bluuebunny/crossref_metadata_2025_split huggingface dataset:
Oral Medications
Authors: Burger Rebecca K. , Jain Shobhit 
Published: January 2019

Abstract
Midazolam, the most commonly used oral sedative in children, is used primarily as a premedication but can also be beneficial in brief, minimally invasive procedures, with few side effects. Ketamine can be used for brief, painful procedures but can cause vomiting. Dexmedetomidine can be used as a premedication but has not been extensively studied. Chloral hydrate is useful for imaging studies and noninvasive procedures but is limited by its prolonged sedative effects. Melatonin can be used for sedation and anxiolysis for imaging and noninvasive testing, but there is conflicting literature about its analgesic effects. There are limited studies on the use of meperidine and hydroxyzine for dental procedures. Ketamine and dexmedetomidine intravenous preparations have been administered enterally. Melatonin and clonidine are enteral medications that may prove useful in pediatric procedural sedation. In general, enteral administration is associated with preprocedural anxiolysis, uneven bioavailability, and unpredictable onset of action and recovery times.
Topical and Local Anesthetics
Authors: Vinson Amy E. , Houck Constance S. 
Published: January 2019

Abstract
Local anesthesia is an important part of pediatric procedural sedation. Not only does it allow for pain reduction during intravenous catheter placement, but it can also reduce the total amount of sedation that is required during painful procedures and minimize the need for postoperative analgesia. This chapter outlines the historical aspects of topical local anesthetic use in children. The benefits and risks of topical and subcutaneous local anesthetics during procedural sedation are reviewed. While the topical use of local anesthetics is generally safe, careful titration of dosage based on the patient’s age and weight and the drug’s side-effect profile is important to prevent toxicity. Current recommendations for the treatment of local anesthetic systemic toxicity are provided.
Nursing Perspective
Authors: Rhoads Michelle M. , Briening Eileen , Crego Nancy , Paula-Santos Kimberly , Huster Lauren 
Published: January 2019

Abstract
The nursing process can be used in the safe and effective delivery of pediatric sedation care. Nurses contribute to the direct care of sedated patients by developing competency and expanding knowledge and expertise within their specialty. While the provision of care to patients and families is of paramount importance, ensuring an environment conducive to delivery of safe, quality care by the healthcare team is another fundamental aspect of nursing. Management of sedation, analgesia, and anxiety in pediatric procedural sedation is an intrinsically multidisciplinary process that involves nursing, physicians, child life specialists, and other healthcare providers. In general, pediatric procedural sedation is a relatively new specialty with limited data on the role of the pediatric nurse in this multiprofessional team. It is an opportunity for nursing to collaborate with other healthcare professionals to establish guidelines and protocols to facilitate optimal patient care and efficiency as well as to share and expand their knowledge base and clinical skill set. Specialty certification and credentialing, team concept values, and the evolving role of the sedation nurse are all elements to consider within pediatric procedural sedation from the nursing perspective.
Society Guidelines
Authors: Tirodker Urmila 
Published: January 2019

Abstract
In the past several decades the practice of procedural sedation and analgesia has evolved into a distinct skill set and a service that has rapidly grown in terms of indications, need, practitioner types, and practice settings. The scope of non-anesthesiology sedation providers includes but is not limited to intensivists, emergency medicine physicians, hospitalists, dentists, gastroenterologists, pulmonologists, cardiologists, advanced practice providers, and nursing. Several subspecialty societies and regulatory institutions have published and revised guidelines and standards to enhance patient safety by standardizing various aspects related to patient evaluation, personnel, monitoring, and management of procedural sedation and analgesia and its recovery. The American Academy of Pediatrics, American Society of Anesthesiologists, and the American College of Emergency Physicians are the groups that have published the most widely disseminated, comprehensive guidelines. This chapter gives an overview of these societies’ guidelines.
Hospital and Professional Reimbursement
Authors: Banks David , Werner David 
Published: January 2019

Abstract
The sustainability of a sedation service depends on its ability to generate revenue, both for the providers and for the facility/institution. A complete understanding of the process of coding and billing to achieve maximum reimbursement is necessary for planning a new sedation service, as well as maintaining and expanding an existing one. This section discusses CPT coding and billing for deep sedation, moderate sedation, provider consulting, and facility fees. Coding and billing for deep sedation involves using CPT codes for anesthesia services. Coding and billing for moderate sedation involves the use of the moderate sedation CPT codes that were updated for 2017. Coding and billing for hospital services associated with providing deep sedation involves the use of facility revenue codes.
Quality Improvement in Pediatric Sedation
Authors: Krishna Ashwin , Landers Cheri 
Published: January 2019

Abstract
Pediatric sedation programs benefit from tracking quality metrics and implementing processes to improve the sedation experience. Quality, safe pediatric sedation care involves well-organized, educated teams that track outcomes and constantly review events and situations that need improvement. This requires a multidisciplinary approach, an effort to decrease waste in terms of time and human resources, a focus on equitable care for all patients, and efforts to tailor care to the specific needs of the individual. Tracking appropriate metrics and making changes to pediatric sedation practice and process in order to maintain benchmarks and improve current practice can help institutions improve the quality of the sedation experience for patients, families, and providers. Pediatric sedation programs, regardless of resources, provider type, or institutional constraints, will benefit from using data to create processes that correctly identify and address obstacles to high-quality sedation care.
What Is Personality?
Authors: Svrakic Dragan M. , Divac-Jovanovic Mirjana 
Published: January 2019

Abstract
This chapter reviews the neuroscience of brain and mind development. Recent advances in cognitive neuroscience, such as the concept of nonconscious working memory, support the psychanalytic concept of early object relations, which are believed to be the “elementary particles of the mind”: each contains a percept, a self-reflection, and the related affect and thus is not divisible to lower order units of mental experience. The functional brain networks giving rise to mental faculties (cognition, motivation, and emotions) are informed by these highly personal units of experience. Such “personalized” mental faculties self-organize into semistable subsystems within the mind, each providing a specific adaptive advantage to the mind as a whole. The impact of sociocultural transitions on human mental life, as well as the concepts of normal, postmodern, and fluid self in the context of conservativism, postmodernism, and liquid modernity, are discussed in detail.
Some Psychological Effects of Changing Public Attitudes on U.S. Vietnam Veterans
Authors: Dohrenwend Bruce P. , Murphy Eleanor , Yager Thomas J. , Hatch Stephani L. 
Published: January 2019

Abstract
This chapter discusses the substantial effect that changing public attitudes toward the Vietnam war had both on veterans’ own attitudes toward the war and on demoralization in the U.S. armed forces toward the end of the war. In addition, as hypothesized, veterans’ negative attitudes at the time of their own entrances and exits from Vietnam, and negative changes in veterans’ initially favorable attitudes, were related to the period of the war in which they served and positively associated with demoralization. Because measurement of veterans’ attitudes toward the war at their entrance and exit occurred long after their service in Vietnam, it is possible that memory distortions played a role in these findings. However, the data indicate that retrospective bias cannot account for the differences in declining favorable and increasing negative attitudes toward the war related to veterans’ time of war entry.
Sacral Endplate Penetrating Screw for Lumbosacral Fixation: A Cadaveric Biomechanical Study
Authors: Grigoryan Grigor , Inceoglu Serkan , Danisa Olumide A , Cheng Wayne 
Published: January 2019

AbstractBACKGROUNDCortical bone trajectory is a relatively new alternative for instrumentation of the lumbar spine. When performing lumbosacral instrumentation, a novel S1 endplate penetrating screw (EPS) has been recently shown to have higher insertional torque than the traditional trajectory screw, but the biomechanical properties of this new trajectory are yet to be verified with the cadaveric studies.OBJECTIVETo evaluate 2 screw trajectories in sacra using cyclic loading and pullout tests, and to determine whether bone quality had different effects on the 2 trajectories.METHODSNine cadaveric sacra were used, 5 of which had normal bone mineral density (BMD) and 4 were osteoporotic. Each side of the sacra was randomly assigned to either EPS trajectory or S1-alar screw (S1AS) trajectory. Each screw then underwent cyclic loading followed by pullout force measurement. A mixed-design 2 way ANOVA test was used to detect differences between the groups.RESULTSThe EPS group had less relative rotation at the bone–screw interface during cyclic loading than the S1AS group (P = .016) regardless of bone quality. The pullout force following the cyclic loading was significantly higher in the EPS group (2349 ± 838 N) than the S1AS group (917 ± 909 N) in normal bone (P < .0001). The difference was more pronounced in osteoporotic bone with the EPS (1075 ± 216 N) compared to the S1AS (365 ± 422 N;P < .0001).CONCLUSIONThe S1 EPS trajectory is significantly more stable against loosening and has a higher pullout force compared to the S1AS trajectory. The difference between the 2 trajectories is more pronounced in osteoporotic bone.
Building a Bridge to the Community: An Integrated Knowledge Translation Approach to Improving Participation in Community-Based Exercise for People After Stroke
Authors: Bird Marie-Louise , Mortenson B William , Chu Francis , Acerra Nicole , Bagnall Eric , Wright Angela , Hayley Karen , Yao Jennifer , Eng Janice J 
Published: January 2019

Abstract

Background
People who have had a stroke and are living in the community have low levels of physical activity, which reduces their functional capacity and increases risks of developing secondary comorbid conditions. Exercise delivered in community centers can address these low levels of physical activity; however, implementing evidence-based programs to meet the needs of all community stakeholders is challenging.

Objectives
The objective of this study was to determine implementation factors to facilitate participation in relevant exercise and physical activity for people with chronic health conditions, like stroke.

Design
The design consisted of a qualitative observational study using an integrated knowledge translation approach.

Methods
Supported by an integrated knowledge translation approach, a series of focus groups—with stakeholder group representation that included people who had had a stroke and care partners, community organizations (ie, support groups, community center staff), health care providers, and exercise deliverers—was conducted. During the focus groups, participants provided perspectives on factors that could influence implementation effectiveness. Focus groups were recorded, transcribed, and thematically analyzed.

Results
Forty-eight stakeholders participated. Based on the themes, a new implementation model that describes the importance of relationships between community centers, clinicians, and people who have had a stroke is proposed. The development of partnerships facilitates the implementation and delivery of exercise programs for people with ongoing health needs. These partnerships address unmet needs articulated in the focus groups and could fill a gap in the continuity of care.

Conclusions
Data from this study support the need for the community sector to offer a continuing service in partnership with the health system and people with chronic health needs. It indicates the potential of clinicians to partner with people with chronic health conditions and empower them to improve participation in relevant health behaviors, like community-based exercise.
Survey Research
Authors: Story David A. , Tait Alan R. 
Published: January 2019

Abstract

SUMMARY
Surveys provide evidence on practice, attitudes, and knowledge. However, conducting good survey research is harder than it looks. The authors aim to provide guidance to both researchers and readers in conducting and interpreting survey research. Like all research, surveys should have clear research question(s) using the smallest possible number of high-quality, essential, survey questions (items) that will interest the target population. Both researchers and readers should put themselves in the position of the respondents. The survey questions should provide reproducible results (reliable), measure what they are supposed to measure (valid), and take less than 10 min to answer. Good survey research reports provide results with valid and reliable answers to the research question with an adequate response rate (at least 40%) and adequate precision (margin of error ideally 5% or less). Possible biases among those who did not respond (nonresponders) must be carefully analyzed and discussed. Quantitative results can be combined with qualitative results in mixed-methods research to provide greater insight.
Characterizing the Natural History of Acute Radiation Syndrome of the Gastrointestinal Tract: Combining High Mass and Spatial Resolution Using MALDI-FTICR-MSI
Authors: Carter Claire L. , Hankey Kim G. , Booth Catherine , Tudor Gregory L. , Parker George A. , Jones Jace W. , Farese Ann M. , MacVittie Thomas J. , Kane Maureen A. 
Published: January 2019

AbstractThe acute radiation syndrome of the gastrointestinal tract has been histologically characterized, but the molecular and functional mechanisms that lead to these cellular alterations remain enigmatic. Mass spectrometry imaging is the only technique that enables the simultaneous detection and cellular or regional localization of hundreds of biomolecules in a single experiment. This current study utilized matrix-assisted laser desorption/ionization mass spectrometry imaging for the molecular characterization of the first natural history study of gastrointestinal acute radiation syndrome in the nonhuman primate. Jejunum samples were collected at days 4, 8, 11, 15, and 21 following 12-Gy partial-body irradiation with 2.5% bone marrow sparing. Mass spectrometry imaging investigations identified alterations in lipid species that further understanding of the functional alterations that occur over time in the different cellular regions of the jejunum following exposure to high doses of irradiation. Alterations in phosphatidylinositol species informed on dysfunctional epithelial cell differentiation and maturation. Differences in glycosphingolipids of the villi epithelium that would influence the absorptive capacity and functional structure of the brush border membrane were detected. Dichotomous alterations in cardiolipins indicated altered structural and functional integrity of mitochondria. Phosphatidylglycerol species, known regulators of toll-like receptors, were detected and localized to regions in the lamina propria that contained distinct immune cell populations. These results provide molecular insight that can inform on injury mechanism in a nonhuman primate model of the acute radiation syndrome of the gastrointestinal tract. Findings may contribute to the identification of therapeutic targets and the development of new medical countermeasures.
Chinese Children's Experience When the Mother Has Breast Cancer
Authors: Huang Xiaoyan , Lee Susan , Hu Yan , Gao Hongyun , O'Connor Margaret 
Published: January 2019

Background
A large number of women with breast cancer may have children younger than 18 years. When the mother has breast cancer, children may experience various concerns.

Objective
The aim of this study was to explore Chinese children's experience when confronted with maternal breast cancer from the perspectives of both children and their mothers.

Methods
Forty mothers with breast cancer were interviewed individually to talk about the experience of their children. In addition, 8 children aged 8 to 18 years were interviewed directly to share their experience, and 6 of them drew pictures to express their feelings.

Results
Six themes were identified: “They were discussing it”—being informed of maternal breast cancer; “What about me if my mother dies?”—children's feelings and concerns; “Grandmother took care of me”—impact on daily life; “Mother did not smile anymore”—impact on mother and family; “I am happy to help”—pleasing their mother; and “I did not tell others”—hiding emotions.

Conclusions
When their mother was diagnosed with breast cancer, Chinese children experienced various negative feelings, although their daily life was not profoundly affected because of grandparents' help. However, children's concerns may be underestimated by their mothers. Fathers and grandparents also played an important role in the interactions with children.

Implications for Practice
Mothers in China need to understand their children's reactions in order to help them cope with the illness. Children's experiences should be further explored. The understanding of children from the perspectives of fathers and grandparents also requires further research.
Single Intra-articular Platelet-Rich Plasma Versus Corticosteroid Injections in the Treatment of Adhesive Capsulitis of the Shoulder
Authors: Barman Apurba , Mukherjee Somnath , Sahoo Jagannatha , Maiti Rituparna , Rao Parnandi Bhaskar , Sinha Mithilesh Kumar , Sahoo Dibyajyoti , Tripathy Sujit Kumar , Patro Binod Kumar , Bag Nerbadyswari Deep 
Published: January 2019

Objective
The aim of the study was to compare the effects of single intra-articular platelet-rich plasma (PRP) and corticosteroid (CS) injections in patients with adhesive capsulitis of the shoulder.

Design
Patients aged 18–70 yrs of either sex, diagnosed with adhesive capsulitis of shoulder, with less than 6-mo duration, were included. In intra-articular corticosteroid (IA-CS, control) group, 30 patients received a single injection (4 ml) of IA-CS and in IA-PRP (test) group, 30 patients received single IA-PRP injection (4 ml) into the glenohumeral joint under ultrasound guidance. All patients were prospectively followed for 12 wks.

Results
Twenty-eight patients in IA-PRP group and 27 in IA-CS group finished the entire 12-wk study period. At 12 wks, decrements in visual analog scale and total shoulder pain and disability index scores, in IA-PRP group, were 58.4 and 55.1, compared with 48.7 and 45.8 in IA-CS group. In range of movement, IA-PRP group showed significant improvement in passive abduction (−50.4 vs. −39.4), internal (−36.8 vs. −25.8), and external rotations (−35.4 vs. −25.9) compared with IA-CS group, respectively. No major complications were observed in any patients.

Conclusions
At 12-wk follow-up, a single dose of IA-PRP injection was found to be more effective than an IA-CS injection, in terms of improving pain, disability, and shoulder range of movement in patients with adhesive capsulitis of the shoulder.
Male sexual signal predicts phenotypic plasticity in offspring: implications for the evolution of plasticity and local adaptation
Authors: Kelly Patrick W. , Pfennig David W. , de la Serna Buzón Sofia , Pfennig Karin S. 
Published: January 2019

In a rapidly changing world, understanding the processes that influence a population's ability to respond to natural selection is critical for identifying how to preserve biodiversity. Two such processes are phenotypic plasticity and sexual selection. Whereas plasticity can facilitate local adaptation, sexual selection potentially impedes local adaptation, especially in rapidly changing or variable environments. Here we hypothesize that, when females preferentially choose males that sire plastic offspring, sexual selection can actually facilitate local adaptation to variable or novel environments by promoting the evolution of adaptive plasticity. We tested this hypothesis by evaluating whether male sexual signals could indicate plasticity in their offspring and, concomitantly, their offspring's ability to produce locally adapted phenotypes. Using spadefoot toads (Spea multiplicata) as our experimental system, we show that a male sexual signal predicts plasticity in his offspring's resource-use morphology. Specifically, faster-calling males (which are preferred by females) produce more plastic offspring; such plasticity, in turn, enables these males' offspring to respond adaptively to the spadefoots’ highly variable environment. The association between a preferred male signal and adaptive plasticity in his offspring suggests that female mate choice can favour the evolution and maintenance of phenotypic plasticity and thereby foster adaptation to a variable environment.This article is part of the theme issue ‘The role of plasticity in phenotypic adaptation to rapid environmental change’.