bluuebunny/crossref_metadata_2025_split huggingface dataset:
Longitudinal Effects of Medical Comorbidities on Functional Outcome and Life Satisfaction After Traumatic Brain Injury: An Individual Growth Curve Analysis of NIDILRR Traumatic Brain Injury Model System Data
Authors: Malec James F. , Ketchum Jessica M. , Hammond Flora M. , Corrigan John D. , Dams-O'Connor Kristen , Hart Tessa , Novack Thomas , Dahdah Marie , Whiteneck Gale G. , Bogner Jennifer 
Published: March 2019

Objective:
To explore associations of specific physical and neuropsychiatric medical conditions to motor and cognitive functioning and life satisfaction over the first 10 years following traumatic brain injury (TBI).

Setting:
Telephone follow-up through 6 TBI Model System centers.

Participants:
In total, 404 individuals or proxies with TBI enrolled in the TBI Model System longitudinal study participating in 10-year follow-up.

Design:
Individual growth curve analysis.

Main Measures:
FIM Motor and Cognitive subscales, Satisfaction With Life Scales, and Medical and Mental Health Comorbidities Interview.

Results:
Hypertension, diabetes, cancers, rheumatoid arthritis, and anxiety negatively affected the trajectory of motor functioning over time. Diabetes, cancers, chronic bronchitis, anxiety, and depression negatively impacted cognitive functioning. Numerous neuropsychiatric conditions (sleep disorder, alcoholism, drug addiction, anxiety, panic attacks, posttraumatic stress disorder, depression, and bipolar disorder), as well as hypertension, liver disease, and cancers, diminished life satisfaction. Other medical conditions had a negative effect on functioning and satisfaction at specific follow-up periods.

Conclusion:
Natural recovery after TBI may include delayed onset of functional decline or early recovery, followed by progressive deterioration, and is negatively affected by medical comorbidities. Results contribute to the growing evidence that TBI is most appropriately treated as a chronic medical condition complicated by a variety of comorbid conditions.
An Evidence-Based Care Model for Workers With Concussion
Authors: Thompson Aaron , Chechulin Yuriy , Bain Donna , Bayley Mark 
Published: March 2019

Objective:
To evaluate the impact of an evidence-based assessment program for people with workers' compensation claims for concussion on healthcare utilization and duration of lost time from work.

Setting:
An assessment program for people with a work-related concussion was introduced to provide physician assessment focused on education and appropriate triage.

Participants:
A total of 3865 people with accepted workers' compensation claims for concussion with dates of injury between January 1, 2014, and February 28, 2017.

Design:
A quasiexperimental pre-/poststudy of healthcare utilization (measured by healthcare costs) and duration of time off work (measured by loss of earnings benefits) in a cohort of people with workers' compensation claims for concussion in the period prior to and following introduction of a new assessment program. Administrative data were retrospectively analyzed to compare outcomes in patients from the preassessment program implementation period to those in the postimplementation period.

Results:
The assessment program resulted in reduced healthcare utilization reflected by a 14.4% (95% confidence interval, −28.7% to −0.8%) decrease in healthcare costs. The greatest decrease in healthcare costs was for assessment services (−27.9%) followed by diagnostic services (−25.7%). There was no significant difference in time off work as measured by loss-of-earnings benefits.

Conclusion:
A care model for people with a work-related concussion involving an evidence-based assessment by a single physician focused on patient education resulted in significantly decreased healthcare utilization without increasing duration of time off work.
Neuropsychiatric Outcomes in UK Military Veterans With Mild Traumatic Brain Injury and Vestibular Dysfunction
Authors: Denby Emma , Murphy Dominic , Busuttil Walter , Sakel Mohamed , Wilkinson David 
Published: March 2019

Objective:
To estimate the frequency of vestibular dysfunction following blunt, blast, and combined blunt and blast mild traumatic brain injury (mTBI) and thereon assess the long-term impact of vestibular dysfunction on neurobehavioral function and disability independently of comorbid psychiatric symptoms.

Setting:
Combat Stress residential and Veterans' Outreach drop-in centers for psychological support.

Participants:
One hundred sixty-two help-seeking UK military veterans.

Main Measures:
Self-reported frequency and severity of mTBI (using the Ohio State TBI Identification Method), Vertigo Symptom Scale, PTSD Checklist for DSM-5, Kessler Psychological Distress Scale (K10), Neurobehavioral Symptom Inventory, Headache Impact Test (HIT6), Memory Complaints Inventory, World Health Organization Disability Assessment Schedule II short version (WHODAS 2.0).

Results:
Seventy-two percent of the sample reported 1 or more mTBIs over their lifetime. Chi-square analyses indicated that vestibular disturbance, which affected 69% of participants, was equally prevalent following blunt (59%) or blast (47%) injury and most prevalent following blunt and blast combined (83%). Mediation analysis indicated that when posttraumatic stress disorder, depression, and anxiety were taken into account, vestibular dysfunction in participants with mTBI was directly and independently associated with increased postconcussive symptoms and functional disability.

Conclusion:
Vestibular dysfunction is common after combined blunt and blast mTBI and singularly predictive of poor long-term mental health. From a treatment perspective, vestibular rehabilitation may provide relief from postconcussive symptoms other than dizziness and imbalance.
Therapeutic Challenges and Prognosis of Descemet's Membrane Endothelial Keratoplasty in Herpes Simplex Eye Disease
Authors: Abdelmassih Youssef , Dubrulle Pierre , Sitbon Charles , el-Khoury Sylvain , Guindolet Damien , Doan Serge , Labetoulle Marc , Cochereau Isabelle , Gabison Eric E. 
Published: March 2019

Purpose:
To describe the functional outcome, postoperative complications, and complication management of Descemet's membrane endothelial keratoplasty (DMEK) in corneal decompensation secondary to Herpes simplex eye disease (HED).

Methods:
This retrospective interventional case series included 17 eyes that received DMEK for endothelial decompensation secondary to HED. Complete ophthalmological examination, including corrected-distance visual acuity (CDVA), anterior segment slit-lamp, and optical coherence tomography assessment, were performed preoperatively and postoperatively at regular follow-up intervals. Visual outcome and complication rates were compared with those of 72 consecutive eyes that received DMEK for Fuchs endothelial corneal dystrophy (FECD) and pseudophakic bullous keratopathy (PBK) during the same period.

Results:
Mean follow-up time was 11.1 ± 5.9 months (range 6–27). CDVA improved from 1.16 ± 0.46 logMAR to 0.62 ± 0.44 logMAR (P = 0.001). Corneal pachymetry significantly decreased from 695 ± 53 μm at day 1 to 569 ± 88 μm at 2 months (P < 0.001). Postoperative complications occurred in 12 eyes, including primary graft failure (12%), endotheliitis (29%), corneal ulcers (35%), and cystoid macular edema (18%). Most complications occurred shortly after surgery, with a median delay of 2.5 months. In comparison, the complication rates for DMEK in FECD and PBK were significantly lower (no graft failure, P = 0.005; no endotheliitis, P < 0.001; no corneal ulcers, P < 0.001 and 3% cystoid macular edema, P = 0.046).

Conclusions:
DMEK surgery significantly improved CDVA in patients with endothelial decompensation due to HED. The rate of postoperative complications was higher than for FECD and PBK. Close follow-up is mandatory and the rate of postoperative inflammatory events suggests that patients should be kept on high doses of oral valacyclovir.
A Comparison Between the Involuntary and Voluntary Treatment of Patients With Alcohol Use Disorder in a Residential Rehabilitation Treatment Program
Authors: Boit Hellen , Palmer Glen A. , Olson Stephen A. 
Published: March 2019

Abstract

Objective:
The purpose of the study was to determine if there was a significant difference between veterans who received treatment voluntarily versus involuntarily in regard to length of sobriety.

Method:
A sample of 120 veterans being treated for alcohol use disorder in a residential rehabilitation treatment program was used for this study. Veterans who were admitted under recommendation by court order (n = 60) were matched with veterans who were admitted without recommendation of court order (n = 60). Success of the program was determined by the number of days of sobriety postdischarge.

Results:
The study revealed that there was no significant difference between types of motivation for residential treatment (i.e., voluntary vs. involuntary treatment) and length of sobriety for veterans with alcohol use disorder posttreatment.

Conclusions:
Findings revealed that there was no significant relationship when comparing types of motivation for treatment in a residential treatment program for veterans in regard to length of sobriety posttreatment. Therefore, a veteran’s motivation for treatment may not necessarily be an accurate indicator of treatment outcomes (i.e., length of sobriety posttreatment) for residential treatment settings.
An Old Treatment for an Even Older Problem
Authors: Legg Timothy J. 
Published: March 2019

Abstract
The fact that addictive disorders have a significant negative impact on the health of the global population is well documented in contemporary health literature. What is less well documented is the uncomfortable realization that the tools in our armament to help individuals who struggle with addictive disorders are limited. Many individuals will spend their lives “cycling” through the addiction treatment continuum only to again be met with relapse. Third-party reimbursement for addiction treatment has focused on time-limited treatments and “brief” therapies with an additional emphasis on support group attendance (aka “free” services) with minimal focus on the fact that brief therapies have poor evidence for efficacy. In this article, we explore an alternative to brief therapies by reaching back to the earliest and most comprehensive treatment we have for behavioral change—psychoanalysis. This article engages in a literature review to determine whether sufficient evidence exists for the use of psychoanalysis as a treatment for addictive disorders. Implications for advanced practice psychiatric nurses are discussed.
A Causal Model of Binge Drinking Among University Students in Northern Thailand
Authors: Tonkuriman Asawinee , Sethabouppha Hunsa , Thungjaroenkul Petsunee , Kittirattanapaiboon Phunnapa 
Published: March 2019

AbstractBinge drinking, an extreme drinking pattern and the most common form of hazardous alcohol consumption among university students, has remained a public health concern with physical, psychological, academic, and social problems. Tracking multiple factors is needed to find ways to deal with such hazardous drinking patterns and their adverse consequences. In Thailand, the particular factors leading to binge drinking patterns among university students are still not recognized. Four hundred thirteen university students in Northern Thailand self-administered a Web-based survey about the causal factors. The survey was based on a hypothesized model from the Social Ecological Model and from empirical studies. There were four factors that were hypothesized to directly increase binge drinking behavior: attitudes toward drinking, peer influence, physical environments of drinking, and alcohol advertisements. However, there were another four factors that were hypothesized to directly decrease binge drinking behavior: drinking refusal self-efficacy, university alcohol regulations, alcohol public policies, and knowledge. Through testing of the hypothesized model by Structural Equation Modeling, the causal model of binge drinking among Thai university students revealed “binge drinking refusal self-efficacy” (β = −.22,p< .001) and “peer influence” (β = −.14,p< .05) as significant negative factors and “physical environments” (β = .18,p< .001) as a positive predictor regarding binge drinking. The study shows how healthcare providers may be able to lessen binge drinking by designing effective prevention programs centering on an intrapersonal factor (binge drinking refusal self-efficacy), an interpersonal factor (peer influence), and a community factor (physical environments).
Effectiveness of Providing Education About Alcohol Use Disorders and Compassion Fatigue for Emergency Department Nurses
Authors: Williamson Dawn 
Published: March 2019

Background:
Emergency departments (EDs) treat over 20,000 patients daily with alcohol use disorders (AUDs). However, nurses receive limited education about AUDs. Studies have shown that ED nurses have negative attitudes about patients with AUDs. Negativity can contribute to the symptoms of compassion fatigue (CF) and to dissatisfaction with work.

Purpose:
The aim of this study was to design, implement, and evaluate education about AUDs and CF for ED nurses.

Design:
This study used a quasi-experimental pretest–posttest within-subjects design.

Sample:
A convenience sample of 44 nurses was recruited at a large urban ED.

Methods:
Nurses completed demographics, Professional Quality of Life: Compassion Satisfaction and Fatigue (ProQOL), and Short Alcohol and Alcohol Problems Perceptions Questionnaire. Then, the nurses participated in 5 hours of an online educational program and a 1-hour live class about AUDs and CF. The surveys were readministered.

Results:
The difference in pretest and posttest Short Alcohol and Alcohol Problems Perceptions Questionnaire subscales of role security (expected value = 8.5, p < .006) and therapeutic commitment (expected value = 7.50, p = .018) was statistically significant. For ProQOL constructs, no statistical significance was found. The ProQOL subscales were compared with norms and were statistically significantly different.

Conclusion:
Nurses’ attitudes about patients with AUDs improved after completing the curriculum. Studied nurses had higher levels of professional satisfaction at baseline.
Predictors for Digital Game Addiction Among Turkish Adolescents
Authors: Irmak Aylin Yalçin , Erdoğan Semra 
Published: March 2019

Abstract

Background:
Digital game addiction among adolescents is a growing problem. The purpose of this study is to describe the predictors for this addiction in a group of Turkish adolescents using a conceptual framework.

Methods:
A descriptive correlational study was conducted on 865 students (aged 11–16 years) and their parents. Self-reported digital game behaviors were measured using the Game Addiction Scale. The risk factors for gaming addiction were examined using multiple regression analysis.

Results:
Adolescents spent 10.78 ± 13.42 hours per week playing digital games, and the rate of digital game addiction was calculated at 4.32% and 28.8% in monothetic and polythetic formats, respectively. Family environment and school performance directly affected female adolescents’ digital gaming behaviors, whereas male adolescents’ digital gaming behaviors were directly affected by computer self-efficacy, psychosocial problems, diminished impulse control, and levels of in-game violence.

Conclusions:
The interaction model of client health behavior can be used to describe adolescents’ digital game use. Nurses can assess adolescents’ gaming behaviors and use the effective predictors from the male and female models to develop intervention programs.
Shining a Light
Authors: Wood Tara , Bordelon Curry , Fogger Susanne 
Published: March 2019

Abstract

Background and Purpose:
The epidemic use of opioids is negatively influencing the health of the American people. Pregnant women and their unborn babies have not escaped the ravages of substance use. A dramatic increase in maternal opioid use has led to an increasing number of infants experiencing withdrawal symptoms known as neonatal abstinence syndrome (NAS). The purpose of this article is to highlight best practice for the management of infants with opioid withdrawal.

Review of Protocols and Treatments:
Review of available protocols and treatments revealed wide variation in the treatment of NAS and little use of standardized guidelines or protocols, despite current recommendations of the American Academy of Pediatrics. There is supporting evidence showing that the use of standardized protocols reduces the length of treatment and enhances outcomes in the neonatal population.

Evidence-Based Recommendations:
Evidence-based strategies to address gaps in practice include developing strong protocols to identify infants at risk and implementing standardized plans when treating NAS. Consistent assessment, initial treatment with nonpharmacologic measures, and conservative use of pharmacologic agents are important elements to an NAS treatment protocol.

Conclusions and Implications:
In evaluating the current literature for best practice in the management of the newborn with opioid withdrawal, it is clear that evidence-based standardized protocols need to be in place for the best treatment of the mother–infant dyad, caring for both the infants with NAS as well as the mothers with opioid use disorder.
International Control Efforts to Curb the Global Production and Trafficking of Fentanyl and Other Synthetic Opioids
Authors: Fornili Katherine Smith 
Published: March 2019

Abstract
The purpose of this Policy Watch column is to provide a brief overview of the global problems associated with the illicit production and trafficking of synthetic opioids as well as international efforts and policy approaches designed to curb them. An in-depth evaluation of drug control efforts of many different nations is important for a comprehensive analysis. However, because of the vast amount of information available, this column is limited to cooperative global control efforts, not efforts specific to any one nation. A great deal of information about production methods, clandestine laboratories, international trafficking methods, and online sales over the dark Web has been omitted. It is important to understand key issues regarding the illicit cultivation and distribution of plant-based opioids derived from natural compounds found in opium poppies (heroin, opium, morphine, codeine) or other drugs (cocaine, methamphetamines, etc.), but the scope of this column is limited to discussion about synthetic opioids including fentanyl, fentanyl analogues, and fentanyl precursor chemicals. Issues about human rights and ethical considerations for nurses and other addictions professionals are also discussed.
Shared Care During Breast and Colorectal Cancer Treatment: Is It Associated With Patient-Reported Care Quality?
Authors: Doose Michelle , McGee-Avila Jennifer , Stroup Antoinette M. , Ferrante Jeanne , Xu Baichen , Herman Natalia L. , Demissie Kitaw , Tsui Jennifer 
Published: March 2019

ABSTRACT
There is growing evidence that shared care, where the oncologist, primary care physician, and/or other specialty physicians jointly participate in care, can improve the quality of patients' cancer care. This cross-sectional study of breast and colorectal cancer patients (N = 534) recruited from the New Jersey State Cancer Registry examined patient and health system factors associated with receipt of shared care during cancer treatment into the early survivorship phase. We also assessed whether shared care was associated with quality indicators of cancer care: receipt of comprehensive care, follow-up care instructions, and written treatment summaries. Less than two-thirds of participants reported shared care during their cancer treatment. The odds of reporting shared care were 2.5 (95% CI: 1.46–4.17) times higher for colorectal than breast cancer patients and 52% (95% CI: 0.24–0.95) lower for uninsured compared with privately insured, after adjusting for other sociodemographic, clinical/tumor, and health system factors. No significant relationships were observed between shared care and quality indicators of cancer care. Given a substantial proportion of patients did not receive shared care, there may be missed opportunities for integrating primary care and nononcology specialists in cancer care, who can play critical roles in care coordination and managing comorbidities during cancer treatment.
Bispectral Index Values Are Accurate Diagnostic Indices Correlated With Glasgow Coma Scale Scores
Authors: Li Shuojie , Fei Zhimin , Zhang Jue , Shu Guowei , Wang Jingyu , Cai Peihao , Gong Li , Kong Lingjun , Xu Leyi , Qiu Feng , Chen Li , Yuan Jie , Zhou Dejun 
Published: March 2019

ABSTRACT

Objective: The Glasgow Coma Scale (GCS) is widely used in neurosurgery to evaluate the depth of coma in patients with brain injury. The bispectral index (BIS) was developed primarily to monitor the depth of unconsciousness. Recent evidence suggests that BIS may also help in the assessment of brain injury. This study explores the correlation between GCS scores and BIS values in patients with brain injury. Methods: Fifty patients were divided into 2 groups—moderate (GCS 9–12) and severe (GCS 3–8)—in this prospective, double-blind, observational study. Bispectral index data were recorded when electromyography was less than 40 and signal quality index was greater than 75 for 5 minutes. Linear regression was used to examine the correlation between BIS and GCS, and receiver operating characteristic curves were plotted. Cutoff points were identified to show the feasibility and accuracy of BIS for assessing brain injury. Results: The mean BIS value of the moderate group was 65.62 ± 12.84, and that of the severe group was 46.27 ± 17.35. Bispectral index values were significantly correlated with GCS (R
2 = 0.729, P < .01). The regression line and 95% confidence interval were determined; the regression equation was BIS = 5.46*GCS + 12.72. The receiver operating characteristic curve showed high diagnostic accuracy when GCS is less than 9; the area under the curve was 0.8164, and the cutoff point (BIS value) corresponding to the maximum sensitivity (0.91) and specificity (0.63) was 60.2. Conclusion: BIS values and GCS scores were significantly correlated in patients with brain injury. As a continuous and objective measurement, BIS is a viable evaluation and monitoring tool for brain injury.
Readmissions after left ventricular assist device implantation: Considerations for nurse practitioners
Authors: Kaiser Jennifer A. 
Published: March 2019

ABSTRACT

Background and purpose:
Left ventricular assist device (LVAD) therapy is becoming a widespread treatment for advanced heart failure. Implantation of an LVAD introduces complications that contribute to high rates of rehospitalization. This study examines the presenting signs and symptoms in LVAD patients at the time of readmission and explores the prevalence of psychosocial factors that are significantly associated with readmissions in this patient population.

Methods:
This is a retrospective review of 226 patients who had an LVAD implanted at a single transplant center. Data were extracted from individual electronic health record review and analyzed for readmissions within 6 months of discharge from the index hospitalization.

Conclusions:
Post-LVAD readmission rates are high and occur more frequently in destination therapy (DT) patients. Anxiety and depression are significant predictors of readmission. These factors negatively affect post-LVAD quality of life, particularly in DT patients.

Implications for practice:
By understanding the etiologies and factors related to readmission after an LVAD, nurse practitioners can identify and address these issues before they result in rehospitalization to improve post-LVAD quality of life. With these considerations, ongoing nonemergent discussions of goals of care and quality of life are imperative because more patients will be offered the choice of an LVAD as a potentially life-long treatment.