bluuebunny/crossref_metadata_2025_split huggingface dataset:
Implementation of an Electronic Checklist to Improve Patient Handover From Ward to Operating Room
Authors: Münter Kristine H. , Møller Thea P. , Østergaard Doris , Fuhrmann Lone 
Published: November 2017

Objective
Research has identified numerous safety risks in perioperative patient handover. In handover from ward to operating room (OR), patients are often transferred by a third person. This adds to the risk of loss of important information and of caregivers in the OR not identifying possible risk factors. The aim of this study was to describe the implementation process and completion rate of a new preoperative, ward-to-OR checklist. Our goal was a 90% fulfillment.

Method
This study is a prospective, observational study in a Danish University Hospital including all patients undergoing surgery in 2013. The checklist was a screen page with 27 checkboxes of information relevant for a safe handover. The checklist should be completed in the ward before handover to the OR and should be checked in the OR before receiving the patient. The Plan-Do-Study-Act (PDSA) cycle method was used in the implementation process of the checklist.

Results
A total of 17.361 patients were included. In wards with only elective surgery (plastic and breast surgery), the checklist was used in 1.419 of 2.286 patients (62.1%). In wards with both elective and emergency surgery (abdominal, orthopedic, urology, gynecology and obstetrics), the checklist was used in 1.963 of 7.460 elective patients (26.3%) and in 812 of 7.615 emergency patients (10.7 %).

Conclusion
Our goal of a 90% fulfillment was not reached. The electronic checklist seemed to be used most frequently in wards with only elective surgery.
Identifying Risks and Opportunities in Outpatient Surgical Patient Safety: A Qualitative Analysis of Veterans Health Administration Staff Perceptions
Authors: Mull Hillary J. , Rosen Amy K. , Charns Martin P. , Itani Kamal M.F. , Rivard Peter E. 
Published: November 2017

Objectives
Little is known about patient safety risks in outpatient surgery. Inpatient surgical adverse events (AEs) risk factors include patient- (e.g., advanced age), process- (e.g., inadequate preoperative assessment), or structure-related characteristics (e.g., low surgical volume); however, these factors may differ from outpatient care where surgeries are often elective and in younger/healthier patients. We undertook an exploratory qualitative research project to identify risk factors for AEs in outpatient surgery.

Methods
We developed a conceptual framework of patient, process, and structure factors associated with surgical AEs on the basis of a literature review. This framework informed our semistructured interview guide with (1) open-ended questions about a specific outpatient AE that the participant experienced and (2) outpatient surgical patient safety risk factors in general. We interviewed nationwide Veterans Health Administration surgical staff. Results were coded on the basis of categories in the conceptual framework, and additional themes were identified using content analysis.

Results
Fourteen providers representing diverse surgical roles participated. Ten reported witnessing an AE, and everyone provided input on risk factors in our conceptual framework. We did not find evidence that patient race/age, surgical technique, or surgical volume affected patient safety. Emerging factors included patient compliance, postoperative patient assessments/instruction, operating room equipment needs, and safety culture.

Conclusions
Surgical staff are familiar with AEs and patient safety problems in outpatient surgery. Our results show that processes of care undertaken by surgical providers, as opposed to immutable patient characteristics, may affect the occurrence of AEs. The factors we identified may facilitate more targeted research on outpatient surgical AEs.
Learning From Incident Reporting? Analysis of Incidents Resulting in Patient Injuries in a Web-Based System in Swedish Health Care
Authors: Ahlberg Eva-Lena , Elfström Johan , Borgstedt Madeleine Risberg , Öhrn Annica , Andersson Christer , Sjödahl Rune , Nilsen Per 
Published: November 2017

Objectives
Incident reporting (IR) systems have the potential to improve patient safety if they enable learning from the reported risks and incidents. The aim of this study was to investigate incidents registered in an IR system in a Swedish county council.

Methods
The study was conducted in the County Council of Östergötland, Sweden. Data were retrieved from the IR system, which included 4755 incidents occurring in somatic care that resulted in patient injuries from 2004 to 2012. One hundred correctly classified patient injuries were randomly sampled from 3 injury severity levels: injuries leading to deaths, permanent harm, and temporary harm. Three aspects were analyzed: handling of the incident, causes of the incident, and actions taken to prevent its recurrence.

Results
Of the 300 injuries, 79% were handled in the departments where they occurred. The department head decided what actions should be taken to prevent recurrence in response to 95% of the injuries. A total of 448 causes were identified for the injuries; problems associated with procedures, routines, and guidelines were most common. Decisions taken for 80% of the injuries could be classified using the IR system documentation and root cause analysis. The most commonly pursued type of action was change of work routine or guideline.

Conclusions
The handling, causes, and actions taken to prevent recurrence were similar for injuries of different severity levels. Various forms of feedback (information, education, and dialogue) were an integral aspect of the IR system. However, this feedback was primarily intradepartmental and did not yield much organizational learning.
Network Viral Load: A Critical Metric for HIV Elimination
Authors: Skaathun Britt , Khanna Aditya S. , Morgan Ethan , Friedman Samuel R. , Schneider John A. 
Published: November 2017

Background:
Associations have been observed between an aggregate viral load measure, the community viral load, and new HIV diagnoses. The community viral load aggregates viral loads within chosen geographic areas, restricting inferences about HIV acquisition risk to these areas. We develop a more precise metric, the network viral load (NVL), to measure the composite viral load within a risk network of a HIV-negative individual.

Methods:
We examined the relationship between NVL and HIV infection among young men who have sex with men in Chicago, United States. Networks were generated using respondent-driven sampling. NVL was defined as the prevalence of viremic individuals in one's risk network, characterized as those with a viral load ≥20 k copies per milliliter. Permutation tests were conducted to account for dependency.

Results:
After controlling for total connections, age, substance use during sex, syphilis diagnosis (previous 12 months), and frequency of condomless anal sex (previous 6 months), we found a positive association between NVL and HIV infection. Compared with a network with all HIV-seronegative members, the odds of HIV infection with an NVL of <10% viremia were 1.85 (95% confidence interval: 1.18 to 2.92) times higher and those with an NVL of ≥10% viremia were 2.73 (95% confidence interval: 1.54 to 4.85) times higher.

Conclusions:
We found a positive association between NVL and HIV seroprevalence. Although limited in its ability to infer causality, NVL could have substantial public health implications for persons most at risk for HIV infection, given that this novel metric avoids overreliance on individual level behavior or broad community indices.
Alcohol and Mortality: Combining Self-Reported (AUDIT-C) and Biomarker Detected (PEth) Alcohol Measures Among HIV Infected and Uninfected
Authors: Eyawo Oghenowede , McGinnis Kathleen A. , Justice Amy C. , Fiellin David A. , Hahn Judith A. , Williams Emily C. , Gordon Adam J. , Marshall Brandon D. L. , Kraemer Kevin L. , Crystal Stephen , Gaither Julie R. , Edelman E. Jennifer , Bryant Kendall J. , Tate Janet P. ,   for the VACS Project team
Published: November 2017

Background:
Unhealthy alcohol use may be particularly detrimental among individuals living with HIV and/or hepatitis C virus (HCV), and is often under-reported. Direct biomarkers of alcohol exposure may facilitate improved detection of alcohol use.

Methods:
We evaluated the association of alcohol exposure determined by both self-report [Alcohol Use Disorders Identification Test-Consumption (AUDIT-C)] and a direct biomarker [phosphatidylethanol (PEth)], with mortality among HIV-infected and HIV-uninfected in the Veterans Aging Cohort Study-Biomarker Cohort. We considered PEth <8 ng/mL to represent no alcohol use. Alcohol exposure by AUDIT-C scores [0, 1–3/1–2 (men/women), 4–7/3–7 (men/women), 8–12] and PEth (<8, ≥8) was combined into categories to model the relationship of alcohol with mortality. Participants were followed from blood collection date for 5 years or until death within 5 years.

Results:
The sample included 2344 (1513 HIV+; 831 uninfected) individuals, 95% men. During a median follow-up of 5 years, 13% died. Overall, 36% were infected with HCV (40% HIV+/HCV+, 27% HIV−/HCV+). Overall, 43% (1015/2344) had AUDIT-C = 0 (abstinence). Of these, 15% (149/1015) had PEth ≥8 suggesting recent alcohol exposure. Among those with AUDIT-C = 0, HCV+ individuals were more likely to have PEth ≥8. After controlling for age, sex, race, HIV, HCV, and HIV viral suppression, those with AUDIT-C = 0 but PEth ≥8 had the highest risk of mortality (adjusted hazard ratio 2.15, 95% confidence interval: 1.40 to 3.29).

Conclusions:
PEth in addition to self-report may improve detection of alcohol use in clinical settings, particularly among those at increased risk of harm from alcohol use. Individuals infected with HCV were more likely to under-report alcohol use.
Mechanisms of Toxicity and Modulation of Hemoglobin-based Oxygen Carriers
Authors: Alayash Abdu I. 
Published: November 2017

ABSTRACT
Several adverse events have been associated with the infusion of hemoglobin-based oxygen carriers (HBOCs), including transient hypertension, gastrointestinal, pancreatic/liver enzyme elevation, and cardiac/renal injury in humans. Although several mechanisms have been suggested, the basis of HBOC toxicity is still poorly understood. Scavenging of vascular endothelial nitric oxide (NO) and heme-mediated oxidative side reactions are thought to be the major causes of toxicity. However, based on more recent preclinical studies, oxidative pathways (driven by the heme prosthetic group) seem to play a more prominent role in the overall toxicity of free Hb or HBOCs. HBOCs display a diversity of physicochemical properties, including molecular size/cross-linking characteristics leading to differences in oxygen affinity, allosteric, redox properties, and even oxidative inactivation by protein/heme clearing mechanisms. These diverse characteristics can therefore be manipulated independently, leaving open the possibility of engineering a safe and effective HBOC. To date, several antioxidative strategies have been proposed to counteract the redox side reactions of current generation HBOCs.
Cardiogenic Shock Due to End-Stage Heart Failure and Acute Myocardial Infarction: Characteristics and Outcome of Temporary Mechanical Circulatory Support
Authors: Lim Hoong Sern , Howell Neil 
Published: November 2017

ABSTRACT

Background:
Mechanical circulatory support (MCS) is increasingly used in cardiogenic shock, but outcomes may differ between patients with acute myocardial infarction (AMI) or end-stage heart failure (ESHF). This study aimed to describe the characteristics of patients with cardiogenic shock due to AMI and ESHF.

Methods:
Single-center study of consecutive patients with cardiogenic shock due to AMI (n = 26) and ESHF (n = 42) who underwent MCS (extracorporeal life support, Impella or temporary ventricular assist devices). Arterial and venous O2 content and CO2 tension (PCO2), O2-hemoglobin affinity (P50) were measured. Veno-arterial difference in PCO2/arterio-venous difference in O2 content ratio was derived. Acid–base balance was characterized by the Gilfix method. MCS-related complications that required intervention or surgery were collected.

Results:
Patients with ESHF had lower ejection fraction, higher right and left-sided filling pressures, pulmonary artery pressure and vascular resistance, lower oxygen delivery (DO2) compared with AMI, which was not fully compensated by the increased hemoglobin P50. As a result, patients with ESHF had higher veno-arterial difference in PCO2 relative to arterio-venous difference in O2 content. Despite greater anerobic metabolism, patients with ESHF had less severe metabolic acidosis and base deficit compared with AMI, predominantly due to differences in strong ions.

Conclusion:
The cardiogenic shock phenotype in ESHF was distinct from AMI, characterized by higher filling and pulmonary artery pressures, lower DO2, greater anaerobic metabolism but less severe metabolic acidosis.
Cardiovascular and Cerebral Hemodynamics in Asymptomatic Healthy Subjects With/Without Abnormal Head-up Tilt Test Versus Recurrent Fainters
Authors: González-Hermosillo Antonio , Sierra-Beltrán Manuel , López-Peña Ulises , Kostin Andrei , Hernández-Pacheco Guadalupe , Lerma Claudia 
Published: November 2017

Purpose:
The aim of this study was to compare hemodynamic and autonomic responses during head-up tilt test (HUTT) between healthy volunteers and patients with a history of fainting and confirmed vasovagal syncope. We hypothesize that the autonomic and hemodynamic physiologic responses remain intact during orthostatic stress in people without previous fainting and negative HUTT, but deteriorate similarly in patients with recurrent vasovagal syncope and in asymptomatic healthy subjects who develop a vasovagal response during HUTT.

Methods:
The study included 57 asymptomatic healthy volunteers (42% women, mean age 23.7 ± 3.6 years) categorized as negative HUTT (n = 41) and positive HUTT (n = 16). They were compared with 14 patients (50% women, mean age 24.2 ± 6.1 years) with previous spontaneous recurrent syncope and inducible vasovagal response during HUTT. Cerebral and cardiovascular hemodynamic variables were assessed noninvasively during the HUTT in each participant.

Results:
In all patients with recurrent syncope, tilt was positive after a mean delay of 15.6 ± 8.6 minutes and did not differ from the time to syncope observed after 19.6 ± 6.9 minutes in asymptomatic healthy subjects with a positive test. A significant decrease throughout the tilting was observed in the blood pressure, peripheral resistances, cerebral blood flow, and vascular efferent sympathetic regulation in both groups of subjects with a positive test.

Conclusions:
This study shows that there are subjects, without a history of syncope, who have a positive HUTT with hemodynamic and autonomic responses alike to patients with confirmed vasovagal syncope, precluding them to be selected as controls in vasovagal syncope studies.
Abnormal reward prediction error signalling in antipsychotic naïve individuals with first episode psychosis or clinical risk for psychosis
Authors: Ermakova Anna O , Knolle Franziska , Justicia Azucena , Bullmore Edward T , Jones Peter B , Robbins Trevor W , Fletcher Paul C , Murray Graham K 
Published: November 2017

AbstractOngoing research suggests preliminary, though not entirely consistent, evidence of neural abnormalities in signalling prediction errors in schizophrenia. Supporting theories suggest mechanistic links between the disruption of these processes and the generation of psychotic symptoms. However, it is not known at what stage in psychosis these impairments in prediction error signalling develop. One major confound in prior studies is the use of medicated patients with strongly varying disease durations. Our study aims to investigate the involvement of the meso-cortico-striatal circuitry during reward prediction error signalling in the earliest stages of psychosis. We studied patients with first episode psychosis (FEP) and help-seeking individuals at risk for psychosis due to subthreshold prodromal psychotic symptoms. Patients with either FEP (n = 14), or at-risk for developing psychosis (n= 30), and healthy volunteers (n = 39) performed a reinforcement learning task during fMRI scanning. ANOVA revealed significant (p<0.05 family-wise error corrected) prediction error signalling differences between groups in the dopaminergic midbrain and right middle frontal gyrus (dorsolateral prefrontal cortex, DLPFC). Patients with FEP showed disrupted reward prediction error signalling compared to controls in both regions. At-risk patients showed intermediate activation in the midbrain that significantly differed from controls and from FEP patients, but DLPFC activation that did not differ from controls. Our study confirms that patients with FEP have abnormal meso-cortical signalling of reward prediction errors, whilst reward prediction error dysfunction in the at-risk patients appears to show a more nuanced pattern of activation with a degree of midbrain impairment but preserved cortical function.
Juggling complex systems within a metropolitan health district
Authors: Scheepers Caren , Thomas Leena , Meyer Ellenore 
Published: November 2017

Subject area
Leadership and Health Care management and Organisational Development and Talent Management.

Study level/applicability
Postgraduate level for honours or master’s programs in courses on public health, executive leadership and management, organisational development and public administration leadership.

Case overview
The case study offers an account of Ms Xolani Ngumi’s Chief Director, Enola District Health Services, South Africa, who was driving from her newly constructed modern district hospital to one of the municipal clinics that she was overseeing. It highlights the dilemma of the general practitioners (GP’s) that refused to be relocated, leading to many clinics being without clinical support.

Expected learning outcomes
Expected learning outcomes are as follows: Identification of stakeholders in a particular dilemma to aid leaders’ decision-making; developing the competence of balancing conflicting needs of stakeholders by juggling complex systems; and analysing staffing issues and offer recommendations to enhance talent management.

Supplementary materials
Teaching Notes are available for educators only. Please contact your library to gain login details or email support@emeraldinsight.com to request teaching notes.

Subject code
CSS 7: Management Science.
The self‐reported quality of life of Lithuanian children with asthma was comparable to Western populations
Authors: Taminskiene Vaida , Vaitkaitiene Egle , Valiulis Algirdas , Turner Steve , Hadjipanayis Adamos , Stukas Rimantas , Valiulis Arunas 
Published: November 2017

AbstractAimQuality of life (QoL) has been widely researched among children with asthma in Western countries, but there is a lack of data from eastern Europe, where the prevalence is relatively low, but hospital admission rates are higher. We evaluated the overall level and major determinants of QoL in Lithuanian children aged 5–11 years with asthma.MethodsThis study was carried out in six asthma outpatient clinics in the two largest cities of Lithuania from January 2015 to July 2016. The children's QoL was measured using the Pediatric Quality of Life Inventory (PedsQL) asthma module, which was completed by the child and one parent.ResultsWe collected questionnaires from 226 children (68% boys) with a mean age of eight (±2) years: 65% had mild asthma, 31% had moderate asthma and 4% had severe asthma. One in 10 had been hospitalised in the preceding 6 months. The mean self‐reported QoL score was 74 and the parent‐reported QoL score was 73. QoL was associated with asthma severity and control, shortness of breath and the child's general health, but not socioeconomic factors.ConclusionThe overall level and major determinants of QoL in children with asthma in Lithuania were comparable with Western populations.
CSR Participation Committees, Wildcat Strikes and the Sourcing Squeeze in Global Supply Chains
Authors: Anner Mark 
Published: November 2017

AbstractLead firms in apparel global supply chains are increasingly using social compliance programmes that require worker‐management participation committees in their supplier factories. These committees are designed to ensure respect for internationally recognized labour standards, to empower workers, and to reduce labour unrest. However, these committees have remained weak, and in countries such as Vietnam worker unrest remains common. This article argues that this is because lead firms in these CSR programmes are imposing a ‘sourcing squeeze’ on supplier factors by reducing the prices and production times they allot to their suppliers, which undermines efforts by committees to address cost‐sensitive issues and overtime violations. At the same time, the sourcing squeeze increases strike leverage, providing workers with a much more effective source of worker voice.
Bioactive treatments in bone grafts for implant‐based rehabilitation: Systematic review and meta‐analysis
Authors: da Rosa Wellington Luiz de Oliveira , da Silva Tiago Machado , da Silva Adriana Fernandes , Piva Evandro 
Published: November 2017

AbstractBackgroundThe use of bioactive proteins, such as rhBMP‐2, may improve bone regeneration in oral and maxillofacial surgery.PurposeAnalyze the effect of using bioactive proteins for bone regeneration in implant‐based rehabilitation.Materials and MethodsSeven databases were screened. Only clinical trials that evaluated the use of heterologous sources of bioactive proteins for bone formation prior to implant‐based rehabilitation were included. Statistical analyses were carried out using a random‐effects model by comparing the standardized mean difference between groups for bone formation, and risk ratio for implant survival (P ≤ .05).ResultsSeventeen studies were included in the qualitative analysis, and 16 in the meta‐analysis. For sinus floor augmentation, bone grafts showed higher amounts of residual bone graft particles than bioactive treatments (P ≤ .05). While for alveolar ridge augmentation bioactive treatments showed a higher level of bone formation than control groups (P ≤ .05). At 3 years of follow‐up, no statistically significant differences were observed for implant survival (P > .05).ConclusionsBioactive proteins may improve bone formation in alveolar ridge augmentation, and reduce residual bone grafts in sinus floor augmentation. Further studies are needed to evaluate the long‐term effect of using bioactive treatments for implant‐based rehabilitation.