bluuebunny/crossref_metadata_2025_split huggingface dataset:
Anemia in Pediatric Celiac Disease
Authors: Rajalahti Teemu , Repo Marleena , Kivelä Laura , Huhtala Heini , Mäki Markku , Kaukinen Katri , Lindfors Katri , Kurppa Kalle 
Published: April 2016

ABSTRACTGoals:The aim of the present study was to compare clinical, serological, and histological manifestations between children with anemia and without anemia at celiac disease (CD) diagnosis.Background:Despite being a common finding, the association between the presence of anemia and clinicohistopathological presentation of CD in children remains obscure.Study:A total of 455 patients with CD <18 years of age were divided into those with anemia and those without anemia at diagnosis. The groups underwent comparisons of a variety of clinical, serological, and laboratory parameters and severity of small‐bowel mucosal damage. Furthermore, adherence and clinical and serological response to the gluten‐free diet (GFD) were compared.Results:Anemia was detected in 18.0% of the patients. Children with anemia had higher values for transglutaminase 2 antibodies (120.0 U/L vs 88.0 U/L, P < 0.001) and, by definition, lower values for hemoglobin (10.5 g/dL vs 12.8 g/dL, P < 0.001) and other iron parameters. They were also less often screen‐detected (13.4% vs 34.6%), had more severe histological damage (P = 0.048), and poorer dietary adherence (78.3% vs 87.5%, P = 0.035) than the patients without anemia. A total of 92% of the patients recovered from anemia after a median of 1 year on a GFD, but hemoglobin values remained significantly lower compared with the nonanemic group (12.5 g/dL vs 13.2 g/dL, P = 0.045). There was no difference between the groups in the clinical and serological response to the GFD (P = 0.318).Conclusions:Anemia at CD diagnosis is associated with more severe histological and serological presentation in children. Furthermore, low hemoglobin may not fully recover even after a median of 1 year on a strict GFD.
Assessing the Colonic Microbiota in Children
Authors: Shaw Alexander G. , Black Naomi , Rushd Azelea , Sim Kathleen , Randell Paul , Kroll J. Simon , Epstein Jenny 
Published: April 2016

ABSTRACTObjectives:Inflammatory bowel disease states are associated with gastrointestinal dysbiosis. Mucosal biopsy sampling, retrieving the bacterial community that most directly interacts with the host, is an invasive procedure that, we hypothesis, may be sufficiently approximated by other sampling methods. We investigate the relatedness of samples obtained by different methods and the effects of bowel preparation on the gastrointestinal community in a paediatric population.Methods:We recruited a cohort of patients undergoing colonoscopy, collecting serial samples via differing methods (rectal swabs, biopsies, and faecal matter/luminal contents) prebowel preparation, during colonoscopy and after colonoscopy. Next‐generation sequencing was used to determine the structure of the microbial community.Results:The microbial community in luminal contents collected during colonoscopy was found to be more similar to that of mucosal biopsies than rectal swabs. Community traits of the mucosal biopsies could be used to segregate patients with inflammatory bowel disease from other patients, and the similarity of the communities in the luminal contents was sufficient for the segregation to be reproduced. Microbial communities sampled by rectal swabs and prebowel preparation faeces were less similar to mucosal biopsies. Bowel preparation was found to have no significant long‐term effects on the microbial community, despite the transient effects evident during colonoscopy.Conclusions:A clinically relevant description of the mucosal microbial community can be obtained via the noninvasive collection of luminal contents after bowel cleansing. Bowel preparation in a paediatric population results in no consistent sustained alterations to the gastrointestinal microbiota.
Postsurgical Perforation of the Esophagus Can Be Treated Using a Fully Covered Stent in Children
Authors: Chauvet Chantal , Bonnard Arnaud , Mosca Alexis , Bellaïche Marc , Philippe‐Chomette Pascale , Viala Jérôme 
Published: April 2016

ABSTRACTObjectives:Surgery and conservative treatment of esophageal or gastric perforations are both often associated with poor results and carry a high morbidity and mortality rate. The aim of the present study was to evaluate the effectiveness and safety of using fully covered self‐expending metallic stents (SEMS) in children with upper digestive leaks.Methods:This retrospective study reviewed all children with esophageal or gastric perforation who were treated with placement of an SEMS from January 2011 to January 2015. Closure of the perforation was the primary outcome measured. Secondary outcomes were the duration of antibiotic therapy and parenteral nutrition, adverse events, and length of hospitalization.Results:A total of 19 SEMS were placed in 10 patients (median age: 5.5 years; 5 girls) treated for postanastomotic leaks of esophageal atresia (n = 3), esophagogastroplasty (n = 4), resection of esophageal duplication (n = 1) or perforation during Toupet surgical dismantling (n = 1), and gastric rupture after Nissen surgery (n = 1). The perforation closed in 9 out of 10 patients in a mean of 36 days after stenting (range: 13–158 days). All patients received antibiotic therapy for an average of 17.5 days (3–109 days) and parenteral nutrition for 49 days (17–266 days). During a median follow‐up of 8.9 months, 4 out of 9 sealed perforations developed stenosis, which was efficiently treated by endoscopic dilations in 2 patients and surgical redo in 2 patients with dilation‐resistant stenosis.Conclusions:Covered stents appear to be beneficial in closing esophageal perforations in children and can avoid the high morbidity of a surgical repair. Stenosis, however, occurred frequently after larger leakages.
Coping With Prediagnosis Symptoms of Colorectal Cancer
Authors: Rogers Heather L. , Siminoff Laura A. , Longo Daniel R. , Thomson Maria D. 
Published: April 2016

Background:
Colorectal cancer (CRC) symptoms are often vague and vary in severity, intensity, type, and timing. Receipt of medical care is dependent on symptom recognition and assessment, which may impede timely diagnosis.

Objective:
The aim of this study was to describe and categorize how CRC patients coped with symptoms prior to seeking medical care, examine sociodemographic differences in these coping strategies, and determine the strategies associated with time to seek medical care and overall time to diagnosis.

Methods:
Two hundred forty-four white and African American patients in Virginia and Ohio who received a diagnosis of CRC and who experienced symptoms prior to diagnosis were administered a semistructured interview and the Brief COPE questionnaire.

Results:
Eighty-three percent used more than 1 coping strategy. Common symptom-specific coping strategies were to “wait-and-see,” self-treat, and rationalize symptoms. Males were more likely to wait and see (P < .001); African Americans and Medicaid recipients were more likely to self-treat via lifestyle changes (P’s < .01). Younger individuals (<50 years old) had higher Brief COPE reframing, planning, and humor scores; those with lower education and income had higher denial scores (P’s < .01). Using more symptom-specific coping strategies and engaging in avoidance/denial were associated with longer time to seek medical care and overall time to diagnosis (P’s < .01).

Conclusions:
Individuals experiencing CRC symptoms use multiple, diverse coping strategies that are influenced by sociodemographic characteristics. Denial is particularly relevant for delay in seeking care and timely diagnosis.

Implications for Practice:
Public health campaigns could focus on secondary prevention of CRC by targeting at-risk groups such as males, African Americans, or Medicaid recipients, who choose waiting or self-treatment in response to initial symptoms.
Communication During Palliative Care and End of Life
Authors: Montgomery Kathleen E. , Sawin Kathleen J. , Hendricks-Ferguson Verna 
Published: April 2016

Background:
Communication between patients, families, and healthcare providers is a central component of end-of-life care. Nurse communication during palliative care (PC) and end of life (EOL) is a phenomenon with limited research. It is unclear how the level of nursing experience influences the perspectives of nurses communicating during EOL.

Objective:
The aim of this study is to describe the commonalities of experienced nurses’ perceptions of communicating during PC and EOL and perceptions of barriers and facilitators to effective communication.

Methods:
This study was part of a larger multisite study that used a qualitative, empirical phenomenology design and represents focus group data gathered from pediatric oncology nurses with more than 5 years of experience or who were advanced practice nurses not involved in the direct evaluation of other nurses.

Results:
Five core themes with corresponding themes and subthemes were identified. The core themes included (a) Evolution of PC/EOL, (b) Skill of Knowing, (c) Expanded Essence of Caring, (d) Experienced Nurse as Committed Advocate, and (e) Valuing Individual Response to Grief.

Conclusions:
Findings reflect how the concept of experience transcended the 5 core themes and captured how experience provided nurses the know-how to fulfill the roles of communication, caring, and advocacy for children and families.

Implications for Practice:
Enhancing nurse communication skills during EOL requires opportunities to gain experience coupled with clinical strategies, such as standardized curricula, simulation, competency-based orientation programs, mentorship, and peer support.
Patients’ Vulnerability in Follow-up After Colorectal Cancer
Authors: Thomsen Thora G. , Hølge-Hazelton Bibi 
Published: April 2016

Background:
In the transition between being a hospitalized patient with cancer and resuming “normal” life, many patients experience physical, mental, and social challenges. Scientifically, as well as politically, it is therefore recommended to undertake research with a focus on rethinking and reorganizing follow-up after cancer treatment.

Objective:
The aim of this study was to identify the perspectives of fast-track colorectal cancer surgery patients on challenges experienced in the transition from being a hospitalized patient with cancer to being a cancer survivor.

Methods:
The current article represents phase 1 in an ongoing action research project. Data were analyzed by using the “interpretive description” method.

Results:
Twelve patients (6 male and 6 female patients; mean age, 72.4 years) participated in the study. The analyses show that the patients physically experienced readiness to leave hospital after a few days; however, shortly after returning home, most of them became mentally overwhelmed by the feeling of vulnerability that was closely related to the feeling of being handed over the responsibility for a newly cancer-operated body and a fragile life situation. Four issues that challenged the patients emerged from the analysis: restore an everyday life, participate in a follow-up program, get relevant information, and manage contact with relevant health professionals.

Conclusions:
The study indicates that the transition to restoring a normal life after cancer surgery had been an experience characterized by more vulnerability than expected by the patients in the study.

Implications for Practice:
The findings provide 4 well-defined themes, each of which constitutes a point of departure related to focused patient-centered interventions related to follow-up after cancer surgery.
Improving the Transition to Palliative Care for Patients With Acute Leukemia
Authors: Hopkins Bianca , Gold Michelle , Wei Andrew , Grigoriadis George 
Published: April 2016

Background:
Currently, there is little guidance available for documenting and executing the change in management goals in the context of incurable hematologic disease.

Objective:
The aim of this study was to improve the transition to palliative care for patients with acute myeloid leukemia (AML) through the development and implementation of a coordinated care plan program.

Methods:
Twenty-three patients with AML who were no longer being treated with curative intent from March 2011 through September 2012 had hematology supportive care plans developed. Patients (n = 7) completed post–care plan implementation questionnaires to determine their level of understanding in relation to the change in treatment intent. Staff completed pre– (n = 26) and post– (n = 19) care plan implementation questionnaires to determine the communication, challenges, and accessibility of changed management goals.

Results:
Seventy-seven percent of patients understood palliative care to be the primary team managing their symptoms, with 75% of patients viewing symptom control as the main goal of treatment. Staff findings demonstrated a significant improvement in the communication of treatment goals (53% preimplementation vs 86% postimplementation). Early timing of referrals remains a significant issue.

Conclusions:
Implementing the individualized care plan program was associated with better communication and accessibility of documented palliative treatment goals for patients with AML.

Implications for Practice:
This study establishes a model of care that addresses symptom and disease burden in end-stage AML and provides valuable insight into the patient and family understanding of treatment intent during this terminal phase.
The Role of Hair Loss in Cancer Identity
Authors: Trusson Diane , Pilnick Alison 
Published: April 2016

Background:
The trauma of chemotherapy-induced alopecia is well documented. However, less is known about how the stereotypical cancer identity affects social interactions.

Objective:
The aim of this study is to explore women’s experiences of hair loss resulting from breast cancer treatment, from a sociological perspective.

Methods:
Twenty-four women who had been treated for early-stage breast cancer or ductal carcinoma in situ were interviewed. References to hair (loss) were isolated from their narratives.

Results:
Findings confirm previous research that hair loss can be traumatic. The stigma attached to both having a cancer patient identity and nonconformity with norms of appearance means that women must decide how much to reveal and to whom. An unexpected finding was that distressing experiences were reported by some women who had not lost their hair.

Conclusions:
Hair is important to identity; therefore, there are implications for social interactions whether women decide to disguise their hair loss or not. There may also be implications for women who do not lose their hair because they fail to conform to the stereotypical appearance of the bald cancer patient. Future research should consider the role of stereotypes in patient experiences.

Implications for Practice:
Nurses should provide sufficient information and support to prepare patients for the impact on self-perception and social interactions when facing hair loss. Also, patients should be forewarned about the possible implications of not conforming to the cancer stereotype. In addition, greater education among the wider population about the possible side effects of cancer treatments may prevent women feeling stigmatized while already undergoing a stressful experience.
Sick Leave and Disability Across Three Decades After a Major Disaster
Authors: Holgersen Katrine Høyer , Klöckner Christian A. , Bøe Hans Jakob , Holen Are 
Published: April 2016

AbstractExtended functional impairment characterized by sick leave and disability after a single disaster has not been documented before. This prospective, longitudinal, case–control study applied growth mixture modeling to predict trajectories of functional impairment in oil rig workers, survivors (n= 68) and a matched comparison group (n= 84), over 27 years after the 1980 North Sea oil rig disaster. In the initial 12 years post-disaster, survivors displayed higher rates of functional impairment than the comparison group. A minor group of survivors (n= 8, 11.8%) demonstrated persistent functional impairment from the start and remained unable to work during the subsequent three decades. Long-term sick leave and disability were related to perceived peritraumatic death threat and a propensity towards social withdrawal. Most survivors (n= 60) revealed no major functional impairment. The study indicates that functional impairment should be counteracted in the early support after a single disaster.
A Randomized, Controlled Pilot Study of a Single-Session Psychoeducation Treatment for Urban, Culturally Diverse, Trauma-Exposed Adults
Authors: Ghafoori Bita , Fisher Dennis , Korosteleva Olga , Hong Madelyn 
Published: April 2016

Abstract
This randomized pilot study aimed to determine whether a single session of psychoeducation improved mental health outcomes, attitudes toward treatment, and service engagement among urban, impoverished, culturally diverse, trauma-exposed adults. Sixty-seven individuals were randomly assigned to a single-session psychoeducation treatment or a delayed treatment comparison control group. The control group was found to be superior to the treatment group at posttest with respect to symptoms of posttraumatic stress disorder, anxiety, and occupational and family disability. At follow-up, all participants had completed the psychoeducation treatment, and a mixed-effects model indicated significant improvements over time in symptoms of posttraumatic stress disorder, anxiety, depression, somatization, and attitudes toward treatment. Ninety-eight percent of the participants reported the psychoeducation was helpful at follow-up. Participants also reported a 19.1% increase in mental health service utilization at follow-up compared with baseline. Implications for treatment and future research are discussed.
Association of Spirituality With Mental Health Conditions in Ohio National Guard Soldiers
Authors: Ganocy Stephen J. , Goto Toyomi , Chan Philip K. , Cohen Gregory H. , Sampson Laura , Galea Sandro , Liberzon Israel , Fine Thomas , Shirley Edwin , Sizemore James , Calabrese Joseph R. , Tamburrino Marijo B. 
Published: April 2016

Abstract
Research exploring spirituality in military populations is a relatively new field with limited published reports. This study used the Spiritual Well-Being Scale to examine the association of spiritual well-being with suicidal ideation/behavior, posttraumatic stress disorder (PTSD), and depression and alcohol use disorders in a randomized sample of Ohio Army National Guard soldiers. The participants were 418 soldiers, mostly white and male, with nearly three-quarters indicating that they had been deployed at least once during their careers. Higher spirituality, especially in the existential well-being subscale, was associated with significantly less lifetime PTSD, depression, and alcohol use disorders and with less suicidal ideation over the past year. Future research in this area may benefit from a longitudinal design that can assess spirituality and mental health behaviors in addition to diagnoses at different time points, to begin to explore spirituality in a larger context.
Optical Characterization Method for Tilted or Decentered Intraocular Lenses
Authors: Bonaque-González Sergio , Bernal-Molina Paula , Marcos-Robles Manuel , López-Gil Norberto 
Published: April 2016

ABSTRACT

Purpose
To test and validate a method for measuring the optical quality and optical power of monofocal intraocular lenses (IOLs) in the presence of a tilt or a decentration as well as its optical power.

Methods
The experimental system consists of an artificial eye (wet-cell) and a commercial aberrometer with a Shack-Hartmann sensor. Optical image quality parameters such as point spread function (PSF), modulation transfer function (MTF), and the simulations of the retinal image of an extended object are computed from the in vitro wavefront data of an IOL. Repeatability and reproducibility of the system are tested. Mathematical and ray-tracing simulations are used to ascertain the precision and accuracy of the method. Comparison with a standard single-pass method of measurement is also made. Optical properties of four commercial monofocal IOLs are measured under tilts of 0°, 2°, and 4°, and vertical decentrations of 0, 0.2, and 0.4 mm; the results of such measurements are compared with a ray-tracing simulation.

Results
Precision and accuracy of the system are in good agreement with theoretical calculations. Reproducibility and repeatability are within standard ISO norms. MTFs obtained with this method and with the standard method are very similar. The precision of the estimation of the IOL’s optical power is higher than 98.6%. Commercially tested IOLs show a decrease of optical quality in the presence of decentrations and tilts, and their susceptibility to tilts and decentrations depends on the asphericity. These results are in concordance with the results obtained by ray-tracing simulation.

Conclusions
A simple wavefront-based method for in vitro measurements of the wavefront aberrations and power of an IOL is proposed and tested showing accurate and precise results.
Prevalence of Diabetic Retinopathy in a Clinic Population from Puerto Rico
Authors: Rodriguez Neisha M. , Aguilar Stephanie 
Published: April 2016

ABSTRACT

Purpose
Diabetic retinopathy (DR) is a preventable or treatable cause of blindness in the adult population. The prevalence of diabetes mellitus (DM) in Puerto Ricans is the highest among Hispanics. This study evaluated the prevalence of DR in a screening program of DM subjects in a clinic system in Puerto Rico.

Methods
A retrospective cross-sectional health records study of DM patients referred by primary care physicians for dilated retinal evaluation to the Inter American University of Puerto Rico School of Optometry Juana Diaz Eye Institute Clinic between 2001 and 2009 was performed. All subjects underwent a complete eye evaluation including fundus photography. Photographs were graded following the Early Treatment Diabetic Retinopathy Study protocols.

Results
A total of 411 randomly selected health records of DM subjects older than 30 years were included. The estimated prevalence of DR among all subjects is 37.7%. DR was more common in males (47.2%) than females (33.7%). The age range with higher frequency of DR is among ages 60 to 69 (34.8%) and the lowest between ages 30 and 39 (3.9%). The average number of years since initial DM diagnosis was 12.48. Probability of developing DR increases with longer duration of DM (p < 0.05). The most common stage was mild non-proliferative DR (22.6%).

Conclusions
Our data revealed that prevalence of DR was high among Puerto Ricans. Mild stage retinopathy was most prevalent and there exists an increase in probability to develop DR with duration of DM. The prevalence of DR in total population may be different than the findings presented in this paper. Comprehensive studies are needed to understand and estimate the progression and impact of DR in this population.