bluuebunny/crossref_metadata_2025_split huggingface dataset:
Influenza Virus Detection Following Administration of Live-Attenuated Intranasal Influenza Vaccine in Children With Cystic Fibrosis and Their Healthy Siblings
Authors: Boikos Constantina , Joseph Lawrence , Martineau Christine , Papenburg Jesse , Scheifele David , Lands Larry C. , De Serres Gaston , Chilvers Mark , Quach Caroline 
Published: August 2016

Abstract
Background.  We aimed to explore the detection profile of influenza viruses following live-attenuated intranasal influenza vaccination (LAIV) in children aged 2–19 years with and without cystic fibrosis (CF).
Methods.  Before the 2013–2014 influenza season, flocked nasal swabs were obtained before vaccination and 4 times in the week of follow-up from 76 participants (nCF: 57; nhealthy: 19). Influenza was detected by reverse transcription polymerase chain reaction (RT-PCR) assays. A Bayesian hierarchical logistic regression model was used to estimate the effect of CF status and age on influenza detection.
Results.  Overall, 69% of the study cohort shed influenza RNA during follow-up. The mean duration of RT-PCR detection was 2.09 days (95% credible interval [CrI]: 1.73–2.48). The odds of influenza RNA detection on day 1 following vaccination decreased with age in years (odds ratio [OR]: 0.82 per year; 95% CrI: 0.70–0.95), and subjects with CF had higher odds of influenza RNA detection on day 1 of follow-up (OR: 5.09; 95% CrI: 1.02–29.9).
Conclusion.  Despite the small sample size, our results indicate that LAIV vaccine strains are detectable during the week after LAIV, mainly in younger individuals and vaccinees with CF. It remains unclear whether recommendations for avoiding contact with severely immunocompromised patients should differ for these groups.
An uncommon cause of acute pulmonary edema
Authors: Nepal Santosh , Giri Smith , Bhusal Mohan , Siwakoti Krishmita , Pathak Ranjan 
Published: August 2016

ABSTRACT
Acute cardiogenic pulmonary edema secondary to catecholamine-induced cardiomyopathy is a very uncommon and fatal initial presentation of pheochromocytoma. However, with early clinical suspicion and aggressive management, the condition is reversible. This case report describes a patient who presented with hypertension, dyspnea, and cough with bloody streaks, and who recovered within 48 hours after appropriate treatment.
Colorectal cancer screening
Authors: Dickerson Lisa , Varcak Susan Combs 
Published: August 2016

ABSTRACT
Recommended screening options for colorectal cancer are divided into noninvasive stool-based options, and invasive procedure-based options. Because multiple screening strategies are effective, efforts to reduce deaths from colorectal cancer should focus on maximizing the number of patients who are screened. This article reviews noninvasive stool-based screening options.
Pain Catastrophizing, Mindfulness, and Pain Acceptance
Authors: Elvery Nichola , Jensen Mark P. , Ehde Dawn M. , Day Melissa A. 
Published: August 2016

Objectives:
It is not known whether psychosocial chronic pain treatments produce benefits through the unique mechanisms specified by theory. Fundamental to gaining an accurate understanding of this issue is to first determine whether the most widely used process measures assess unique constructs and predict unique variance in pain outcomes. This study examined the associations between the Pain Catastrophizing Scale (PCS), Five-Facet Mindfulness Questionnaire (FFMQ-SF), and the Chronic Pain Acceptance Questionnaire (CPAQ-8), and determined their unique contributions to the prediction of pain intensity, pain interference, and depression.

Methods:
A cross-sectional study was conducted with undergraduate students (N=260) reporting chronic or intermittent pain. Correlations, regression models, and multiple mediation models were performed. Relevant covariates were included.

Results:
The PCS, FFMQ-SF scales, and CPAQ-8 were correlated in mostly expected directions, but not so highly as to indicate redundancy. The PCS significantly predicted pain intensity, interference, and depression. The FFMQ-SF Observing and Describing scales predicted pain intensity; Nonreactivity and Nonjudging significantly predicted interference and depression, respectively. The CPAQ-8 was not a significant predictor in any of the regression models. The PCS was a comparatively stronger mediator than the FFMQ-SF scales in the intensity to interference, and intensity to depression mediation models.

Discussion:
The findings indicate that pain catastrophizing, mindfulness, and pain acceptance are related, but unique constructs. The PCS and select FFMQ-SF scales were uniquely associated with the criterion measures. However, the PCS emerged as the most robust process, highlighting the importance of targeting this cognitive domain in streamlining pain treatments to optimize outcome.
Lateralization of Interaural Level Differences with Multiple Electrode Stimulation in Bilateral Cochlear-Implant Listeners
Authors: Stakhovskaya Olga A. , Goupell Matthew J. 
Published: August 2016

Objective:
There is currently no accepted method of mapping bilateral cochlear-implant (BiCI) users to maximize binaural performance, but the current approach of mapping one ear at a time could produce spatial perceptions that are not consistent with a sound’s physical location in space. The goal of this study was to investigate the perceived intracranial lateralization of bilaterally synchronized electrical stimulation with a range of interaural level differences (ILDs) and to determine a method to produce relatively more centered auditory images when provided multielectrode stimulation.

Design:
Using direct stimulation, lateralization curves were measured in nine BiCI listeners using 1000-pulses per second (pps), 500-msec constant-amplitude pulse trains with ILDs that ranged from −20 to +20 clinical current units (CUs). The stimuli were presented bilaterally at 70 to 80% of the dynamic range on single or multiple electrode pairs. For the multielectrode pairs, the ILD was applied consistently across all the pairs. The lateralization response range and the bias magnitude at 0 CU ILD (i.e., the number of CUs needed to produce a centered auditory image) were computed. Then the levels that elicit a centered auditory image with single-electrode stimulation were used with multielectrode stimulation to determine if this produced fewer significant biases at 0 CU ILD. Lastly, a multichannel ILD processing model was used to predict lateralization for the multielectrode stimulation from the single-electrode stimulation.

Results:
BiCI listeners often perceived both single- and multielectrode stimulation at 0-CU ILD as not intracranially centered. For single-electrode stimulation, 44% of the lateralization curves had relatively large (≥5 CU) bias magnitudes. For the multielectrode stimulation, 25% of the lateralization curves had large bias magnitudes. After centering the single-electrode pairs, the percentage of multielectrode combinations that produced large biases significantly decreased to only 4% (p < 0.001, McNemar’s test). The lateralization with multielectrode stimulation was well predicted by a model that used unweighted or weighted average single-electrode lateralization percepts across electrode pairs (87 or 90%, respectively).

Conclusion:
Current BiCI mapping procedures can produce an inconsistent association between a physical ILD and the perceived location across electrodes for both single- and multielectrode stimulation. Explicit centering of single-electrode pairs using the perceived centered intracranial location almost entirely corrects this problem and such an approach is supported by our understanding and model of across-frequency ILD processing. Such adjustments might be achieved by clinicians using single-electrode binaural comparisons. Binaural abilities, like sound localization and understanding speech in noise, may be improved if these across-electrode perceptual inconsistencies are removed.
Comparison Between Minimally Invasive Surgery and Conventional Open Surgery for Patients With Spinal Metastasis
Authors: Hansen-Algenstaedt Nils , Kwan Mun Keong , Algenstaedt Petra , Chiu Chee Kidd , Viezens Lennart , Chan Teik Seng , Lee Chee Kean , Wellbrock Jasmin , Chan Chris Yin Wei , Schaefer Christian 
Published: August 2016

Study Design.Prospective propensity score-matched study.Objective.To compare the outcomes of minimal invasive surgery (MIS) and conventional open surgery for spinal metastasis patients.Summary of Background Data.There is lack of knowledge on whether MIS is comparable to conventional open surgery in treating spinal metastasis.Methods.Patients with spinal metastasis requiring surgery from January 2008 to December 2010 in two spine centers were recruited. The demographic, preoperative, operative, perioperative and postoperative data were collected and analyzed. Thirty MIS patients were matched with 30 open surgery patients using propensity score matching technique with a match tolerance of 0.02 based on the covariate age, tumor type, Tokuhashi score, and Tomita score.Results.Both groups had significant improvements in Eastern Cooperative Oncology Group (ECOG), Karnofsky scores, visual analogue scale (VAS) for pain and neurological status postoperatively. However, the difference comparing the MIS and open surgery group was not statistically significant. MIS group had significantly longer instrumented segments (5.5 ± 3.1) compared with open group (3.8 ± 1.7). Open group had significantly longer decompressed segment (1.8 ± 0.8) than MIS group (1.0 ± 1.0). Open group had significantly more blood loss (2062.1 ± 1148.0 mL) compared with MIS group (1156.0 ± 572.3 mL). More patients in the open group (76.7%) needed blood transfusions (with higher average units of blood transfused) compared with MIS group (40.0%). Fluoroscopy time was significantly longer in MIS group (116.1 ± 63.3 s) compared with open group (69.9 ± 42.6 s). Open group required longer hospitalization (21.1 ± 10.8 days) compared with MIS group (11.0 ± 5.0 days).Conclusion.This study demonstrated that MIS resulted in comparable outcome to open surgery for patients with spinal metastasis but has the advantage of less blood loss, blood transfusions, and shorter hospital stay.Level of Evidence:3
Evolving Alignment in International Continuing Professional Development Accreditation
Authors: McMahon Graham T. , Aboulsoud Samar , Gordon Jennifer , McKenna Mindi , Meuser James , Staz Mark , Campbell Craig M. 
Published: August 2016

Abstract:
Several of the world's accreditation systems for continuing professional development (CPD) are evolving to encourage continuous improvement in the competence and performance of health care providers and in the organizations in which they provide patient care. Clinicians learn best when they can to choose from a diverse array of activities and formats that are relevant and meet their needs. Since choice and diversity are key to meeting clinicians' needs, several CPD accreditors have been engaging in deliberate, concerted efforts to identify a core set of principles that can serve as the basis for determining substantive equivalency between CPD accreditation systems. Substantive equivalency is intended to support the mobility of learners, allowing them to access accredited learning activities that are recognized by various CPD accreditation systems in a manner that maximizes the value of those accreditation systems, while minimizing the burden of adhering to their requirements. In this article, we propose a set of core principles that all CPD accreditation systems must express as the basis for determining substantive equivalency between CPD accreditation systems. The article will illustrate how five CPD accreditation systems (two in the USA, two in Canada, and one in Qatar), differing in focus (activity-based versus provider-based), context, and culture, express these values and metrics, and concludes by identifying the value of substantive equivalency for learners, medical regulators, and CPD accreditation systems.
Ensuring Competent Care by Senior Physicians
Authors: Hawkins Richard E. , Welcher Catherine M. , Stagg Elliott Victoria , Pieters Richard S. , Puscas Liana , Wick Paul H. 
Published: August 2016

Abstract:
The increasing number of senior physicians and calls for increased accountability of the medical profession by the public have led regulators and policymakers to consider implementing age-based competency screening. Some hospitals and health systems have initiated age-based screening, but there is no agreed upon assessment process. Licensing and certifying organizations generally do not require that senior physicians pass additional assessments of health, competency, or quality performance. Studies suggest that physician performance, on average, declines with increasing years in medical practice, but the effect of age on an individual physician's competence is highly variable. Many senior physicians practice effectively and should be allowed to remain in practice as long as quality and safety are not endangered. Stakeholders in the medical profession should consider the need to develop guidelines and methods for monitoring and/or screening to ensure that senior physicians provide safe and effective care for patients. Any screening process needs to achieve a balance between protecting patients from harm due to substandard practice, while at the same time ensuring fairness to physicians and avoiding unnecessary reductions in workforce.
Creation of a Tool for Assessing Knowledge in Evidence-Based Decision-Making in Practicing Health Care Providers
Authors: Spurr Kathy , Dechman Gail , Lackie Kelly , Gilbert Robert 
Published: August 2016

Introduction:
Evidence-based decision-making (EBDM) is the process health care providers (HCPs) use to identify and appraise potential evidence. It supports the integration of best research evidence with clinical expertise and patient values into the decision-making process for patient care. Competence in this process is essential to delivery of optimal care. There is no objective tool that assesses EBDM across HCP groups. This research aimed to develop a content valid tool to assess knowledge of the principles of evidence-based medicine and the EBDM process, for use with all HCPs.

Methods:
A Delphi process was used in the creation of the tool. Pilot testing established its content validity with the added benefit of evaluating HCPs' knowledge of EBDM. Descriptive statistics and multivariate mixed models were used to evaluate individual survey responses in total, as well as within each EBDM component.

Results:
The tool consisted of 26 multiple-choice questions. A total of 12,884 HCPs in Nova Scotia were invited to participate in the web-based validation study, yielding 818 (6.3%) participants, 471 of whom completed all questions. The mean overall score was 68%. Knowledge in one component, integration of evidence with clinical expertise and patient preferences, was identified as needing development across all HCPs surveyed.

Discussion:
A content valid tool for assessing HCP EBDM knowledge was created and can be used to support the development of continuing education programs to enhance EBDM competency.
The Health Impacts of Climate Change: A Continuing Medical Education Needs Assessment Framework
Authors: Valois Pierre , Blouin Patrick , Ouellet Claudine , Renaud Jean-Sébastien , Bélanger Diane , Gosselin Pierre 
Published: August 2016

Introduction:
As the health consequences of climate change (CC) will likely become more manifest in the future, family physicians have to be knowledgeable about these impacts and the ways in which they can affect their patients. The main aim of this study was to propose a competency framework and questionnaire used to conduct a needs analysis to identify and prioritize family physicians' real educational needs regarding the health impacts of CC.

Methods:
A mixed method combining a qualitative interview and a quantitative online questionnaire was used (n = 24 physicians). The interview assessed key beliefs related to participating in an online continuing medical education (eCME) activity on the health impacts of climate change, and the perception of the key factors or conditions required to ensure the family physicians' satisfaction with this eCME activity. The questionnaire assessed the current and desired levels of competency on five general training themes: general knowledge about CC; heat-related illnesses; CC, extreme weather events and modification of vector-borne and zoonotic diseases; CC, extreme weather events and modification of water-borne diseases; and mental health impacts of natural disasters.

Results:
Results revealed the need for improved medical education on climate change and health. Results also add to the literature by showing that a 3-hour eCME activity covering these topics would be useful and would allow family physicians to use this knowledge in their daily practice, notably through prevention and counseling.

Discussion:
Introducing a CME needs assessment framework and a generic instrument that reflects family physicians' needs regarding the health impacts of CC has the added advantage of standardizing the assessment procedure.
What Do We Need to Protect, at All Costs, During the 21st Century? Reflections From a Curated, Interactive Co-Created Intellectual Jazz Performance
Authors: Jadad Alejandro R. , Davis Dave 
Published: August 2016

Abstract:
The question that forms the title of this article, “What do we need to protect, at all costs, during the 21st century?,” speaks to the sizable changes in health care systems and settings that surround the continuing professional development (CPD) provider, and the need to establish a core set of principles and practices as the field moves forward from both theoretical and practical aspects. It also provided the focus for one of the five keynote lectures presented during the 2016 World Congress on Continuing Professional Development. As the planners of this keynote session, we sought to evoke answers to the question, not from the speaker, but from the audience itself, a process enabled by a highly engaging presentation style and powered by interactive digital technologies. Further, we believed that the session would not directly lead to suggestions to improve the theory and practice of CPD, but rather to create the biopsychosocial context—a sort of platform—on which such discussions can occur.
Using Interprofessional Learning for Continuing Education: Development and Evaluation of the Graduate Certificate Program in Health Professional Education for Clinicians
Authors: Henderson Saras , Dalton Megan , Cartmel Jennifer 
Published: August 2016

Introduction:
Health professionals may be expert clinicians but do not automatically make effective teachers and need educational development. In response, a team of health academics at an Australian university developed and evaluated the continuing education Graduate Certificate in Health Professional Education Program using an interprofessional learning model.

Methods:
The model was informed by Collins interactional expertise and Knowles adult learning theories. The team collaboratively developed and taught four courses in the program. Blended learning methods such as web-based learning, face-to-face workshops, and online discussion forums were used. Twenty-seven multidisciplinary participants enrolled in the inaugural program. Focus group interview, self-report questionnaires, and teacher observations were used to evaluate the program.

Results:
Online learning motivated participants to learn in a collaborative virtual environment. The workshops conducted in an interprofessional environment promoted knowledge sharing and helped participants to better understand other discipline roles, so they could conduct clinical education within a broader health care team context. Work-integrated assessments supported learning relevance. The teachers, however, observed that some participants struggled because of lack of computer skills.

Discussion:
Although the interprofessional learning model promoted collaboration and flexibility, it is important to note that consideration be given to participants who are not computer literate. We therefore conducted a library and computer literacy workshop in orientation week which helped. An interprofessional learning environment can assist health professionals to operate outside their “traditional silos” leading to a more collaborative approach to the provision of care. Our experience may assist other organizations in developing similar programs.
Observations on the 2016 World Congress on Continuing Professional Development: Advancing Learning and Care in the Health Professions
Authors: Turco Mary G. , Baron Robert B. 
Published: August 2016

Abstract:
The 2016 World Congress on Continuing Professional Development: Advancing Learning and Care in the Health Professions took place in San Diego, California, March 17–19, 2016. Hosts were the Association for Hospital Medical Education (AHME), Alliance for Continuing Education in the Health Professionals (ACEhp), and Society for Academic Continuing Medical Education (SACME). The target audience was the international community working to improve medical (CME), nursing (CNE), pharmacy (CPE), and interprofessional (CIPE) continuing education (CE) and continuing professional development (CPD). Goals included: addressing patients' concerns and needs; advancing global medical and interprofessional health sciences education; utilizing learning to address health disparities; and promoting international cooperation. The five keynote speakers were: patient advocate Alicia Cole (“Why What We Do Matters: The Patients Voice”); linguist Lorelei Lingard (“Myths about Healthcare Teamwork and Their Implications for How We Understand Competence”); futurist and philosopher Alex Jadad (“What Do We Need to Protect at All Costs in the 21st Century?”); ethicist and change agent Zeke Emanuel (“Learn to Change: Teaching Toward a Shifting Healthcare Horizon”); and technology innovator Stephen Downes (“From Individual to Community: The Learning Is in the Doing”). Organizers announced the new Dave Davis Distinguished Award for Excellence in Mentorship in Continuing Professional Development to honor the career of David Davis, MD, in CME/CPD scholarship in Canada, the United States, and beyond. Participants valued the emphasis on interprofessional education and practice, the importance of integrating the patient voice, the effectiveness of flipped classroom methods, and the power of collective competency theories. Attendee-respondents encouraged Congress planners to continue to strive for a broad global audience and themes of international interest.