bluuebunny/crossref_metadata_2025_split huggingface dataset:
Anatomy of the Anterior Root Attachments of the Medial and Lateral Menisci
Authors: LaPrade Christopher M. , Ellman Michael B. , Rasmussen Matthew T. , James Evan W. , Wijdicks Coen A. , Engebretsen Lars , LaPrade Robert F. 
Published: August 2014

Background: While the biomechanical importance of the meniscal roots has been demonstrated, the anatomy of the anterior meniscal roots remains largely unknown. Defining the quantitative anatomy of the anterior meniscal root attachments is essential for developing improved diagnostic and surgical techniques. Hypothesis: The anterior medial (AM) and anterior lateral (AL) meniscal roots could be quantitatively defined relative to open and arthroscopic surgical landmarks. Study Design: Descriptive laboratory study. Methods: Twelve nonpaired human cadaveric knees were used (average age, 51.3 years). A coordinate measuring device quantified the anatomic relationships of the AM and AL root attachments to open and arthroscopic surgical landmarks. The tibial attachments of both anterior roots were defined and quantified by categorizing the fibers of the root as either central, dense attachments or peripheral, supplemental attachments. Results: The center of the tibial tuberosity and the medial tibial eminence apex were 27.0 mm lateral and distal and 27.5 mm posterior to the center of the AM root, respectively. The center of the anterior cruciate ligament (ACL) and the lateral tibial eminence apex were 5.0 mm posteromedial and 14.4 mm posterolateral to the center of the AL root, respectively. The AM root attachment had a mean area of 110.4 mm2 (95% CI, 92.2-128.5) with a central attachment of 56.3 mm2 (95% CI, 46.9-65.8). The AL root attachment had a mean area of 140.7 mm2 (95% CI, 121.6-159.8) and inserted deeply beneath the ACL in all specimens. The overlap of the ACL on the AL root averaged 88.9 mm2 (95% CI, 63.3-114.6), comprising 63.2% of the AL root attachment. Conclusion: The anterior meniscal roots were identified in relation to pertinent open and arthroscopic landmarks. The extended overlap between the AL root and ACL attachment revealed a more intimate tibial attachment relationship than previously recognized. Clinical Relevance: Quantitative descriptions of the anterior meniscal roots elucidate the relationship between the root attachments and pertinent surgical landmarks. In addition, the supplemental attachments of both menisci may contribute to native meniscal function, and further investigation is recommended.
A Review of Paroxetine for the Treatment of Vasomotor Symptoms
Authors: Slaton Rachel M. , Champion Megan N. , Palmore Kayla B. 
Published: August 2014

Background: Studies in recent years have exposed concerns about the safety of hormone replacement therapy (HRT) in the treatment of vasomotor symptoms (VMS) in menopausal women. Numerous studies have examined the use of antidepressants for relief of VMS. Despite recommendations to deny approval of paroxetine mesylate (Brisdelle™) for the treatment of VMS, the Food and Drug Administration (FDA) recently granted it approval for this indication. Objective: To evaluate all published literature examining use of paroxetine salts (mesylate and hydrochloride) in the treatment of menopausal VMS. Methods: Both PubMed and International Pharmaceutical Abstracts (IPA) were searched using the keywords hot flashes, vasomotor symptoms, menopause, and paroxetine. In PubMed, MeSH terms were used for paroxetine, menopause, and hot flashes. Searches were limited to humans, English language, and clinical trial design. The references for each study identified in this search process were examined in order to locate any additional relevant articles. Results: Compared with placebo, paroxetine salts offer a modest benefit in the treatment of menopausal VMS reducing the frequency and severity of weekly hot flashes. Conclusion: Paroxetine (mesylate or hydrochloride) is an effective alternative to HRT for the reduction in VMS in menopausal women. Future head-to-head studies with active medications are needed in order to identify the best algorithm of treatment for this condition.
Intrapleural Antimicrobial Irrigation for Postpneumonectomy Empyema in Patients With Lung Cancer
Authors: Torbic Heather , Glasser Nicole , Rostas Sara E. , Alquwaizani Mohammed , Hacobian Gaspar 
Published: August 2014

Purpose: Postpneumonectomy empyema (PPE) is a possible complication after a pneumonectomy in patients with lung cancer. The use of intrapleural (IP) antibiotic irrigation to treat infections in the pleural space may be indicated after systemic antimicrobial therapy, and drainage of the pleural space has been insufficient. Methods: Adult patients ≥18 years old who received IP antibiotic irrigation between 2006 and 2011 were included. Demographic data, past medical history, surgical procedure, systemic antibiotics, and culture data were collected. Additionally, the IP antibiotic administered, the dose, and how it was prepared and administered were collected. Results: A total of 18 patients were evaluated in this retrospective descriptive analysis. The majority of patients underwent an extrapleural pneumonectomy (EPP; 72%). Most patients received systemic antibiotics before IP antibiotic administration (95%). Vancomycin was the most common antibiotic used for both systemic therapy (100%) and IP irrigation (94%). The median number of IP antibiotic doses received per patient was 5.5 (interquartile range [IQR] 1-9). Recurrence of PPE within 6 months of initial PPE resolution occurred in 28% of patients. Intrapleural antibiotic irrigation was well tolerated in all patients. Conclusion: Vancomycin is most commonly used for IP antibiotic irrigation at our institution after patients have undergone a thoracic surgery, which was most commonly an EPP.
Impact of Pharmacist Involvement in Early Identification and Enrollment in Patient Assistance Programs on CMV Outcomes in Transplantation
Authors: Byrns Jennifer S. , Pilch Nicole W. , Taber David J. 
Published: August 2014

Background: No data exist evaluating the utilization of patient assistance programs (PAPs) on cytomegalovirus (CMV)-related outcomes. Objective: To determine whether early identification and enrollment in PAPs can prevent CMV-related events. Methods: Retrospective analysis of patients at risk of CMV reactivation who received kidney and/or pancreas transplants. Two groups were evaluated with patients receiving oral valganciclovir for CMV prophylaxis through enrollment in PAPs or oral acyclovir with preemptive CMV monitoring. Primary outcomes include the incidence of CMV infection. Secondary outcomes include a cost benefit analysis, incidence of rejection, patient/graft survival, and time to CMV infection. Results: There were 97 patients identified; valganciclovir through PAPs (n = 39) and preemptive CMV quantitative nucleic acid testing monitoring (n = 58). The incidence of CMV viremia was lower in the PAP group (12.8% vs 36.2%, respectively; P = .021). There were no significant differences in CMV syndrome/disease, acute rejection, graft loss, or death between the groups. The time to CMV infection was shorter in the preemptive group. Cost benefit analysis found that hiring a full time pharmacy employee for enrolling patients in PAPs was cost beneficial for the institution/health care system. Conclusion: Early identification and enrollment of patients in PAPs reduces the incidence of CMV viremia. Pharmacists play a crucial role in this process.
Language Concordance as a Determinant of Patient Outcomes in a Pharmacist-Managed Cardiovascular Risk Reduction Clinic
Authors: Gonzalvo Jasmine D. , Sharaya Nora H. 
Published: August 2014

Background: Published literature reveals that health care disparities exist due to race, gender, and language, although this has not been confirmed in a pharmacist-managed patient population. Objective: The objective of this study is to examine the association of language concordance and clinical outcomes in a comparison of English-speaking (ES) and Spanish-speaking (SS) patients in a pharmacist-managed cardiovascular risk reduction clinic (CVRRC). Methods: A retrospective chart review was undertaken to collect hemoglobin A1C, blood pressure, and low-density lipoprotein cholesterol (LDL-C) for patients enrolled in the CVRRC from July 2010 and August 2012. A 2-sample t-test was utilized to compare these outcomes between ES and SS patients. Results: A total of 9 SS patients and 62 ES patients were included. No statistically significant differences were found between ES and SS patients in this language-concordant, pharmacist-managed clinic setting. Conclusions: These results suggest that similar clinical outcomes between ES and SS patients may be achieved with the ability of pharmacists to speak the same language as their patients.
What Is the Appropriate Duration of High-Dose Atorvastatin Therapy Post-Acute Coronary Syndrome?
Authors: Goriacko Pavel , Andersen Matthew , Fazylov Roman , Plakogiannis Roda 
Published: August 2014

Purpose: To determine the optimal duration of high-intensity atorvastatin therapy post-acute coronary syndrome (ACS). Summary: A literature review was conducted using the MEDLINE database (1966-October 2013) and employing the search terms “atorvastatin OR statins AND myocardial infarction OR acute coronary syndromes.” Clinical trials in the English language with available abstracts were used to identify potential data sources. Four major trials evaluating atorvastatin 80 mg daily after an ACS were identified. The duration of follow-up ranged from 16 weeks to a median of 4.9 years. High-dose atorvastatin regimens were associated with a reduction in coronary events but also with higher rates of drug discontinuation due to adverse reactions. The benefit of high-dose atorvastatin has been sustained for at least 5 years. Conclusion: After an ACS, high-dose atorvastatin should be continued for at least 5 years. High-dose atorvastatin demonstrated a reduction in coronary events but dose reductions and higher discontinuation rates were also noted.
Evaluation of a Pharmacy-Managed Pharmacokinetic Dosing Program
Authors: Meyenburg Lyndsi K. , Crannage Andrew J. , Murphy Julie A. , Korobey Matthew J. 
Published: August 2014

Purpose: The objective of this study was to determine the impact of a pharmacy-managed pharmacokinetic dosing program on appropriate dosing of famotidine, enoxaparin, and ketorolac. Methods: A large community teaching hospital implemented a pharmacy-managed pharmacokinetic dosing program for famotidine, enoxaparin, and ketorolac. Subjects were included if they received famotidine and had a creatinine clearance (CrCl) of <50 mL/min; received therapeutic enoxaparin and had a CrCl of <30 mL/min; or received ketorolac and had a CrCl <30 mL/min, age > 65 years or weight <50 kg. Results: One hundred and forty-six patients were included in the preimplementation group (famotidine [n = 50], enoxaparin [n = 46], and ketorolac [n = 50]) and 143 patients were included in the postimplementation group (famotidine [n = 50], enoxaparin [n = 43], and ketorolac [n = 50]). In all, 66% of patients were dosed appropriately in the preimplementation group (famotidine 28%, enoxaparin 85%, and ketorolac 86%) compared to 94% in the postimplementation group (famotidine 92%, enoxaparin 95%, and ketorolac 94%), P < .001. Conclusion: Implementation of a pharmacy-managed pharmacokinetic dosing program significantly improved appropriate dosing of famotidine, enoxaparin, and ketorolac. These findings could justify expansion of pharmacist autonomy through institution–approved, pharmacy-managed programs for other medications to improve appropriate dosing. Analyses specifically evaluating patient-oriented or financial outcomes may provide additional support for expansion.
Impact of ethical climate on moral distress revisited
Authors: Atabay Gülem , Çangarli Burcu Güneri , Penbek Şebnem 
Published: August 2014

Background: Moral distress is a major problem in nursing profession. Researchers identified that the stronger the ethical basis of the organization, the less moral distress is reported. However, different ethical climates may have different impacts on moral distress. Moreover, conceptualization of moral distress and ethical climate as well as their relationship may change according to the cultural context. Objectives: The main aim of the study is to investigate the relationship between different types of ethical climate as described in Victor and Cullen’s framework, and moral distress intensity among nurses in Turkish healthcare settings. Research design: An online survey was administrated to collect data. Questionnaires included moral distress and ethical climate scales in addition to demographic questions. Participants and research context: Data were collected from registered nurses in Turkey. In all, 201 of 279 nurses completed questionnaires, resulting in a response rate of 72%. Ethical considerations: Ethical approval was obtained from the university to which the authors were affiliated, after a detailed investigation of the content and data collection method. Findings: Factor analyses showed that moral distress had three dimensions, namely, organizational constraints, misinformed and over-treated patients, and lack of time and resources, while ethical climate had four types, namely, rules, well-being of stakeholders, individualism, and organizational interests. Positive correlations were identified between certain types of ethical climate (rules, individualism, or organizational interests) and moral distress intensity. Discussion: Factor distribution of the scales shows some commonalities with the findings of previous research. However, context-specific dimensions and types were also detected. No particular ethical climate type was found to have a negative correlation with moral distress. Conclusion: Recommendations were made for reducing the negative impact of ethical climate on moral distress. These include solving the nursing-shortage problem, increasing autonomy, and improving physical conditions.
Student nurses’ experiences of preserved dignity in perioperative practice – Part I
Authors: Blomberg Ann-Catrin , Willassen Elin , von Post Iréne , Lindwall Lillemor 
Published: August 2014

Background: In recent years, operating theatre nurse students’ education focussed on ethical value issues and how the patient’s dignity is respected in the perioperative practice. Health professionals are frequently confronted with ethical issues that can impact on patient’s care during surgery. Objective: The objective of this study was to present what operating theatre nurse students experienced and interpreted as preserved dignity in perioperative practice. Research design: The study has a descriptive design with a hermeneutic approach. Data were collected using Flanagan’s critical incident technique. Participants and research context: Operating theatre nurse students from Sweden and Norway participated and collected data in 2011, after education in ethics and dignity. Data consisting of 47 written stories and the text were analysed with hermeneutical text interpretation. Ethical considerations: The study was conducted accordance with the Declaration of Helsinki and approved by a local University Ethics Research Committee. Findings: The findings revealed that students experienced that operating theatre nurses perserved patient's dignity in perioperative practice by being present for each other and making themselves known to the patient. Operating theatre nurses caring for the patient by being compassionate and preserved the patient privacy. The new understanding that emerged was that the operating theatre nurse students understood that the operating theatre nurse wanted to care for the patient like a human being. Discussion: In the discussion, we have illuminated how professional ethics may be threatened by more pragmatic and utilitarian arguments contained in regulations and transplant act. Conclusion: Preserved dignity is an ethical and caring act. Ethical questions and how to preserve dignity in perioperative practice should be discussed more both in educations of healthcare professionals and in clinical practice.
Ethically difficult situations in hemodialysis care – Nurses' narratives
Authors: Fischer Grönlund Catarina EC , Söderberg Anna IS , Zingmark Karin M , Sandlund S Mikael , Dahlqvist Vera 
Published: August 2014

Background: Providing nursing care for patients with end-stage renal disease entails dealing with existential issues which may sometimes lead not only to ethical problems but also conflicts within the team. A previous study shows that physicians felt irresolute, torn and unconfirmed when ethical dilemmas arose. Research question: This study, conducted in the same dialysis care unit, aimed to illuminate registered nurses’ experiences of being in ethically difficult situations that give rise to a troubled conscience. Research design: This study has a phenomenological hermeneutic approach. Participants: Narrative interviews were carried out with 10 registered nurses working in dialysis care. Ethical considerations: The study was approved by the Ethics Committee of the Faculty of Medicine, Umeå University. Results: One theme, ‘Calling for a deliberative dialogue’, and six sub-themes emerged: ‘Dealing with patients’ ambiguity’, ‘Responding to patients’ reluctance’, ‘Acting against patients’ will’, ‘Acting against one’s moral convictions’, ‘Lacking involvement with patients and relatives’ and ‘Being trapped in feelings of guilt’. Discussion: In ethically difficult situations, the registered nurses tried, but failed, to open up a dialogue with the physicians about ethical concerns and their uncertainty. They felt alone, uncertain and sometimes had to act against their conscience. Conclusion: In ethical dilemmas, personal and professional integrity is at stake. Mistrusting their own moral integrity may turn professionals from moral actors into victims of circumstances. To counteract such a risk, professionals and patients need to continuously deliberate on their feelings, views and experiences, in an atmosphere of togetherness and trust.
Researching moral distress among New Zealand nurses
Authors: Woods Martin , Rodgers Vivien , Towers Andy , La Grow Steven 
Published: August 2014

Background: Moral distress has been described as a major problem for the nursing profession, and in recent years, a considerable amount of research has been undertaken to examine its causes and effects. However, few research projects have been performed that examined the moral distress of an entire nation’s nurses, as this particular study does. Aim/objective: The purpose of this study was to determine the frequency and intensity of moral distress experienced by registered nurses in New Zealand. Research design: The research involved the use of a mainly quantitative approach supported by a slightly modified version of a survey based on the Moral Distress Scale–Revised. Participants and research context: In total, 1500 questionnaires were sent out at random to nurses working in general areas around New Zealand and 412 were returned, giving an adequate response rate of 27%. Ethical considerations: The project was evaluated and judged to be low risk and recorded as such on 22 February 2011 via the auspices of the Massey University Human Ethics Committee. Findings: Results indicate that the most frequent situations to cause nursing distress were (a) having to provide less than optimal care due to management decisions, (b) seeing patient care suffer due to lack of provider continuity and (c) working with others who are less than competent. The most distressing experiences resulted from (a) working with others who are unsafe or incompetent, (b) witnessing diminished care due to poor communication and (c) watching patients suffer due to a lack of provider continuity. Of the respondents, 48% reported having considered leaving their position due to the moral distress. Conclusion: The results imply that moral distress in nursing remains a highly significant and pertinent issue that requires greater consideration by health service managers, policymakers and nurse educators.
Labour market outcomes for Indigenous Australians
Authors: Gray Matthew , Howlett Monica , Hunter Boyd 
Published: August 2014

AbstractRecent research has identified a substantial increase in Indigenous mainstream employment since the mid-1990s, but there has been relatively little regional analysis of such employment. The aim of this article is to build on this previous research using the 2006 and 2011 censuses to provide a more disaggregated descriptive analysis of changes in the character of labour market outcomes for Indigenous Australians aged 15–64 years. One of the new findings in the article is that the employment of Indigenous youth (i.e. those aged 15–24 years) in remote areas is different from that of Indigenous youth in non-remote areas, but older Indigenous residents of such areas are not very different in employment terms. Policy-makers thus need to pay particular attention to Indigenous youth employment in remote areas because the failure to address these differentials may lead to a foreclosure of future labour market options. Policy also needs to facilitate Indigenous engagement in the mainstream economy by assisting Indigenous people to be work-ready, especially in ensuring that Indigenous skills are matched with employer demands, and expediting employment by informing businesses on how to provide an Indigenous-friendly workplace.
Process evaluation of a walking programme delivered through the workplace in the South Pacific island Vanuatu
Authors: Siefken Katja , Schofield Grant , Schulenkorf Nico 
Published: August 2014

Background: The South Pacific region is experiencing significant rates of chronic diseases. Well-evaluated health promotion programmes are needed as a central piece of a strategic solution. Just as important as the evaluation itself is how that evaluation outcome can be communicated for future programme use by local programme planners. The objective of this study is to evaluate a physical activity (PA) programme that was designed for Pacific women in urban Vanuatu, and subsequently to develop new techniques to display data that support the understanding and communication of programme success and challenges. Methods: Data collection methods included quantitative Likert scale questions and qualitative open-ended questions. A new analysis technique visualises open-ended process evaluation data. We present themes using word sizes proportional to the frequency of the themes identified through thematic analysis. Results: The Likert scale technique revealed little meaningful information; almost all participants rated most elements of the programme highly. This may be related to Pacific people being frequently inclined to assent with external ideas. Open-ended questions provided more significant insights. For example, we found a stronger change in eating habits (68.9%) than in exercise behaviour (28.2%). Conclusion: We present an evaluation of the first pedometer-based PA intervention in the Pacific and respond to the paucity of process evaluations that have been carried out in the context of low- and middle-income countries. Moreover, the new thematic data visualisation (TDV) approach may aid in understanding complex and cluttered data in a constructive and coordinated way; we present a new approach in health promotion research.