bluuebunny/crossref_metadata_2025_split huggingface dataset:
Midwifery
Authors: Worth Valerie 
Published: August 2017

Midwifery was a subject of both popular and scientific interest and often of regular scrutiny through the early modern period. While many births continued to be conducted by a local midwife, and family and religious rituals often remained constant, in other respects there were significant changes. However, their extent and the speed at which they affected different countries, even different regions, were extremely varied. The advent of print culture led to a sharp increase, from the 16th century onward, in the number of midwifery manuals available; those in the vernacular rather than Latin particularly found a wider, lay readership, especially when they contained descriptions and illustrations of “monstrous” births. Although most manuals were authored by male surgeons and physicians, in the 17th and 18th centuries some female midwives also kept detailed case notes and published textbooks. This contribution from women coincided in part with the rise of the male midwife, a phenomenon that challenged traditional midwifery, especially in England and France, and led to hotly contested debates over the use by male surgeons of the newly invented forceps, rather than relying on the skills of the expert female midwife. The period thus saw the emergence in some places of a medicalization of normal as well as complicated childbirth, and a potential diminution in the authority of the female midwife. Nonetheless, midwives, like surgeons and physicians, continued to be key members of the community, and midwifery was one of the limited number of remunerated, professional roles open to women. The regulation of midwifery varied by country and state/town, and was often a matter for both ecclesiastical and medical authorities: the former became critical after the Reformations because of the midwife’s potential role in baptizing the newborn. Although ecclesiastical licensing and medical regulations were undoubtedly sometimes more honored in the breach than in the observance, in some cities some formal training was provided for midwives. While the stereotypes of ignorant midwives and the associations of midwifery with witchcraft persisted in the popular imagination, by the 18th century Louis XV of France charged one midwife, Madame du Coudray (c. 1712–1794), with touring the provinces to teach midwifery skills in order to halt the decline in the population. In the cultural imagination, as well as in practice, the midwife remained a powerful if contested figure.
Preference for the Workplace, Investment in Human Capital, and Gender*
Authors: Wiswall Matthew , Zafar Basit 
Published: August 2017

Abstract
We use a hypothetical choice methodology to estimate preferences for workplace attributes from a sample of high-ability undergraduates attending a highly selective university. We estimate that women on average have a higher willingness to pay (WTP) for jobs with greater work flexibility and job stability, and men have a higher WTP for jobs with higher earnings growth. These job preferences relate to college major choices and to actual job choices reported in a follow-up survey four years after graduation. The gender differences in preferences explain at least a quarter of the early career gender wage gap.
Transitioning Florida NPs to opioid prescribing
Authors: Craig-Rodriguez Alicia , Gordon Glenna , Kaplan Louise , Grubbs Laurie 
Published: August 2017

Abstract:
Prior to statutory changes in prescriptive authority for controlled substances, this study examined the knowledge gaps and prescribing limitations of Florida advanced registered nurse practitioners regarding opioids. Study results revealed statistically significant knowledge gaps in the areas of federal and state guidelines; opioid classes and proper doses; risk assessment skills; monitoring of treatment; and confidence in dealing with challenges of opioid prescribing.
Are Anesthesia and Surgery during Infancy Associated with Decreased White Matter Integrity and Volume during Childhood?
Authors: Block Robert I. , Magnotta Vincent A. , Bayman Emine O. , Choi James Y. , Thomas Joss J. , Kimble Karolie K. 
Published: August 2017

Abstract

Background
Anesthetics have neurotoxic effects in neonatal animals. Relevant human evidence is limited. We sought such evidence in a structural neuroimaging study.

Methods
Two groups of children underwent structural magnetic resonance imaging: patients who, during infancy, had one of four operations commonly performed in otherwise healthy children and comparable, nonexposed control subjects. Total and regional brain tissue composition and volume, as well as regional indicators of white matter integrity (fractional anisotropy and mean diffusivity), were analyzed.

Results
Analyses included 17 patients, without potential confounding central nervous system problems or risk factors, who had general anesthesia and surgery during infancy and 17 control subjects (age ranges, 12.3 to 15.2 yr and 12.6 to 15.1 yr, respectively). Whole brain white matter volume, as a percentage of total intracranial volume, was lower for the exposed than the nonexposed group, 37.3 ± 0.4% and 38.9 ± 0.4% (least squares mean ± SE), respectively, a difference of 1.5 percentage points (95% CI, 0.3 to 2.8; P = 0.016). Corresponding decreases were statistically significant for parietal and occipital lobes, infratentorium, and brainstem separately. White matter integrity was lower for the exposed than the nonexposed group in superior cerebellar peduncle, cerebral peduncle, external capsule, cingulum (cingulate gyrus), and fornix (cres) and/or stria terminalis. The groups did not differ in total intracranial, gray matter, and cerebrospinal fluid volumes.

Conclusions
Children who had anesthesia and surgery during infancy showed broadly distributed, decreased white matter integrity and volume. Although the findings may be related to anesthesia and surgery during infancy, other explanations are possible.
Clinical Updates in Women’s Health Care Summary: Mood and Anxiety Disorders
Authors: Osborne Lauren M. , Payne Jennifer L. 
Published: August 2017

Abstract
The management of psychiatric disorders in women is complicated by reproductive life cycle events. Psychiatric disorders can be initiated or exacerbated during times of hormonal change (such as menarche, the premenstrual period, the postpartum period, and perimenopause), and during the childbearing years, treatment is complicated by pregnancy and breastfeeding. These issues make determining the appropriate psychiatric medications to use in the treatment of mood and anxiety disorders in women complex. This monograph addresses practical approaches in the provision of thorough and individualized care for women with mood or anxiety disorders.
Spinal Cord Injury—What Are the Controversies?
Authors: Ahuja Christopher S. , Schroeder Gregory D. , Vaccaro Alexander R. , Fehlings Michael G. 
Published: August 2017

Summary:
Traumatic spinal cord injuries have a tremendous impact on individuals, families, and society as a whole. Substantial heterogeneity in the patient population, their presentation and underlying pathophysiology has sparked debates along the care spectrum from initial assessment to definitive treatment. This article reviews spinal cord injury (SCI) management followed by a discussion of the salient controversies in the field. Current care practices modeled on the American Association of Neurological Surgeons/Congress of Neurological Surgeons joint section guidelines are highlighted including key recommendations regarding immobilization, avoidance of hypotension, early International Standards for Neurological Classification of SCI examination and intensive care unit treatment. From a diagnostic perspective, the evolving roles of CT, MRI, and leading-edge microstructural MRI techniques are discussed with descriptions of the relevant clinical literature for each. Controversies in management relevant to clinicians including the timing of surgical decompression, methylprednisolone administration, blood pressure augmentation, intraoperative electrophysiological monitoring, and the role of surgery in central cord syndrome and pediatric SCI are also covered in detail. Finally, the article concludes with a reflection on clinical trial design tailored to the heterogeneous population of individuals with SCI.
Controversies in the Management of Geriatric Odontoid Fractures
Authors: Wagner Scott C. , Schroeder Gregory D. , Kepler Christopher K. , Schupper Alexander J. , Kandziora Frank , Vialle Emiliano N. , Oner Cumhur , Fehlings Michael G. , Vaccaro Alexander R. 
Published: August 2017

Summary:
Fractures of the odontoid process of C2 have become increasingly prevalent in the aging population and are typically associated with a high incidence of morbidity. Dens fractures comprise the majority of all cervical fractures in patients older than 80 years and remain the most common cervical fracture pattern in all geriatric patients. Type II odontoid fractures have been associated with limited healing potential, and both nonoperative and operative management are associated with high mortality rates. Historically, there has been some debate in the literature with regards to optimal management strategies to maximize outcomes in geriatric patients. Recent, high-quality evidence has indicated that surgical treatment of type II odontoid fractures in elderly patients is associated with improvements in both short- and long-term mortality. Additionally, surgical intervention has been shown to improve functional outcomes when compared with nonsurgical treatment. Factors to consider before surgery for geriatric type II odontoid fractures include associated comorbidities and the safety of general anesthesia administration. With appropriate measures of patient selection, surgery can provide an efficacious option for geriatric patients with type II odontoid fractures. We recommend surgical intervention via a posterior C1–C2 arthrodesis for geriatric type II odontoid fractures, provided that the surgery itself does not represent an unreasonable risk for mortality.
Functional Outcomes of Syndesmotic Injuries Based on Objective Reduction Accuracy at a Minimum 1-Year Follow-Up
Authors: Cherney Steven M. , Cosgrove Christopher T. , Spraggs-Hughes Amanda G. , McAndrew Christopher M. , Ricci William M. , Gardner Michael J. 
Published: August 2017

Objective:
To evaluate whether objective syndesmosis reduction predicts functional outcomes and pain scores in patients with operatively treated syndesmotic injuries at a minimum 1-year follow-up.

Design:
Prospective Cohort.

Setting:
Urban Level I Trauma Center.

Patients:
Sixty-nine patients with operatively treated syndesmotic injuries were initially identified and consented for inclusion in the study. Nine patients were excluded perioperatively. Twelve patients were lost to follow-up. Forty-eight patients with operatively treated unilateral syndesmotic injuries were available and participated at the final follow-up.

Intervention:
Trans-syndesmotic stabilization with either 1 or 2 quadricortical position screws. Postoperatively, bilateral ankle computed tomography scans were obtained to objectively assess syndesmosis reduction accuracy.

Main Outcome Measurements:
Olerud–Molander Ankle Score, Short Musculoskeletal Function Assessment Dysfunction Index and Bother Index, and Numeric Pain Rating Scales at a minimum 1-year postoperative follow-up.

Results:
At 1-year follow-up, there was no significant difference in functional outcomes between reduced and malreduced groups at the 1.5-, 2-, and 3-mm thresholds for linear measurements. Similarly, there was no functional difference between the reduced and malreduced groups for rotational malreductions at a 10 or 15 degrees threshold. Patients with state-sponsored insurance (Medicaid) had significantly worse functional scores and pain scores when compared with the groups with private insurance, Medicare, or no insurance.

Conclusions:
At 1-year follow-up, functional outcomes were not related to objective measures of syndesmosis reduction.

Level of Evidence:
Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.
Quengel Casting for the Management of Pediatric Knee Flexion Contractures: A 26-Year Single Institution Experience
Authors: Wiley Marcel R. , Riccio Anthony I. , Felton Kevin , Rodgers Jennifer A. , Wimberly Robert L. , Johnston Charles E. 
Published: August 2017

Background:
Quengel casting was introduced in 1922 for nonsurgical treatment of knee flexion contractures (KFC) associated with hemophilic arthropathy. It consists of an extension-desubluxation hinge fixed to a cast allowing for gradual correction of a flexion deformity while preventing posterior tibial subluxation. The purpose of this study is to report 1 center’s experience with this technique for the treatment of pediatric KFC.

Methods:
A retrospective review was conducted over a 26-year period. All patients with KFC treated with Quengel casting were included. Demographic data, associated medical conditions, adjunctive soft tissue releases, complications, and the need for late surgical intervention were recorded. Tibiofemoral angle measurements in maximal extension were recorded at initiation and termination of casting, 1-year follow-up, and final follow-up. Success was defined as no symptomatic recurrence of KFC or need for subsequent surgery.

Results:
Eighteen patients (26 knees) were treated for KFC with Quengel casting. Average age at initiation of casting was 8.1 years with average follow-up of 59.9 months. Fifteen knees (58%) underwent soft tissue releases before casting. An average of 1.5 casts per knee were applied over an average of 23.9 days. Average KFC before casting was 50.6 degrees (range, 15 to 100 degrees) which improved to 5.96 degrees (0 to 40 degrees) at cast removal (P<0.00001). Sixteen patients (22 knees) had 1-year follow-up or failed casting before 1 year. Of these, 11 knees (50%) had a successful outcome. Residual KFC of those treated successfully was 6.8 degrees (range, 0 to 30 degrees) at 1 year and 8.2 degrees (range, 0 to 30 degrees) at final follow-up, averaging 71.4 months (P=0.81). Of the 11 knees deemed failures, all had recurrence of deformity within an average of 1 year from cast removal. Surgical release before Quengel casting did not improve the chances for success (P=0.09).

Conclusions:
Quengel casting can improve pediatric KFC an average of 44.2 degrees with minimal complications. Although 50% of treated patients will demonstrate significant recurrence or need later surgery, the majority of those treated successfully have durable results at intermediate term follow-up.

Level of Evidence:
Level IV—therapeutic study.
Severe Burnout Is Common Among Critical Care Physician Assistants: Retracted
Authors: Bhatt Muneer , Lizano Danny , Carlese Anthony , Kvetan Vladimir , Gershengorn Hayley Beth 
Published: August 2017

Objectives:
To determine the prevalence of and risk factors for burnout among critical care medicine physician assistants.

Design:
Online survey.

Settings:
U.S. ICUs.

Subjects:
Critical care medicine physician assistant members of the Society of Critical Care Medicine coupled with personal contacts.

Interventions:
None.

Measurements and Main Results:
We used SurveyMonkey to query critical care medicine physician assistants on demographics and the full 22-question Maslach Burnout Inventory, a validated tool comprised of three subscales—emotional exhaustion, depersonalization, and achievement. Multivariate regression was performed to identify factors independently associated with severe burnout on at least one subscale and higher burnout scores on each subscale and the total inventory. From 431 critical care medicine physician assistants invited, 135 (31.3%) responded to the survey. Severe burnout was seen on at least one subscale in 55.6%—10% showed evidence of severe burnout on the “exhaustion” subscale, 44% on the “depersonalization” subscale, and 26% on the “achievement” subscale. After multivariable adjustment, caring for fewer patients per shift (odds ratio [95% CI]: 0.17 [0.05–0.57] for 1–5 vs 6–10 patients; p = 0.004) and rarely providing futile care (0.26 [0.07–0.95] vs providing futile care often; p = 0.041) were independently associated with having less severe burnout on at least one subscale. Those caring for 1–5 patients per shift and those providing futile care rarely also had a lower depersonalization scores; job satisfaction was independently associated with having less exhaustion, less depersonalization, a greater sense of personal achievement, and a lower overall burnout score.

Conclusions:
Severe burnout is common in critical care medicine physician assistants. Higher patient-to-critical care medicine physician assistant ratios and provision of futile care are risk factors for severe burnout.
A Review of Digital, Social, and Mobile Technologies in Health Professional Education
Authors: Curran Vernon , Matthews Lauren , Fleet Lisa , Simmons Karla , Gustafson Diana L. , Wetsch Lyle 
Published: August 2017

Introduction:
Digital, social, and mobile technologies (DSMTs) can support a wide range of self-directed learning activities, providing learners with diverse resources, information, and ways to network that support their learning needs. DSMTs are increasingly used to facilitate learning across the continuum of health professional education (HPE). Given the diverse characteristics of DSMTs and the formal, informal, and nonformal nature of health professional learning, a review of the literature on DSMTs and HPE could inform more effective adoption and usage by regulatory organizations, educators, and learners.

Methods:
A scoping review of the literature was performed to explore the effectiveness and implications of adopting and using DSMTs across the educational continuum in HPE. A data extraction tool was used to review and analyze 125 peer-reviewed articles. Common themes were identified by thematic analysis.

Results:
Most articles (56.0%) related to undergraduate education; 31.2% to continuing professional development, and 52.8% to graduate/postgraduate education. The main DSMTs described include mobile phones, apps, tablets, Facebook, Twitter, and YouTube. Approximately half of the articles (49.6%) reported evaluative outcomes at a satisfaction/reaction level; 45.6% were commentaries, reporting no evaluative outcomes. Most studies reporting evaluative outcomes suggest that learners across all levels are typically satisfied with the use of DSMTs in their learning. Thematic analysis revealed three main themes: use of DSMTs across the HPE continuum; key benefits and barriers; and best practices.

Discussion:
Despite the positive commentary on the potential benefits and opportunities for enhancing teaching and learning in HPE with DSMTs, there is limited evidence at this time that demonstrates effectiveness of DSMTs at higher evaluative outcome levels. Further exploration of the learning benefits and effectiveness of DSMTs for teaching and learning in HPE is warranted.
Transition of care to an adult provider
Authors: Zuckerman Andrea L. 
Published: August 2017

Purpose of review
The transition from adolescence to young adulthood can be a difficult and overwhelming time. Many adult care providers are unaware of the issues facing adolescents and young adults. Often the focus is on older patients and their problems. Internists, family practitioners and obstetricians and Gynecologists (OBGYNs) typically care for these patients. Often, young adults view their obstetrician and gynecologist as their primary care physician, so reviewing the issues facing this age group is important.

Recent findings
Lifestyle habits begun in childhood frequently continue throughout life. Adolescence and young adulthood are times when change in these habits may be easier to enforce. Reviewing nutrition, exercise, risky behaviors, preventive health objectives, sexuality and mental health are of utmost importance in the transition of care from a pediatric to an adult provider.

Summary
The transition from adolescence to young adulthood can be difficult for patients. Knowledge of these issues is crucial to the adult provider caring for these patients. Although visits frequently are short in duration, using screening tools and checklists filled out by the patient prior to the visit may be beneficial.
Efficacy and safety of bazedoxifene in postmenopausal Latino women with osteoporosis
Authors: Bueno Jose A. Hernández , Arias Lizbeth , Yu Ching-Ray , Williams Robert , Komm Barry S. 
Published: August 2017

Abstract

Objective:
Bazedoxifene (BZA) reduces fractures and bone turnover in postmenopausal women with osteoporosis. This report evaluates safety and efficacy of BZA in Latin American women in the global trial.

Methods:
In the 3-year, phase 3, randomized, double-blind trial, postmenopausal women with osteoporosis (N = 7,492) received BZA 20 or 40 mg/d, raloxifene 60 mg/d, or placebo. Outcomes included vertebral fractures, bone mineral density, bone turnover markers, and safety. This post hoc analysis included 3,036 Latin American women.

Results:
Incidence of vertebral fractures at month 36 with BZA 20 mg, BZA 40 mg, raloxifene, and placebo was 1.87%, 1.90%, 1.43%, and 2.83%, respectively (differences not significant). Adjusted mean percentage increases in bone mineral density were 2.49%, 2.79%, 3.18%, and 1.26% for lumbar spine, and 0.40%, 0.95%, 1.11%, and −0.41% for total hip (P < 0.001 for BZA 20/40 mg vs placebo). Adjusted median percentage reductions in osteocalcin at month 12 were −43.0%, −44.1%, −46.9%, and −27.0%, and C-telopeptide were −50.7%, −53.4%, −57.6%, and −32.1% (P < 0.001 for BZA 20/40 mg vs placebo). Common adverse events included pain and flu syndrome.

Conclusions:
BZA significantly improved bone mineral density and reduced bone turnover, and numerically reduced fractures, compared with placebo in postmenopausal Latin American women with osteoporosis. Results were similar to the global trial.
SEX STEROIDS AND MACULAR TELANGIECTASIA TYPE 2
Authors: Müller Simone , Allam Jean-Pierre , Bunzek Christopher G. , Clemons Traci E. , Holz Frank G. , Issa Peter CHARBEL 
Published: August 2017

Purpose:
To investigate the relationship between macular telangiectasia Type 2 and systemic levels of sex steroids or their antagonization.

Methods:
In a prospective single-center study, 90 patients with macular telangiectasia Type 2 were investigated. Female patients were evaluated for previous surgical (e.g., ovariectomy) and/or pharmacological (e.g., aromatase inhibitors, tamoxifen) therapy resulting in reduced action of sex steroids. In males, free serum testosterone levels were assessed in patients and controls.

Results:
Fourteen of 49 (29%) female patients had a history of pharmacological suppression of sex steroids and/or ovariectomy. These patients were younger at disease onset when compared with those without such medical history (mean ± SD: 47.1 ± 7.8, range: 38–59, versus 60.1 ± 7.6, range: 45–76; P < 0.0001). Male patients showed significantly lower free serum testosterone levels compared with controls at younger age (P < 0.0001 and 0.04 in the first and second age quartiles, respectively), as opposed to nonsignificant differences in older patients. In men ≤ 60 years of age, a biochemical hypogonadism (free serum testosterone < 0.05 ng/mL) was present in 53% (8/15) and 4% (2/49) of patients and controls, respectively (P < 0.0001).

Conclusion:
The results indicate that steroidal sex hormones might be involved in the presumably multifactorial pathophysiology of macular telangiectasia Type 2.