bluuebunny/crossref_metadata_2025_split huggingface dataset:
Measuring the Gap Between Students’ Expectations and Experiences in an RN-to-BSN Nursing Program
Authors: Dabney Beverly W. , Linton Mary , Duncan Chelsea , Koonmen Jamie 
Published: May 2018

Abstract
With the nursing profession requiring a more educated workforce, RN-to-BSN program enrollment has increased. Therefore, many nursing schools have expanded these programs and incorporated online learning components. The purpose of this study was to explore student expectations and perceptions of a Midwestern university’s RN-to-BSN program. A modified SERVQUAL tool was used to measure student perceptions of six quality dimensions: empathy, assurance, responsiveness, reliability, website content, and e-learning quality. Results showed that the expectation-perception gap was greatest for responsiveness (−0.506) and least for website content (−0.156). Results from this and future gap analyses will be used to develop quality improvement measures.
Self-Publishing
Authors: Waldrop Julee 
Published: May 2018

Abstract
Professional communication and the dissemination of expertise are expected of nurses prepared at the doctoral level. However, little emphasis is placed on opportunities for professional writing in most clinically focused doctoral programs for nurse practitioners. This innovative extracurricular writing project provided a professional writing experience for novice writers, helping them gain the confidence needed to achieve dissemination beyond the educational setting in the form of a self-published e-book. This project could be used for many other types of writing in nursing.
The Extended Dwell Peripheral Intravenous Catheter Is an Alternative Method of NICU Intravenous Access
Authors: Chenoweth Kimberlee B. , Guo Jia-Wen , Chan Belinda 
Published: May 2018

Background:
Establishing vascular access is a common neonatal intensive care unit procedure. The extended dwell peripheral intravenous (EPIV) catheter is a 6-cm and 8-cm silicone catheter for peripheral vein insertion, which is a newer vascular access device than peripherally inserted central catheters (PICCs) and peripheral intravenous (PIV) catheter. Extended dwell peripheral intravenous catheters have been widely used in adults but evidence in neonates is lacking.

Purpose:
To explore indwell time, success rate, catheter-associated complications, and cost among EPIV catheters, PICCs, and PIV catheters in neonates.

Methods:
We retrospectively compare patient demographics, indwell time, success rate, and catheter-associated complications, and analyze the rate of hyaluronidase-treated intravenous (IV) fluid extravasation on neonates who had an EPIV catheter, a PICC, or a PIV catheter in a level III neonatal intensive care unit. We also estimate the insertion cost of these 3 vascular access devices on the basis of our hospital charges.

Results:
Extended dwell peripheral intravenous catheters were inserted in 432 neonates with an indwell time of 4.0 ± 2.3 (mean ± SD) days. Peripherally inserted central catheters were inserted in 202 neonates with an average indwell time of 7.3 ± 4.4 (mean ± SD) days, which was longer than EPIV catheters (P < .001). Peripherally inserted central catheters had a higher success rate of 83.6% than 71.7% of EPIV catheters, meaning succeeded in lasting through the completion of therapy (P = .001). Peripherally inserted central catheters were associated with 4 cases of life-threatening complications; none was seen in the EPIV catheter group. The incidence of hyaluronidase-treated IV fluid extravasation was less in EPIV catheter recipients (1.2%) than in the PIV catheter recipients (3.9%) (P = .004); none was in the PICC group. Cost savings were noted with using an EPIV catheter.

Implications for Practice:
Extended dwell peripheral intravenous catheter is a feasible option for neonatal vascular access.

Implications for Research:
These data provide a baseline for future studies to explore the efficacy and effectiveness of EPIV catheter in the neonates.
Congenital Unilateral Atlanto-Occipital Rotatory Subluxation
Authors: Bapat Mihir R. , Gujral Amandeep , Patel Bharat K. 
Published: May 2018

Study Design.
Case report.

Objective.
We report a rare case of congenital unilateral rotatory atlanto-occipital subluxation that presented with left C1 neuralgia.

Summary of Background Data.
Secondary occipital neuralgia is commonly attributed to pathologies of the atlanto-axial joint and C2/C3 nerve involvement. Our case depicts a model of slow creeping atlanto-occipital subluxation due to a rare left C1 superior articular facet dysplasia with C1 foraminal stenosis presenting as C1 neuralgia. We discuss the eitology and patho-anatomy of this rare undescribed presentation.

Methods.
A 42-year-old gentleman presented with deteriorating and intractable left occipital headache of 6 months duration. The neck disability index (NDI) was 64%. Cervical MR/computed tomography scan showed a unilateral C1 facet dysmorphism with a left sided C1 foramen bony compression. There was no central canal stenosis.

Results.
Posterior left C1 arch excision and decompression of C1 foramina with occipital-cervical fusion relieved C1 neuralgia.

Conclusion.
Our case depicts a model of slow creeping deformation due to left C1 superior articular facet dysplasia. An abnormal facet slope allowed the occipital condyle to migrate posteriorly and medially leading to crowding of the left C1 foramen. Although the etiology was congenital, the neck spasm was delayed till fourth decade. A secondary C1 foramen stenosis led to C1 occipital neuralgia that presented as an intractable headache.

Level of Evidence: 5
A Guide for Planning and Implementing Successful Mental Health Educational Programs
Authors: Blanco-Vieira Thiago , Ramos Fernando Augusto da Cunha , Lauridsen-Ribeiro Edith , Ribeiro Marcos Vinícius Vieira , Meireles Elisa Andrade , Nóbrega Brunno Araújo , Motta Palma Sonia Maria , Ratto Maria de Fátima , Caetano Sheila Cavalcante , Ribeiro Wagner Silva , Rosário Maria Conceição do 
Published: May 2018

Introduction:
Considering the global burden of mental disorders, there is a worldwide need to improve the quality of mental health care. In order to address this issue, a change in how health care professionals are trained may be essential. However, the majority of the few reports published on this field's training programs do not discuss the characteristics associated with the success or failure of these strategies. The purpose of this review was to systematically examine the literature about mental health training programs designed for health care professionals in order to identify the relevant factors associated with their effective implementation.

Methods:
The MEDLINE/PubMed, SciELO, and Virtual Health Library databases were used to search for articles published before February 2017 and reviewed by two double-blind reviewers.

Results:
We found 77 original papers about mental health educational programs. Many of these studies were conducted in the USA (39%), addressed depression as the main subject (34%), and applied a quasi-experimental design (52%). Effective interventions were associated with the following characteristics: the use of learner-centered and interactive methodological approaches; a curriculum based on challenges in the trainees' daily routines; the involvement of experts in the program's development; the enrollment of experienced participants; interdisciplinary group work; flexible timing; the use of e-learning resources; and optimizing the implementation of knowledge into the participants' routine work practices.

Implications for Practice:
These results will be helpful for planning and improving the quality of future educational programs in mental health.
Making the Most of Continuing Medical Education: Evidence of Transformative Learning During a Course in Evidence-Based Medicine and Decision Making
Authors: Sokol Randi G. , Shaughnessy Allen F. 
Published: May 2018

Introduction:
Continuing medical information courses have been criticized for not promoting behavior change among their participants. For behavior change to occur, participants often need to consciously reject previous ideas and transform their way of thinking. Transformational learning is a process that cultivates deep emotional responses and can lead to cognitive and behavioral change in learners, potentially facilitating rich learning experiences and expediting knowledge translation. We explored participants' experiences at a 2-day conference designed to support transformative learning as they encounter new concepts within Information Mastery, which challenge their previous frameworks around the topic of medical decision making. Using the lens of transformative learning theory, we asked: how does Information Mastery qualitatively promote perspective transformation and hence behavior change?

Methods:
We used a hermeneutic phenomenologic approach to capture the lived experience of 12 current and nine previous attendees of the “Information Mastery” course through individual interviews, focus groups, and observation. Data were thematically analyzed.

Results:
Both prevoius and current conference attendees described how the delivery of new concepts about medical decision making evoked strong emotional responses, facilitated personal transformation, and propelled expedited behavior change around epistemological, moral, and information management themes, resulting in a newfound sense of self-efficacy, confidence, and ownership in their ability to make medical decisions.

Discussion:
When the topic area holds the potential to foster a qualitative reframing of learners' guiding paradigms and worldviews, attention should be paid to supporting learners' personalized meaning-making process through transformative learning opportunities to promote translation into practice.
Common Use of Stimulants and Alpha-2 Agonists to Treat Preschool Attention-Deficit Hyperactivity Disorder: A DBPNet Study
Authors: Blum Nathan J. , Shults Justine , Harstad Elizabeth , Wiley Susan , Augustyn Marilyn , Meinzen-Derr Jareen K. , Wolraich Mark L. , Barbaresi William J. 
Published: May 2018

ABSTRACT:

Objective:
To describe the use of stimulants and alpha-2 agonists (A2As) for the treatment of preschool-aged children with attention-deficit hyperactivity disorder (ADHD) at 2 Developmental-Behavioral Pediatrics Research Network sites.

Methods:
Demographic information, diagnoses, and medications prescribed by developmental-behavioral pediatricians (DBPs) were extracted from the electronic health record for all outpatient visits from January 1, 2010, to December 31, 2011. The subset of visits for children aged 2 to 5 years who had a diagnosis of ADHD was included in this analysis. Multivariable models were constructed to identify factors associated with prescribing stimulants and A2As.

Results:
Over the 2-year period, 984 children with a diagnosis of ADHD were seen at 1779 visits. Of the 984 children, 342 (34.8%) were prescribed a stimulant, and 243 (24.7%) were prescribed an A2A. Both medications were prescribed at the same visit at least once during the 2-year period for 97 children (9.9%). Alpha-2 agonists were prescribed more often at site 2 than site 1 (OR [odds ratio] = 1.62, p = 0.015). Stimulants were more likely to be prescribed for older preschool-aged children (OR = 1.66, p < 0.001), and A2As were more likely to be prescribed for younger children (OR = 0.82, p = 0.02). Both stimulants and A2As were more likely to be prescribed to children with ADHD and comorbid conditions.

Conclusion:
Alpha-2 agonists are commonly used by some DBPs for preschool ADHD. Variation in the use of A2As across sites may indicate a lack of consensus on when to use these medications and suggests a need for comparative effectiveness research to better define the relative benefits and side effects of A2As and stimulants for the treatment of preschool ADHD.
Melanoma Reporting Practices of United States Dermatologists
Authors: Svoboda Ryan M. , Glazer Alex M. , Farberg Aaron S. , Cowdrey Molly C.E. , Rigel Darrell S. 
Published: May 2018

BACKGROUND
Accuracy of US cancer statistics depends on physicians' knowledge of and adherence to reporting mandates. Significant knowledge and practice gaps have been documented in regards to melanoma reporting requirements.

OBJECTIVE
To determine whether the gaps in dermatologists' knowledge and practice of melanoma reporting persist.

MATERIALS AND METHODS
The authors performed a survey of US dermatologists attending a national conference. The proportion aware of the melanoma reporting mandate and the proportion who routinely report newly diagnosed cases were calculated.

RESULTS
Ninety-one percent (158/174) of those sampled completed the survey. Forty-nine percent correctly identified melanoma as being a disease of mandated reporting. Only 34% reported newly diagnosed cases to their state registry. Dermatologists seeing low melanoma volumes were less likely to routinely report newly diagnosed cases to registries than those seeing high volumes (22.9% vs 45.4%, p = .004). Those in practice for ≤10 years were less likely to be aware of the mandate than those in practice longer (32.6% vs 57.0%, p = .006).

CONCLUSION
Most dermatologists remain unaware of melanoma reporting requirements. Resultant underestimates of the true incidence of melanoma could have resource allocation implications. Interventions aimed at improving knowledge of the mandate should focus on younger clinicians and those with lower melanoma case volumes.
Evaluating the Efficacy of Different Platelet-Rich Plasma Regimens for Management of Androgenetic Alopecia: A Single-Center, Blinded, Randomized Clinical Trial
Authors: Hausauer Amelia K. , Jones Derek H. 
Published: May 2018

BACKGROUND
Studies suggest platelet-rich plasma (PRP) may mitigate androgenetic alopecia (AGA), but each varies in the frequency of and interval between treatments.

OBJECTIVE
To compare the efficacy, satisfaction, tolerability, and safety of 2 initial PRP injection protocols over 6 months.

METHODS
Prospective, randomized, single-blinded trial among 40 patients with moderate AGA. Participants received subdermal PRP injections according to 1 of 2 treatment protocols: 3 monthly sessions with booster 3 months later (Group 1) or 2 sessions every 3 months (Group 2). Folliscope hair count and shaft caliber, global photography, and patient satisfaction questionnaires were obtained at baseline, 3 months, and 6 months.

RESULTS
At 6 months, both groups demonstrated statistically significant increases in hair count (p < .001). These improvements occurred more rapidly and more profoundly for Group 1 (mean percent change: Group 1, 29.6 ± 13.6 vs Group 2, 7.2 ± 10.4; p < .001). Shaft caliber also increased significantly with no difference between groups. Treatments produced high satisfaction (82% “satisfied” or “highly satisfied”) and were safe and well tolerated (mean pain score 2.1).

CONCLUSION
Subdermal PRP injections are an efficacious and tolerable therapy among men and women with AGA. The benefits may be greater if first administered monthly. Clinicians should consider these findings when designing treatment plans.
Association between Oklahoma earthquakes and anxiety-related Google search episodes
Authors: Casey Joan A. , Goldman-Mellor Sidra , Catalano Ralph 
Published: May 2018

Background:
Oklahoma has experienced a rise in seismicity since 2010, with many earthquakes induced by wastewater injection. While large single earthquakes have documented mental health repercussions, health implications of these new, frequent earthquakes remain unknown. We aimed to examine associations between Oklahoma earthquakes and statewide anxiety measured by Google queries.

Methods:
The U.S. Geologic Survey’s Advanced National Seismic System Comprehensive Catalog supplied earthquake dates and magnitudes. We used the Google Health application programming interface to compile the proportion of weekly Oklahoma-based health-related search episodes for anxiety. A quasi-experimental time-series analysis from January 2010 to May 2017 evaluated monthly counts of earthquakes ≥ magnitude 4 (a level felt by most people) in relation to anxiety, controlling for US-wide anxiety search episodes and Oklahoma-specific health-related queries.

Results:
Oklahoma experienced an average of two (SD = 2) earthquakes ≥ magnitude 4 per month during the study period. For each additional earthquake ≥ magnitude 4, the proportion of Google search episodes for anxiety increased by 1.3% (95% confidence interval = 0.1%, 2.4%); 60% of this increase persisted for the following month. In months with 2 or more ≥ magnitude 4 earthquakes, the proportion of Google search episodes focused on anxiety increased by 5.8% (95% confidence interval = 2.3%, 9.3%). In a sub-analysis, Google search episodes for anxiety peaked about 3 weeks after ≥ magnitude 4 quakes.

Conclusions:
These findings suggest that the recent increase in Oklahoma earthquakes has elicited a psychological response that may have implications for public health and regulatory policy.
RECURRENT BRANCH RETINAL ARTERY OCCLUSION FROM SUSAC SYNDROME: CASE REPORT AND REVIEW OF LITERATURE
Authors: Ammar Michael J. , Kolomeyer Anton M. , Bhatt Nirali , Tamhankar Madhura A. , Mullen Michael T. , Brucker Alexander J. 
Published: May 2018

Purpose:
We report a patient with branch retinal artery occlusion predominant Susac syndrome and review the literature on current diagnostic modalities and therapeutic approaches for this rare condition.

Methods:
Case report.

Results:
A 23-year-old white male presented with a 5-month history of a scotoma in his right eye vision, headaches, and intermittent paresthesias of the lower extremities. Ophthalmic examination was normal with the exception of a hypopigmented small retinal area inferonasal to the fovea in the right eye. Optical coherence tomography demonstrated inner retinal atrophy and optical coherence tomography angiography showed deep capillary layer vessel dropout in both eyes. Ultra-wide-field fluorescein angiography revealed bilateral arteriolar wall hyperfluorescence. Corpus callosal lesions were present on magnetic resonance imaging. Lumbar puncture demonstrated elevated protein. Audiogram was normal. A diagnosis of Susac syndrome was made. The patient initially received oral steroids followed by intravenous steroids and mycophenolate mofetil because of new branch retinal artery occlusions. Thirteen months after initial presentation, the vision was stable at 20/20 in both eyes.

Conclusion:
It is a diagnostic challenge when recurrent branch retinal artery occlusion secondary to Susac syndrome presents without the classic symptoms. Optical coherence tomography angiography and subtle magnetic resonance imaging findings aided in early recognition of the diagnosis in our patient. Ultra-wide-field fluorescein angiography was an important tool in disease monitoring. Aggressive management with intravenous corticosteroids and initiation of immunosuppression resulted in long-term preservation of vision and improvement in visual field.
Acanthamoeba Keratitis: Are Recent Cases More Severe?
Authors: Roozbahani Mehdi , Hammersmith Kristin M. , Rapuano Christopher J. , Nagra Parveen K. , Zhang Qiang (Ed) , Siu Sophia Y. 
Published: May 2018

Purpose:
To identify a recent change in disease severity and visual outcomes of patients with Acanthamoeba keratitis (AK) at Wills Eye Hospital (WEH).

Methods:
A retrospective chart review was performed of all cases diagnosed with AK at WEH between January 1, 2009, and December 31, 2015. Failure of treatment was defined as having a final best-corrected visual acuity worse than 20/100 and/or requiring keratoplasty. The patients were grouped into 2 outcome categories: successfully treated and those who failed treatment; and prognostic factors associated with failure status were evaluated. Additionally, patients who presented from 2009 to 2012 (labeled “first interval”) were compared with those who presented more recently from 2013 to 2015 (labeled “second interval”) to determine whether the treatment outcomes and patients' characteristics from the 2 intervals were different.

Results:
Fifty-nine patients were diagnosed. The rate of treatment failure in the second interval was significantly higher than in the first interval (68% vs. 28%, P = 0.004). Compared with the patients in the first interval, those who presented in the second interval were significantly older, were treated with more corticosteroids before diagnosis, had more days from the symptom onset to initiation of AK treatment, and presented to WEH with poorer vision.

Conclusions:
In recent years, the general profile of patients with AK has changed at WEH. Currently, we are treating older patients with more severe keratitis who are presenting later and with worse vision compared with our previous patients. At the same time, treatment outcomes have been poorer.
Retrospective Analysis of Hearing-Impaired Adult Patients Treated With an Active Transcutaneous Bone Conduction Implant
Authors: Rader Tobias , Stöver Timo , Lenarz Thomas , Maier Hannes , Zahnert Thomas , Beleites Thomas , Hagen Rudolf , Mlynski Robert , Baumgartner Wolf Dieter 
Published: May 2018

Objective:
To determine the therapeutic success and safety of an active transcutaneous bone conduction implant (tBCI) in adult patients with conductive or mixed hearing loss.

Study Design:
Retrospective case review.

Setting:
Five university hospitals in Frankfurt, Hannover, Dresden, Würzburg, and Vienna.

Patients:
Data were analyzed from 61 patients (31 women, 30 men) with a mean age of 50 years (min. 26, max. 80). Forty patients had mixed, and 21 conductive hearing loss. Typical etiologies were history of otitis media (n = 20) and cholesteatoma (n = 17).

Interventions:
Implantation of the active tBCI.

Main Outcome Measures:
Data were analyzed for the following time points: up to 6 months postoperatively (“short-term”), 6 to 37 months postoperatively (“long-term”), and the last available measurement per patient (“most recent”). Pure-tone audiometry (air and bone conduction, AC and BC) and sound field thresholds with warble tones (WT), word recognition scores with Freiburger monosyllables (WRS), as well as speech reception thresholds (SRT) using the Oldenburg sentence test (OLSA) in quiet (SRT) and in noise (signal-to-noise ratio, SNR) were collected.

Results:
No significant changes in air- and bone-conduction thresholds were observed after implantation. A mean WRS improvement of 54% using the active tBCI was shown at the short-term assessment, i.e., a mean score of 79% compared with 25% in the unaided condition. Results remained stable, with a mean score of 75% at the long-term assessment. SRT in noise improved by 3.6 dB SNR in the implanted ear at the short-term assessment. Overall six adverse events and four serious adverse events were reported, resulting in a rate of 9.84 and 6.56%, respectively.

Conclusion:
The tBCI clearly improves speech intelligibility in patients with conductive or mixed hearing loss, showing stable results up to 1 year post-implantation.