bluuebunny/crossref_metadata_2025_split huggingface dataset:
Combating Opioid Overdose With Public Access to Naloxone
Authors: Mitchell Kathryn Dambrino , Higgins Leslie J. 
Published: August 2016

Abstract

Purpose
Opioid overdose deaths have become an escalating epidemic in the United States. To combat this complex issue, naloxone distribution to the public has been initiated in many states as a harm reduction strategy. While supportive legislation develops and community programs expand, research- and policy-focused literature surrounding this timely topic require exploration, compilation, and analysis. The purpose of this systematic review is to identify trends in the current literature, gaps in the findings, nursing implications, and opportunities for further exploration.

Methods
Following a systematic approach, the keywords “naloxone” and “opioid overdose” were used to retrieve articles through the search engines Academic Search Premier, CINAHL Complete, MEDLINE Complete, PubMed, and Psychology and Behavior Sciences Collection.

Findings
In the 38 articles selected for the final review, six categories were discussed: global trends, U.S. overdose education programs with naloxone distribution, barriers to public access of naloxone, political opposition and support, financial impact, and recommendations. After reviewing the findings, gaps in the literature were examined, and nursing implications were acknowledged.

Originality and Value
Although many authors have researched and discussed public naloxone distribution, a comprehensive review of the current evidence is useful and necessary to enhance future research, practice, and policy efforts. By discovering significant gaps in the literature and by recognizing opportunities for nursing practice, this literature review provides valuable input for healthcare professionals, public health officials, policymakers, and laypersons to better understand an ethically, politically, and socially complicated public health initiative.
Women and Alcohol Use Disorders
Authors: Brighton Renee , Moxham Lorna , Traynor Victoria 
Published: August 2016

Abstract
Women, alcohol, and alcohol use disorders are underresearched topics when compared with the plethora of literature exploring male alcohol consumption and its related harms. It is time to change the fact that women are underrepresented in research and programs targeting alcohol use disorders. Given the changing patterns of alcohol consumption by women, coupled with the fact that women experience a telescoping effect in alcohol-related harms, it is time that increasing attention be paid to the way gender influences the experience of alcohol-related harms, including the development of alcohol use disorders. Recovery-orientated systems are not possible without the voices of the consumers being heard. With this in mind, the purposes of this article are to explore factors that lead to alcohol-related harm in women and to highlight the gender-specific barriers to service engagement.
How Quality Improvement Practice Evidence Can Advance the Knowledge Base
Authors: O'Rourke Hannah M. , Fraser Kimberly D. 
Published: August 2016

Abstract:
Recommendations for the evaluation of quality improvement interventions have been made in order to improve the evidence base of whether, to what extent, and why quality improvement interventions affect chosen outcomes. The purpose of this article is to articulate why these recommendations are appropriate to improve the rigor of quality improvement intervention evaluation as a research endeavor, but inappropriate for the purposes of everyday quality improvement practice. To support our claim, we describe the differences between quality improvement interventions that occur for the purpose of practice as compared to research. We then carefully consider how feasibility, ethics, and the aims of evaluation each impact how quality improvement interventions that occur in practice, as opposed to research, can or should be evaluated. Recommendations that fit the evaluative goals of practice-based quality improvement interventions are needed to support fair appraisal of the distinct evidence they produce. We describe a current debate on the nature of evidence to assist in reenvisioning how quality improvement evidence generated from practice might complement that generated from research, and contribute in a value-added way to the knowledge base.
Immediate Effects of Clock-Turn Strategy on the Pattern and Performance of Narrow Turning in Persons With Parkinson Disease
Authors: Yang Wen-Chieh , Hsu Wei-Li , Wu Ruey-Meei , Lin Kwan-Hwa 
Published: August 2016

Background and Purpose:
Turning difficulty is common in people with Parkinson disease (PD). The clock-turn strategy is a cognitive movement strategy to improve turning performance in people with PD despite its effects are unverified. Therefore, this study aimed to investigate the effects of the clock-turn strategy on the pattern of turning steps, turning performance, and freezing of gait during a narrow turning, and how these effects were influenced by concurrent performance of a cognitive task (dual task).

Methods:
Twenty-five people with PD were randomly assigned to the clock-turn or usual-turn group. Participants performed the Timed Up and Go test with and without concurrent cognitive task during the medication OFF period. The clock-turn group performed the Timed Up and Go test using the clock-turn strategy, whereas participants in the usual-turn group performed in their usual manner. Measurements were taken during the 180° turn of the Timed Up and Go test. The pattern of turning steps was evaluated by step time variability and step time asymmetry. Turning performance was evaluated by turning time and number of turning steps. The number and duration of freezing of gait were calculated by video review.

Results:
The clock-turn group had lower step time variability and step time asymmetry than the usual-turn group. Furthermore, the clock-turn group turned faster with fewer freezing of gait episodes than the usual-turn group. Dual task increased the step time variability and step time asymmetry in both groups but did not affect turning performance and freezing severity.

Discussion and Conclusions:
The clock-turn strategy reduces turning time and freezing of gait during turning, probably by lowering step time variability and asymmetry. Dual task compromises the effects of the clock-turn strategy, suggesting a competition for attentional resources.

Video Abstract available for more insights from the authors (see Supplemental Digital Content 1, http://links.lww.com/JNPT/A141).
Neisseria meningitidis Isolated in Postmortem Vitreous Humor in a Death Due to Meningococcal Sepsis
Authors: Garland Jack , Tse Rexson , Cala Allan D 
Published: August 2016

Abstract
Sepsis remains a difficult diagnosis at autopsy. With respect to meningococcal sepsis, a timely and definite diagnosis is critical because it requires public health department notification and the administration of prophylactic antibiotics to potential close contacts. A previous case series, in which both blood and cerebrospinal fluid were unavailable, suggested vitreous humor polymerase chain reaction might be a useful test in diagnosing meningococcal sepsis. We describe a fatal case of meningococcal sepsis where Neisseria meningitidis was detected in both vitreous humor and blood polymerase chain reaction, in addition to positive blood cultures. This gives further support to using microbiology of vitreous humor in suspected meningococcal sepsis, especially when microbiology samples are limited.
Vertebral Artery Dissection Masquerading as Concussion in an Adolescent
Authors: Kumar Gogi , Ludwig Bryan , Patel Vipul V. 
Published: August 2016

Objective
Educate providers about the clinical presentation and consequences of delaying diagnosis of traumatic vertebral artery dissection with thromboembolic ischemic strokes in the pediatric population. Vertebral artery dissection is often difficult to diagnose and can be a potentially devastating cause of ischemic stroke.

Methods
Review of the chart, peer review/discussion, and imaging interpretation.

Results
A 16-year-old boy was admitted with confusion after a head and neck trauma was sustained while wrestling. (Glasgow Coma Scale=15, NIHSS = 0). Investigations including computed tomography (CT) head and cervical spine were normal. He then developed severe nausea, vomiting, dizziness, and headaches and was admitted for symptoms of concussion. Ten hours later, patient declined (hypertensive and unresponsive) and was noted to have decerebrate posturing. After emergent intubation, he was transferred to the pediatric intensive care unit. Repeat CT head showed an acute left cerebellar infarct with associated cerebellar edema resulting in effacement of the fourth ventricle/basilar cisterns and acute hydrocephalus. The CT angiography and magnetic resonance imaging of brain confirmed arterial dissection and near occlusion of the left vertebral artery at the C2 level. Extensive infarct was seen in the left cerebellum, brainstem, and right cerebellum. During a prolonged hospital stay, the family opted to continue care, and he was transferred to an inpatient rehabilitation facility because of limited brainstem activity, being nonverbal, and not demonstrating purposeful spontaneous movements.

Conclusions
Detailed history and thorough neurological examination in conjunction with appropriate imaging are necessary to distinguish between brainstem/cerebellar ischemia from vertebral artery dissection and concussion.
Sudden Cardiac Arrest in Pediatrics
Authors: Scheller RoseAnn L. , Johnson Laurie , Lorts Angela , Ryan Thomas D. 
Published: August 2016

Abstract
Sudden cardiac arrest (SCA) in the pediatric population is a rare and potentially devastating occurrence. An understanding of the differential diagnosis for the etiology of the cardiac arrest allows for the most effective emergency care and provides the patient with the best possible outcome. Pediatric SCA can occur with or without prodromal symptoms and may occur during exercise or rest. The most common cause is arrhythmia secondary to an underlying channelopathy, cardiomyopathy, or myocarditis. After stabilization, evaluation should include electrocardiogram, chest radiograph, and echocardiogram. Management should focus on decreasing the potential for recurring arrhythmia, maintaining cardiac preload, and thoughtful medication use to prevent exacerbation of the underlying condition. The purpose of this review was to provide the emergency physician with a concise and current review of the incidence, differential diagnosis, and management of pediatric patients presenting with SCA.
Prediction of Postpartum Weight in Low-Income Mexican-Origin Women From Childhood Experiences of Abuse and Family Conflict
Authors: Luecken Linda J. , Jewell Shannon L. , MacKinnon David P. 
Published: August 2016

ABSTRACT

Objectives
The postpartum period represents a crucial transition period in which weight gain or loss can affect lifetime obesity risk. This study examined the prevalence of obesity and the influence of childhood abuse and family conflict on postpartum weight among low-income Mexican-origin women. Depressive symptoms and partner support were evaluated as mediators.

Methods
At a prenatal assessment, low-income Mexican-origin women (N = 322; mean [SD] age, 27.8 [6.5]) reported on childhood abuse and family conflict. Weight was measured 7 times between 6 weeks and 2 years postpartum and calculated as body mass index. Regression and growth models were used to estimate the impact of childhood abuse, childhood family conflict, partner support, and depressive symptoms on weight and weight change.

Results
Higher family conflict predicted higher weight across the first (β = .12; p = .037) and second (β = .16; p = .012) postpartum years. Family conflict (β = .17; p = .018) and low partner support (β = −.16; p = .028) also predicted increasing weight in the first year. Partner support partially mediated the effect of childhood abuse on weight change in the first year (p = .031). Depressive symptomatology mediated the effects of childhood abuse and family conflict on weight status in the second year (abuse: p = .005; conflict: p = .023).

Conclusions
For low-income Mexican-origin women with a history of childhood abuse or high family conflict, depression and low partner support may be important targets for obesity prevention efforts in the postpartum period.
Interpreting BOLD: towards a dialogue between cognitive and cellular neuroscience
Authors: Hall Catherine N. , Howarth Clare , Kurth-Nelson Zebulun , Mishra Anusha 
Published: August 2016

Cognitive neuroscience depends on the use of blood oxygenation level-dependent (BOLD) functional magnetic resonance imaging (fMRI) to probe brain function. Although commonly used as a surrogate measure of neuronal activity, BOLD signals actually reflect changes in brain blood oxygenation. Understanding the mechanisms linking neuronal activity to vascular perfusion is, therefore, critical in interpreting BOLD. Advances in cellular neuroscience demonstrating differences in this neurovascular relationship in different brain regions, conditions or pathologies are often not accounted for when interpreting BOLD. Meanwhile, within cognitive neuroscience, the increasing use of high magnetic field strengths and the development of model-based tasks and analyses have broadened the capability of BOLD signals to inform us about the underlying neuronal activity, but these methods are less well understood by cellular neuroscientists. In 2016, a Royal Society Theo Murphy Meeting brought scientists from the two communities together to discuss these issues. Here, we consolidate the main conclusions arising from that meeting. We discuss areas of consensus about what BOLD fMRI can tell us about underlying neuronal activity, and how advanced modelling techniques have improved our ability to use and interpret BOLD. We also highlight areas of controversy in understanding BOLD and suggest research directions required to resolve these issues.This article is part of the themed issue ‘Interpreting BOLD: a dialogue between cognitive and cellular neuroscience’.
Neuronal networks and mediators of cortical neurovascular coupling responses in normal and altered brain states
Authors: Lecrux C. , Hamel E. 
Published: August 2016

Brain imaging techniques that use vascular signals to map changes in neuronal activity, such as blood oxygenation level-dependent functional magnetic resonance imaging, rely on the spatial and temporal coupling between changes in neurophysiology and haemodynamics, known as ‘neurovascular coupling (NVC)’. Accordingly, NVC responses, mapped by changes in brain haemodynamics, have been validated for different stimuli under physiological conditions. In the cerebral cortex, the networks of excitatory pyramidal cells and inhibitory interneurons generating the changes in neural activity and the key mediators that signal to the vascular unit have been identified for some incoming afferent pathways. The neural circuits recruited by whisker glutamatergic-, basal forebrain cholinergic- or locus coeruleus noradrenergic pathway stimulation were found to be highly specific and discriminative, particularly when comparing the two modulatory systems to the sensory response. However, it is largely unknown whether or not NVC is still reliable when brain states are altered or in disease conditions. This lack of knowledge is surprising since brain imaging is broadly used in humans and, ultimately, in conditions that deviate from baseline brain function. Using the whisker-to-barrel pathway as a model of NVC, we can interrogate the reliability of NVC under enhanced cholinergic or noradrenergic modulation of cortical circuits that alters brain states.
This article is part of the themed issue ‘Interpreting BOLD: a dialogue between cognitive and cellular neuroscience’.
Neural–metabolic coupling in the central visual pathway
Authors: Freeman Ralph D. , Li Baowang 
Published: August 2016

Studies are described which are intended to improve our understanding of the primary measurements made in non-invasive neural imaging. The blood oxygenation level-dependent signal used in functional magnetic resonance imaging (fMRI) reflects changes in deoxygenated haemoglobin. Tissue oxygen concentration, along with blood flow, changes during neural activation. Therefore, measurements of tissue oxygen together with the use of a neural sensor can provide direct estimates of neural–metabolic interactions. We have used this relationship in a series of studies in which a neural microelectrode is combined with an oxygen micro-sensor to make simultaneous co-localized measurements in the central visual pathway. Oxygen responses are typically biphasic with small initial dips followed by large secondary peaks during neural activation. By the use of established visual response characteristics, we have determined that the oxygen initial dip provides a better estimate of local neural function than the positive peak. This contrasts sharply with fMRI for which the initial dip is unreliable. To extend these studies, we have examined the relationship between the primary metabolic agents, glucose and lactate, and associated neural activity. For this work, we also use a Doppler technique to measure cerebral blood flow (CBF) together with neural activity. Results show consistent synchronously timed changes such that increases in neural activity are accompanied by decreases in glucose and simultaneous increases in lactate. Measurements of CBF show clear delays with respect to neural response. This is consistent with a slight delay in blood flow with respect to oxygen delivery during neural activation.
This article is part of the themed issue ‘Interpreting BOLD: a dialogue between cognitive and cellular neuroscience’.
What is feasible with imaging human brain function and connectivity using functional magnetic resonance imaging
Authors: Ugurbil Kamil 
Published: August 2016

When we consider all of the methods we employ to detect brain function, from electrophysiology to optical techniques to functional magnetic resonance imaging (fMRI), we do not really have a ‘golden technique’ that meets all of the needs for studying the brain. We have methods, each of which has significant limitations but provide often complimentary information. Clearly, there are many questions that need to be answered about fMRI, which unlike other methods, allows us to study the human brain. However, there are also extraordinary accomplishments or demonstration of the feasibility of reaching new and previously unexpected scales of function in the human brain. This article reviews some of the work we have pursued, often with extensive collaborations with other co-workers, towards understanding the underlying mechanisms of the methodology, defining its limitations, and developing solutions to advance it. No doubt, our knowledge of human brain function has vastly expanded since the introduction of fMRI. However, methods and instrumentation in this dynamic field have evolved to a state that discoveries about the human brain based on fMRI principles, together with information garnered at a much finer spatial and temporal scale through other methods, are poised to significantly accelerate in the next decade.
This article is part of the themed issue ‘Interpreting BOLD: a dialogue between cognitive and cellular neuroscience’.
Gene transcription profiles associated with inter-modular hubs and connection distance in human functional magnetic resonance imaging networks
Authors: Vértes Petra E. , Rittman Timothy , Whitaker Kirstie J. , Romero-Garcia Rafael , Váša František , Kitzbichler Manfred G. , Wagstyl Konrad , Fonagy Peter , Dolan Raymond J. , Jones Peter B. , Goodyer Ian M. ,   the NSPN Consortium, Bullmore Edward T. 
Published: August 2016

Human functional magnetic resonance imaging (fMRI) brain networks have a complex topology comprising integrative components, e.g. long-distance inter-modular edges, that are theoretically associated with higher biological cost. Here, we estimated intra-modular degree, inter-modular degree and connection distance for each of 285 cortical nodes in multi-echo fMRI data from 38 healthy adults. We used the multivariate technique of partial least squares (PLS) to reduce the dimensionality of the relationships between these three nodal network parameters and prior microarray data on regional expression of 20 737 genes. The first PLS component defined a transcriptional profile associated with high intra-modular degree and short connection distance, whereas the second PLS component was associated with high inter-modular degree and long connection distance. Nodes in superior and lateral cortex with high inter-modular degree and long connection distance had local transcriptional profiles enriched for oxidative metabolism and mitochondria, and for genes specific to supragranular layers of human cortex. In contrast, primary and secondary sensory cortical nodes in posterior cortex with high intra-modular degree and short connection distance had transcriptional profiles enriched for RNA translation and nuclear components. We conclude that, as predicted, topologically integrative hubs, mediating long-distance connections between modules, are more costly in terms of mitochondrial glucose metabolism.
This article is part of the themed issue ‘Interpreting BOLD: a dialogue between cognitive and cellular neuroscience’.
How networks communicate: propagation patterns in spontaneous brain activity
Authors: Mitra Anish , Raichle Marcus E. 
Published: August 2016

Initially regarded as ‘noise’, spontaneous (intrinsic) activity accounts for a large portion of the brain's metabolic cost. Moreover, it is now widely known that infra-slow (less than 0.1 Hz) spontaneous activity, measured using resting state functional magnetic resonance imaging of the blood oxygen level-dependent (BOLD) signal, is correlated within functionally defined resting state networks (RSNs). However, despite these advances, the temporal organization of spontaneous BOLD fluctuations has remained elusive. By studying temporal lags in the resting state BOLD signal, we have recently shown that spontaneous BOLD fluctuations consist of remarkably reproducible patterns of whole brain propagation. Embedded in these propagation patterns are unidirectional ‘motifs’ which, in turn, give rise to RSNs. Additionally, propagation patterns are markedly altered as a function of state, whether physiological or pathological. Understanding such propagation patterns will likely yield deeper insights into the role of spontaneous activity in brain function in health and disease.
This article is part of the themed issue ‘Interpreting blood oxygen level-dependent: a dialogue between cognitive and cellular neuroscience’.