bluuebunny/crossref_metadata_2025_split huggingface dataset:
Personality traits and diabetes incidence among postmenopausal women
Authors: Luo Juhua , Manson JoAnn E. , Weitlauf Julie C. , Shadyab Aladdin H. , Rapp Stephen R. , Garcia Lorena , Jonasson Junmei M. , Tindle Hilary A. , Nassir Rami , Wactawski-Wende Jean , Hendryx Michael 
Published: January 2019

AbstractObjective:We examined whether personality traits, including optimism, ambivalence over emotional expressiveness, negative emotional expressiveness, and hostility, were associated with risk of developing type 2 diabetes (hereafter diabetes) among postmenopausal women.Methods:A total of 139,924 postmenopausal women without diabetes at baseline (between 1993 and 1998) aged 50 to 79 years from the Women's Health Initiative were prospectively followed for a mean of 14 (range 0.1-23) years. Multivariable Cox proportional hazards regression models were used to assess associations between personality traits and diabetes incidence adjusting for common demographic factors, health behaviors, and depressive symptoms. Personality traits were gathered at baseline using questionnaires. Diabetes during follow-up was assessed via self-report of physician-diagnosed treated diabetes.Results:There were 19,240 cases of diabetes during follow-up. Compared with women in the lowest quartile of optimism (least optimistic), women in the highest quartile (most optimistic) had 12% (hazard ratio [HR], 0.88; 95% confidence interval [CI]: 0.84-0.92) lower risk of incident diabetes. Compared with women in the lowest quartile for negative emotional expressiveness or hostility, women in the highest quartile had 9% (HR, 1.09; 95% CI: 1.05-1.14) and 17% (HR, 1.17; 95% CI: 1.12-1.23) higher risk of diabetes, respectively. The association of hostility with risk of diabetes was stronger among nonobese than obese women.Conclusions:Low optimism and high NEE and hostility were associated with increased risk of incident diabetes among postmenopausal women independent of major health behaviors and depressive symptoms. In addition to efforts to promote healthy behaviors, women's personality traits should be considered to guide clinical or programmatic intervention strategies in diabetes prevention.
Human-Centered Design of a Low Molecular Weight Heparin Order Set to Reduce Medication Errors
Authors: D'Souza Anishka , Wu Phillis , Jung Laura , Nungaray Karla , Richman Mark 
Published: January 2019

ABSTRACT
Inpatient anticoagulation medication errors for venous thromboembolism (VTE) therapy are common. Our VTE Team identified frequent dosing and duplicate order errors for therapeutic-dose low molecular weight heparin, which (lacking computerized physician order entry) was ordered using blank forms. To decrease such errors, a nonmandatory order form with weight-based dosing and prechecked orders discontinuing existing injectable anticoagulation was developed using human-centered design innovation principles/processes emphasizing end-user engagement in all phases: observation, exploring solutions, and rapid prototyping/feedback. Three physicians independently reviewed ordering errors the year before versus after implementation. Before implementation, 11% of orders contained any error versus 10.5% after implementation (p = .82); 6.2% had a dosing or duplicate therapy error versus 4.2% after implementation (all made when the form was not used; p = .19). No dosing or duplicate therapy errors were made when the form was used. Were the form mandatory, all such ordering errors would likely have been eliminated, leaving 11% before versus 6.3% after implementation orders with any error (p = .015), and 6.2% before versus 0% after implementation orders with duplicate or dosing therapy errors (p < .001). Human-centered design of an anticoagulation order form can reduce anticoagulation order errors; such principles can be applied to other health care innovations, including electronic order sets.
Decreasing Adverse Events in Pediatric Patients With End-Stage Renal Disease
Authors: Childs Gwendolyn D. , Sims Rebekah 
Published: January 2019

ABSTRACT
Children with end-stage renal disease (ESRD) are at a higher risk of adverse events when they live at a distance from a pediatric facility with specialty services specific to the disease process. At a children's hospital in the southeast, a dialysis unit provides care for 27 patients with chronic ESRD. Nineteen of the 27 patients live more than 1 hour away from the children's hospital. Over the past 3 years, adverse events have occurred in patients being treated at another hospital. These adverse events included sepsis, bacterial and fungal infections, and compromised residual glomerular filtration rate because of the administration of nephrotoxic medications. The purpose of this article is to describe the findings from an improvement effort aimed at decreasing adverse events in the pediatric patient population with ESRD who require urgent or emergent care using an emergency room dialysis card as a communication tool for patients, families, and providers.
Artificial liver support in acute and acute-on-chronic liver failure
Authors: Larsen Fin Stolze 
Published: January 2019

Purpose of review
Liver failure is a life-threatening condition, and an artificial liver is highly desirable to replace the failing liver-functions in the waiting time for liver regeneration to happen or until liver transplantation can be undertaken. This review focuses on the efficacy of using artificial extracorporeal liver support devices.

Recent findings
Artificial liver support devices such as the molecular adsorbent recirculating system (MARS), fractionated plasma separation and adsorption, and therapeutic plasma exchange (TPE) are well tolerated. MARS and TPE improve systemic haemodynamics and the grade of hepatic encephalopathy. However, randomized, controlled trials of MARS and fractionated plasma separation and adsorption have failed to show improvement in survival in patients with acute liver failure (ALF) and patients with acute-on-chronic liver failure (ACLF). Only TPE improves survival in patients with ALF by ameliorate the release of ammonia, damage-associated molecular patterns and sB7 (CD80/86) from the necrotic liver. No randomized, controlled trials on survival in patients with ACLF using TPE have been done.

Summary
Liver support systems such as MARS and TPE may temporarily improve systemic haemodynamics and the degree of encephalopathy. However, TPE is the only procedure that improves survival in patients with ALF. The role of TPE in ACLF remains unknown.
The significance of the small adenoma: a longitudinal study of surveillance colonoscopy in an Australian population
Authors: Symonds Erin L. , Cole Stephen R. , Lau Su Yin , Steele Simon , Meng Rosie , Woodman Richard J. , Young Graeme P. , Cock Charles , Fraser Robert , Bampton Peter 
Published: January 2019

Background
The international guidelines for surveillance following the finding of a small tubular adenoma vary between no surveillance or colonoscopy at 5 or 10 years, whereas surveillance after an advanced adenoma is 3 years. Optimization of surveillance reduces the risk of colorectal cancer (CRC) with efficient use of colonoscopy resources. We assessed the risks of advanced colorectal neoplasia following a baseline finding of a small adenoma compared with advanced adenoma.

Patients and methods
A retrospective audit was undertaken of patients enrolled in a CRC surveillance program, wherein regular colonoscopies and screening with faecal immunochemical test (FIT) were provided. Patients diagnosed with either small or advanced adenoma followed by at least one surveillance colonoscopy were included. Advanced adenoma included adenomas with features of villous change, size of at least 10 mm, high-grade dysplasia, three or more small tubular adenomas and traditional and sessile serrated adenomas. Subdistribution hazard ratios were calculated for advanced neoplasia (CRC or advanced adenoma).

Results
Overall, 378 patients (62.6±11.2 years, 57.9% male) were included, with 44.2% diagnosed with small adenoma and 55.5% with advanced adenoma at baseline. The crude cumulative incidence of advanced neoplasia at first surveillance was 13.2 and 18.5% after small and advanced adenoma (P=0.16) (at 45.9 and 35.6 months, respectively), which became significant for advanced adenoma after adjustment (subdistribution hazard ratio=2.55, 95% confidence interval=1.49–4.35, P<001). A positive FIT was the only independent predictor of advanced neoplasia after a small adenoma at baseline colonoscopy (odds ratio=5.05, 95% confidence interval=1.27–20.02, P=0.02).

Conclusions
The risk of advanced neoplasia following a small adenoma was lower than that following an advanced adenoma, but was strongly predicted by a positive FIT. Reducing frequency of colonoscopy while providing regular FIT might be a more efficient use of resources for this population.
Senior NCLEX-RN Coaching Model
Authors: Schlairet Maura C. , Rubenstein Cynthia 
Published: January 2019

Background
A host of interventions have been used to improve NCLEX outcomes, yet scant evidence exists to show the influence of academic coaching on pass rates.

Purpose
To improve NCLEX confidence/readiness and pass rates in a baccalaureate nursing program, an NCLEX Coaching Model was developed and implemented.

Method
Senior students were paired with faculty for 6 weeks of NCLEX coaching. Students self-assessed strengths, risk factors, and challenges related to NCLEX preparation. Coaches and students co-developed the NCLEX Preparation and Success Plan using standardized NCLEX predictor scores. Success plans represented individualized preparation strategies focused on specific NCLEX Client Needs categories.

Result
National Council Licensure Examination confidence/readiness scores improved significantly, and first-time NCLEX pass rates improved slightly after coaching.

Conclusion
An NCLEX Coaching Model can build student confidence/readiness and promote NCLEX success among nursing students. Peplau's Theory of Interpersonal Relations was useful in guiding development and implementation of a coaching model.
Teaching Nursing Students How to Decrease the Stigma Against People Who Use Drugs
Authors: Dion Kimberly 
Published: January 2019

Background
People who use drugs (PWUD) experience bias and stigmatization from their health care providers at higher rates than do people with other health conditions.

Problem
Nursing students are ill-prepared to care for PWUD.

Approach
Nursing students received 2 educational sessions targeted at caring for PWUD. One hour focused on identifying and intervening in the case of an opioid overdose. The other was about stigmatization experienced by PWUD, harm reduction, nonstigmatizing language, and ways in which nurses can improve care for PWUD.

Outcomes
Students demonstrated the use of destigmatizing language, applied learned harm reduction concepts, and incorporated referral to area resources for counseling or treatment during care of PWUD.

Conclusions
By using the reflective learning taught in the classroom, nursing students were able to establish the human connection needed to improve care for this vulnerable population.
Human Factors Associated With the Use of Manual Bulb Suction Devices
Authors: O'Neal Pamela V. , Black Caroline Bryson , Adams Ellise D. , Armentrout Daniel L. 
Published: January 2019

Background
Manual bulb suction is commonly used to promote naso-oropharyngeal airway clearance. Human factors of hand placement (radial vs. axial) and relative negative pressure generated are not known. This study is the first step in developing clinical guidelines for safe and effective mechanical use of manual bulb suction to reduce and prevent upper airway injury.

Objective
The aim of this study was to determine the negative pressure generated when a 2-oz. manual bulb suction device is compressed and released, and hand placement is either in a radial or axial position.

Methods
A total of 87 subjects were recruited using a convenience sampling method to identify hand placement and predicted negative pressures emitted during bulb compression and release. A pressure transmitter system was developed and tested with 666 negative pressure measurements to verify internal consistency and reliability in predicting negative pressure.

Results
The majority of subjects compressed the bulb radially (55%). Suction pressures ranged from −42 mm Hg to −81 mm Hg, with a standard deviation of −7 mm Hg. Males tended to have statistically significant higher negative pressures (U = 170, p = .021) when radially compressing the bulb. Females generated statistically significant higher negatives pressures (U = 71.50, p = .001) when axially compressing the bulb.

Discussion
A 2-oz. manual bulb suction device creates negative pressures less than 85 mm Hg when using moderate compression regardless of hand placement (radial or axial placement). Further studies are needed to explore additional healthcare provider and patient human factor variables related to the mechanical use of manual bulb suction.
Are Pediatric Critical Personnel Satisfied With Their Lives? Prediction of Satisfaction With Life From Burnout, Posttraumatic Stress, and Posttraumatic Growth, and Comparison With Noncritical Pediatric Staff
Authors: Rodríguez-Rey Rocío , Palacios Alba , Alonso-Tapia Jesús , Pérez Elena , Álvarez Elena , Coca Ana , Mencía Santiago , Marcos Ana , Mayordomo-Colunga Juan , Fernández Francisco , Gómez Fernando , Cruz Jaime , Ramos Victoria , Olmedilla Marta 
Published: January 2019

Objectives:
Staff in PICUs shows high burnout, posttraumatic stress disorder symptoms, and posttraumatic growth levels. However, their levels of satisfaction with life and how positive and negative posttrauma outcomes relate to each other and contribute to predict satisfaction with life remain unknown. Thus, we attempted to explore these aspects and to compare the findings with data from pediatric professionals working in noncritical units.

Design:
This is an observational multicentric, cross-sectional study.

Setting:
The PICU of nine hospitals in Spain, and other pediatric units in the same hospitals.

Subjects:
Two hundred ninety-eight PICU workers (57 physicians, 177 nurses, and 64 nursing assistants) and 189 professionals working in noncritical pediatric units (53 physicians, 104 nurses, and 32 nursing assistants).

Intervention:
Participants completed the Maslach Burnout Inventory, the Trauma Screening Questionnaire, the Posttraumatic Growth Inventory, and the Satisfaction With Life Scale.

Measurements and Main Results:
Of PICU staff, 16.4% were very satisfied with their lives, 34.2% were satisfied, 34.6% showed average satisfaction with life, and 14.8% were below average. No differences were found between PICU and non-PICU workers. Women reported lower satisfaction with life than men, and physicians reported higher satisfaction with life than other professional groups. The correlation between posttraumatic stress disorder and posttraumatic growth was low, but significant and positive. According to the path analysis with latent variables, 20% of the variance satisfaction with life could be predicted from burnout, posttraumatic stress disorder symptoms, and posttraumatic growth. Higher distress was inversely associated to satisfaction with life, whereas posttraumatic growth contributed to higher satisfaction with life.

Conclusions:
Posttraumatic growth can moderate the negative effect of traumatic work-related experiences in satisfaction with life. PICU and non-PICU workers were equally satisfied with their lives. Positive and negative impact of work-related potentially traumatic events can coexist in the same person. Interventions aimed at reducing distress and fostering posttraumatic growth could impact in an improvement in pediatric health professionals’ satisfaction with life.
Bridging the Stressful Gap Between ICU and Home: Medical Simulation for Pediatric Patients and Their Families*
Authors: Graham Robert J. , Amar-Dolan Laura R. , Roussin Christopher J. , Weinstock Peter H. 
Published: January 2019

Objectives:
Introduce an expanding role for pediatric critical care and medical simulation to optimize the care for children with technology dependence.

Data Sources:
Limited review of literature and practice for current teaching paradigms, vulnerability of the patient population, and efficacy of simulation as a medical educational tool.

Conclusions:
In accordance with new care models and patient need, critical care requires parallel evolution of care practices, including new educational and care models, in order to maximally reduce risk, fear, and anxiety and to insure quality and consistent care in the community for patients and families transitioning between the ICU and home environments.
Population Pharmacokinetics and Dosing of Milrinone After Patent Ductus Arteriosus Ligation in Preterm Infants
Authors: Hallik Maarja , Ilmoja Mari-Liis , Tasa Tõnis , Standing Joseph F. , Takkis Kalev , Veigure Rūta , Kipper Karin , Jalas Tiiu , Raidmäe Maila , Uibo Karin , Starkopf Joel , Metsvaht Tuuli 
Published: January 2019

Objectives:
The postoperative course of patent ductus arteriosus ligation is often complicated by postligation cardiac syndrome, occurring in 10–45% of operated infants. Milrinone might prevent profound hemodynamic instability and improve the recovery of cardiac function in this setting. The present study aimed to describe the population pharmacokinetics of milrinone in premature neonates at risk of postligation cardiac syndrome and give dosing recommendations.

Design:
A prospective single group open-label pharmacokinetics study.

Settings:
Two tertiary care neonatal ICUs: Tallinn Children’s Hospital and Tartu University Hospital, Estonia.

Patients:
Ten neonates with postmenstrual age of 24.6–30.1 weeks and postnatal age of 5–27 days undergoing patent ductus arteriosus ligation and at risk of postligation cardiac syndrome, based on echocardiographic assessment of left ventricular output of less than 200 mL/kg/min 1 hour after the surgery.

Interventions:
Milrinone at a dose of 0.73 μg/kg/min for 3 hours followed by 0.16 μg/kg/min for 21 hours. Four blood samples from each patient for milrinone plasma concentration measurements were collected.

Measurements and Main Results:
Concentration-time data of milrinone were analyzed with nonlinear mixed-effects modeling software (NONMEM Version 7.3 [ICON Development Solutions, Ellicott City, MD]). Probability of target attainment simulations gave a dosing schedule that maximally attains concentration targets of 150–250 μg/L. Milrinone pharmacokinetics was described by a one-compartmental linear model with allometric scaling to bodyweight and an age maturation function of glomerular filtration rate. Parameter estimates for a patient with the median weight were 0.350 (L/hr) for clearance and 0.329 (L) for volume of distribution. The best probability of target attainment was achieved with a loading dose of 0.50 μg/kg/min for 3 hours followed by 0.15 μg/kg/min (postmenstrual age < 27 wk) or 0.20 μg/kg/min (postmenstrual age ≥ 27 wk).

Conclusions:
Population pharmacokinetic modeling and simulations suggest a slow loading dose followed by maintenance infusion to reach therapeutic milrinone plasma concentrations within the timeframe of the postligation cardiac syndrome.
Use of Capnography and Cardiopulmonary Resuscitation Feedback Devices Among Prehospital Advanced Life Support Providers
Authors: Sahyoun Cyril , Siliciano Christina , Kessler David 
Published: January 2019

Background
Capnography and cardiopulmonary resuscitation (CPR) feedback devices have been shown to improve resuscitation outcomes, with the American Heart Association recommending their use during advanced life support (ALS). Little is known about the availability of these devices, their protocoled use, and the attitudes toward them in the prehospital setting.

Objectives
The objectives of this study were to assess the availability of capnography and CPR feedback devices among prehospital ALS agencies in New York State (NYS), to describe the protocoled use of these devices, and to evaluate the attitudes of providers toward the use of these devices.

Methods
Prehospital agencies that provide ALS services in NYS were identified using an online registry. Managers in these agencies were contacted by electronic mail and asked to complete a questionnaire regarding their agency's experience with capnography and CPR feedback devices. The questionnaire included questions on the availability of capnography and CPR feedback devices, the existence of clinical protocols for using capnography, and provider opinion on the utility of capnography and CPR feedback devices for improving pediatric resuscitation.

Results
Of 710 ALS agencies, 238 (33.5%) completed the survey. Ninety-five percent and 24% of agencies reported having capnography and CPR feedback devices available aboard ambulances, respectively. Ninety-seven percent of agencies reported having capnography clinical protocols for endotracheal intubation, 63% for return of spontaneous circulation, and 54% for guiding CPR. Forty-seven percent agreed that capnography improves outcomes in the resuscitation of pediatric patients, whereas 51% of providers were neutral and 2% disagreed.

Conclusions
Capnography is available in most NYS ALS agencies surveyed. Cardiopulmonary resuscitation feedback devices are less common. Protocols for the use of capnography mainly focused on endotracheal intubation and less for the recognition of return of spontaneous circulation and for guiding CPR. Half of the providers surveyed were neutral on whether capnography improves outcomes in the resuscitation of pediatric patients.
Hospital-Based Emergency Department Visits With Pediatric Burns
Authors: Abramowicz Shelly , Allareddy Veerasathpurush , Lee Min Kyeong , Nalliah Romesh P. , Rampa Sankeerth , Allareddy Veerajalandhar 
Published: January 2019

Objective
The objective of this study was to examine the characteristics and outcomes in children presenting to emergency departments (EDs) with burn injuries.

Methods
The Nationwide Emergency Department Sample (NEDS) for the years 2008 to 2013 was used. All patients younger than 18 years who visited a hospital-based ED with a burn injury were selected. The study focused on (1) demographics (age, sex, insurance status), (2) characteristics of burns (types, causes), (3) disposition status after ED/hospitalization, (4) charges (ED and hospital), and (5) patient outcomes. Inclusion criteria were a visit to ED in the United States with a burn. Descriptive statistics were used to summarize the findings.

Results
During the study period, there were 746,593 ED visits due to burn injuries. Majority were insured by Medicaid (52.8%). Most frequent injuries were burns of wrists/hands (39.5%), lower limbs (24.1%), and upper limb—except wrist/hand (20.1%). The most common causes of burns were heat from electric appliances (37.1%) or hot liquids and vapors (24.8%). Following the ED visit, 89.1% were discharged routinely, and 4.3% were admitted. Mean charge per patient per ED visit was $1117. Total ED charges across the United States was $708.7 million. When admitted, mean length of stay was 5.7 days. Total hospitalization charge across the United States was $1.7 billion.

Conclusions
Pediatric burn injuries require significant resources for stabilization and treatment by EDs. The present study highlights the burden and impact of pediatric burn injuries in the United States.