bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epidemiology, Resistance Profiles, and Outcomes of Bloodstream Infections in Community-Onset Sepsis in the United States*
Authors: Ohnuma Tetsu , Chihara Shingo , Costin Blair , Treggiari Miriam , Bartz Raquel R. , Raghunathan Karthik , Krishnamoorthy Vijay 
Published: June 2023

OBJECTIVES:
To describe frequency of positive blood cultures, patterns of pathogens’ characteristics and their resistance profile in patients with blood cultures drawn due to a presumed diagnosis of community-onset sepsis, and to examine the association between blood culture-positive pathogens and hospital mortality.

DESIGN:
Retrospective cohort study.

SETTING:
Two hundred one U.S. hospitals from 2016 to 2020 using the Premier Healthcare Database.

SUBJECTS:
Adult patients presenting with community-onset sepsis who had blood cultures collected within 2 days of hospital admission. We defined sepsis using the U.S. Centers for Disease Control Adult Sepsis Event Surveillance criteria.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
We identified 147,061 patients with community-onset sepsis. The number of blood culture-positive sepsis episodes was 21,167 (14%) and the number of nonblood culture-positive sepsis episodes was 20,326 (14%). Among patients with blood culture-positive sepsis, Gram-negative rods were isolated in 55% of patients, Gram-positive cocci were isolated in 47%. Of those, methicillin-resistant Staphylococcus aureus (MRSA) was 11%, ceftriaxone-resistant Enterobacterales/extended-spectrum β-lactamase was 7%, and carbapenem-resistant Enterobacterales was 1.3%. The crude in-hospital mortality was 17% for culture-negative sepsis, 13% for nonblood culture-positive sepsis, and 17% for blood culture-positive sepsis. In multilevel logistic regression models, compared with culture-negative sepsis, blood culture-positive sepsis (adjusted odds ratio [aOR], 0.89; 95% CI, 0.85–0.94) and nonblood culture-positive sepsis (aOR, 0.82; 95% CI, 0.78–0.87) were associated with lower odds of in-hospital mortality. Acinetobacter species, Pseudomonas aeruginosa, methicillin-sensitive Staphylococcus aureus, and MRSA were associated with higher in-hospital mortality, whereas Escherichia coli, Klebsiella species, Proteus species, and Streptococcus species were associated with lower in-hospital mortality.

CONCLUSIONS:
In patients hospitalized with community-onset sepsis, the prevalence of blood culture-positive sepsis was 14%. Among positive blood culture sepsis resistant organisms were infrequent. Compared with culture-negative sepsis, blood culture-positive sepsis and nonblood culture-positive sepsis were associated with lower in-hospital mortality.
Effect of Structural Moral Case Deliberation on Burnout Symptoms, Moral Distress, and Team Climate in ICU Professionals: A Parallel Cluster Randomized Trial*
Authors: Kok Niek , Zegers Marieke , Teerenstra Steven , Fuchs Malaika , van der Hoeven Johannes G. , van Gurp Jelle L.P. , Hoedemaekers Cornelia W.E. 
Published: June 2023

OBJECTIVES:
Moral case deliberation (MCD) is a team-based and facilitator-led, structured moral dialogue about ethical difficulties encountered in practice. This study assessed whether offering structural MCD in ICUs reduces burnout symptoms and moral distress and strengthens the team climate among ICU professionals.

DESIGN:
This is a parallel cluster randomized trial.

SETTING:
Six ICUs in two hospitals located in Nijmegen, between January 2020 and September 2021.

SUBJECTS:
Four hundred thirty-five ICU professionals.

INTERVENTIONS:
Three of the ICUs organized structural MCD. In three other units, there was no structural MCD or other structural discussions of moral problems.

MEASUREMENTS AND MAIN RESULTS:
The primary outcomes investigated were the three burnout symptoms—emotional exhaustion, depersonalization, and a low sense of personal accomplishment—among ICU professionals measured using the Maslach Burnout Inventory on a 0–6 scale. Secondary outcomes were moral distress (Moral Distress Scale) on a 0–336 scale and team climate (Safety Attitude Questionnaire) on a 0–4 scale. Organizational culture was an explorative outcome (culture of care barometer) and was measured on a 0–4 scale. Outcomes were measured at baseline and in 6-, 12-, and 21-month follow-ups. Intention-to-treat analyses were conducted using linear mixed models for longitudinal nested data. Structural MCD did not affect emotional exhaustion or depersonalization, or the team climate. It reduced professionals’ personal accomplishment (−0.15; p < 0.05) but also reduced moral distress (−5.48; p < 0.01). Perceptions of organizational support (0.15; p < 0.01), leadership (0.19; p < 0.001), and participation opportunities (0.13; p < 0.05) improved.

CONCLUSIONS:
Although structural MCD did not mitigate emotional exhaustion or depersonalization, and reduced personal accomplishment in ICU professionals, it did reduce moral distress. Moreover, it did not improve team climate, but improved the organizational culture.
I am Seen
Authors: Burke Erin 
Published: June 2023

ABSTRACT:
Nurses and advanced practice providers are encouraged to embrace resilience skills to deal with compassion fatigue and prevent burnout. As a Christian nurse, I learned the importance of daily staying close to Jesus when a beloved pediatric oncology patient died and I experienced overwhelming grief. Through prayers, Bible reading, and honoring the patient with coworkers, I found hope in Jesus' presence. God sees me as his beloved child and gives me strength to continue my work.
Prolonged Grief Disorder
Authors: Stegmeir Diane 
Published: June 2023

ABSTRACT:
Prolonged grief disorder (PGD), sometimes called complicated grief, can impair a person's ability to function in daily life and elevate the risk for physical and mental decompensation. In 2022, PGD was added to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR), increasing the potential for treatment with interpersonal therapy and medication. Nurses with knowledge of the signs and risk factors of PGD can identify people experiencing extended, unresolving grief and can offer care and referrals for therapy and support.
Cultivating Student Success After Repeated Failure
Authors: Mingo Sharon 
Published: June 2023

ABSTRACT:
Everyone experiences failure. This reality contrasts with human desire and societal culture to succeed. Students experiencing academic failure can struggle to learn from failure, find hope, build resilience, and create self-efficacy. Insights and strategies of learning and applying Scripture and practicing positive affirmations in a mentoring atmosphere with Christian faculty can lead students to understand and accept God's orchestration of failure for good.
Opening My Eyes Building Nursing Student Awareness of Spirituality and Catholic Social Justice Principles
Authors: Watson Sherylyn M. , Cole Michelle A. , Goncalves Susan A. 
Published: June 2023

ABSTRACT:
How can nursing academia impart concepts of spirituality, social justice, and personal and professional growth to nursing students? The authors of this qualitative study explored the narratives of 21 nursing students' reflective journals written while students were participating in a global clinical mission. A guided reflective journal grounded in Catholic social teachings and St. Francis' social justice principles was used daily during the mission to capture participants' thoughts and feelings. Data analysis revealed that students discovered principles of spirituality and social justice and expressed a deeper appreciation for being present for others, providing healthcare to all equally, and promoting the common good. Guided questions enhanced the experiential learning experience, fostering personal and professional growth.
Global Service-Learning Fosters Collaboration, Cultural Humility, and Spiritual Growth among BSN Students
Authors: Digges Jean Marie , Faw Kathy 
Published: June 2023

ABSTRACT:
Nursing practice is evolving to include a more global perspective; therefore, nursing education must transcend the confines of the traditional classroom to prepare students to serve vulnerable populations across the globe. Collaboration, cultural humility, and spiritual growth through reflective practice are three themes identified in the literature as takeaways for students participating in global service-learning experiences. The development and implementation of a course on global service-learning is explored in this article. Biblical examples and anecdotal student comments support the themes identified in the literature.
Is My Child Racist? Supporting Caregivers in Conceptualizing Race for Children
Authors: Carrasco Veronica Ilene , Solgi Mohadeseh , Davis Aaron , Chavis Antwon , Zuckerman Katharine , Augustyn Marilyn 
Published: June 2023

CASE:
M is a 4-year-old White girl whose parents contact their primary care pediatric clinician with a behavioral concern: over the course of several months, M has insisted that she is pregnant with quintuplets. Although some of the quintuplets have light skin tones, others have darker skin tones. When elaborating about the fantasy, M often explains that the babies fight in her tummy, and the Brown babies are “acting badly” by spitting, scratching, and hitting the others. Although M can sometimes provide an explanation for why the Brown babies misbehaved (i.e., they ate chocolate), often she is not able to produce an answer. The child frequently reiterates the same story to her parents, which has left M's parents uncertain how to react.
In terms of her life course thus far, M has had typical development and behavior. She has attended all her well-child visits and met the usual developmental milestones. Beyond general development, her exposure to diverse people has been ample because she is from a multiethnic household in which 2 languages are regularly spoken. Outside of her home, she has close Brown and Black friends in her preschool, and the school has discussed race and skin color in an affirming way with the children. At home, she has books that feature children of different skin tones.
What advice can M's pediatric clinician offer? How can parents and pediatric clinicians support children who present with race-based thoughts or actions that seem discriminatory?
Prenatal organophosphate ester exposure and executive function in Norwegian preschoolers
Authors: Hall Amber M. , Keil Alexander P. , Choi Giehae , Ramos Amanda M. , Richardson David B. , Olshan Andrew F. , Martin Chantel L. , Villanger Gro D. , Reichborn-Kjennerud Ted , Zeiner Pål , Øvergaard Kristin R. , Sakhi Amrit K. , Thomsen Cathrine , Aase Heidi , Engel Stephanie M. 
Published: June 2023

Background:
Organophosphate esters (OPEs) are ubiquitous chemicals, used as flame retardants and plasticizers. OPE usage has increased over time as a substitute for other controlled compounds. This study investigates the impact of prenatal OPE exposure on executive function (EF) in preschoolers.

Methods:
We selected 340 preschoolers from the Norwegian Mother, Father, and Child Cohort Study. Diphenyl-phosphate (DPhP), di-n-butyl-phosphate (DnBP), bis(2-butoxyethyl) phosphate (BBOEP), and bis(1,3-dichloro-2-propyl) phosphate (BDCIPP) were measured in maternal urine. EF was measured using the Behavior Rating Inventory of Executive Functioning-Preschool (BRIEF-P) and the Stanford-Binet fifth edition (SB-5). EF scores were scaled so a higher score indicated worse performance. We estimated exposure-outcome associations and evaluated modification by child sex using linear regression.

Results:
Higher DnBP was associated with lower EF scores across multiple rater-based domains. Higher DPhP and BDCIPP were associated with lower SB-5 verbal working memory (β = 0.49, 95% CI = 0.12, 0.87; β = 0.53, 95% CI = 0.08, 1.02), and higher BBOEP was associated with lower teacher-rated inhibition (β = 0.34, 95% CI = 0.01, 0.63). DPhP was associated with lower parent-reported BRIEF-P measures in boys but not girls [inhibition: boys: 0.37 (95% CI = 0.03, 0.93); girls: –0.48 (95% CI = –1.27, 0.19); emotional control: boys: 0.44 (95% CI = –0.13, 1.26); girls: –0.83 (95% CI = –1.73, –0.00); working memory: boys: 0.49 (95% CI = 0.03, 1.08); girls: –0.40 (95% CI = –1.11, 0.36)]. Fewer sex interactions were observed for DnBP, BBOEP, and BDCIPP, with irregular patterns observed across EF domains.

Conclusions:
We found some evidence prenatal OPE exposure may impact EF in preschoolers and variation in associations by sex.
Safety of office-based lens surgery: U.S. multicenter study
Authors: Kugler Lance J. , Kapeles Matthew J. , Durrie Daniel S. 
Published: June 2023

Purpose:
To evaluate the rate of adverse events after office-based lens surgery performed across multiple private practices in the United States.

Setting:
36 private practices across the U.S.

Design:
Retrospective multicenter study.

Methods:
This analysis included case records of all consecutive patients who underwent office-based lens surgery for visually significant cataract, refractive lens exchange, or phakic intraocular lens implantation between August 2020 and May 2022 at 36 participating sites across the U.S. The study outcome measures included the assessment of intraoperative and postoperative complications such as the incidence of unplanned vitrectomy, iritis, corneal edema, and endophthalmitis after lens surgery. The frequency of patients requiring a return to the operating room (OR) or referral to a retina surgeon and the frequency of patients requiring hospitalization or calling emergency services (911) for any reason were also evaluated.

Results:
The study reviewed 18 005 cases of office-based cataract or refractive lens surgery performed at 36 clinical sites. The rates of postoperative endophthalmitis, toxic anterior segment syndrome, and corneal edema were 0.028%, 0.022%, and 0.027%, respectively. Unplanned anterior vitrectomy was performed in 0.177% of patients. Although 0.067% of patients needed to return to the OR, 0.011% of patients were referred to the hospital.

Conclusions:
The rate of adverse events for office-based cataract or refractive lens surgery is similar to or less than the reported adverse event rate for modern cataract surgery in the ambulatory surgery center setting.
Substance Misuse Themes Among Women Living in Transitional Housing
Authors: Lopez Alexa A. , Dressel Anne E. , Deal Emily , Krueger Emma , Graf Maria , Pittman Belinda , Schmitt Marin , Kako Peninnah , Ochoa-Nordstrum Brittany , Mkandawire-Valhmu Lucy 
Published: June 2023

Abstract
Traditional substance misuse treatments have not always taken women or marginalized populations into consideration. A holistic approach that addresses how drugs may be used to cope with trauma caused by violence, poverty, and neglect as well as employment of engagement strategies that connect populations with culturally relevant support systems are key, especially in treating African American women. As substance misuse rates rise among African American women, characterizing how this may influence or be influenced by relationships (such as with children, intimate partners, and social relations) is especially important in the context of effective treatment. The purpose of this qualitative study was to examine the themes surrounding substance misuse and close relationships among women previously enrolled in a transitional housing treatment program grounded in social support. Many women discussed how the program itself was an impetus in addressing not only their own substance use but also intergenerational substance use within their families. Women also noted how relationships with their children were vastly different pretreatment compared with during and after treatment, specifically emphasizing a positive improvement. Regarding intimate relationships, African American women learned to establish assertiveness and navigate healthier social relationships, all while sustaining drug abstinence. It is important to acknowledge the role of the healthcare professional in ensuring effective and culturally relevant treatment for African American women; nursing curricula should include evidence-based practice education and training on mental health and substance misuse specific to marginalized communities to more deeply understand the complex intersections of substance misuse, poverty, and social relationships in the lives of women.
Utilization of Nurse-Administered Screening, Brief Intervention, and Referral to Treatment in a Brief Psychiatric Inpatient Unit
Authors: Kracher Stacy , Bayette Lorrie , Young Doris , Goebert Deborah A. , Guerrero Maria , Agapoff Jame A. 
Published: June 2023

Background
Screening, Brief Intervention, and Referral to Treatment (SBIRT) has been established as an effective screening tool for providing interventions for patients with risky substance use.

Objectives
The objectives of this project were to train and coach staff nurses in the use of SBIRT, offer SBIRT to all admissions of a brief psychiatric inpatient unit, and decrease readmission rates.

Design
Using the Iowa Model for Implementing Evidence-Based Practices, SBIRT was implemented on the unit. Data were collected on the frequency of patients offered SBIRT and readmission rates.

Results
Fifty-nine percent of all admissions were offered SBIRT. The average readmission rates decreased by 18.3% for the first 2 months of implementation and by 67.5% for Days 16–31 postdischarge.

Conclusions
SBIRT is an effective tool for nurses on psychiatric units to address substance use and to decrease readmission rates.
Multilevel Factors Associated With Lifetime, Current, and Binge Drinking Among Korean Adolescents Based on the Ecological Model
Authors: Kim Eun-Mi , Kim Heejung 
Published: June 2023

Abstract

Background
Drinking usually begins in adolescence and is a major public health concern. Few studies have identified multilevel factors considering the frequency and amount of drinking among adolescents. This study aimed to identify the multilevel factors associated with lifetime, current, and binge drinking among Korean adolescents based on the ecological model.

Methods
This cross-sectional study used data from the 2018 Korea Youth Risk Behavior Survey (N = 60,040). Hierarchal multinomial logistic regression analyses were performed using complex sample data.

Results
Overall, 15,030 (25.4%), 4,629 (8.0%), and 5,038 (8.9%) subjects were involved in lifetime, current, and binge drinking, respectively. The following multilevel factors revealed significant associations with lifetime, current, and binge drinking: boys, high school students, depression, suicidal ideation at individual level, family acceptance of alcohol use, poor household economic status at family level, poor academic achievement, not receiving education on alcohol use at school level, possible alcohol access, and harm caused by drinkers at social level (all ps < .01). The main risk factors were family acceptance of alcohol use (lifetime, current, and binge drinking vs. OR = 3.95, 6.88, and 5.46, respectively) and possible alcohol access (OR = 5.65, 19.78, and 93.62).

Discussion
This study revealed multilevel factors associated with lifetime, current, and binge drinking. School nurses and community leaders are necessary to develop customized drinking prevention programs considering drinking frequency and amount, and individual, family, school, and social factors. Especially, the implementation of a drinking prevention program that reduces family acceptance of alcohol use and access to alcohol could be an effective strategy.
Relapse Prevention and Prediction Strategies in Substance Use Disorder
Authors: Carter T'Anya , Heaton Karen , Merlo Lisa J. , Roche Bernadette T. , Puga Frank 
Published: June 2023

Background
Relapse prevention for those with substance use disorder (SUD) is an evolving practice. Initiatives focused on relapse prevention from other populations may provide the foundation for future considerations and recommendations for recovering anesthesia providers in the workplace. The purpose of this scoping review was to examine what is known about return-to-use prediction and prevention strategies in various populations struggling with SUDs to inform future considerations and implications for recovering anesthesia providers with a history of SUD.

Methods
The Arksey and O'Malley framework was used to conduct a scoping review of the literature. A systematic search was conducted across three databases (PubMed, CINAHL, and PsycInfo) for relevant literature. Search terms used were “measures predicting relapse in substance use disorder” and “relapse prevention in substance use disorder AND anesthesia.” Data from articles that met the eligibility criteria were extracted and summarized by the primary author.

Results
The search identified 46 articles highlighting various relapse prediction and prevention strategies related to craving and stress, underlying biological factors, neuroimaging, and mindfulness. Relapse prediction and prevention strategies ranged from cell phone applications, monitoring biological markers, and functional neuroimaging of the brain.

Conclusions
Relapse is a concern for individuals with a history of SUD. For anesthesia providers, immediate access to powerful anesthesia medications requires return-to-use prediction and prevention strategies when anesthesia providers return to work after SUD treatment. Although some identified strategies are practical, more research is needed to predict and prevent return to use for recovering anesthesia providers.
To explore the effects of herbal medicine among cancer patients in Taiwan: A cohort study
Authors: Li Tsai-Feng , Hwang I-Hsuan , Tsai Cheng-Hung , Hwang Shinn-Jang , Wu Ta-Peng , Chen Fang-Pey 
Published: June 2023

Background:
Traditional Chinese medicine (TCM) is widely used by ethnic Chinese communities. TCM is covered by Taiwan’s National Health Insurance (NHI) program. We evaluated the efficacy and outcomes of complementary Chinese herbal medicine (CHM) therapy in patients with cancer.

Methods:
This population-based cohort study was conducted using the data of patients who received a cancer diagnosis between 2005 and 2015 in Taiwan. Eligible patients were divided into standard and complementary CHM therapy groups. The complementary CHM therapy group was further divided into low cumulative dosage (LCD), medium cumulative dosage (MCD), and high cumulative dosage (HCD) subgroups. Overall survival (OS), mortality risk, cancer recurrence, and metastasis were analyzed for all cancers and five major cancers (lung, liver, breast, colorectal, and oral cancers).

Results:
We included 5707 patients with cancer (standard therapy, 4797 [84.1%]; complementary CHM therapy, 910 [15.9%]; LCD, 449 [7.9%]; MCD, 374 [6.6%], and HCD, 87 [1.5%]). For the LCD, MCD, and HCD subgroups, the mortality risk was 0.83, 0.64, and 0.45, and the 11-year OS, 5-year cumulative cancer recurrence, and 5-year cumulative cancer metastasis rates were 6.1 ± 0.2, 6.9 ± 0.2, and 8.2 ± 0.4 years; 39.2%, 31.5%, and 18.8%; and 39.5%, 32.8%, and 16.6%, respectively. The cumulative cancer recurrence and metastasis rates of the standard therapy group were 40.9% and 32.8%, respectively. The cumulative recurrence and metastasis rates of all cancers, lung cancer, and liver cancer and all cancers, colorectal cancer, and breast cancer, respectively, were significantly lower in the HCD subgroup than in the other subgroups and standard therapy group (p < 0.05).

Conclusion:
Patients receiving complementary CHM therapy may have prolonged OS and reduced risks of mortality, recurrence, and metastasis. A dose–response relationship was noted between CHM therapy and mortality risk: increased dosage was associated with improved OS and reduced mortality risk.