment was initiated in 35% (n = 22) of the cases. When urine culture reports were available, previously untreated 28.57% (n = 18) cases received antibiotics for colony counts of >100,000 CFU/ml. Antibiotics were given for colony counts of <100,000 CFU/ml for 17.46% (n = 11) of the cases. Increased urinary frequency or burning on urination (95.23%) and change in behavior (88.9%) were the primary reasons for initiation of urinalysis and urine culture testing. Nurse practitioner implementation of protocols for antibiotic stewardship programs in LTCFs can prevent overprescription for UTI in these facilities.
Gallbladder Polyps
Authors: Demirbaş Fatma , Çaltepe Gönül , Comba Atakan , Bilgin Meltem C. , Eren Esra , Abbasguliyev Hasan , Kalayci Ayhan G. 
Published: March 2019

ABSTRACTObjective:Unlike adults, gallbladder polyps (GPs) are rare in childhood. The aim of this study was to evaluate patients with a GP diagnosis.Methods:Patients who were diagnosed with GP via ultrasonography from October 2012 to October 2017 were retrospectively evaluated in terms of sociodemographic characteristics and laboratory findings.Results:The study included 19 patients diagnosed with GP and followed up in our department. The patients comprised 14 (73.6%) girls with a mean age of 13.9 ± 4.1 years and a mean follow‐up period of 10.2 ± 5.4 months (range, 3–26 months). The most common presenting symptom of the patients (n = 15, 78.9%) for ultrasonography was abdominal pain without biliary symptoms. Location of the polyps was in the corpus in 55% of patients, and either in the fundus (20%) or the neck of the gallbladder (25%). The average diameter of the polyps was 4.5 ± 1.6 mm (range, 2–9 mm). Multiple polyps were observed in 3 patients. No significant change in the number or size of polyps was noted at the end of the follow‐up periods. Cholecystectomy was applied to 1 patient who had >5 polyps with a rapid increase in size, and the pathology report was hamartomatous polyp. There was no remarkable change in the clinical or laboratory findings of other patients during the follow‐up period.Conclusion:In this study, GPs could be seen in young children as young as 16 months of age and ultrasonography is sufficient for follow‐up in stable and asymptomatic patients.
Isolated Amylase Deficiency in Children and Its Clinical Implication
Authors: Hopson Puanani , Patel Samit , Bornstein Jeffrey , Mehta Devendra , Horvath Karoly 
Published: March 2019

ABSTRACTObjectives:Among the 3 lines of pancreatic enzymes, amylase secretion develops last and it is not detected in duodenal aspirates of infants in the first month after birth. The aim of this study was to assess the prevalence and symptoms of isolated amylase deficiency in children.Methods:During a 6‐year period, we performed endoscopic pancreatic function tests (ePFT) in 712 children. Isolated amylase deficiency was defined as activity that was below the third percentile of our referenced population with normal lipase and protease activities.Results:Seventy‐two children between age 0.21 and 15.7 years (boys, n = 35) had isolated amylase deficiency. The highest prevalence of isolated amylase deficiency was found in patients less than 6 months of age (52.9%). From 6 months to 1 year of age, the prevalence was 40%. The prevalence gradually decreased until 18 months. Failure to thrive, poor weight gain, diarrhea, and abdominal bloating were the most frequent indications for ePFT. Eleven children had repeat ePFT after initial diagnosis and 6 had normal enzyme activity, whereas 5 had remained amylase‐deficient an average of 1.65 years later.Conclusions:The prevalence of selective amylase deficiency was 10.1% in the 712 children who underwent ePFT with the suspicion of malabsorption. Low amylase activity is “physiologic” in infants <6 months of age, however, this study supports that it should be considered in the differential diagnosis in children older than 6 months of age.
Horizontal Transmission of Hepatitis B Virus From Mother to Child Due to Immune Escape Despite Immunoprophylaxis
Authors: Kanji Jamil N. , Penner Robert E.D. , Giles Elizabeth , Goodison Karin , Martin Steven R. , Marinier Eric , Osiowy Carla 
Published: March 2019

ABSTRACTHepatitis B virus (HBV) vaccination starting at birth is approximately 95% effective in preventing mother‐to‐child transmission to infants born to HBV‐infected mothers. A higher risk of transmission is associated with birth to a highly viremic mother, often due to transplacental exposure, while later horizontal transmission is much less common, particularly following complete vaccination. This study reports a case of infection in an older child despite appropriate immunoprophylaxis starting at birth and an apparent protective immune response post‐vaccination. Two immune escape mutations within the antigenic determinant of the surface antigen‐coding region were observed in the child's dominant HBV sequence, whereas the maternal HBV variant lacked mutations at both sites. Ultra‐deep sequencing confirmed the presence of 1 mutation at low levels within the maternal HBV quasispecies population, suggesting early exposure to the child followed by viral evolution resulting in immunoprophylaxis escape and chronic infection.
Avoidant/Restrictive Food Intake Disorder in Diet‐treated Children With Eosinophilic Esophagitis
Authors: Robson Jacob , Laborda Trevor , Fitzgerald Susan , Andersen Joseph , Peterson Kathryn , O'Gorman Molly , Guthery Stephen , Bennett‐Murphy Laura 
Published: March 2019

ABSTRACTEosinophilic esophagitis (EoE) is an inflammatory condition of the esophagus with rising incidence in children. Owed to potential adverse effects and high costs of EoE medications, strict elimination diets are often employed as a mainstay of long‐term EoE therapy in children. Currently, there are no effective tests to pinpoint food protein triggers in children with EoE. Therefore, EoE elimination diets are often broad (including milk, soy, wheat, egg, fish/shellfish, and nuts) and can greatly alter a child's baseline eating habits. Herein, we describe 2 cases of avoidant/restrictive food intake disorder (ARFID) in children with remitted EoE maintained on an elimination diet. We also present comorbidity data on ARFID and diet‐treated EoE from our pediatric EoE clinic. This is the first report of disordered eating associated with EoE therapy. As EoE is becoming more common, close monitoring of intake and growth in patients treated with elimination diets will be key.
Impact of outpatient pharmacy services collaborating with oncologists at an outpatient clinic for outpatient chemotherapy prescription orders
Authors: Demachi Ken , Suzuki Shinya , Kamata Hayato , Suzuki Hidetaka , Sugama Yuka , Ikegawa Kiwako , Igarashi Takashi , Kawasaki Toshikatsu , Johnson Philip E. , Yamaguchi Masakazu 
Published: March 2019

Abstract

Objectives:
This retrospective study was conducted to evaluate the impact of a service in which clinical pharmacists collaborated with oncologists at an outpatient clinic on chemotherapy order prescriptions and adverse drug reaction management in outpatient cancer chemotherapy.

Methods:
This was a single-center retrospective cohort study. Subjects were patients who received pharmacist services at an outpatient clinic in 6 treatment divisions at the National Cancer Center Hospital East from June to September 2016. Pharmacist interventions were categorized and assessed for impact by 2 pharmacists according to previously published methods.

Results:
The 6 pharmacists worked a total of 1396 hours, providing 1645 pharmacy interventions to 3419 patients. Of the 1645 interventions, 459 interventions (27.9%) involved chemotherapy order prescriptions. The 459 interventions for chemotherapy prescriptions were categorized according to the previously reported categories “drug therapy safety” (n = 330, 71.9%), “other” (n = 91, 19.8%), “drug therapy efficacy” (n = 28, 6.1%), and “drug therapy indication” (n = 10, 2.2%). Of the 91 interventions categorized as “other,” the 2 most frequent types of interventions were “confirmation from pharmacists to oncologists about laboratory test order” (n = 54, 11.7%) and “consultation from oncologists to pharmacists about chemotherapy regimen” (n = 23, 5.0%). Most interventions were identified as having “no error” (n = 369, 80.4%), while 8 interventions (1.8%) were identified as being “potentially lethal” or “serious.” Moreover, 92.8% of interventions were identified as being “extremely significant,” “very significant” or “significant.”

Conclusions:
This study clarified the benefits of outpatient pharmacy services in which pharmacists collaborate with oncologists at an outpatient clinic on outpatient chemotherapy prescription orders.
Do Social and Environmental Factors Affect the Emergency Service Admission Characteristics of Preschool-Aged Pediatric Trauma Patients?
Authors: Gürmen Ekim Saglam , Doğan Serkan , Ocak Tarik 
Published: March 2019

Objective
Studies related to the epidemiology of trauma play a major role in determining the health status of the communities living in the vicinity of the centers that they are conducted. We have found no epidemiological study related to emergency service admission conducted only on preschool-aged children in the literature. Our aim was to determine characteristics of trauma in this age group, to analyze encountered trauma types, and to investigate possible associations among epidemiological factors, characteristics of the trauma victims, and trauma itself in pediatric patients admitted to our emergency service.

Methods
We conducted a prospective study with patients aged 66 months and younger, admitted to Emergency Service of Istanbul Kanuni Sultan Suleyman Training and Research Hospital between July 1, 2015, and December 31, 2015. Data related to age, sex, occupational status of parents, number of siblings, Glasgow coma scale score, transport mode, admission time period of the day, general health status, type of trauma, the trauma site, involved body regions, radiologic imaging and laboratory results, consultations, clinical diagnosis and outcome, duration of emergency service stay, and treatment cost were collected and statistically analyzed.

Results
A total of 688 preschool-aged cases were admitted owing to trauma. The major mode of transport was a private vehicle (98.3%), and the major cause was falling (64.0%). The major traumatized body region was head and neck (51.0%), and the major diagnosis was soft tissue trauma (90.1%). The average duration of stay was 122.01 minutes and affected by sibling number, trauma type, and employment status. The total service fee was interrelated with the type of trauma and the site that trauma occurred; it also was strongly correlated with duration of emergency service stay.

Conclusions
Our results suggest that both in-hospital and social/environmental aspects should be improved to reduce the clinical and social burden of trauma.