bluuebunny/crossref_metadata_2025_split huggingface dataset:
Frail Phenotype and Disability Prediction in Community-Dwelling Older People: A Systematic Review and Meta-Analysis of Prospective Cohort Studies
Authors: CHANG Shu-Fang , CHENG Chih-Ling , LIN Hsiang-Chun 
Published: February 2019

ABSTRACT

Background:
The World Health Organization has identified frailty as a crucial factor affecting successful aging. Systematic literature reviews have yet to focus on the relationship between stages of frailty and disability in community-dwelling older adults.

Purpose:
The purpose of this study was to investigate the relationships between various frailty types and disability in community-dwelling older adults and to explore how various frailty criteria have been used to assess disability in this population.

Methods:
A systematic literature review and meta-analysis were conducted on articles from the following databases: Cochrane Library, CINAHL, PubMed, and Ovid. Database search criteria included articles that were published between January 2001 and July 2017 and study samples that included community-dwelling adults aged 60 years and older. We excluded studies that were conducted in institutions or hospitals and experimental studies on frailty. Two reviewers independently assessed eligibility and extracted data. A random-effects model was used to analyze the literature and to calculate the pooled disability of frailty.

Results:
In total, nine studies with a total sample of 32,998 participants that recorded 8,666 disabilities and a mean follow-up time of 30.4 months (SD = 29.26) were pooled for the meta-analysis. Using various indicators to predict the risk of disability compared with robust older adults, those with frailty faced a higher risk of disability, followed by older adults at risk of frailty.

Conclusions/Implications for Practice:
Frailty is a crucial health consideration among older adults. Those who are frail have the highest relative risk of disability, followed by those at risk of frailty. Early assessment of frailty may effectively prevent the occurrence of frailty-induced disability in older adults.
Psychometric Testing of the Turkish Version of the Stroke Self-Efficacy Questionnaire
Authors: ARKAN Gulcihan , BESER Ayse , OZTURK HANEY Meryem , OZTURK Vesile 
Published: February 2019

ABSTRACT

Background
When stroke survivors return to their lives in society, they often face issues such as physical or cognitive impairment, dependence on others, social isolation, and reduced self-esteem, which may lead to disastrous consequences in patients' self-perceived self-efficacy and self-confidence in everyday life. Self-efficacy plays an important role in the well-being of stroke patients. Accurate assessment of the stroke patients' self-efficacy by health professionals is critical to obtaining data regarding their functioning levels.

Purpose
The aim of this study was to evaluate the psychometric properties of the Turkish version of the Stroke Self-Efficacy Questionnaire (T-SSEQ).

Methods
A sample of 185 stroke patients (mean age = 64.78 ± 10.7) was recruited from a university hospital in Izmir, Turkey. Data were collected between April and October 2016. Translation and back-translation processes were used to translate the T-SSEQ into Turkish. Data were analyzed using the Rasch partial credit model with the Winsteps program to investigate the response scale analysis, tests of fit to the model, unidimensionality, local dependency, item and person separation reliability, separation index, and differential item functioning.

Results
The Rasch analysis showed goodness of fit for both the activity and self-management subscales. Moreover, both scales were identified as being unidimensional in structure. Furthermore, the participants were able to distinguish between the categories of the response options, and scale reliability was supported for both subscales using Rasch analyses.

Conclusions/Implications for Practice
These results indicate that the T-SSEQ is acceptable for use with Turkish stroke patients in both practice and research settings. Furthermore, the questionnaire is suitable for nurses to use in designing interventions and evaluating stroke patients' self-efficacy in clinics, home care, and rehabilitation centers.
An Evidence-Based Approach to Casting and Orthosis Management of the Pediatric, Adolescent, and Young Adult Population for Injuries of the Upper Extremity: A Review Article
Authors: McVeigh Kimberly H. , Berger Thomas G. , Cudahy Ryan , Dekker Timothy M. , Brigham Tara J. , Braxton James C. 
Published: February 2019

Objective:
Review the use of upper-extremity orthoses and casts after injuries to the wrist and hand in the pediatric, adolescent, and young adult population. The common injuries reviewed include pediatric distal radius fractures, scaphoid fractures, metacarpal fractures, mallet fingers, volar plate injuries of the proximal interphalangeal (PIP) joint, and ulnar collateral ligament (UCL) tears of the thumb metacarpophalangeal (MCP) joint.

Data Sources:
We conducted a literature review from 1985 to 2016 of upper-extremity orthotic interventions. Non–English language citations and animal studies were excluded. Citations from retrieved studies were used to identify other relevant publications. This review included cases of common injuries to the upper extremity, which required orthotic intervention.

Main Results:
Immobilization recommendations for nonsurgical pediatric distal radius fractures, nonsurgical metacarpal fractures, mallet fingers, and UCL tears of the thumb MCP include a removable orthosis. Nondisplaced scaphoid fracture orthosis recommendations include initial immobilization in a nonremovable short-arm thumb spica cast. Volar plate injuries of the PIP joint require buddy straps for healing.

Conclusions:
The literature demonstrates the effectiveness of removable orthoses in healing, patient satisfaction, and time to return to activity after many common upper-extremity injuries. Removable orthoses should be considered an equal or superior treatment method to cast immobilization, immobilization of additional joints, or longer periods of immobilization.
Interprofessional “on-call” e-learning for family nurse practitioner students: Preparing for primary care across the life span
Authors: Conelius Jaclyn , Grossman Sheila , Becht Lisa Grossman 
Published: February 2019

ABSTRACT

Background and Purpose:
Nurse practitioners (NPs) are expected to fill gaps in providing primary care in the United States and need vital skills to meet the growing need for primary care providers. One necessary skill is managing “on-call” clinical questions/concerns by patients across the life span. To date, there are no published studies that address “on-call” simulations for family NP (FNP) students across the life span.

Methods:
This quasi-experimental, mixed-methods design used a confidence scale and Krippendorff's method for content analysis of discussion pages to determine the effectiveness and confidence of simulated “on-call” scenarios for FNP students during each of their clinical courses.

Conclusions:
There was a significant increase in the confidence level of students as measured by the confidence questionnaire (t = 3.07 [33]; p < .001), at the end of the FNP didactic and clinical courses. Krippendorff content analysis revealed three themes: self-reliance; thinking on your feet; and uncertainty of management.

Implications for Practice:
“On-call” processing is a skill that is needed in graduate FNP programs so that these providers are fully prepared to meet any challenge they may encounter.
Preparing for the transition from clinical practice to academia
Authors: Smith Susan , Karosas Laima , Beauchesne Michelle A. 
Published: February 2019

ABSTRACT
Although education is an essential component of good nursing practice, clinical practice proficiency does not equate to competence in academia. Expert clinicians are not automatically expert educators. However, more and more academic institutions are relying on full-time clinicians to assume academic teaching positions. The decision to transition from clinical practice to academia requires careful consideration of numerous personal and professional issues. The purpose of this brief overview is to offer insight and guidance for nursing professionals embarking on this journey.
Role of Diagnostic Endoscopic Ultrasound in Idiopathic Acute Pancreatitis and Acute Recurrent Pancreatitis in Children
Authors: Kadyada Srikanth Puttaiah , Thapa Babu Ram , Dhaka Narendra , Bhatia Anmol , Menon Jagadeesh 
Published: February 2019

Objectives
Endoscopic ultrasound (EUS) is a minimally invasive pancreatic imaging modality. We evaluated children with idiopathic acute pancreatitis (IAP) and acute recurrent pancreatitis (ARP) for changes of chronicity (Rosemont criteria) and biliary risk factors. Diagnostic yield of simultaneously performed transabdominal ultrasonography (TUS) was compared with EUS.

Methods
This was a prospective observational study. Patients underwent EUS and TUS after 2 months of pancreatitis attack.

Results
Forty-five (18 IAP, 27 ARP) patients underwent EUS and TUS. Mean (standard deviation) age and weight were 9.1 (2.6) years and 32.66 (12.43) kg in IAP, whereas these were 12.2 (3.1) years and 44.84 (15.12) kg in ARP, respectively. Endoscopic ultrasound demonstrated morphological abnormality in 33.3% and 40.7% of IAP and ARP, respectively (P = 0.61), whereas 16.6% and 25.9% were abnormal in TUS. Endoscopic ultrasound showed unequivocal changes of chronicity (11.1% vs 0%) and risk factors only among ARP (25.9% vs 0%; P = 0.03) and demonstrated slightly higher odds ratio (95% confidence interval) as compared with TUS to detect abnormalities in both IAP (2.43 [0.49–14.17], P = 0.28) and ARP (1.94 [0.60–6.47], P = 0.26).

Conclusions
Applying EUS, changes of chronicity and risk factors were noted only in ARP. Endoscopic ultrasound performed better than TUS in detecting chronicity.
Expression and Clinical Significance of Protein Kinase RNA–Like Endoplasmic Reticulum Kinase and Phosphorylated Eukaryotic Initiation Factor 2α in Pancreatic Ductal Adenocarcinoma
Authors: Wang Eric M. , Akasaka Hironari , Zhao Jun , Varadhachary Gauri R. , Lee Jeffrey E. , Maitra Anirban , Fleming Jason B. , Hung Mien-Chie , Wang Huamin , Katz Matthew H. G. 
Published: February 2019

ObjectivesEndoplasmic reticulum stress and subsequent phosphorylation of eukaryotic initiation factor 2α (eIF2α) by protein kinase R–like endoplasmic reticulum kinase (PERK) plays an important role in the development and chemoresistance of pancreatic ductal adenocarcinoma (PDAC). However, the expression and significance of phosphorylated eIF2α (p-eIF2α) and PERK in PDAC have not been examined.MethodsWe examined p-eIF2α and PERK expression in 84 PDAC and paired normal pancreas samples by immunohistochemistry and Western blotting and correlated the results with clinicopathologic parameters and survival.ResultsMean PERK H score was 140.8 in PDAC compared with 82.1 in normal pancreas (P< 0.001). High p-eIF2α expression was present in 56% of PDACs versus 7.6% of normal pancreases (P< 0.001). High PERK and p-eIF2α expression correlated with shorter overall survival (P= 0.048 andP= 0.03, respectively). By multivariate analysis, high p-eIF2α (P= 0.01), positive margin (P= 0.002), and lymph node metastasis (P= 0.01) were independent prognosticators for survival.ConclusionsThe expression levels of PERK and p-eIF2α are higher in PDAC than those in normal pancreas. High levels of PERK and p-eIF2α are predictors of shorter survival in PDAC patients, suggesting that PERK and eIF2α could be promising targets in PDAC.
HLA‐DQ Genotyping, Duodenal Histology, and Response to Exclusion Diet in Autistic Children With Gastrointestinal Symptoms
Authors: Alessandria Carlo , Caviglia Gian P. , Campion Daniela , Nalbone Federica , Sanna Claudia , Musso Alessandro , Abate Maria L. , Rizzetto Mario , Saracco Giorgio M. , Balzola Federico 
Published: February 2019

ABSTRACTObjectives:A correlation between autism spectrum disorders (ASDs) and gastrointestinal (GI) problems, and a possible link between gluten consumption and ASD have been increasingly reported. Gluten/casein‐free diet (GCFD) is often undertaken, with conflicting results. This study aimed at evaluating the distribution of human leukocyte antigen (HLA)‐DQ2/DQ8 typing among patients with ASD with GI symptoms, together with its correlation with duodenal histology and response to GCFD.Methods:Between 2002 and 2015 all patients with ASD with GI symptoms referred to our outpatient clinic, displaying clinical, laboratory, or ultrasound findings suggestive of organic disease, underwent endoscopy, celiac disease (CD) serum antibodies testing and HLA‐DQ2/DQ8 genotyping. Patients were prescribed a 6‐month GCFD, and then clinically reassessed.Results:Among 151 enrolled patients, 134 (89%) were negative for CD‐specific antibodies; 72 (48%) were positive for HLA‐DQ2/DQ8; and 56 (37%) showed duodenal microscopic inflammation. Clinical improvement was observed in non‐CD patients irrespective of the rigorous or partial adherence to the diet, being the difference nonstatistically significant. Response to diet was related to the presence of histological duodenal alterations at baseline (odds ratio 11.323, 95% confidence interval 1.386–92.549 for Marsh 2 pattern), but not to HLA‐DQ2/DQ8 positivity (odds ratio 1.120, 95% confidence interval 0.462–2.716).Conclusions:Our data suggest that children with ASD with GI symptoms have a high prevalence of duodenal intraepithelial lymphocytic infiltration, which seems to be linked to a mechanism other than autoimmune response to gluten consumption. Alteration of duodenal histology, but not the HLA‐DQ2/DQ8 status, was associated with clinical response to the diet.
Risk‐factors Associated With Poor Outcomes in VEO‐IBD Secondary to XIAP Deficiency
Authors: Lekbua Asama , Ouahed Jodie , O'Connell Amy E. , Kahn Stacy A. , Goldsmith Jeffrey D. , Imamura Toshihiko , Duncan Christine N. , Kelsen Judith R. , Worthey Elizabeth , Snapper Scott B. , Softic Samir 
Published: February 2019

ABSTRACTVery early onset inflammatory bowel disease (VEO‐IBD) represents a diagnostic and treatment challenge. Here we present a case of VEO‐IBD secondary to a mutation in BIRC4 gene, which encodes X‐linked inhibitor of apoptosis protein (XIAP), in a 17‐month‐old boy with severe failure to thrive, intractable diarrhea, and hepatosplenomegaly. Endoscopy and histology identified only mild duodenitis and ileitis, but severe pancolitis with crypt abscesses and epithelium apoptosis. Minimal improvement in symptoms was achieved with total parenteral nutrition (TPN), intravenous (IV) corticosteroids, and tacrolimus, whereas induction and maintenance therapy with adalimumab led to complete remission. After 6 months, the patient developed hemophagocytic lymphohistiocytosis and eventually died due to multisystem organ failure. A review of the literature revealed that some patients with VEO‐IBD secondary to XIAP deficiency develop symptoms that are refractory to medical and surgical management, while initial reports suggest that allogeneic hematopoietic stem cell transplantation (HSCT), with reduced intensity conditioning, can successfully induce long‐lasting remission and may even be curative. We propose that in patients with XIAP deficiency a constellation of symptoms including colitis at an early age, severe failure to thrive, and splenomegaly/hepatosplenomegaly can identify a subgroup of patients at high risk of experiencing medically refractory IBD phenotype and increased mortality. Hematopoietic stem cell transplant should be considered early in these high‐risk patients, as it may resolve both their intestinal inflammation and a risk of developing life threatening hemophagocytic lymphohistiocytosis .
The Association of Glasgow Coma Scale Score With Clinically Important Traumatic Brain Injuries in Children
Authors: Johnson M. Austin , Nishijima Daniel K. , Kuppermann Nathan 
Published: February 2019

Objective
An accurate understanding of the incidence of clinically important traumatic brain injuries (ciTBIs) based on presenting Glasgow Coma Scale (GCS) scores in pediatric patients is required to formulate a pretest probability of disease to guide testing and treatment. Our objective was to determine the prevalence of ciTBI and neurosurgical intervention for each GCS score (range 3–15) in children presenting after blunt head trauma.

Methods
This was a secondary analysis of prospectively collected observational data from 25 pediatric emergency departments in the Pediatric Emergency Care Applied Research Network. Patients younger than 18 years with nontrivial blunt head injury were included.

Results
A total of 43,379 children with complete GCS scores were included in the analysis. Seven hundred sixty-three children had ciTBIs (1.8%) and 200 underwent neurosurgery (0.5%). Children with GCS scores of 4 had the highest incidence of ciTBI (21/22, 95.5%) and neurosurgical intervention (16/22, 72.2%). A nearly linear decrease in the prevalence of ciTBI from a GCS score of 4 to a score of 15 was observed (R = 0.92). Of 1341 children, 107 (8.0%) presenting with GCS scores of 14 were found to have ciTBIs and 17 (1.3%) underwent neurosurgical intervention.

Conclusions
A nearly linear relationship exists between the initial GCS score and ciTBI in children with blunt head trauma. The highest prevalence of ciTBI and neurosurgical intervention occurred in children with GCS scores of 4. Children presenting with GCS scores of 14 had a nonnegligible prevalence of ciTBI. These findings are critical to providers caring for children with blunt head trauma to accurately formulate pretest probabilities of ciTBI.
Patient Experience in a Spanish Pediatric Emergency Department
Authors: Parra Cristina , Carreras Nuria , Vergés Alba , Trenchs Victoria , Luaces Carles 
Published: February 2019

Objectives
To study the experience reported by pediatric patients when visiting a pediatric emergency department (PED).

Methods
This was a prospective descriptive study, carried out in November 2014. A 12-question survey was developed, based on the Picker Patient Experience Questionnaire. The aim was to assess patient experience of children between 8 and 18 years old, attended in the PED of a high-complexity pediatric hospital. Questions were about the waiting time and setting, medical staff explanations and actions, treatment, and discharge. The questionnaires were administered and filled in by the children themselves at discharge.

Results
One-hundred seventy questionnaires were completed; 17.1% of respondents had to wait longer than expected, and 44.7% said that there was not enough to do when waiting to be seen. Pain was not correctly treated (3%), there was a lack of privacy (14.7%), and the information provided to the patients during the visit was wanting (10%). However, 80% said that they had been well treated.

Conclusions
The patient experience of children in our PED was positive, although some aspects should be improved such as offering entertainment in the waiting area, increasing privacy during the medical visit, and giving better explanations to the children.
Management of a Pediatric Type 3C Open Femoral Fracture Following a High-Velocity Gunshot Wound at an Adult Level II Trauma Center
Authors: Grisoli Anne , Dynako Joseph , Zimmer David , Zackariya Nuha , Shariff Faadil , Walsh Mark , Mamczak Christiaan N. , Peterson Charles , Boyer Bryan , Hurwich Maurice , Duprat Gerard 
Published: February 2019

Abstract
We present a case of a 10-year-old girl shot in the thigh by a stray bullet who had a favorable outcome when treated with a multidisciplinary approach at the nearest nonpediatric level II trauma center. Point-of-care thromboelastography facilitated effective resuscitation based on her coagulation profile, minimized blood product use, and allowed for damage-control surgery to stabilize and revascularize her complex femur fracture.
Two-Thumb Encircling Technique With a Novel Compression Assist Device Provides Safe and Effective Chest Compressions in Infants
Authors: Lee Se Uk , Kim Do Kyun , Chang Ikwan , Jung Jae Yun , Paek So Hyun , Park Joong Wan , Lee Jin Hee , Kwak Young Ho 
Published: February 2019

Objective
Currently, 2-thumb encircling technique is recommended in 2-rescuer infant cardiopulmonary resuscitation (CPR). However, many complications can occur during CPR. Therefore, we developed a novel compression assist device (Reheart) that can reduce chest compression area and determined whether using our device provides better compression quality.

Methods
A novel compression assist device consists of 2 parts. The upper part was designed to put 2 thumbs together in the thumb sleeves, and the lower part was designed based on a circular rubber plate with a 2.0-cm diameter to confine compression area. Infant manikin CPR simulations using the 2-thumb encircling technique with Reheart and without Reheart were sequentially performed by participants in randomized crossover fashion.

Results
A total of 32 health care providers were included. The average age of the participants was 30.2 ± 3.5 years, and 21 participants (65.6%) were male. The accuracy in the Reheart group was better than that in the conventional group (proportion of compression on target area, 52.5% ± 13.2% vs 35.4% ± 17.6%; P < 0.001). The difference in the rates of chest compressions between the 2 groups was not significant (119.6 ± 14.4 vs 120.7 ± 14.0 compressions/min, P = 0.59). The depth of chest compressions was also not significantly different between the 2 groups (34.5 mm [33.6–34.9 mm] vs 34.2 mm [33.0–34.9 mm], P = 0.32).

Conclusions
Our new compression assist device can help provide safe and effective chest compressions during 2-rescuer infant CPR.
Accuracy of Parental-Reported Tetanus Vaccination Status for Children With Lacerations
Authors: Drapkin Zachary , Madsen Troy E. , Weaver Nicholas , Soprano Joyce V. 
Published: February 2019

Objectives
The aim of this study was to determine whether emergency department (ED) providers are able to accurately assess whether a child with a laceration needs tetanus prophylaxis.

Methods
We conducted an 8-month prospective cross-sectional study of children presenting with a laceration to a pediatric ED. We asked ED providers whether tetanus prophylaxis was necessary. An ED pharmacist accessed the Utah Statewide Immunization Information System (USIIS), and we assessed the accuracy of the ED provider's determination of necessary tetanus prophylaxis compared with USIIS records.

Results
Among 375 patients aged 5 months to 17 years, ED providers made an inaccurate assessment of necessary tetanus prophylaxis in 33 cases (8.8%; 95% confidence interval [CI], 6.3%–12.1%). Emergency department providers would have inappropriately administered tetanus prophylaxis in 5 cases (1.3%; 95% CI, 0.5%–3.2%) and would have missed the need for tetanus prophylaxis in 28 cases (7.5%; 95% CI, 5.2%–10.6%). Emergency department providers were more likely to provide an inaccurate recommendation in older children (8.3 vs 4.8 years; P < 0.001), in patients with a dirty wound (45.5% vs 11.7%; P < 0.001), and in children who had fewer than 3 vaccines recorded in the USIIS (54.5% vs 1.2%; P < 0.001).

Conclusions
Emergency department providers may inaccurately assess the need for tetanus prophylaxis in children. Special attention should be paid to cases of dirty wounds and cases in which fewer than 3 tetanus-containing vaccines have been given.