bluuebunny/crossref_metadata_2025_split huggingface dataset:
Student-centred photovoice as a mechanism for home-school interaction: Teacher perceptions of efficacy
Authors: McKernan Christine , Gleddie Douglas , Storey Kate 
Published: July 2019

Objective: The school and home environments play a significant role in shaping the health behaviours of children. Understanding students’ home environments is essential for teachers to recognise and meet their students’ needs, while collaborative partnerships between the school and home have been shown to result in academic success and improved behaviour management. This study explores the unique features of photovoice as a student-centred approach to understanding the links between the school and home environments, and its feasibility to be implemented independently by teachers in the classroom. Design: Descriptive qualitative method. Setting: A Project Promoting healthy Living for Everyone in Schools (APPLE Schools) is a school-based health promotion project being conducted in 70 school communities across northern Alberta, Northwest Territories, and Manitoba, Canada. Method: One-on-one interviews with teachers who were involved in an initial photovoice project ( n = 3) and researcher field notes from observations conducted over a period of 8 months were used. Data were analysed using latent content analysis. Results: Strengths, limitations and future directions of photovoice were identified. The strengths of using photovoice included genuine student participation, strengthened communication between the school and home, and the ability to address multiple learning domains. Limitations were cost, privacy and parental support. Teachers shared promising ideas about photovoice being used for health promotion advocacy. Conclusion: Photovoice can be used by teachers as tool to strengthen the relationship between the home and the school environments. Future use of photovoice in schools is encouraged.
Post-Tonsillectomy Outcomes in Children With and Without Narcotics Prescriptions
Authors: Carr Michele M. , Schaefer Eric W. , Schubart Jane R. 
Published: July 2019

Objective: To examine differences in outcomes after tonsillectomy in children who received outpatient narcotics prescriptions compared to those who did not. Methods: The MarketScan database was analyzed for claims made for 14 days following tonsillectomy/adenotonsillectomy between 2008 and 2012 for privately insured children 1 to 17 years. Post-op bleeding, dehydration, emergency department (ED) visits, readmissions, and mean total costs for the 14 days after tonsillectomy were compared. Results: Of the 294 795 patients included, 60.9% received a narcotic prescription. Acetaminophen/hydrocodone bitartrate was received by 53.2% of the group receiving narcotic drugs, 42.5% received acetaminophen/codeine phosphate, 3.0% received acetaminophen/oxycodone hydrochloride, and 0.5% received oxycodone hydrochloride alone. Children who had been prescribed narcotics had significantly higher percentages of bleeding complications (2.7% vs 2.5%, P < .001), and ED visits (6.8% vs 6.6%, P < .001) within 14 days, but a lower percentage of readmissions (1.0% vs 1.5%, P < .001). No significant difference was observed between groups for dehydration. There were some age-related differences. The mean total health-care costs for 14 days post-op were the same in each group, except for the 4- to 6-year-olds, where the narcotic group had higher costs (US $7060 vs US $5840, P = .006). Conclusion: In this large-scale study, we found small but statistically significant differences in outcomes related to use of narcotics. The only outcome that benefitted the narcotics group was a lower readmission rate.
Selective serotonin reuptake inhibitors and benzodiazepines in panic disorder: A meta-analysis of common side effects in acute treatment
Authors: Quagliato Laiana A , Cosci Fiammetta , Shader Richard I , Silberman Edward K , Starcevic Vladan , Balon Richard , Dubovsky Steven L , Salzman Carl , Krystal John H , Weintraub Steve J , Freire Rafael C , Nardi Antonio E ,   International Task Force on Benzodiazepines
Published: July 2019

Background: Benzodiazepines (BZs) and selective serotonin reuptake inhibitors (SSRIs) are effective in the pharmacologic treatment of panic disorder (PD). However, treatment guidelines favor SSRIs over BZs based on the belief that BZs are associated with more adverse effects than SSRIs. This belief, however, is currently supported only by opinion and anecdotes. Aim: The aim of this review and meta-analysis was to determine if there truly is evidence that BZs cause more adverse effects than SSRIs in acute PD treatment. Methods: We systematically searched Web of Science, PubMed, Cochrane Central Register of Controlled Trials, and clinical trials register databases. Short randomized clinical trials of a minimum of four weeks and a maximum of 12 weeks that studied SSRIs or BZs compared to placebo in acute PD treatment were included in a meta-analysis. The primary outcome was all-cause adverse event rate in participants who received SSRIs, BZs, or placebo. Results: Overall, the meta-analysis showed that SSRIs cause more adverse events than BZs in short-term PD treatment. Specifically, SSRI treatment was a risk factor for diaphoresis, fatigue, nausea, diarrhea, and insomnia, whereas BZ treatment was a risk factor for memory problems, constipation, and dry mouth. Both classes of drugs were associated with somnolence. SSRIs were associated with abnormal ejaculation, while BZs were associated with libido reduction. BZs were protective against tachycardia, diaphoresis, fatigue, and insomnia. Conclusion: Randomized, blinded studies comparing SSRIs and BZs for the short-term treatment of PD should be performed. Clinical guidelines based on incontrovertible evidence are needed.
Injury Surveillance in Major League Soccer: A 4-Year Comparison of Injury on Natural Grass Versus Artificial Turf Field
Authors: Calloway Sean P. , Hardin David M. , Crawford Matthew D. , Hardin J. Michael , Lemak Lawrence J. , Giza Eric , Forsythe Brian , Lu Yining , Patel Bhavik H. , Osbahr Daryl C. , Gerhardt Michael B. , Mandelbaum Bert R. , Baldwin William W. 
Published: July 2019

Background: Artificial playing surfaces are becoming more common due to decreased cost of maintenance and increased field usability across different environmental conditions. The Fédération Internationale de Football Association (FIFA) has approved newer generation artificial turf for soccer competition at the elite level, but many elite-level athletes prefer to play on natural grass surfaces due to a perceived increase in injury rate, discomfort, and fatigability on artificial turf. Hypothesis: Injury rates and rates of individually categorized types of injury experienced on artificial turf are noninferior to rates of injury on the standard comparator, natural grass, in elite-level Major League Soccer athletes. Study Design: Cohort study; Level of evidence, 2. Methods: Over the course of 4 Major League Soccer seasons (2013-2016), athlete injury data were recorded electronically. Injury data recorded in matches between 2 Major League Soccer teams were then analyzed. Playing surface was known for each venue, and all artificial turf surfaces were rated as 2-star according to FIFA criteria. Incidence rate ratios (Artificial Turf ÷ Natural Grass) were calculated with a 95% CI (α = .05) for both overall injury incidence and individual injury subgroups. A noninferiority margin (δ) of 0.15 was used to determine noninferiority of injury incidence rates. Results: A total of 2174 in-game injuries were recorded during the study period, with 1.54 injuries per game on artificial turf and 1.49 injuries per game on natural grass (incidence rate ratio, 1.033; 95% CI, 0.937-1.139). Within injury subgroups, overall ankle injury, Achilles injury, and ankle fracture were found to have a statistically higher incidence on artificial turf. Artificial turf was found to be noninferior to natural grass for overall foot injury and forefoot injury. No statistically significant differences were found in knee injuries between the 2 surfaces. Conclusion: The overall rate of injury on artificial turf was noninferior to that on natural grass. Within individual injury categories, a higher rate of ankle injury was found on artificial turf. No other injury subgroup demonstrated statistically significant differences between surfaces. Clinical Relevance: FIFA 2-star rated artificial turf is a viable alternative to natural grass in elite-level soccer competition. Innovative research methods for comparing artificial turf versus natural grass may elucidate relative advantages with respect to player safety.
A Randomized Controlled Trial of PEEK Versus Titanium Interference Screws for Anterior Cruciate Ligament Reconstruction With 2-Year Follow-up
Authors: Shumborski Sarah , Heath Emma , Salmon Lucy J. , Roe Justin P. , Linklater James P. , Facek Michael , Pinczewski Leo A. 
Published: July 2019

Background: Graft fixation with interference screws for anterior cruciate ligament (ACL) reconstruction is a highly successful technique. Polyether ether ketone (PEEK) is a novel thermoplastic polymer with high biocompatibility and mechanical properties that mimic native bone, and it can be imaged on computed tomography or magnetic resonance imaging (MRI) without signal flare. Purpose: To compare the clinical performance of ACL reconstruction with PEEK and titanium interference screws at 2 years and to evaluate a novel method of measuring tunnel volume. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: A total of 133 patients underwent arthroscopic ACL reconstruction with 4-strand hamstring autografts and were randomized to have titanium or PEEK interference screws for femoral and tibial tunnel fixation. At 2 years, subjective Lysholm and International Knee Documentation Committee scores were assessed and clinical examination performed. At 12 months, MRI was performed to assess graft incorporation and cyst formation, and a novel technique was employed to measure tunnel volumes. Results: There were no significant differences in graft rerupture rate, contralateral ACL rupture rate, subjective outcomes, or objective outcomes. In the titanium and PEEK groups, MRI demonstrated high overall rates of graft integration (96%-100% and 90%-93%, respectively) and ligamentization (89% and 84%) and low rates of synovitis (22% and 10%) and cyst formation (0%-18% and 13%-15%). There was a higher proportion of patients with incomplete graft integration within the femoral tunnel in the PEEK group as compared with the titanium group (10% vs 0%, P = .03); however, the authors suggest that metal artifact precluded proper assessment of the graft in the titanium group by MRI. Tunnel volumes also appeared to be equivalent in the 2 groups and were measured with a novel technique that was highly reproducible in the PEEK group secondary to the absence of flare. Conclusion: Two-year clinical analysis of PEEK interference screws for femoral and tibial fixation of ACL reconstructions showed equivalent clinical performance to titanium interference screws. Given the excellent mechanical characteristics, biological compatibility, and absence of metal artifact on MRI, PEEK has become our material of choice for interference screw fixation in ACL reconstruction.
Urinary Organic Acids Increase After Clinical Stabilization of Hospitalized Children With Severe Acute Malnutrition
Authors: Daniel Allison I. , Kvissberg Matilda E. Arvidsson , Senga Edward , Versloot Christian J. , Harawa Philliness Prisca , Voskuijl Wieger , Wishart David , Mandal Rupasri , Bandsma Robert , Bourdon Céline 
Published: July 2019

Background: Despite a reduction of child mortality in low-income countries, acutely ill undernourished children still have an elevated risk of death. Those at highest risk are children with severe acute malnutrition (SAM) who often show metabolic dysregulation that remains poorly understood. Objective: We performed a pilot study to examine changes in urinary organic acids during nutritional rehabilitation of children with SAM, and to identify metabolites associated with the presence of edema or with mortality. Methods: This study included 76 children aged between 6 and 60 months, hospitalized for SAM at the Moyo Nutritional Rehabilitation and Research Unit in Blantyre, Malawi. Urine was collected at admission and 3 days after clinical stabilization and metabolomics were performed using gas chromatography–mass spectrometry. Metabolite concentrations were evaluated with both uni- and multivariate approaches. Results: Most metabolites increased 3 days after clinical stabilization, and total urinary concentration changed from 1.2 mM (interquartile range [IQR], 0.78-1.7) at admission to 3.8 mM (IQR, 2.1-6.6) after stabilization ( P < .0001). In particular, 6 metabolites showed increases: 3-hydroxybutyric, 4-hydroxyhippuric, p-hydroxyphenylacetic, oxoglutaric, succinic, and lactic acids. Urinary creatinine was low at both time points, but levels did increase from 0.63 mM (IQR, 0.2-1.2) to 2.6 mM (IQR,1.6-4.4; P < .0001). No differences in urinary profiles were found between children who died versus those who survived, nor between children with severe wasting or edematous SAM. Conclusions: Total urinary metabolites and creatinine increase after stabilization and may reflect partial recovery of overall metabolism linked to refeeding. The use of urinary metabolites for risk assessment should be furthered explored. Trial registration: TranSAM study (ISRCTN13916953).
The acute scrotum: Frequency and range of etiologies in a Middle Eastern setting
Authors: Nasr Rami , Tayara Ziad , Abou Ghayda Ramy , Alsheikh Deeb Ibrahim , Ghieh Diamond , El-Achkar Bassam , Saade Charbel , El-Merhi Fadi 
Published: July 2019

Aim: To investigate the frequency of different etiologies of acute scrotal pain in males presenting to the emergency department at American University of Beirut Medical Center in Beirut, Lebanon. Materials and Methods: In all, 94 patients between the ages 18 and 40 years presenting to the emergency room at American University of Beirut Medical Center with acute scrotum were recruited. The scrotum was inspected with palpation, and Doppler Ultrasound of the testicle was performed by a radiology resident to confirm the diagnosis. The study results were then collected after the official reports were signed by a board-certified radiology attending with expertise in ultrasound. Results: Of the 94 patients presenting with acute scrotal pain, 23.4% (95% confidence interval (0.70–0.87)) had no ultrasound findings and were considered normal. On the other hand, 54.3% (95% confidence interval (0.45–0.66)) were diagnosed with varicocele, 9.6% (95% confidence interval (0.04–0.16)) were diagnosed with epididymo-orchitis, and 9.6% (95% confidence interval (0.04–0.16)) had a history of trauma to the testicle. Patients presenting with acute scrotum had a pain duration of 13.2 ± 4.5 h, with 10.6% (95% confidence interval (0.04–0.17)) having associated urinary symptoms, 18.1% (95% confidence interval (0.09–0.25)) have had sexual activity within 48 h of presentation, and 10.6% (95% confidence interval (0.04–0.17)) were pre-diagnosed with varicocele. Conclusion: Varicocele is the most common cause of acute scrotal pain in patients presenting to American University of Beirut Medical Center in Beirut. This should direct varicocele to the top of our differential when a patient with acute scrotum presents to the emergency department. Nevertheless, ruling out torsion remains the first step in the workup.
Life-threatening Double-J stent migration with helicoidal appearance: Length matters
Authors: Lorusso Vito , Palmisano Franco , Morelli Michele , Spinelli Matteo Giulio , Dell’Orto Paolo Guido , Montanari Emanuele 
Published: July 2019

Background: The Double-J stent is one of the most commonly used devices in urologic practice. Due to its widespread use, numerous common complications have been reported, such as irritative symptoms, infection, and encrustation. More rare complications have also been described, such as up or downward migration and displacement outside the urinary tract. We present a rare case of downward migration of a Double-J stent in a 21-year-old Caucasian female. Case Presentation: A 21-year-old female with a solitary kidney presented to the emergency department with acute renal failure, left flank pain, and fever. She had undergone left Double-J stenting 1 week earlier in her homeland for left renal colic and anuria. A kidney–ureter–bladder X-ray revealed a 10-mm lumbar ureteral stone and the proximal coil of the Double-J stent making multiple loops along the ureter, resulting in a helical appearance. She underwent surgery to remove the previous stent and to place a new one. She was discharged 2 days later and her renal function had returned to normal values at her 1-week follow-up. Conclusions: Double-J Stent placement is a common procedure in the management of urinary tract diseases but is not devoid of life-threatening complications. Regular follow-up of stents and on-time evaluation of clinical complaints are mandatory for an aggressive treatment of complications.
Ethical conflicts and their characteristics among critical care nurses
Authors: Lluch-Canut Teresa , Sequeira Carlos , Falcó-Pegueroles Anna , Pinho José António , Rodrigues-Ferreira Albina , Olmos Joan Guàrdia , Roldan-Merino Juan 
Published: July 2019

Introduction: Ethical conflict is a phenomenon that has been under study over the last three decades, especially the types moral dilemma and moral distress in the field of nursing care. However, ethical problems and their idiosyncrasies need to be further explored. Aim: The objectives of this study were, first, to obtain a transcultural Portuguese-language adaptation and validation of the Ethical Conflict Nursing Questionnaire–Critical Care Version and, second, to analyse Portuguese critical care nurses’ level of exposure to ethical conflict and its characteristics. Methods: A cross-cultural validation and descriptive, prospective and correlational study. The sample was made for 184 critical care nurses in 2016. Ethical Considerations: The study was authorised by Bioethics Commission of the University of Barcelona, the Associaçâo de Apoio ao Serviço de Cuidados Intensivos do Centro Hospitalar do Porto and the Sociedade Portuguesa de Enfermagem de Saúde Mental. Findings: The Portuguese version of the Ethical Conflict Nursing Questionnaire–Critical Care Version was a valid and reliable instrument to measure exposure to conflict. Moral outrage was the most common type of conflict. The most problematic situations were the ineffectiveness of analgesic treatments, the administration of treatments considered futile and the mismanagement of resources.
Borderline personality disorder and auditory verbal hallucinations
Authors: Beatson Josephine 
Published: July 2019

Objective: Auditory verbal hallucinations (AVH) frequently co-occur with borderline personality disorder (BPD) and can lead to misdiagnosis with schizophrenia (SCZ) or other primary psychotic disorders. Misdiagnosis is more common when AVH meet criteria for Schneiderian first rank symptoms (FRS). This paper’s objective is to improve diagnostic accuracy by outlining particular clinical features that can assist the distinction between BPD and psychotic disorders in these cases. Conclusion: The overall clinical presentation when AVH occur in BPD can assist in determining a primary diagnosis of BPD when frank psychotic disorder is absent. AVH in BPD cannot be distinguished phenomenologically from AVH in SCZ. Clinical experience and increasing research suggest that AVH in BPD are often dissociative in origin and highly correlated with the presence of FRS, elevated levels of dissociation and a history of childhood trauma. When AVH occur in BPD in the absence of co-occurring psychotic disorder, formal thought disorder is usually absent, negative symptoms minimal or absent, bizarre symptoms absent, affect reactive and the patient retains sociability. Psychotropic medication may be less effective for the AVH in these cases, while they may improve or remit during psychotherapy for BPD.
Meanings of Care Convoys: The Structure, Function, and Adequacy of Care Networks Among Frail, Community-Dwelling Older Adults
Authors: Lambotte Deborah , Smetcoren An-Sofie , Zijlstra G. A. Rixt , De Lepeleire Jan , De Donder Liesbeth , Kardol Martinus J. M. , Smetcoren A-.S. , Dury S. , De Donder L. , Dierckx E. , Lambotte D. , Fret B. , Duppen D. , Kardol M. , Verté D. , Hoeyberghs L. J. , De Witte N. , De Roeck E. E. , Engelborghs S. , De Deyn P. P. , Van der Elst M. , De Lepeleire J. , Schoenmakers B. , van der Vorst A. , Zijlstra G.A.R. , Kempen G. I. J. M. , Schols J. M. G. A. 
Published: July 2019

Researchers propose that the convoy of care model should be used to study care networks of frail, older individuals. Care convoys are defined as the evolving collection of individuals who may or may not have close personal connections to the recipient or to one another, but who provide care, including help with activities of daily living (ADLs) and instrumental activities of daily living (IADLs), socio-emotional care, skilled health care, monitoring, and advocacy. This study reports on community-dwelling older adults’ experiences of their care convoy, how care convoys change over time, and perceived (positive) outcomes. A qualitative analysis among 65 semi-structured interviews with frail, community-dwelling older adults demonstrates a great variety in the composition of care convoys. Participants were often actively involved in their care convoy and valued the social/relational aspect of care. Care and support covered a wide range of activities, with some activities being provided by specific types of caregivers. Participants expressed the adequacy of their care convoy in terms of satisfaction and sufficiency. Noteworthy, participants who were satisfied with their care convoy did not necessarily receive sufficient help. Policies and practice should recognize the relational aspect of care, the complex interplay between all actors, and the dynamic character of care convoys.
Immune Checkpoint Inhibitor Use Near the End of Life Is Associated With Poor Performance Status, Lower Hospice Enrollment, and Dying in the Hospital
Authors: Glisch Chad , Hagiwara Yuya , Gilbertson-White Stephanie , Gao Yubo , Lyckholm Laurel 
Published: July 2019

Background: Immune checkpoint inhibitors have changed the landscape of cancer care by increasing progression-free and overall survival in some patients with cancer. We evaluated use and variables contributing to immune checkpoint inhibitor treatment near the end of life. Methods: We studied 157 patients who received immune checkpoint inhibitors and died between January 2015 and December 2018. All patients had a palliative care consult any time between starting an immune checkpoint inhibitor and death. Univariate and multivariate models were used to examine variables related to immune checkpoint inhibitor use near the end of life. Results: Among 157 patients studied, 42 (27%) received a dose of immune checkpoint inhibitor in the last 30 days of life. Those who received treatment in the last 30 days of life had lower hospice enrollment (19 [45%] vs 78 [69%], P = .007) and higher rates of dying in the hospital (23 [56%] vs 33 [29%], P = .002). The percentage of patients with Eastern Cooperative Oncology Group (ECOG) ≥3 at the time of last immune checkpoint inhibitor dose was higher in the group that received immune checkpoint inhibitor treatment in the last 30 days of life (11 [26%] vs 9 [8%], P = .003). Lack of traditional chemotherapy after immune checkpoint inhibitor, ECOG ≥3, and lack of hospice enrollment were independently associated with receiving immune checkpoint inhibitor in the last 30 days of life. Conclusion: Immune checkpoint inhibitor use in the last 30 days of life is common and associated with poor performance status, lower hospice enrollment, and dying in the hospital.