bluuebunny/crossref_metadata_2025_split huggingface dataset:
Human Trafficking: How Nurses Can Make a Difference
Authors: Scannell Meredith , MacDonald Andrea E. , Berger Amanda , Boyer Nichole 
Published: May 2018

ABSTRACT
Human trafficking is a human rights violation and a global health problem. Victims of human trafficking have medical and mental health sequelae requiring specific healthcare interventions. Healthcare professionals may be the initial contact that these victims make outside the world of trafficking. Healthcare professionals are key agents in the identification of human trafficking, which is essential in eliminating this public health problem. Unfortunately, healthcare professionals are not always able to detect signs of human trafficking. Failure to detect results in missed opportunities to assist victims. This is a case report of a victim of human trafficking who presented to an emergency department with medical and mental health issues. Despite numerous encounters with different healthcare professionals, signs and symptoms of human trafficking were not identified. Skilled assessment made by a forensic nurse alerted the healthcare team to clear features of human trafficking associated with this person. Through this case report we illustrate the key role the nurse played in identifying signs of human trafficking. Improvement of human trafficking educational programs is highlighted as a key adjunct to improving detection and facilitating the proper treatment of victims.
Injectable Nonsteroidal Anti-Inflammatory Drugs in Sport
Authors: Matava Matthew J. 
Published: May 2018

Objective:
The primary objective of this article is to review the basic science of nonsteroidal anti-inflammatory drugs (NSAIDs), their clinical effects, indications, potential complications, and ethical issues associated with the use of injectable NSAIDs in the treatment of athletes. These objectives are presented taking into consideration the contemporaneous issues associated with the treatment of amateur and professional athletes.

Data Sources:
A nonformal review of the published medical literature and lay media focusing on the use of injectable NSAIDs in athletes was used for this article.

Main Results:
All NSAIDs work through the inhibition of the cyclooxygenase (COX) pathway (either one or both subtypes) to reduce inflammation and inhibit pain by reducing prostaglandin and thromboxane synthesis. Complications related to NSAID use involve primarily the gastrointestinal, renal, and cardiovascular systems through this COX pathway inhibition. Ketorolac is the only NSAID currently available in an injectable form. Despite its analgesic efficacy comparable with opioid medication, injectable ketorolac has the potential to cause bleeding in collision athletes resulting from impaired hemostasis.

Conclusions:
Nonsteroidal anti-inflammatory drug medications are currently used at every level of competition. Injectable ketorolac is an effective analgesic and anti-inflammatory drug. However, its potential effectiveness must be weighed against the risk of potential complications in all athletes, especially those who participate in contact/collision sports. The team physician must balance the goal of treating pain and inflammation with the ethical implications and medical considerations inherent in the administration of injectable medications solely to prevent pain and/or return the athlete to competition.
Endobronchial Ultrasound-guided Transbronchial Needle Aspiration With a 19-G Needle Device
Authors: Tremblay Alain , McFadden Seamus , Bonifazi Martina , Luzzi Valentina , Kemp Samuel V. , Gasparini Stefano , Chee Alex , MacEachern Paul , Dumoulin Elaine , Hergott Christopher A. , Shah Pallav L. 
Published: May 2018

Background:
Endobronchial ultrasound (EBUS)-guided transbronchial needle aspiration is a well-established first-line minimally invasive modality for mediastinal lymph node sampling. Although results are excellent overall, the technique underperforms in certain situations. We aimed to describe our results using a new 19-G EBUS-guided transbronchial needle aspiration device to determine safety and feasibility of this approach.

Methods:
We completed a retrospective chart review of all cases performed to the time of data analysis at each of 3 study sites.

Results:
A total of 165 procedures were performed with a total of 297 individual lymph nodes or lesions sampled with the 19-G device by 10 bronchoscopists. Relatively large targets were selected for sampling with the device (mean lymph node size: 20.4 mm; lung lesions: 33.5 mm). A specific diagnosis was obtained in 77.3% of cases with an additional 13.6% of cases with benign lymphocytes, for a procedural adequacy rate of 90.9%. Procedure sample adequacy was 88.6% in suspected malignant cases, 91.0% in suspected sarcoidosis/lymphadenopathy cases, and 85.7% of cases with suspected lymphoma. On a per-node basis, a specific diagnosis was noted in 191/280 (68.2%) of samples, with an additional 61 showing benign lymphocytes for a per-node sample adequacy rate of 90%. One case (0.6%) of intraprocedure bleeding was noted.

Conclusions:
A new flexible 19-G EBUS needle was successfully and safely applied in a large patient cohort for sampling of lung and enlarged mediastinal lesions with high diagnostic rates across clinical indications.
Changes in Psychiatric and Medical Conditions and Health Care Utilization Following a Diagnosis of Sexual Assault
Authors: Young-Wolff Kelly C. , Sarovar Varada , Klebaner Daniella , Chi Felicia , McCaw Brigid 
Published: May 2018

Introduction:
Sexual assault (SA) is alarmingly common and is associated with higher prevalence of psychiatric and medical conditions. However, many prior studies are limited to cross-sectional designs. Health care systems with electronic health records provide unique longitudinal data to examine whether SA is associated with changes in health and health care utilization.

Methods:
The sample included 1350 Kaiser Permanente Northern California adult female patients with a SA diagnosis from 2009 to 2015 and 4050 adult female patients without a SA diagnosis, matched on age, medical facility, and continuous enrollment during the study period. Using a retrospective cohort design, we tested whether a SA diagnosis was associated with 12-month changes in psychiatric and medical comorbidities and health care utilization using difference-in-difference models. Analyses were conducted in 2017.

Results:
Patients with a SA diagnosis had a higher prevalence of psychiatric and medical comorbidities and greater health care utilization than matched patients without SA in the 12 months before the SA diagnosis, and greater increases in the prevalence of psychiatric disorders and stress-related somatic conditions, and psychiatry and obstetrics/gynecology utilization (all P<0.001), 12 months after the SA diagnosis, relative to matched non-SA patients during this time.

Discussion:
SA is associated with increases in psychiatric disorders and stress-related somatic conditions as well as increases in utilization of psychiatry and obstetrics/gynecology. Clinicians should be trained in how to inquire about, respond to, and refer women who have experienced SA.
A Therapeutic Strategy for Resectable Pancreatic Cancer Based on Risk Factors of Early Recurrence
Authors: Kurahara Hiroshi , Maemura Kosei , Mataki Yuko , Sakoda Masahiko , Iino Satoshi , Kawasaki Yota , Arigami Takaaki , Mori Shinichiro , Kijima Yuko , Ueno Shinichi , Shinchi Hiroyuki , Natsugoe Shoji 
Published: May 2018

Objectives
The aim of this study was to identify risk factors for early recurrence and assess the prognostic benefit of neoadjuvant therapy (NAT) for resectable pancreatic cancer.

Methods
Patients with radiographically resectable pancreatic cancer according to the National Comprehensive Cancer Network guidelines were enrolled. We regarded recurrence within 6 months after surgery as early recurrence.

Results
This study involved 115 patients (80 who underwent upfront surgery and 35 who received NAT). Serum carbohydrate antigen 19-9 greater than 85 U/mL and p53 expression in 0 or more than 80% of tumor cells were independent risk factors for early recurrence after upfront surgery. We classified patients into a high-risk group (1 or 2 risk factors) and a low-risk group (no risk factors). In the high-risk group, the median overall survival time of patients with NAT was significantly longer than that of patients without NAT (P = 0.028). By contrast, the median overall survival time was not different according to NAT in the low-risk group.

Conclusions
Serum carbohydrate antigen 19-9 and p53 expression of the primary tumor could be predictors of early recurrence in patients with resectable pancreatic cancer. The prognosis of patients with a high risk of early recurrence may be improved using NAT.
Neurophysiological Response to Olfactory Stimuli in Combat Veterans With Posttraumatic Stress Disorder
Authors: Bedwell Jeffrey S. , Bohil Corey J. , Neider Mark B. , Gramlich Michael A. , Neer Sandra M. , O'Donnell John P. , Beidel Deborah C. 
Published: May 2018

Abstract
There is a need for a better understanding of underlying pathology in posttraumatic stress disorder (PTSD) to develop more effective treatments. The late positive potential (LPP) amplitude from electroencephalogram has been used to assess individual differences in emotional reactivity. There is evidence that olfaction is particularly important in emotional processing in PTSD. The current study examined LPP amplitudes in response to olfactory stimuli in 24 combat veterans with PTSD and 24 nonmilitary/non-PTSD controls. An olfactometer delivered three negatively valenced odorants, with 12 trials of each delivered in a random order. The groups did not differ in LPP amplitude across odorants. However, within the PTSD group, higher Clinician-Administered PTSD Scale scores related to an increased LPP amplitude after diesel fuel and rotten egg, but not n_butanol, odorants. Results provide specific targets and theory for further research into clinical applications such as selection of idiographic odorants for use in virtual-reality exposure therapy.
Using a Clinician-Administered Interview to Examine the Overlap in Posttraumatic Stress Disorder Criteria D and E
Authors: Franklin C. Laurel , Raines Amanda M. , Walton Jessica L. , Chambliss Jessica L. , Maieritsch Kelly P. 
Published: May 2018

Abstract
Although the diagnosis of posttraumatic stress disorder (PTSD) is often criticized for including symptoms that overlap with one another, only one study has explored the impact of symptom reporting. Using a clinician-rated interview for PTSD (N = 558), the current study examined overlap between PTSD criteria D1, D2, and D3 (“target D symptoms”) and criterion E symptoms of similar content (i.e., E1 and E3). Furthermore, their impact on meeting criterion and disorder cutoffs was examined. Results revealed that target symptoms were endorsed in conjunction more than half the time. Criteria D and E also were often coded together. Removal of target D symptoms resulted in 24.7% of participants no longer meeting criterion D, but no reduction in the diagnosis of PTSD. This article is one of the first to report the functioning of the new criterion D symptoms, and the results have diagnostic implications for research and clinical work.
Burnout Among US Military Behavioral Health Providers
Authors: Stearns Shaun , Shoji Kotaro , Benight Charles C. 
Published: May 2018

Abstract
The present study investigated the prevalence of burnout among US military behavioral health providers (BHPs) and tested a mechanism of developing burnout in a job demands–resources model. Surveys were sent to BHPs working with US military populations globally (T1). Six months after, surveys were collected again at T2. In total, 271 providers completed T1, and 116 completed T2. The job demands–resources model showed that T1 burnout self-efficacy and support predicted T2 burnout and work engagement. T1 job demands predicted T2 burnout. To provide a deeper comparison of our findings, we included a meta-analysis, which indicated burnout among BHPs working on a military installation was equivalent with other professions. Providers working with military clients within the community reported lower burnout than other professionals. Findings suggest BHPs working on a military installation might be at greater risk of developing burnout. Burnout might be preventable by increasing job resources and decreasing job demands.
Self-esteem and Symptoms in Individuals at Clinical High Risk for Psychosis
Authors: Benavides Caridad , Brucato Gary , Kimhy David 
Published: May 2018

Abstract
Individuals with psychotic symptoms often report low global self-esteem (GSE). However, it remains unclear whether the low GSE is linked to the presence of psychotic symptoms or it is present before the onset of psychosis. In addition, the specific subdomains of GSE in these populations are unknown. To address this question, we conducted a cross-sectional study comparing global and SE elements among individuals at clinical high risk for psychosis (CHR; n = 36), individuals with schizophrenia (SCZ; n = 43), and healthy controls (HCs; n = 40). We then examined among CHR individuals the association between GSE, subdomains, and symptoms. CHR individuals displayed significantly lower GSE compared to HCs, at a level comparable with those for individuals with SCZ. The low GSE was driven primarily by self-perceptions of work and interpersonal relationships abilities. Lower GSE was associated with overall negative and disorganized symptoms severity, but not positive ones. The authors discuss the implications of the findings to intervention development.
Recovery From Schizophrenia
Authors: Santos Maria M. , Kopelowicz Alex , López Steven R. 
Published: May 2018

Abstract
This study examined the views about the future of persons with schizophrenia and their caregivers to understand what is at stake in engaging in recovery. The views of 60 Mexican-origin consumer-caregiver dyads were coded by three independent raters using a recovery literature-based coding system of recovery components: social relations, caregiving burden relief, independence, self-responsibility, and empowerment. General recovery expectations were also rated. Interrater reliability, component frequency, and congruence between the consumers and caregivers' expectations were statistically examined. Dominant recovery components for consumers and caregivers were independence (72.5%), general expectations for recovery (51%), and social relations (43%). Relatives differed in two important ways. Consumers held significantly greater expectations for independence (p < 0.01), whereas caregivers focused more on general recovery (p < 0.001). What matters for recovery for this sample of Mexican-origin consumers and caregivers differs. Addressing differences in views may facilitate person-centered treatment that considers the views of consumers and caregivers.
Bipolar Disorder Is Associated With an Increased Risk of Sexually Transmitted Infections: A Nationwide Population-based Cohort Study
Authors: Chen Shih-Fen , Wang Ling-Yi , Chiang Jen-Huai , Shen Yu-Chih 
Published: May 2018

Background
Previous studies have suggested that sexually transmitted infections (STI) tend to increase in patients with bipolar disorder during a manic or hypomanic episode. However, in the long-term course of this disease, it is unclear whether patients with bipolar disorder have a higher risk of incident STI.

Methods
Using the National Health Insurance Research Database of Taiwan, 3721 patients with bipolar disorder and 14,884 controls without bipolar disorder matched by gender and age were enrolled between 2000 and 2010 and followed up until the end of 2013. Participants who developed any STI (human immunodeficiency virus [HIV], syphilis, genital warts, gonorrhea, chlamydial infection, and trichomoniasis) during the follow-up period were identified. Cox regression analysis was performed to examine the risk of STI between patients with bipolar disorder and comparative controls.

Results
Patients with bipolar disorder were prone to develop STI (hazard ratio [HR], 1.67, 95% confidence interval [95% CI], 1.27–2.18) especially for HIV (HR, 3.59; 95% CI, 1.16–11.08) and syphilis (HR, 2.26; 95% CI, 1.06–4.85). In addition, this study found that the incidence of STI was higher among women than men (HR, 1.83; 95% CI, 1.41–2.39).

Conclusions
This study shows that bipolar disorder is associated with an increased risk of developing STI, which has direct implications for the development of targeted prevention interventions or regular sexual health screening in mental health clinics to reduce the disproportionate burden of HIV and other STI in patients with bipolar disorder.
Performance of the Atlas Genetics Rapid Test for Chlamydia trachomatis and Women's Attitudes Toward Point-Of-Care Testing
Authors: Widdice Lea E. , Hsieh Yu-Hsiang , Silver Barbara , Barnes Mathilda , Barnes Perry , Gaydos Charlotte A. 
Published: May 2018

Purpose
This study compared performance of the Atlas io polymerase chain reaction–based, point-of-care (POC) assay for Chlamydia trachomatis (CT), to Aptima Combo 2, a standard of care nucleic acid amplification assay, and evaluated patient attitudes toward POC testing.

Methods
Women 14 years or older undergoing CT screening/testing were recruited from Teen Health Center and a sexually transmitted disease clinic. Participants provided self-obtained vaginal swabs for testing with the Atlas io and Aptima Combo 2, and completed questionnaires assessing attitudes toward POC testing.

Results
Of 296 women recruited, 284 (192 from sexually transmitted disease clinic, 92 from Teen Health Center) had Aptima Combo 2 and Atlas io results available; 273 completed the questionnaire. Average age was 27.4 years (SD, 10.8 years). Sensitivity and specificity of the Atlas io test were 83.9% (26/31 specimens; 95% confidence interval [CI], 70.9–96.8%) and 98.8% (250/253 specimens; 95% CI, 97.5–100%), respectively. When specimens with discrepant results were included in the analyses, adjudicated sensitivity and specificity were 92.9% (26/28 specimens; 95% CI, 83.3 to 100%) and 98.8% (253/256 specimens; 95% CI, 97.5 to 100%), respectively.
A majority (70%) of women preferred to collect vaginal self-swab if a POC test were available. Most (61%) were willing to wait up to 20 minutes, and 26% were willing to wait up to 40 minutes for results, if they could be treated before leaving clinic.

Conclusions
A POC polymerase chain reaction test detecting CT had high sensitivity and specificity when testing prospective, vaginal swab samples. Availability of CT results during patients' visits may decrease time to treatment.
The Causality Nexus Between the Tako-tsubo Syndrome and an Assault
Authors: Zribi Malek , Manoubi Syrine Azza , Karray Narjes , Charfeddine Salma , Benamar Wiem , Hammami Zouhir , Kammoun Samir , Maatoug Samir 
Published: May 2018

Abstract
“Tako-tsubo” cardiomyopathy, also known as “broken heart syndrome,” is one of the rarest types of stress-induced cardiomyopathy. It frequently mimics acute coronary syndrome, characterized by transient left ventricular dysfunction, electrocardiographic changes, and release of myocardial enzymes. After treatment, the patients are cured in most cases without sequelae. Tako-tsubo syndrome is rarely considered as a reason for consultation in the forensic department.
Herein, we report a case of a 68-year-old woman who was assaulted by her police officer neighbor. The latter punched her in the arms and kneed her in the gut without causing any intrathoracic or abdominal injury. The victim was urgently hospitalized in the cardiology department for chest pain and dyspnea accompanied by ST-segment elevation and high troponin level.
Tako-tsubo cardiomyopathy diagnosis was based on clinical findings, echocardiography, coronary angiography, and magnetic resonance imaging findings. A forensic medicine consult was initially solicited for the drafting of an initial medical certificate and for evaluating the total transitory disability rate. A second consultation was then sought to evaluate the permanent partial disability.
We report this work to discuss the conduct of the forensic pathologist and to prove the causality relationship between the assault and the physical injuries.
A Fatal Outcome of Pica Syndrome
Authors: Bogdanovic Milenko , Alempijevic Djordje , Curcic Djordje , Durmic Tijana 
Published: May 2018

Abstract
We present the case of a 42-year-old man, with a medical history of schizophrenic psychosis, who was found dead on the floor of his bedroom. At the autopsy, a bottle lid with a notched edge was found in the lower pharynx, partially obstructing the larynx and thus keeping the epiglottis in an open position. Airway obstruction was caused by edema and inflammation of the surrounding tissue. After removal of the foreign body, the tissue of the larynx was left with an impression of the bottle lid. The adjacent mucosa was swollen, hyperemic, partly necrotic, and covered with fibrin deposits. Also, foreign bodies were found in the stomach. The histological analysis of the hypopharynx showed severe nonspecific inflammation and necrosis of epithelium. The cause of death was a complication of subacute laryngeal obstruction caused by a foreign body.
National Patient Safety Program in Brazil: Incidents Reported Between 2014 and 2017
Authors: Faustino Tássia Nery , Batalha Edenise Maria Santos da Silva , Vieira Silvana Lima , Nicole Andressa Garcia , Morais Alexandre Souza , Tronchin Daisy Maria Rizatto , Melleiro Marta Maria 
Published: May 2018

Objective
The aim of the study was to analyze the patient safety incidents reported to the Brazilian National Health Surveillance System from March 2014 to March 2017.

Method
A documentary study that used the records of the incidents published in the Reports of Adverse Events (AE) in Brazil. The following variables were selected: number of incidents by type, type of health service, hospital unit, and degree of harm. To find whether there was a significant difference across the Brazilian regions by notifications related to general incidents, AE, and deaths, the analysis of variance and the Tukey tests were used.

Results
A total of 109,082 incidents were reported, of which 75,088 were AE, with 649 deaths. In relation to the types of incidents reported, there was a higher frequency in the categories other (30.04%) and failures during health care (26.72%). A total of 93.90% of the incidents occurred in hospitals, with 54,950 cases registered in hospitalization units and 30,141 cases in intensive care units. Statistically significant differences across the Brazilian regions were observed in the number of incidents (P = 0.004), AE (P = 0.004), and deaths (P = 0.024).

Conclusions
A significant underreporting of incidents was found in Brazil, demonstrating only the tip of a giant iceberg. More than half of the incidents were reported as AE and were registered in hospitals, reiterating the importance of establishing public health policies at national, state, and municipal levels, with adequate supervision of the health service regarding the implementation of the Patient Safety Nuclei and the preparation of new protocols based on the most prevalent incidents.