bluuebunny/crossref_metadata_2025_split huggingface dataset:
Influenza and vaccination: beliefs and practices of local authority staff
Authors: Mc Conalogue D , Verle N , Ellis H , Scott S 
Published: July 2019

Abstract

Background
Influenza causes large outbreaks every year. Professionals outside healthcare, including social care staff and non-care giving roles, have a key role in protecting their clients and sustaining operational productivity through influenza vaccination. There has been little research on non-healthcare staff working with vulnerable people and those working in non-caregiving settings regarding influenza and influenza vaccination.

Aims
To understand the practices, experiences, perceptions and motivations of local authority staff regarding influenza and influenza vaccination.

Methods
Semi-structured focus groups were carried out with local authority staff in Gloucestershire. Transcripts were thematically analysed.

Results
Participants tended to perceive influenza as a serious illness, where a person had a specific risk factor or during pandemics. They did not feel vulnerable unless they had previous experience of infection or had an underlying health condition. Motivation to vaccinate was based on previous experience of influenza, where they had a close family member at risk or when working directly with vulnerable clients. Beliefs about negative side effects of the vaccine were the strongest reason for vaccine refusal. Ease of access to vaccination through on-site clinics is key to uptake. Management are perceived as key motivators or blockers to vaccine uptake.

Conclusions
Workers outside healthcare settings do not feel vulnerable to influenza and have low motivation to vaccinate, unless they have previous experience of infection or an underlying health condition. Vaccination programmes must proactively address workers’ beliefs and motivations to ensure their participation in flu vaccination programmes.
A retrospective study of patients with blood culture-confirmed typhoid fever in Fiji during 2014–2015: epidemiology, clinical features, treatment and outcome
Authors: S Aneley Getahun , Parry Christopher M , Crump John A , Rosa Varanisese , Jenney Adam , Naidu Ravi , Mulholland Kim , Strugnell Richard A 
Published: July 2019

Abstract

Background
Typhoid fever is endemic in Fiji. We sought to describe the epidemiology, clinical features and case fatality risk of blood culture-confirmed typhoid fever from January 2014 through December 2015.

Methods
Blood culture-positive patients were identified from a typhoid surveillance line list. A standardised case investigation form was used to record data from patients’ medical records.

Results
Of 542 patients, 518 (95.6%) were indigenous Fijians (iTaukei) and 285 (52.6%) were male. The median (IQR) age was 25 (16–38) y. Mean (SD) time from the onset of illness to admission was 11.1 (6.9) d. Of 365 patients with clinical information, 346 (96.9%) had fever, 239 (66.9%) diarrhoea, 113 (33.5%) vomiting, and 72 (30.2%) abdominal pain. There were 40 (11.0%) patients with complications, including 17 (4.7%) with shock, and 11 (3.0%) with hepatitis. Nine patients died for a case fatality risk of 1.7%. Of the 544 Salmonella Typhi isolates tested, none were resistant to first line antimicrobials; 3(0.8%) were resistant to ciprofloxacin and 5(1.4%) to nalidixic acid.

Conclusions
In Fiji, most blood culture-confirmed typhoid fever cases were in young adults. Common clinical manifestations were fever and gastrointestinal symptoms. Further studies are required to elucidate the factors associated with complications and death.
Exploring Online RN-to-BSN Student Perceptions of Learner Presence
Authors: Olson Christina , Benham-Hutchins Marge 
Published: July 2019

Abstract

AIM
The aim of this study was to describe how RN-to-BSN student and program-specific characteristics influence student perceptions of learner presence (LP) in the online learning environment.

BACKGROUND
Online RN-to-BSN students represent a diverse group of practicing nurses who must balance multiple obligations and challenging learner requirements. LP represents the student’s perceptions of being close to and interacting with faculty and peers within the online learning environment.

METHOD
A descriptive, exploratory design was used to examine the relationship between participant perceptions of LP and student and program characteristics.

RESULTS
Findings describe student and program characteristics and perceptions of LP. Significant findings revealed that more collaborative assignments were associated with higher perceptions of LP; individual assignments resulted in lower perceptions.

CONCLUSION
This study may enhance faculty understanding of this population of students and the extent to which course activities impact students’ communication and collaboration to meet online learner requirements.
A Creative Teaching Method for Research and Evidence-Based Practice
Authors: Weathers Elizabeth 
Published: July 2019

Abstract
With nursing students placed in busy clinical environments where evidence-based practice (EBP) and research are often not considered a priority, teaching EBP to nursing students can be challenging. Innovation is required to ensure that nursing students not only recognize the importance of EBP but are also equipped with the knowledge, skills, and attitudes required to promote and implement EBP. This article describes the implementation of a video project as part of the EBP and research module. Feedback from students was positive, and the project has now been formally introduced into the curriculum.
Nursing Student Perceptions of Faculty Advising
Authors: Snyder Brenda , Quinn Griffin Mary 
Published: July 2019

Abstract

AIM
The aim of the study was to determine student perceptions of faculty advising and the most effective method of faculty advising.

BACKGROUND
The nursing faculty advisor is important in facilitating the timely completion of the program. Faculty members have initiated synchronous electronic methods of advising to facilitate advising.

METHOD
A descriptive study was conducted with a convenience sample of members of a student nurses’ association. The Faculty Advisor Evaluation Questionnaire was used for data collection via online survey.

RESULTS
With 106 respondents, results demonstrated high levels of student-perceived effectiveness of the advising session, advocacy/accountability, faculty advisor knowledge, and availability. The majority of nursing students reported that face-to-face advising (58.5 percent, n = 62) was the most helpful method.

CONCLUSION
This study is one of the first to examine nursing students’ perceptions of faculty advising. As nursing faculty implement online methods of advising, it is important to evaluate the evidence.
Malassezia furfur Emergence and Candidemia Trends in a Neonatal Intensive Care Unit During 10 Years
Authors: Chen I-Ting , Chen Chih-Cheng , Huang Hsin-Chun , Kuo Kuang-Che 
Published: July 2019

Background:
Because Candida spp is a major cause of mortality and morbidity in preterm infants, fluconazole prophylaxis has been suggested by some experts and hospital policy. In our hospital, fluconazole prophylaxis was used in eligible preterm infants and set as the neonatal intensive care unit (NICU) practice in 2014.

Purpose:
This study focused on fungal bloodstream infections and aimed to evaluate the benefit and harm of fluconazole prophylaxis.

Methods/Search Strategy:
This retrospective, descriptive study involved medical record reviews in our hospital from April 2005 to October 2016. NICU patients were included if Candida species, yeast-like organisms, or Malassezia species were cultured from their venous catheter tips or blood cultures.

Findings/Results:
After fluconazole prophylaxis, cases of Candida spp decreased and those of Malassezia furfur emerged. We reviewed 19 cases of catheter-related M furfur colonization and 1 case of M furfur fungemia. The gestational age was 27.3 ± 2.0 weeks and birth weight was 959.2 ± 229.8 g. Hyperalimentation with lipid infusion was used in all cases. All of the neonates survived with antifungal agent use.

Implications for Practice:
This study highlights that prophylactic fluconazole may be an associated factor of Malassezia colonization; M furfur remains a potential concern for fungemia in the care of premature infants and thus requires our attention.

Implications for Research:
Future studies should further investigate the incidence and impact of noncandidal fungal infections with fluconazole prophylaxis use in premature infants.
Urologic Injury and Fistula After Hysterectomy for Benign Indications
Authors: Dallas Kai B. , Rogo-Gupta Lisa , Elliott Christopher S. 
Published: July 2019

OBJECTIVE:
To explore the rates and risk factors for sustaining a genitourinary injury during hysterectomy for benign indications.

METHODS:
In this population-based cohort study, all women who underwent hysterectomy for benign indications were identified from the Office of Statewide Health Planning and Development databases in California (2005–2011). Genitourinary injuries were further classified as identified at the time of hysterectomy, identified after the date of hysterectomy; or unidentified until a fistula developed.

RESULTS:
Of the 296,130 women undergoing hysterectomy for benign indications, there were 2,817 (1.0%) ureteral injuries, 2,058 (0.7%) bladder injuries and 834 (0.3%) genitourinary fistulas (80/834 of which developed after an injury repair). Diagnosis was delayed in 18.6% and 5.5% of ureteral and bladder injuries, respectively. Subsequent genitourinary fistula development was lower if the injury was identified immediately (compared with delayed) for both ureteral (0.7% vs 3.4% odds ratio [OR] 0.28; 95% CI 0.14–0.57) and bladder injuries (2.5% vs 6.5% OR 0.37; 95% CI 0.16–0.83). Indwelling ureteral stent placement alone was more successful in decreasing the risk of a second ureteral repair for immediately recognized ureteral injuries (99.0% vs 39.8% for delayed injuries). With multivariate adjustment, prolapse repair (OR 1.44, 95% CI 1.30–1.58), an incontinence procedure (OR 1.40, 95% CI 1.21–1.61), mesh augmented prolapse repair (OR 1.55, 95% CI 1.31–1.83), diagnosis of endometriosis (OR 1.46, 95% CI 1.36–1.56), and surgery at a facility in the bottom quartile of hysterectomy volume (OR 1.37, 95% CI 1.01–1.89) were all associated with an increased likelihood of a genitourinary injury. An exclusively vaginal (OR 0.56, 95% CI 0.53–0.64) or laparoscopic (OR 0.80, 95% CI 0.75–0.86) approach was associated with lower risk of a genitourinary injury as compared with an abdominal approach.

CONCLUSION:
Genitourinary injury occurs in 1.8% of hysterectomies for benign indications; immediate identification and repair is associated with a reduced risk of subsequent genitourinary fistula formation.
Short-Term Health-Related Quality of Life After Hysterectomy Compared With Myomectomy for Symptomatic Leiomyomas
Authors: Nicholson Wanda K. , Wegienka Ganesa , Zhang Shuaiqi , Wallace Kedra , Stewart Elizabeth , Laughlin-Tommaso Shannon , Thomas Laine , Jacoby Vanessa L. , Marsh Erica E. , Wise Lauren , Borah Bijan J. , Spies James , Venable Sateria , Anchan Raymond M. , Larry Maxwell G. , Diamond Michael , Lytle Barbara , Myers Evan R. 
Published: July 2019

OBJECTIVE:
To compare short-term health-related quality of life (HRQOL) 6–12 weeks after hysterectomy or myomectomy for the treatment of symptomatic leiomyomas.

METHODS:
We conducted a prospective comparative effectiveness analysis of data. In an existing multisite registry, we compared 6–12-week postsurgical HRQOL using the disease-specific Uterine Fibroid Symptom Quality of Life and the generic EuroQoL 5-Dimension Health Questionnaire, in women from the ages of 18–54 years with documented leiomyomas undergoing hysterectomy or myomectomy. Propensity score weighting was used to adjust for confounding, and analyses were also stratified by route of surgery.

RESULTS:
A total of 1,295 patients (727 with hysterectomy and 568 with myomectomy) enrolled from registry initiation in November 2015 until June 2018 met inclusion criteria. At baseline, leiomyoma-specific HRQOL (44.0±25.4 and 50.2±25.3, P<.01), symptom severity (60.7±23.6 and 51.7±24.6, P<.01), and generic HRQOL (69.3±20.4 and. 73.4±18.9, P<.01) were significantly different between the hysterectomy compared with myomectomy groups, respectively. Differences were eliminated by propensity adjustment. Substantial improvement in HRQOL measures were seen in both groups at 6–12 weeks, with the mean propensity-adjusted symptom severity score 4 points lower in hysterectomy patients (mean difference −4.6; 95% CI −7.0 to −2.3), compared with myomectomy patients. Hysterectomy patients had better scores on the concern and self-consciousness subscales compared with myomectomy patients. When stratified by surgical route, these two subscale findings were similar between minimally invasive hysterectomy and minimally invasive myomectomy. Symptom severity scores did not differ after abdominal myomectomy compared with abdominal hysterectomy, but subscale scores on activity and energy/mood were higher with myomectomy.

CONCLUSION:
Both hysterectomy and myomectomy were associated with substantial improvement in HRQOL at short-term follow-up, with small but statistically significant differences in symptom severity and certain subscales.

CLINICAL TRIAL REGISTRATION:
ClinicalTrials.gov, NCT02260752.
Medication Abortion Provided Through Telemedicine in Four U.S. States
Authors: Kohn Julia E. , Snow Jennifer L. , Simons Hannah R. , Seymour Jane W. , Thompson Terri-Ann , Grossman Daniel 
Published: July 2019

OBJECTIVE:
To assess outcomes of medication abortion provided through telemedicine compared with standard medication abortion at Planned Parenthood health centers in four U.S. states.

METHODS:
In this retrospective cohort study, we analyzed electronic health records for patients receiving telemedicine compared with standard medication abortion at 26 health centers in Alaska, Idaho, Nevada, and Washington from April 2017 to March 2018. All patients had on-site ultrasound scans, laboratory testing, and counseling and provided informed consent before meeting with the clinician. Telemedicine patients met with a clinician by secure videoconference platform; standard patients met with a clinician in person. We also reviewed adverse event reports submitted during this period. Study outcomes included ongoing pregnancy, receipt of or referral for aspiration procedure, and clinically significant adverse events. To compare outcomes between the telemedicine and standard groups, we performed logistic regression accounting for gestational age and health center clustering.

RESULTS:
A total of 5,952 patients underwent medication abortion (738 telemedicine and 5,214 standard). Mean gestational age was 50.4 days for telemedicine patients compared with 48.9 days for standard patients (prevalence ratio 1.02; 95% CI 1.00–1.03). We had outcome data for 4,456 (74.9%) patients; follow-up within 45 days of abortion was lower among telemedicine patients (60.3%) than standard patients (76.9%) (prevalence ratio 0.83; 95% CI 0.78–0.88). Among patients with follow-up data, ongoing pregnancy was less common among telemedicine patients (2/445, 0.5%) than standard patients (71/4,011, 1.8%) (adjusted odds ratio [OR] 0.23; 95% CI 0.14–0.39). Aspiration procedures were less common among telemedicine patients (6/445, 1.4%) than standard patients (182/4,011, 4.5%) (adjusted OR 0.28; 95% CI 0.17–0.46). Fewer than 1% of patients in each group reported clinically significant adverse events. No deaths were reported.

CONCLUSION:
Findings from this study conducted across geographically diverse settings support existing evidence that outcomes for medication abortion provided through telemedicine are comparable with standard provision of medication abortion. Differences in observed outcomes may be due to differential follow-up between groups.
Association Between First-Trimester Subchorionic Hematomas and Pregnancy Loss in Singleton Pregnancies
Authors: Naert Mackenzie N. , Khadraoui Hanaa , Muniz Rodriguez Alberto , Naqvi Mariam , Fox Nathan S. 
Published: July 2019

OBJECTIVE:
To assess the association of a first-trimester subchorionic hematoma with pregnancy loss in women with singleton pregnancies.

METHODS:
We conducted a retrospective cohort study of all women with singleton pregnancies presenting for prenatal care before 14 weeks of gestation over a 3-year period at a single obstetric practice. All patients had routine first-trimester ultrasound scans. We reviewed ultrasound data from the first ultrasound scan performed between 6 0/7 and 13 6/7 weeks of gestation and compared rates of pregnancy loss before 20 weeks in women with and without a subchorionic hematoma. Logistic regression analysis was used to control for potential confounding variables.

RESULTS:
From January 2015 to December 2017, a total of 2,446 women met inclusion criteria, 451 (18.4%) of whom had subchorionic hematomas. Women with subchorionic hematomas had their first ultrasound scans at an earlier gestational age (8 5/7 vs 9 6/7 weeks of gestation, P<.001) and were more likely to have vaginal bleeding (33.3% vs 8.1%, P<.001). Maternal age, race, use of in vitro fertilization, body mass index, prior number of losses, and medical comorbidities did not differ between the groups. On univariable analysis, subchorionic hematoma was associated with an increased risk of pregnancy loss before 20 weeks of gestation (7.5% vs 4.9%, P=.026); however, after adjusting for gestational age and vaginal bleeding, this association was no longer significant (adjusted odds ratio 1.13, 95% CI 0.74–1.74). In the 451 women with subchorionic hematomas, no characteristics of the subchorionic hematoma, including size by volume, largest diameter, presence of vaginal bleeding, and presence of an additional subchorionic hematoma, were associated with pregnancy loss. Post hoc power analysis showed we had 80% power to detect an increase in pregnancy loss before 20 weeks of gestation from 4.9% in women with no subchorionic hematoma to 8.3% in women with subchorionic hematoma.

CONCLUSION:
In this cohort of women with singleton pregnancies, subchorionic hematoma before 14 weeks of gestation was not independently associated with pregnancy loss before 20 weeks of gestation.
Screening and Treatment After Implementation of a Universal Perinatal Depression Screening Program
Authors: Miller Emily S. , Wisner Katherine L. , Gollan Jacqueline , Hamade Sara , Gossett Dana R. , Grobman William A. 
Published: July 2019

OBJECTIVE:
To evaluate whether initiation of an institutional policy of universal perinatal depression screening was associated with sustained increases in frequency in screening and of depression treatment subsequent to a positive screen.

METHODS:
This retrospective cohort study included women receiving prenatal care in outpatient offices at a single academic medical center from 2008 to 2015. In 2009, an institutional policy of universal perinatal depression screening was disseminated in which screening twice antenatally and again postpartum were recommended. The frequency of screen completion at each recommended time point was compared between the prepolicy and postpolicy cohorts. A test of trend that assessed the frequency of screening each year after policy initiation was used to assess changes over time. The frequency with which care plans were created for women who screened positive for perinatal depression were compared before and after implementation.

RESULTS:
Of the 5,127 women who met inclusion criteria, 4,005 (78%) were in the postpolicy cohort. The frequency of completion of depression screening at the first prenatal visit (0.1% vs 65.5%), in the third trimester (0.0% vs 42.7%), and at the postpartum visit (69.5% vs 90.0%) increased after initiation of the policy (P<.001 for all). The improvement in postpartum depression screening completion persisted after controlling for potential confounders (adjusted odds ratio 5.3, 95% CI 4.4–6.5). After the initial increase in uptake of screening, the frequency of screening at the first and third trimester prenatal visits continued to increase over time (P<.001 for each), although this frequency remained stable for the postpartum visit (P=.29). Women with a positive postpartum depression screen were more likely to have depression treatment recommended or provided by their obstetrician postpolicy (64.7% vs 30.1%, P<.001).

CONCLUSION:
Implementation of an institutional policy of universal perinatal depression screening was associated with improvements in perinatal depression screening with concomitant improvements in depression treatment recommendations for women with a positive postpartum depression screen.
Effects of Educational Interventions on Human Papillomavirus Vaccine Acceptability
Authors: Cory Lori , Cha Beda , Ellenberg Susan , Bogner Hillary R. , Hwang Wei-Ting , Smith Jennifer S. , Haggerty Ashley , Morgan Mark , Burger Robert , Chu Christina , Ko Emily M. 
Published: July 2019

OBJECTIVE:
To estimate whether targeted educational interventions can increase human papillomavirus (HPV) vaccine acceptability and knowledge among young women.

METHODS:
An exploratory phase of the study was conducted to determine baseline acceptance of the prophylactic HPV vaccine and barriers to acceptance. Based on the results of that phase of the study, a randomized controlled trial of women aged 12–26 at a single institution was completed. A sample size of at least 84 women in each of three study arms (control, educational handout, or educational video) was planned to detect a 20% difference in vaccine acceptability among arms. All participants completed a survey collecting data on demographics, HPV vaccine preferences, and HPV vaccine knowledge after completion of their randomization assignments. The primary outcome was HPV vaccine acceptability. The secondary outcome was HPV vaccine knowledge.

RESULTS:
From March 2017 through August 2017, 256 women were randomized to one of three study arms: control (n=85), educational handout (n=84), or educational video (n=87). Demographics were similar between study arms. Overall, 51.7% of participants in the educational video arm reported willingness to accept the HPV vaccine compared with 33.3% and 28.2% of participants in the educational handout and control arms, respectively (P<.01). Those in the educational video and handout arms had higher median HPV vaccine knowledge scores than those in the control arm (6 and 5 vs 3, P<.01). Both interventions were reported as helpful in learning (97.7% vs 92.9%, P=.15), but the educational video arm was more likely to be helpful in deciding on vaccination (86.2% vs 70.2%, P<.01).

CONCLUSION:
Targeted educational interventions increase HPV vaccine acceptability and knowledge among young women. Follow up studies are needed to determine whether these interventions also increase rates of vaccine uptake and series completion.

CLINICAL TRIAL REGISTRATION:

Clinicaltrials.gov, NCT03337269.