bluuebunny/crossref_metadata_2025_split huggingface dataset:
Establishing and implementing a health promoting school in rural Cambodia
Authors: Heesch Kristiann C , Hepple Erika , Dingle Kaeleen , Freeman Natasha 
Published: December 2018

Summary
Few studies have used a whole-of-school approach in implementing a health promoting schools (HPS) framework. Descriptions of how HPS is being implemented, particularly in low-resourced, developing countries, are limited. This study used an exploratory case study design to examine the planning and implementation of a HPS in a rural Cambodian village. Data were collected via observations of the school, school documentation, and interviews with stakeholders (n = 9). The data were analysed inductively as an iterative process, from initial coding, through to categorizing, leading to concept mapping and then identifying the emergent themes within the stages of school development and implementation of educational and health programming. The case study demonstrated how all six components of the HPS framework can be used to plan and implement a school in a rural village in a developing country. The key elements of implementation were building local and international partnerships, local leadership, and a culture of change and participation. These elements were used to establish a non-profit school that aimed to address the stated health and educational needs of local villagers. This case study adds to the limited evidence on the HPS components and implementation methods that are being applied in low-resourced, developing countries.
The Impact of Universal Infant Hepatitis B Immunization on Reducing the Hepatitis B Carrier Rate in Pregnant Women
Authors: Su Wei-Ju , Chen Shu-Fong , Yang Chin-Hui , Chuang Pei-Hung , Chang Hsiu-Fang , Chang Mei-Hwei 
Published: December 2018

Abstract

Background
The hepatitis B virus (HBV) status of pregnant women affects HBV vaccine failure in their offspring. This study is aimed to investigate the impact of the universal infant HBV vaccination program on the long-term hepatitis B surface antigen (HBsAg) rate in pregnant women.

Methods
Using the National Immunization Information System, we examined a 32-year period of cross-sectional data on a maternal HBsAg and hepatitis B e antigen (HBeAg) screening program launched in July 1984. An age-period-cohort model analysis of 940 180 pregnant women screened for July 1996–June 1997 and the years 2001, 2006, 2011, and 2016 was applied.

Results
The annual HBsAg- and HBeAg-seropositive rates decreased from 13.4% and 6.4%, respectively, for the period 1984–1985 to 5.9% and 1.0% in 2016 (P for both trends < .0001). Pregnant women with birth years after July 1986 (the HBV vaccination cohort) had the lowest relative risk (0.27 [95% confidence interval, .26–.28]) of HBsAg positivity compared with birth years before June 1984.

Conclusions
The birth cohort effect in relation to the universal infant HBV immunization program has effectively reduced the HBV carrier rate in pregnant women and the burden of perinatal HBV infection on the next generation.
ADP-ribosylation factor-like 8b is required for the development of mouse models of systemic lupus erythematosus
Authors: Saitoh Shin-Ichiroh , Saitoh Yoshiko Mori , Kontani Kenji , Sato Katsuaki , Miyake Kensuke 
Published: December 2018

Abstract
Toll-like receptor 7 (TLR7) and type I interferons (IFN-1) are essential for the development of systemic lupus erythematosus (SLE) models such as BXSB.Yaa and 2,6,10,14-tetramethyl-pentadecane (TMPD)-induced experimental lupus. However, the mechanism underlying the development of SLE remains undefined. We report a requirement for ADP-ribosylation factor-like 8b (Arl8b) for TLR7-dependent IFN-1 production in plasmacytoid dendritic cells (pDCs). We analyzed whether Arl8b plays a role in two SLE models by comparing wild-type and Arl8b-deficient Arl8b GeneTrap (Arl8bGt/Gt) mice. We found that BXSB.Yaa Arl8bGt/Gt mice showed none of the abnormalities characterized in BXSB.Yaa mice. TMPD treatment of Arl8bGt/Gt mice significantly inhibited the development of SLE. pDCs were required for TMPD-induced peritonitis. Our data demonstrate that Arl8b contributes to disease pathogenesis in two SLE models via IFN-1-dependent and -independent mechanisms and suggest that Arl8b is an attractive new target for therapeutic intervention in SLE.
Withdrawal Symptom, Treatment Mechanism, and/or Side Effect? Developing an Explicit Measurement Model for Smoking Cessation Research
Authors: Tonkin Sarah S , Williams Trevor F , Simms Leonard J , Tiffany Stephen T , Mahoney Martin C , Schnoll Robert A , Cinciripini Paul M , Hawk Larry W 
Published: December 2018

Abstract

Introduction
Assessment of withdrawal symptoms, treatment mechanisms, and side effects is central to understanding and improving smoking cessation interventions. Though each domain is typically assessed separately with widely used questionnaires to separately assess each domain (eg, Minnesota Nicotine Withdrawal Scale = withdrawal; Questionnaire of Smoking Urges-Brief = craving; Positive and Negative Affect Schedule = affect; symptom checklist = side effects), there are substantial problems with this implicit “one questionnaire equals one construct” measurement model, including item overlap across questionnaires. This study sought to clarify the number and nature of constructs assessed during smoking cessation by developing an explicit measurement model.

Methods
Two subsamples were randomly created from 1246 smokers in a clinical trial. Exploratory and confirmatory factor analyses were conducted to identify and select a model that best represented the data. Measurement invariance was assessed to determine if the factors and their content were consistent prior to and during the quit. Improvement in construct overlap within this model was compared against the implicit measurement model using correlational analyses.

Results
A 5-factor measurement model composed of negative affect, somatic symptoms, sleep problems, positive affect, and craving fits the data well prior to and during quitting. All factor content except somatic symptoms was consistent over time. Correlational analyses indicated that the 5-factor model attenuated construct overlap compared to the implicit model.

Conclusions
The models generated from data-driven approaches (eg, the 5-factor model) reduced overlap and better represented the constructs underlying these measures. This approach created distinct, stable constructs that span over measures of side effects and potential treatment mechanisms.

Implications
This study demonstrated that measures assessing treatment mechanisms, withdrawal symptoms, and side effects contain problematic overlap that reduces the clarity of these key constructs. The use of data-driven approaches showed that these measures do not map on to their posited latent constructs (eg, the Minnesota Nicotine Withdrawal Scale does not yield a withdrawal factor). Rather, these measures form distinct, basic processes that may represent more meaningful constructs for future research on cessation and treatment. Assessments designed to individually examine these processes may improve the study of treatment mechanisms.
Evaluation of the Impact of an Online Opioid Education Program for Acute Pain Management
Authors: Langford Dale J , Gross Jacob B , Doorenbos Ardith Z , Tauben David J , Loeser John D , Gordon Debra B 
Published: December 2018

Abstract

Objective
The University of Washington instituted a policy requiring all credentialed clinicians who prescribe opioids to complete a one-time education activity about safe and responsible opioid prescribing. A scenario-based, interactive online learning module was developed for opioid management of acute pain in hospitalized adults. This study examined the impact of the education module on learners’ knowledge, perceived competence, and use of guideline-adherent practices.

Methods
Clinicians who completed the education module participated in a voluntary de-identified online survey approximately six months after the learning activity. Survey questions were related to 1) the perception of improved knowledge; 2) impact on learner’s use of three guideline-adherent practices; and 3) perceived competence in managing opioids for acute pain. Descriptive statistics were generated, and multiple linear regression models were used for analysis.

Results
Clinicians (N = 167) reported improvement in knowledge and perceived competence. Controlling for other aspects of knowledge evaluated, learning to construct a safe opioid taper plan for acute pain, distinguishing between short- and long-acting opioids, and safely initiating opioids for acute pain were significantly associated with increased self-reported likelihood of incorporating the Washington state Prescription Monitoring Program (P = 0.003), using multimodal analgesia (P = 0.022), and reducing the duration of opioids prescribed (P = 0.016). Only improvement in knowledge of how to construct a safe opioid taper plan was significantly associated with increased perceived competence (P = 0.002).

Conclusions
Our findings suggest that this online education module about safe opioid prescribing for acute pain management was effective at improving knowledge, increasing the likelihood of using guideline-adherent clinical practices, and increasing perceived competence.
Managing dyslipidemia for CVD prevention
Authors: Ciffone Nicole A. , Copple Tina 
Published: December 2018

Abstract:
The American Association of Clinical Endocrinology and the American College of Endocrinology Clinical Practice Guideline is a comprehensive, practical tool that can be used to diagnose and manage dyslipidemia, a major risk for the development and progression of atherosclerotic cardiovascular disease. Effective therapies are available to improve lipid profiles and reduce cardiovascular events.
Prolonged Anesthetic Exposure in Children and Factors Associated With Exposure Duration
Authors: Ing Caleb , Ma Xiaoyue , Klausner Anna J. , Dutton Richard P. , Li Guohua 
Published: December 2018

Introduction:
Anesthetic exposure duration has come under scrutiny because of a Food and Drug Administration warning against prolonged use of anesthesia in children, defined as exposures longer than 3 hours.

Methods:
Data for 2,613,344 pediatric anesthetic records from the American Society of Anesthesiologist’s National Anesthesia Clinical Outcomes Registry from 2010 to 2015 were analyzed to describe anesthetic duration and the prevalence of prolonged exposures in children. Common pediatric inpatient procedures were independently assessed to determine factors associated with exposure duration.

Results:
The overall mean pediatric anesthetic duration was 83.3±107.4 minutes (median, 57 min). Prolonged exposures comprised 7% of pediatric anesthetic records, and 15% of anesthetic records in infants. After restricting to common pediatric inpatient procedures (n=96,603) and adjusting for procedure type using a Poisson model, compared with children 10 years or older, exposures in infants were 20.5% longer (anesthetic duration ratio [ADR], 1.205; 95% confidence interval [CI], 1.202–1.208). Longer exposures were also seen with a variety of other patient and hospital factors including ASA 4 patients versus ASA 1 patients, (ADR, 1.381; 95% CI, 1.376-1.386), and university hospitals versus surgery centers (ADR, 1.241; 95% CI, 1.236-1.246).

Conclusions:
Most pediatric anesthetic exposures last <1 hour with a small percentage lasting over 3 hours. Anesthetic duration for inpatient pediatric procedures, however, is associated with specific patient and hospital characteristics. These results may help identify children potentially at risk for prolonged anesthetic exposure and inform procedure time prediction and operating room scheduling.
Retrospective Analysis of Perioperative Variables Associated With Postoperative Delirium and Other Adverse Outcomes in Older Patients After Spine Surgery
Authors: Susano Maria J. , Scheetz Seth D. , Grasfield Rachel H. , Cheung Dominique , Xu Xinling , Kang James D. , Smith Timothy R. , Lu Yi , Groff Michael W. , Chi John H. , Crosby Gregory , Culley Deborah J. 
Published: December 2018

Background:
The aim of this retrospective study was to identify perioperative variables predictive of the development of delirium in older surgical patients after spine surgery.

Materials and Methods:
We collected preoperative, intraoperative, and postoperative data on patients 65 years of age and above having spine surgery between July 1, 2015 and March 15, 2017. The primary outcome was the development of postoperative delirium. Data were analyzed using univariate and multivariable analysis.

Results:
Among the 716 patients included in this study 127 (18%) developed postoperative delirium. On multivariable analysis, independent predictors of postoperative delirium included older age (odds ratio [OR]=1.04; 95% confidence interval [CI], 1.00-1.09; P=0.048), American Society of Anesthesiologists physical status >2 (OR=1.89 [95% CI, 1.04-3.59]; P=0.042), metabolic equivalents of task <4 (OR=1.84 [95% CI, 1.10-3.07]; P=0.019), depression (OR=2.01 [95% CI, 1.21-3.32]; P=0.006), nonelective surgery (OR=4.81 [95% CI, 1.75-12.79]; P=0.002), invasive surgical procedures (OR=1.97 [95% CI, 1.10-3.69]; P=0.028) and higher mean pain scores on postoperative day 1 (OR=1.28 [95% CI, 1.11-1.48]; P<0.001).

Conclusions:
Postoperative delirium is a common complication in older patients after spine surgery, and there are several perioperative risk factors associated with its development.
What Is Faith-Based Health Promotion? A Working Definition
Authors: Patestos Chrysanthe 
Published: December 2018

ABSTRACT:
Faith-based health promotion (FBHP) is a concept utilized across multiple disciplines, including nursing, public health, government, social work, and medicine. This article presents a hybrid concept analysis of FBHP and construction of a working definition for further investigative study. Defining FBHP is especially valuable for faith community nurses (FCNs), public health nurses, and other healthcare professionals who seek to study and offer FBHP. The relationship and application of FBHP to FCN practice is explored.
Treating Chronic Nonmalignant Pain
Authors: Snell Sarah , Hughes Tia , Fore Carolyn , Lukman Roy , Morgan Brett 
Published: December 2018

ABSTRACT:
A significant portion of the world's population is impacted by chronic pain; in the United States, chronic pain costs billions annually in treatment and lost productivity. A needs assessment was conducted to evaluate the prevalence of chronic nonmalignant pain (CNMP) at a university occupational therapy clinic over a 3-month period; recommendations were made to improve pain management at the clinic and referring hospital system. Graded Chronic Pain Scale 2.0 results indicated the prevalence of CNMP was a significant problem. Three evidence-based interventions based on the biblically based CREATION Health Model were developed.
Ready to Care? Student Nurse Perceptions of Spiritual Care Education
Authors: Brown Kimberly , Humphreys Heather , Whorley Elizabeth , Bridge Diane 
Published: December 2018

ABSTRACT:
This research investigated the spiritual care educational preparation that nursing students perceive they have received as they transition to practice. A survey using the Spirituality and Spiritual Care Rating Scale and interviews with senior BSN students at a Christian university demonstrated students' perceptions that their spiritual care education focused primarily on the practice of presence, emphasis on prayer, and the integration of faith in the curricula. Survey results showed a strong perception of readiness to provide spiritual care as graduate nurses.
Attitudes of Iranian Nurses Toward Spirituality and Spiritual Care
Authors: Abdollahyar Asma , Baniasadi Hamidehe , Doustmohammadi Mohammad M. , Sheikhbardesiri Hojjat , Yarmohammadian Mohammad H. 
Published: December 2018

ABSTRACT:
Spirituality and spiritual care play a crucial role in providing more effective treatment for patients. The purpose of this study was to determine nurses' attitudes toward spirituality and spiritual care in an educational hospital in Iran. A significant association was found between nurses' spirituality/spiritual care attitudes and age, education level, and type of hospital ward employment (noncritical vs. critical care). Nurses' scores on attitudes toward spirituality and spiritual care suggest the need for more education in this area.
Patient-reported Outcomes in Facial Reconstruction: Assessment of FACE-Q Scales and Predictors of Satisfaction
Authors: Elegbede Adekunle , Mermulla Sara , Diaconu Silviu C. , McNichols Colton , Liang Yuanyuan , Liang Fan , Rasko Yvonne M. , Grant Michael P. , Nam Arthur J. 
Published: December 2018

Background:
There is a paucity of patient-reported outcome measures for facial trauma reconstruction. To measure satisfaction and health-related quality of life (HRQOL), following repair of traumatic facial fractures, we used the FACE-Q, a set of patient-reported outcome instruments designed for aesthetic facial surgery. As a step toward validating the scales for facial trauma, we evaluated their reliability.

Methods:
This is a prospective study of patients following primary repair of traumatic facial fractures at a level 1 trauma center from 2016 to 2018. Six FACE-Q scales with relevance to the facial trauma population were completed by patients at their 1-month postoperative visits. Predictors of satisfaction were examined using multiple linear regression models. Reliability of the scales in this population was evaluated using psychometric methods.

Results:
One hundred eighty-five participants fulfilled inclusion criteria. Mean scores for the 6 scales ranged from 59 (SD = 15) for Recovery-Early Life Impact to 94 (SD = 13) for Satisfaction with Medical Team. Predictors of lower satisfaction and/or HRQOL include current tobacco smoking status, mandibulomaxillary fixation, and Le Fort pattern fractures. All scales were found to have good to excellent reliability (Cronbach’s alpha = 0.824–0.969).

Conclusions:
Following repair of facial fractures, patient-reported outcomes can be reliably measured using FACE-Q scales. On average, patients report poor health-related quality of life in the early postoperative period. Predictors of low satisfaction and/or poor HRQOL include current smoking habit, mandibulomaxillary fixation, and Le Fort fractures.
Expanded Utilization of the Digital Atasoy Flap
Authors: Viciana Enrique J. , Lessard Anne-Sophie 
Published: December 2018

Background:
The Atasoy, or Kleinert flap, is well-known to hand surgeons. This triangular volar V-Y flap is frequently used for reconstruction of fingertip amputations with exposed bone. It is indicated in transverse amputations or in dorsal oblique amputations, providing replacement of an area of skin and subcutaneous tissues with sensibility. Originally, this flap was not recommended for use in volar oblique amputations (greater volar tissue loss). With the described modifications and recommendations, modest volar oblique amputations can be closed in a single stage, obviating a 2-stage procedure.

Methods:
With the described technical modifications, modest volar oblique amputations can be closed. An injury that previously may have required a 2-stage procedure can be closed in a single stage.

Results:
The elevation of the flap was originally described as a dissection at the volar periosteum from a distal approach. This distal dissection is no longer recommended, as it does not create advancement. Beasley indicated the need for division of the vertical fibrous septa proximally for flap mobilization. This technique description emphasizes the importance of this division of the fibrous septa rather than stretching. Careful treatment of the remaining bone is stressed. Coverage of the nail bed is not recommended.
The impact of anxiety on chronic musculoskeletal pain and the role of astrocyte activation
Authors: Burston James J. , Valdes Ana M. , Woodhams Stephen G. , Mapp Paul I. , Stocks Joanne , Watson David J.G. , Gowler Peter R.W. , Xu Luting , Sagar Devi R. , Fernandes Gwen , Frowd Nadia , Marshall Laura , Zhang Weiya , Doherty Michael , Walsh David A. , Chapman Victoria 
Published: December 2018

AbstractAnxiety and depression are associated with increased pain responses in chronic pain states. The extent to which anxiety drives chronic pain, or vice versa, remains an important question that has implications for analgesic treatment strategies. Here, the effect of existing anxiety on future osteoarthritis (OA) pain was investigated, and potential mechanisms were studied in an animal model. Pressure pain detection thresholds, anxiety, and depression were assessed in people with (n = 130) or without (n = 100) painful knee OA. Separately, knee pain and anxiety scores were also measured twice over 12 months in 4730 individuals recruited from the general population. A preclinical investigation of a model of OA pain in normo-anxiety Sprague-Dawley (SD) and high-anxiety Wistar Kyoto (WKY) rats assessed underlying neurobiological mechanisms. Higher anxiety, independently from depression, was associated with significantly lower pressure pain detection thresholds at sites local to (P< 0.01) and distant from (P< 0.05) the painful knee in patients with OA. Separately, high anxiety scores predicted increased risk of knee pain onset in 3274 originally pain-free people over the 1-year period (odds ratio = 1.71; 95% confidence interval = 1.25-2.34,P< 0.00083). Similarly, WKY rats developed significantly lower ipsilateral and contralateral hind paw withdrawal thresholds in the monosodium iodoacetate model of OA pain, compared with SD rats (P= 0.0005). Linear regressions revealed that baseline anxiety-like behaviour was predictive of lowered paw withdrawal thresholds in WKY rats, mirroring the human data. This augmented pain phenotype was significantly associated with increased glial fibrillary acidic protein immunofluorescence in pain-associated brain regions, identifying supraspinal astrocyte activation as a significant mechanism underlying anxiety-augmented pain behaviour.
Assessment of the Abuse Potential of Cebranopadol in Nondependent Recreational Opioid Users
Authors: Göhler Karin , Sokolowska Marta , Schoedel Kerri A. , Nemeth Robert , Kleideiter Elke , Szeto Isabella , Eerdekens Marie-Henriette 
Published: December 2018

AbstractBackgroundCebranopadol is a nociceptin/orphanin FQ peptide/opioid receptor agonist with central antinociceptive activity. We hypothesize that this novel mechanism of action may lead to a lower risk of abuse compared with pure μ-opioid peptide receptor agonists.MethodsWe conducted a single-dose, nested-randomized, double-blind crossover study in nondependent recreational opioid users to evaluate the abuse potential of single doses of cebranopadol relative to hydromorphone immediate release and placebo. The study consisted of a qualification phase and a 7-period treatment phase (cebranopadol 200, 400, and 800 μg; hydromorphone 8 and 16 mg; and 2 placebos). The primary end point was the peak effect of drug liking at this moment, measured by visual analog scale (VAS). Various secondary end points (eg, VAS rating for good drug effects, high, bad drug effects, take drug again, drug similarity, and pupillometry) were also investigated.ResultsForty-two subjects completed the study. Cebranopadol 200 and 400 μg did not differentiate from placebo on the abuse potential assessments and generated smaller responses than hydromorphone. Responses observed with cebranopadol 800 μg were similar to hydromorphone 8 mg and smaller than hydromorphone 16 mg. The maximum effect for VAS drug liking at this moment was delayed compared with hydromorphone (3 and 1.5 hours, respectively). Cebranopadol administration was safe; no serious adverse events or study discontinuation due to treatment-emergent adverse events occurred.ConclusionsThese results confirm our hypothesis that cebranopadol, a nociceptin/orphanin FQ peptide/opioid receptor agonist, has lower abuse potential than hydromorphone immediate release, a pure μ-opioid peptide agonist.