bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mental Health Stigma: Explicit and Implicit Attitudes of Canadian Undergraduate Students, Medical School Students, and Psychiatrists
Authors: Sandhu Harman S. , Arora Anish , Brasch Jennifer , Streiner David L. 
Published: July 2018

Objectives: To compare explicit and implicit stigmatizing attitudes towards mental illness among undergraduate students, medical school students, and psychiatrists, and to assess whether attitudes are associated with education level, exposure to, and personal experience with mental illness. Methods: Participants from McMaster University were recruited through email. Participants completed a web-based survey consisting of demographics; the Opening Minds Scale for Healthcare Providers (OMS-HC) 12-item survey, which measures explicit stigma; and an Implicit Association Test (IAT), measuring implicit bias toward physical illness (diabetes mellitus) or mental illness (schizophrenia). Results: A total of 538 people participated: undergraduate students ( n = 382), medical school students ( n = 118), and psychiatrists ( n = 38). Psychiatrists had significantly lower explicit and implicit stigma than undergraduate students and medical school students. Having been diagnosed with mental illness or having had a relationship with someone experiencing one was significantly associated with lower explicit stigma. Mean scores on the OMS-HC “disclosure/help-seeking” subscale were higher compared with the “attitudes towards people with mental illness” subscale. There was no correlation between the OMS-HC and IAT. Conclusions: These findings support the theory that increased education and experience with mental illness are associated with reduced stigma. Attitudes regarding disclosure/help-seeking were more stigmatizing than attitudes towards people with mental illness. The groups identified in this study can potentially benefit from anti-stigma campaigns that focus on reducing specific components of explicit, implicit, public and self-stigma.
Be like water: a personal strategy for clinical psychiatric research
Authors: Looi Jeffrey CL 
Published: July 2018

Objectives: This paper describes, from the personal perspective of a mid-career researcher, principles and advice regarding the development of an embedded clinical psychiatric research program within a medical school and public sector mental health service. From this experience, some general principles are drawn. Conclusions: Through careful strategic planning, together with collaboration with the mental health service, it is possible to bootstrap and develop an embedded clinical research program.
A comparison of Indigenous and non-Indigenous users of MindSpot: an Australian digital mental health service
Authors: Titov Nickolai , Schofield Carlie , Staples Lauren , Dear Blake F , Nielssen Olav 
Published: July 2018

Objective: To report on Aboriginal and Torres Strait Islander (Indigenous) users of MindSpot, a national service for the remote assessment and treatment of anxiety and depression. Methods: The characteristics and treatment outcomes of Indigenous patients who registered with MindSpot between January 2015 and December 2016, were compared with non-Indigenous users. Changes in psychological distress, depression and anxiety were measured using the Kessler 10-Item (K-10), Patient Health Questionnaire 9-Item (PHQ-9), and Generalised Anxiety Disorder Scale 7-Item (GAD-7), respectively. Results: Of 23,235 people who completed a MindSpot assessment between 1 January 2015 and 31 December 2016, 780 (3.4%) identified as Indigenous Australian. They had higher symptom scores, were more likely to live in a remote location, and a third reported no previous contact with mental health services. Fewer Indigenous patients enrolled in a treatment course, but those who did had similar rates of completion and similar reductions in symptoms to non-Indigenous patients. Conclusions: MindSpot treatments were effective in treating anxiety and depression in Indigenous Australians, and outcomes were similar to those of non-Indigenous patients. Services like MindSpot are a treatment option that can help overcome barriers to mental health care for Indigenous Australians.
Revising the Royal Australian and New Zealand College of Psychiatrists code of ethics
Authors: Bloch Sidney , Kenn Felicity , Smith Geoffrey 
Published: July 2018

Objectives: To describe the process adopted by the Committee for Professional Practice (CPP) of the Royal Australian and New Zealand College of Psychiatrists (RANZCP) in devising the 5th edition of its code of ethics and to outline principal changes. Methods: CPP members planned, scrutinised and documented the steps taken in preparing the new edition. Results: The process, following that used in all previous updates of the code and which had proved effective and productive on each occasion, comprised consultations with RANZCP committees and relevant external stakeholders. Canvasing the views of so many groups was regarded as essential to ensure that multiple perspectives were considered and any bias of the CPP avoided. The United Nations Convention on the Rights of Persons with Disabilities (CRPD) was examined with two aims: promoting a robust clinician and patient partnership, and acknowledging the psychiatrist’s advocacy role. The psychiatrist’s duty to be alert to colleagues’ wellbeing and to safeguard respectful professional relationships was highlighted. Conclusions: A comprehensive, rigorous and established review process occurred and was carefully documented resulting in a sound and contemporary revision of the code of ethics. RANZCP members will be duty-bound to adhere to, and apply, the code to optimise their ethical standards.
Comparison of Visual Analog Pain Score Reported to Physician vs Nurse in Nonoperatively Treated Foot and Ankle Patients
Authors: Martin Kevin D. , McBride Trevor , Wake Jeffrey , Van Buren Jeffrey Preston , Dewar Cuyler 
Published: July 2018

Background: Patient-reported outcome measures (PROMs) are taking a more prominent role in orthopedics as health care seeks to define treatment outcomes. The visual analog scale (VAS) is considered a reliable measure of acute pain. A previous study found that operative candidates’ VAS pain score was significantly higher when reported to the surgeon compared to the nurse. This study’s aim is to examine whether this phenomenon occurs in patients that do not undergo an operative procedure. We hypothesized that patients’ VAS pain scores reported to the surgeon vs the nurse would be the same. Methods: This study is a retrospective cohort of 201 consecutive nonoperative foot and ankle patients treated by a single surgeon. Patients were asked to rate pain intensity by a nurse followed by the surgeon using a horizontal VAS, 0 “no pain” to 10 “worst pain.” Differences in reported pain levels were compared with data from the previous cohort of 201 consecutive operative foot and ankle patients. Results: The mean VAS score reported to the nurse was 3.2 whereas the mean VAS score reported to the surgeon was 4.2 ( P < .001). The mean difference in VAS scores reported for operative patients was 2.9, whereas the mean difference for nonoperative patients was 1.0 ( P < .001). Conclusion: This study found statistically significant differences between VAS pain scores reported to the surgeon vs the nurse in nonoperative patients. These results support the trend found in our previous study, where operative patients reported significantly higher pain scores to the surgeon vs the nurse. The mean difference between reported pain scores was significantly higher for operative patients compared to nonoperative patients. Level of Evidence: Level III, comparative study.
Randomized Controlled Trial of Micronized Dehydrated Human Amnion/Chorion Membrane (dHACM) Injection Compared to Placebo for the Treatment of Plantar Fasciitis
Authors: Cazzell Shawn , Stewart Jordan , Agnew Patrick S. , Senatore John , Walters Jodi , Murdoch Douglas , Reyzelman Alex , Miller Stuart D. 
Published: July 2018

Background: Failure of conservative management to reduce/eliminate symptoms of plantar fasciitis (PF) may indicate need for advanced treatments. This study reports Level 1 evidence supporting 3-month safety and efficacy of micronized dehydrated human amnion/chorion membrane (dHACM) injection as a treatment for PF. Methods: A prospective, single-blind, randomized controlled trial was conducted at 14 sites in the United States. Subjects were randomized to receive 1 injection, in the affected area, of micronized dHACM (n=73) or 0.9% sodium chloride placebo (n=72). Safety/efficacy assessments were conducted at 4 weeks, 8 weeks, 3 months, 6 months, and 12 months postinjection, using visual analog scale (VAS) for pain, Foot Function Index–Revised (FFI-R) score, and presence/absence of adverse events. Primary outcome was mean change in VAS score between baseline and 3 months expressed as difference in means for treatment versus control subjects. Secondary outcome was mean change in FFI-R score between baseline and 3 months expressed as difference in means for treatment versus control subjects. Results: Baseline VAS scores were similar between groups. At the 3-month follow-up, mean VAS scores in the treatment group were 76% lower compared with a 45% reduction for controls ( P < .0001), FFI-R scores for treatment subjects had mean reduction of 60% versus baseline, whereas control subjects had mean reduction of 40% versus baseline ( P = .0004). Of 4 serious adverse events, none were related to study procedures. Conclusion: Pain reduction and functional improvement outcomes were statistically significant and clinically relevant, supporting use of micronized dHACM injection as a safe and effective treatment for PF. Level of Evidence: Level I, prospective randomized trial.
Long-lasting response with polycythemia to third-line axitinib treatment in metastatic renal cell carcinoma: Very rare case presentation
Authors: Dulgar Ozgecan , Cil Ibrahim , Zirtiloglu Alisan , Tural Deniz 
Published: July 2018

Introduction Clear cell renal cell carcinoma is characterized by mutation or inactivation of Von Hippel-Lindau suppressor gene. The mutation of Von Hippel-Lindau mechanism is associated with the upregulation of the hypoxia-inducible factor protein, inducing the overexpression of proteins including erythropoietin and vascular endothelial growth factor. Vascular endothelial growth factor receptor-targeted tyrosine kinase inhibitors are widely used in treatment of metastatic renal cell carcinoma. In paradoxical hematological effect with tyrosine kinase inhibitor therapies, hemoglobin level may be increased, but polycythemia requiring phlebotomy is very rare. Case description We present here a case of renal cell carcinoma who received successive treatment with sunitinib, everolimus, and axitinib. While he had a normal hemoglobin level with prior sunitinib treatment, on the sixth week of axitinib treatment, he developed polycythemia and treatment response was seen after axitinib-associated polycythemia. Conclusion Progression-free survival (PFS) was 30 months in our case with third-line treatment axitinib. Higher hemoglobin levels may be associated with longer survival. Polycythemia was the first response to treatment of axitinib in our patient. It may be an indicator of persistent treatment response.
Autopsy Patients With Obesity or Metabolic Syndrome as Basic Cause of Death: Are There Pathological Differences Between These Groups?
Authors: Gonçalves Lucas Braz , Miot Helio Amante , Domingues Maria Aparecida Custódio , Oliveira Cristiano Claudino 
Published: July 2018

Background: The objectives of this study were the evaluation of pathological characteristics of patients with obesity or metabolic syndrome (MS) as basic cause of death, associating the autopsy findings with some clinical aspects and the abdominal adipose panicle thickness. Methods: A total of 88 autopsy cases were studied, divided into 2 groups based on the main cause of death: group 1 (n = 15) obesity and group 2 (n = 73) MS. Clinical summaries of autopsy requests, macroscopic findings, and histologic sections were reviewed. Results: The definition of obesity as the basic cause of death is associated with larger thickness of the abdominal adipose panicle, being 8.5 cm ( P = .001) the best measurement, according to the receiver operating characteristic curve. Hypertensive cardiopathy ( P = .001), ischemic cardiopathy ( P = .003), coronary ( P = .008)/systemic ( P = .005) atherosclerosis, and arterial ( P = .014)/arteriolar ( P = .027) nephrosclerosis are associated with the diagnosis of MS. Steatohepatitis is associated with the diagnosis of obesity ( P = .030); however, its association with the thickness of the abdominal adipose panicle is not statistically significant ( P = .211). Conclusions: In the context of an obese patient in autopsy, pathologist may use the information about abdominal adipose panicle associated with heart, kidney, and liver findings, even macroscopic ones, to decide the basic cause death between obesity and MS.
(Re)writing woman: Unshaming shame with Cixous
Authors: Beavan Katie 
Published: July 2018

shame. shamed. shameful. body. my body. practitioner’s body. scholar’s body. female body. affect. embodied affects. blushing. shrinking. averting my gaze. feeling shame. writing shame. féminine writing. feminist writing shame. ruptured by Cixous. blood. blood staining page. blood flows. unpleasant. unruly. uncontained. performing writing. writing performing. performative. performing shame. ethical moment. ethical resistance. resisting agency. my agency. movement through shame to the other. (re)finding you, my body, our bodies, love, loving, cor-po-real gen-er-os-ity, feeling joy, feeling scholarship, leaky bodies, our bodies, not knowing, not ever knowing, Cixous, feeling scholarship, féminine writing, joy, JOUISSANCE,living differently in organizations, our organizations, nourishing milk, uncontained, connected, connecting, féminine, feminist, flowing
Developing dementia: The existential experience of the quality of life with young-onset dementia – A longitudinal case study
Authors: Thorsen Kirsten , Dourado Marcia Cristina Nascimento , Johannessen Aud 
Published: July 2018

BackgroundCognition and the ability to take care of daily activities and oneself gradually declines among people with dementia. Studies are scarce, especially regarding how people with young-onset dementia (YOD) (<65 years) experience the quality of their lives with the progression of dementia. People with dementia living alone face special challenges.AimTo examine the experience of the quality of life with YOD as a single person.MethodThe study presents a longitudinal case study with in-depth interviews exploring the experiences of a person with YOD. Individual interviews were conducted seven times over a period of three years from 2014 to 2017.FindingsWe examined if and how seven themes concerning the quality of life and well-being were fruitful for understanding the experiences of dementia in the everyday life of a single individual. The study explored needs and challenges during the development of dementia, and how the person reacted over time, set in context. The themes significant for well-being are: identity, connectedness, security, autonomy, meaning, growth and joy.ConclusionThe study shows how treatment, support, and services must be individualized when dementia develops in order to support identity, resources and mastering capacity, and promote well-being.
The impact of risk factor trends on intracerebral hemorrhage incidence over the last two decades—The Tromsø Study
Authors: Carlsson Maria , Wilsgaard Tom , Johnsen Stein Harald , Johnsen Liv-Hege , Løchen Maja-Lisa , Njølstad Inger , Bøgeberg Mathiesen Ellisiv 
Published: July 2018

Background Studies on the relationship between temporal trends in risk factors and incidence rates of intracerebral hemorrhage are scarce. Aims To analyze temporal trends in risk factors and incidence rates of intracerebral hemorrhage using individual data from a population-based study. Methods We included 28,167 participants of the Tromsø Study enrolled between 1994 and 2008. First-ever intracerebral hemorrhages were registered through 31 December 2013. Hazard ratios (HRs) for intracerebral hemorrhage were analyzed by Cox proportional hazards models, risk factor levels over time by generalized estimating equations, and incidence rate ratios (IRR) by Poisson regression. Results We registered 219 intracerebral hemorrhages. Age, male sex, systolic blood pressure (BP), diastolic BP, and hypertension were associated with intracerebral hemorrhage. Hypertension was more strongly associated with non-lobar intracerebral hemorrhage (HR 5.08, 95% CI 2.86–9.01) than lobar intracerebral hemorrhage (HR 1.91, 95% CI 1.12–3.25). In women, incidence decreased significantly (IRR 0.46, 95% CI 0.23–0.90), driven by a decrease in non-lobar intracerebral hemorrhage. Incidence rates in men remained stable (IRR 1.27, 95% CI 0.69–2.31). BP levels were lower and decreased more steeply in women than in men. The majority with hypertension were untreated, and a high proportion of those treated did not reach treatment goals. Conclusions We observed a significant decrease in intracerebral hemorrhage incidence in women, but not in men. A steeper BP decrease in women may have contributed to the diverging trends. The high proportion of untreated and sub-optimally treated hypertension calls for improved strategies for prevention of intracerebral hemorrhage.
Acute renal failure in an adult cat following oral administration of fosfomycin
Authors: Sakai Yohei , Yoshida Toshinori , Shibutani Makoto , Ohmori Keitaro 
Published: July 2018

Case summary A spayed female mixed breed cat of unknown age (presumably more than 9 years old), weighing 2.9 kg, was presented with a 4 day history of lethargy, anorexia and vomiting following oral administration of calcium fosfomycin (20 mg/kg q12h). A serum biochemical analysis revealed a dramatic increase in the levels of blood urea nitrogen (>140 mg/dl) and creatinine (15.3 mg/dl), and hypercalcaemia (13.1 mg/dl), hyperphosphataemia (13.3 mg/dl) and hyperkalaemia (6.1 mmol/l). The cat was hospitalised and treated with infusion therapy. However, the renal function and clinical signs did not improve with any treatment. The cat was euthanased upon the owner’s request. Histopathological analysis of the kidneys revealed acute tubular necrosis in the cortex. Relevance and novel information The present case report provides, for the first time, clinical and histopathological evidence for acute renal failure induced by oral administration of fosfomycin in an adult cat. It is highly advisable that fosfomycin should not be used in either young or adult cats.
Quality of Life in Patients Undergoing Spine Surgery: Systematic Review and Meta-Analysis
Authors: Nayak Nikhil R. , Stephen James H. , Piazza Matthew A. , Obayemi Adetokunbo A. , Stein Sherman C. , Malhotra Neil R. 
Published: July 2018

Study Design: Meta-analysis. Objective: Despite the increasing importance of tracking clinical outcomes using valid patient-reported outcome measures, most providers do not routinely obtain baseline preoperative health-related quality of life (HRQoL) data in patients undergoing spine surgery, precluding objective outcomes analysis in individual practices. We conducted a meta-analysis of pre- and postoperative HRQoL data obtained from the most commonly published instruments to use as reference values. Methods: We searched PubMed, EMBASE, and an institutional registry for studies reporting EQ-5D, SF-6D, and Short Form-36 Physical Component Summary scores in patients undergoing surgery for degenerative cervical and lumbar spinal conditions published between 2000 and 2014. Observational data was pooled meta-analytically using an inverse variance-weighted, random-effects model, and statistical comparisons were performed. Results: Ninety-nine articles were included in the final analysis. Baseline HRQoL scores varied by diagnosis for each of the 3 instruments. On average, postoperative HRQoL scores significantly improved following surgical intervention for each diagnosis using each instrument. There were statistically significant differences in baseline utility values between the EQ-5D and SF-6D instruments for all lumbar diagnoses. Conclusions: The pooled HRQoL values presented in this study may be used by practitioners who would otherwise be precluded from quantifying their surgical outcomes due to a lack of baseline data. The results highlight differences in HRQoL between different degenerative spinal diagnoses, as well as the discrepancy between 2 common utility-based instruments. These findings emphasize the need to be cognizant of the specific instruments used when comparing the results of outcome studies.
Non-Operative Management of Femoroacetabular Impingement: A Prospective Study
Authors: Pennock Andrew T. , Bomar James D. , Parvanta Kristina , Upasani Vidyadhar Vinayak 
Published: July 2018

Objectives: Little attention has been given to the non-operative management of femoroacetabular impingement (FAI) in the literature despite a rapidly expanding body of research on the topic. The purpose of the current project was to perform a prospective study utilizing a non-operative protocol on a consecutive series of patients presenting to our clinic with FAI. Methods: Between 2013 and 2016, patients referred to our clinic for hip pain that had a positive impingement sign were prospectively recruited in a non-operative FAI study. The protocol consisted of an initial trial of rest, physical therapy, and activity modification with a focus on avoidance of high hip flexion (Activity Mod group). Patients who remained symptomatic were then treated with an image-guided intra-articular steroid injection (Injection group). Patients with residual symptoms were then offered arthroscopic treatment (Surgery group). Outcome scores were collected at 12 and 24 months. Statistical analysis was performed to identify risk factors for failure of non-operative treatment. Results: 129 symptomatic hips in 100 patients were enrolled. After our exclusion criteria were applied, 110 hips in 84 patients remained with a mean follow-up of 25.5 months. Eighty-one hips (73.6%) were managed with PT, rest, and activity modification alone. Thirteen hips (11.8%) required a steroid injection, but did not progress to surgery. Sixteen hips (14.5%) required arthroscopic management. All three groups saw similar improvements in modified Harris hip score (mHHS)(p=0.706) and non-arthritic hips score (NAHS)(p=0.712). Initial, and most recent, mHHS and NAHS can be found in Table 1. Labral tears were distributed similarly among the three groups (n=41, p=0.09) and saw similar improvements in outcomes (p>0.5) as hips without labral tears. The surgical patients attempted non-operative treatment for a mean of 8.8 months prior to surgical intervention. Delays in surgery were not associated with worse outcomes. Cam lesion size, acetabular coverage, and the presence of a labral tear were not associated with non-operative treatment failure (p=0.579). Conclusion: A large majority of adolescent patients presenting with FAI can be managed nonoperatively with significant improvements in outcomes scores and continuation of sport at a mean follow up of two years. This is the first prospective study evaluating the outcomes of a standardized non-operative protocol for the management of FAI. Our results show that a commitment to non-operative care can work for a large percentage of patients. We will be following these patients further into the future to examine the durability of these results. [Table: see text]