bluuebunny/crossref_metadata_2025_split huggingface dataset:
Organoselenium Polymer Inhibits Biofilm Formation in Polypropylene Contact Lens Case Material
Authors: Tran Phat L. , Huynh Eric , Pham Patrick , Lacky Blake , Jarvis Courtney , Mosley Thomas , Hamood Abdul N. , Hanes Rob , Reid Ted 
Published: March 2016

Objectives:
Contact lens-acquired bacterial infections are a serious problem. Of the reported cases, inadequate cleaning of the lens case was the most common cause of lens contamination. Organoselenium has been shown to inhibit bacterial attachment to different polymer materials. This study evaluates the ability of an organoselenium monomer, incorporated into the polymer of a polypropylene contact lens case coupon, to block the formation of biofilms in a lens case.

Methods:
The bacteria tested were Pseudomonas aeruginosa, Staphylococcus aureus, Stenotrophomonas maltophilia, and Serratia marcescens. For this study, the bacteria were allowed to grow overnight, in trypticase soy broth media, in the presence of the selenium-containing polymer or the same polymer without organoselenium. The material was studied by both colony-forming unit determination and by confocal laser scanning microscopy.

Results:
The results showed that the organoselenium polymer versus the control polymer resulted in the following effect on biofilm formation: (1) a reduction in P. aeruginosa of 7.3 logs (100%); (2) a reduction in S. aureus of 7.3 logs (100%); (3) a reduction in S. maltophilia of 7.5 logs (100%); and (4) a reduction in S. marcescens reduction of 3.3 logs (99.9%). To test the stability of the organoselenium polypropylene contact lens coupon, the coupon was soaked in PBS for eight weeks at room temperature. It was found that when these soaked coupons were tested against S. aureus, complete inhibition (8.1 logs) was obtained. Because organoselenium cannot leach from the polymer, this would imply that the organoselenium polypropylene contact lens case coupon would be inhibitory toward bacterial biofilm for the life of the case.

Conclusion:
The organoselenium polypropylene contact lens case coupon shows the ability to inhibit biofilm formation. The use of organoselenium copolymer should play an important role in protecting against contact lens case-acquired infection.
Combination of pregabalin with duloxetine for fibromyalgia: a randomized controlled trial
Authors: Gilron Ian , Chaparro Luis E. , Tu Dongsheng , Holden Ronald R. , Milev Roumen , Towheed Tanveer , DuMerton-Shore Deborah , Walker Sarah 
Published: March 2016

Abstract
Fibromyalgia is a syndrome characterized by chronic widespread pain and associated with sleep disturbance, depression, fatigue, and cognitive dysfunction. Polypharmacy is commonly used, but supportive evidence is limited. Most fibromyalgia trials focus primarily on pain reduction with monotherapy. This trial compares a pregabalin–duloxetine combination to each monotherapy. Using a randomized, double-blind, 4-period crossover design, participants received maximally tolerated doses of placebo, pregabalin, duloxetine, and pregabalin–duloxetine combination—for 6 weeks. Primary outcome was daily pain (0-10); secondary outcomes included global pain relief, Fibromyalgia Impact Questionnaire, SF-36 survey, Medical Outcomes Study Sleep Scale, Beck Depression Inventory (BDI-II), adverse events, and other measures. Of 41 participants randomized, 39 completed ≥2 treatments. Daily pain during placebo, pregabalin, duloxetine, and combination was 5.1, 5.0, 4.1, and 3.7, respectively (P < 0.05 only for combination vs placebo, and pregabalin). Participants (%) reporting ≥moderate global pain relief were 18%, 39%, 42%, and 68%, respectively (P < 0.05 for combination vs placebo, pregabalin, and duloxetine). Fibromyalgia Impact Questionnaire scores were 42.9, 37.4, 36.0, and 29.8, respectively (P < 0.05 for combination vs placebo, pregabalin, and duloxetine). SF-36 scores were 50.2, 55.7, 56.0, and 61.2, respectively (P < 0.05 for combination vs placebo, pregabalin, and duloxetine). Medical Outcomes Study Sleep Scale scores were 48.9, 35.2, 46.1, and 32.1, respectively (P < 0.05 only for combination vs placebo, and duloxetine). BDI-II scores were 11.9, 9.9, 10.7, and 8.9, respectively (P < 0.05 only for combination vs placebo). Moderate–severe drowsiness was more frequent during combination vs placebo. Combining pregabalin and duloxetine for fibromyalgia improves multiple clinical outcomes vs monotherapy. Continued research should compare this and other combinations to monotherapy for fibromyalgia.
The Perceptions and Expectations Toward the Social Responsibility of Hospitals and Organizational Commitment of Nursing Staff
Authors: Hsieh Sheng-Che , Chiu Herng-Chia , Hsieh Ya-Hui , Ho Pei-Shen , Chen Li-Chin , Chang Wei-Chou 
Published: March 2016

ABSTRACT

Background:
The labor rights of medical workers in hospitals in Taiwan have been a key issue of discussion and controversy in recent years. Generally, poor work conditions and manpower shortages in hospitals have resulted in a vicious circle of severely overworked medical and healthcare staff and chronically low staffing and retention rates.

Purpose:
This study employed corporate social responsibility as the conceptual framework of the social responsibility of hospitals to examine the perceptions and expectations of nurses toward the social responsibility practices of the hospital where they serve and to explore the relationship between these perceptions and organizational commitment (OC).

Methods:
The participants were all nurses who were employed by one medical group in southern Taiwan. Two hundred forty anonymous questionnaires, which included scales that were designed to measure the social responsibility of hospitals and OC, were distributed. Two hundred twenty-seven valid questionnaires were returned. Exploratory factor analysis was used to validate the dimension of the social responsibility of hospitals, and hierarchical multiregression analyses were used to verify the relationship between the perceptions of nurses with regard to the social responsibility practices of the hospital where nurses serve and OC.

Results:
There were considerable differences between participants’ perceptions and expectations toward the social responsibility of hospitals. The nurses with high perceptions toward the social responsibility practices of the hospital where they serve tended to have relatively high OC. Senior nurses who had high perceptions of the legal and rational, ethical, and economic dimensions of the social responsibility practices of the hospital where they serve exhibited relatively strong affective commitment. Nurses in junior positions who had high perceptions of the practices of ethical responsibilities exhibited relatively strong continuance commitment. Senior nurses who had high perceptions of the legal and rational, ethical, and discretionary dimensions of the social responsibility practices of the hospital where they serve exhibited relatively strong normative commitment.

Conclusions/Implications for Practice:
A friendly and humane work environment in hospital settings facilitates the implementation of social responsibility, which has been shown to foster higher levels of organizational identification and job performance among nurses and other hospital employees.
A Study of Bullying Against Nursing Students
Authors: Karatas Hulya , Ozturk Candan , Bektas Murat 
Published: March 2016

ABSTRACT

Background:
Many institutions have conducted research on the subject of bullying. The literature includes many studies of the effects of widespread bullying among primary and secondary school students. Bullying against hospital nurses and also bullying against university students are well-known and frequently discussed research topics. Yet, the exposure of nursing students to bullying has not been sufficiently explored, and few studies have focused on the issue of bullying against nursing students.

Purpose:
The aim of this study is to examine bullying against nursing students, including the rate of bullying, types of bullying, and responses to the negative effects of bullying.

Methods:
This study was conducted on 202 nursing students (including sophomores, juniors, and seniors) during the 2013–2014 academic year. The participation rate was 88.5%. The Negative Attitudes Scale was used to collect data, and descriptive statistics were used in data analysis.

Results:
Participants were evenly distributed between women (49.5%) and men (50.5%). The median age of participants was 21.58 ± 2.28 years; the frequency of bullying was 78.1%. The types of bullying were pejorative statements about the nursing profession (11.3%); low grades used as a form of punishment (9.9%); work, homework, and job rotation used as punishment in lieu of training (9.4%); impossible workloads (9.0%); and the spreading of rumors and gossip (7%).

Conclusions/Implications for Practice:
This study indicates that the participants were exposed to high levels of bullying. As exposure to bullying negatively affects the job attitudes of nursing students, further studies are necessary to develop strategies to prevent horizontal bullying.
The Reliability and Validity of the Arabic World Health Organization Quality of Life-BREF Instrument Among Family Caregivers of Relatives With Psychiatric Illnesses in Jordan
Authors: Dalky Heyam F. , Meininger Janet C. , Al-Ali Nahla M. 
Published: March 2016

ABSTRACT

Background:
The concept of quality of life (QOL) has increasingly attracted the interest of healthcare providers and is considered a valid end point for assessing the overall mental health of patients and their caregivers. Instruments with psychometric and cross-cultural validity are recommended for making accurate QOL assessments.

Purpose:
The aim of this study was to provide further validation of the Arabic World Health Organization (WHO)QOL-BREF for use among family caregivers of relatives with psychiatric illnesses in Jordan. Of the 26 items that constitute the scale, 24 are in the domains of physical health, psychological health, social interactions, and environment.

Method:
Of the 328 family caregivers approached, data for 266 respondents were kept for analysis. The Arabic WHOQOL-BREF internal consistency, item internal consistency, item discriminant validity, and construct validity were evaluated.

Results:
The Cronbach’s alpha coefficient was ≥0.7. The 24 items constituting the evaluated domains reported an item internal consistency of ≥0.4 and met the item discriminant validity criterion of having a higher correlation with its corresponding domain than with other domains. Factor analysis revealed four strong factors that constituted the same constructs as in the WHO report.

Conclusions:
This study ascertains further validity of the Arabic WHOQOL-BREF scale for use among family caregivers of relatives with psychiatric illnesses in Jordan.
Does it matter who places the intravenous? An inter-professional comparison of prehospital intravenous access difficulties between physicians and paramedics
Authors: Prottengeier Johannes , Maier Jan-Niklas , Gall Christine , Heinrich Sebastian , Schmidt Joachim , Birkholz Torsten 
Published: March 2016

Objectives
Depending on the specific national emergency medical systems, venous cannulations may be performed by physicians, paramedics or both alike. Difficulties in the establishment of vascular access can lead to delayed treatment and transport. Our study investigates possible inter-professional differences in the difficulties of prehospital venous cannulation.

Methods
Paramedics were interviewed for their personal attitudes towards and experiences in venous access. We analysed 47 candidate predictor variables in terms of cannulation failure and exceedance of a 2 min time threshold. Multivariable logistic regression models were fitted for variables of potential predictive value (P<0.25) and evaluated by the area under the curve (AUC>0.60) of their respective receiver operating characteristic curve. Results were compared with previously published data from emergency physicians.

Results
A total of 552 cannulations were included in our study. All 146 participants voted that paramedics should be eligible to perform venous catheterizations. Despite ample experience in the task, almost half of them considered prehospital venous cannulations more difficult than those performed in hospital. However, the multivariable logistic regression found only patient-related and puncture site factors to be predictive of cannulation failure (patient age, vein palpability with tourniquet, insufficient ambient lighting: model AUC: 0.72) or cannulation delay (vein palpability with tourniquet: model AUC: 0.60).

Conclusion
Our study shows that venous cannulation is well established among paramedics. It presents itself with similar difficulties across medical professions. Not the numerous specific circumstances of prehospital emergency care, but universal factors inherent to the task will influence the success at venous catheterization.
Intranasal fentanyl for the prehospital management of acute pain in children
Authors: Murphy Adrian P. , Hughes Macartan , Mccoy Siobhan , Crispino Gloria , Wakai Abel , O’Sullivan Ronan 
Published: March 2016

IntroductionAcute pain is the most common symptom in the emergency setting and its optimal management continues to challenge prehospital emergency care practitioners, particularly in the paediatric population. Difficulty in establishing vascular access and fear of opiate administration to small children are recognized reasons for oligoanalgesia. Intranasal fentanyl (INF) has been shown to be as safe and effective as intravenous morphine in the treatment of severe pain in children in the Emergency Department setting.AimThis study aimed to describe the clinical efficacy and safety of INF when administered by advanced paramedics in the prehospital treatment of acute severe pain in children.MethodsA 1-year prospective cross-sectional study was carried out of children (>1 year, <16 years) who received INF as part of the prehospital treatment of acute pain by the statutory national emergency medical services in Ireland.ResultsNinety-four children were included in the final analysis [median age 11 years (interquartile range 7–13)]; 53% were males and trauma was implicated in 86% of cases. A clinically effective reduction in the pain score was found in 78 children [83% (95% confidence interval: 74–89%)]. The median initial pain rating score was 10. Pain assessment at 10 min after INF administration indicated a median pain rating of 5 (interquartile range 2–7). No patient developed an adverse event as a result of INF.DiscussionINF at a dose of 1.5 µg/kg appears to be a safe and effective analgesic in the prehospital management of acute severe pain in children and may be an attractive alternative to both oral and intravenous opiates.
The Use of Enhanced Appointment Access Strategies by Medical Practices
Authors: Rodriguez Hector P. , Knox Margae , Hurley Vanessa , Rittenhouse Diane R. , Shortell Stephen M. 
Published: March 2016

Background:
Strategies to enhance appointment access are being adopted by medical practices as part of patient-centered medical home (PCMH) implementation, but little is known about the use of these strategies nationally.

Objectives:
We examine practice use of open access scheduling and after-hours care.

Research Design:
Data were analyzed from the Third National Study of Physician Organizations (NSPO3) to examine which enhanced appointment access strategies are more likely to be used by practices with more robust PCMH capabilities and with greater external incentives. Logistic regression estimated the effect of PCMH capabilities and external incentives on practice use of open access scheduling and after-hours care.

Subjects:
Physician organizations with >20% primary care physicians (n=1106).

Measures:
PCMH capabilities included team-based care, health information technology capabilities, quality improvement orientation, and patient experience orientation. External incentives included public reporting, pay-for-performance (P4P), and accountable care organization participation.

Results:
A low percentage of practices (19.8%) used same-day open access scheduling, while after-hours care (56.1%) was more common. In adjusted analyses, system-owned practices and practices with greater use of team-based care, health information technology capabilities, and public reporting were more likely to use open access scheduling. Accountable care organization–affiliated practices and practices with greater use of public reporting and P4P were more likely to provide after-hours care.

Conclusions:
Open access scheduling may be most effectively implemented by practices with robust PCMH capabilities. External incentives appear to influence practice adoption of after-hours care. Expanding open access scheduling and after-hours care will require distinct policies and supports.
Health Care Use, Health Behaviors, and Medical Conditions Among Individuals in Same-Sex and Opposite-Sex Partnerships
Authors: Blosnich John R. , Hanmer Janel , Yu Lan , Matthews Derrick D. , Kavalieratos Dio 
Published: March 2016

Background:
Prior research documents disparities between sexual minority and nonsexual minority individuals regarding health behaviors and health services utilization. However, little is known regarding differences in the prevalence of medical conditions.

Objectives:
To examine associations between sexual minority status and medical conditions.

Research Design:
We conducted multiple logistic regression analyses of the Medical Expenditure Panel Survey (2003–2011). We identified individuals who reported being partnered with an individual of the same sex, and constructed a matched cohort of individuals in opposite-sex partnerships.

Subjects:
A total of 494 individuals in same-sex partnerships and 494 individuals in opposite-sex partnerships.

Measures:
Measures of health risk (eg, smoking status), health services utilization (eg, physician office visits), and presence of 15 medical conditions (eg, cancer, diabetes, arthritis, HIV, alcohol disorders).

Results:
Same-sex partnered men had nearly 4 times the odds of reporting a mood disorder than did opposite-sex partnered men [adjusted odds ratio (aOR)=3.96; 95% confidence interval (CI), 1.85–8.48]. Compared with opposite-sex partnered women, same-sex partnered women had greater odds of heart disease (aOR=2.59; 95% CI, 1.19–5.62), diabetes (aOR=2.75; 95% CI, 1.10–6.90), obesity (aOR=1.92; 95% CI, 1.26–2.94), high cholesterol (aOR=1.89; 95% CI, 1.03–3.50), and asthma (aOR=1.90; 95% CI, 1.02–1.19). Even after adjusting for sociodemographics, health risk behaviors, and health conditions, individuals in same-sex partnerships had 67% increased odds of past-year emergency department utilization and 51% greater odds of ≥3 physician visits in the last year compared with opposite-sex partnered individuals.

Conclusions:
A combination of individual-level, provider-level, and system-level approaches are needed to reduce disparities in medical conditions and health care utilization among sexual minority individuals.
The Role of Bias by Emergency Department Providers in Care for American Indian Children
Authors: Puumala Susan E. , Burgess Katherine M. , Kharbanda Anupam B. , Zook Heather G. , Castille Dorothy M. , Pickner Wyatt J. , Payne Nathaniel R. 
Published: March 2016

Background:
American Indian children have high rates of emergency department (ED) use and face potential discrimination in health care settings.

Objective:
Our goal was to assess both implicit and explicit racial bias and examine their relationship with clinical care.

Research Design:
We performed a cross-sectional survey of care providers at 5 hospitals in the Upper Midwest. Questions included American Indian stereotypes (explicit attitudes), clinical vignettes, and the Implicit Association Test. Two Implicit Association Tests were created to assess implicit bias toward the child or the parent/caregiver. Differences were assessed using linear and logistic regression models with a random effect for study site.

Results:
A total of 154 care providers completed the survey. Agreement with negative American Indian stereotypes was 22%–32%. Overall, 84% of providers had an implicit preference for non-Hispanic white adults or children. Older providers (50 y and above) had lower implicit bias than those middle aged (30–49 y) (P=0.01). American Indian children were seen as increasingly challenging (P=0.04) and parents/caregivers less compliant (P=0.002) as the proportion of American Indian children seen in the ED increased. Responses to the vignettes were not related to implicit or explicit bias.

Conclusions:
The majority of ED care providers had an implicit preference for non-Hispanic white children or adults compared with those who were American Indian. Provider agreement with negative American Indian stereotypes differed by practice and respondents’ characteristics. These findings require additional study to determine how these implicit and explicit biases influence health care or outcomes disparities.
Anxiety and Shame as Risk Factors for Depression, Suicidality, and Functional Impairment in Body Dysmorphic Disorder and Obsessive Compulsive Disorder
Authors: Weingarden Hilary , Renshaw Keith D. , Wilhelm Sabine , Tangney June P. , DiMauro Jennifer 
Published: March 2016

Abstract
Body dysmorphic disorder (BDD) and obsessive compulsive disorder (OCD) are associated with elevated depression, suicidality, functional impairment, and days housebound, yet little research has identified risk factors for these outcomes. Using path analysis, the present study examined anxiety and shame as risk factors for these outcomes across Internet-recruited self-report groups (BDD [n = 114], OCD [n = 114], and healthy control [HC; n = 133]). Paths from anxiety and shame to outcomes were similar and mostly significant across BDD and OCD, compared to non-significant paths for HCs, with one exception: the path from shame to depression was significant in the BDD group (b = 0.32) but non-significant in the OCD group (b = 0.07). Findings underscore similarities in BDD and OCD, supporting their reclassification into the same Obsessive Compulsive Related Disorders category. Results emphasize the importance of targeting shame, in addition to anxiety, in treatments for BDD and OCD.
Immunohistochemical Expression of MCM-2 in Oral Epithelial Dysplasias
Authors: Zakaria Samar H. , Farag Heba A. , Khater Dina S. 
Published: March 2016

Background:
Oral cancer is one of the most frequent cancers in the world. It arises from epithelial dysplasia. Hence, identifying these lesions in an early stage could prevent their malignant transformation. The aim of the present work was to assess the cell proliferative activity of minichromosome maintenance protein (MCM-2) in oral epithelial dysplastic lesions and to correlate the results with different grades of epithelial dysplasia in an attempt to use MCM-2 in the early detection of malignancy.

Methods:
MCM-2 expression was determined by the nuclear count in a total of 30 oral epithelial dysplastic specimens roughly classified into 10 cases of mild, moderate, and severe dysplasia. Five cases of early invasive squamous-cell carcinomas and 5 cases of epithelial hyperplasia were also included.

Results:
The MCM-2 immunostaining was found to increase gradually from mild to moderate to severe dysplasia and reached its maximum value in early invasive squamous cell carcinoma.

Conclusion:
MCM-2 is of prognostic value in cases of oral dysplasia that have a tendency to undergo malignant transformation.