bluuebunny/crossref_metadata_2025_split huggingface dataset:
Virtual Reality Reduces Fear and Anxiety During Pediatric Orthopaedic Cast Room Procedures: A Randomized Controlled Trial
Authors: Richey Ann E. , Hastings Katherine G. , Karius Alexander , Segovia Nicole A. , Caruso Thomas J. , Frick Steven , Rodriguez Samuel 
Published: August 2022

Background:
Virtual Reality (VR) has been used as a distraction tool in various medical settings to reduce pain and anxiety associated with procedures. This study evaluates the effectiveness of VR as a distraction tool for decreasing fear, anxiety, and pain in pediatric patients undergoing common outpatient orthopaedic procedures.

Methods:
A total of 210 patients were recruited from a single orthopaedic clinic between October 2017 and July 2019. Patients were randomized to the VR group or to the control group (standard of care). Outpatient procedures included cast and/or pin removals. Primary outcome measures were collected preprocedure and postprocedure using validated surveys, and included: fear (Children’s Fear Scale), anxiety (Children’s Anxiety Meter-State), and pain (Numerical Rating Scale). Patients and caregivers in the VR group completed a satisfaction survey at the end of their appointment. Fear, anxiety, and pain scores between the 2 groups were analyzed using multivariable linear regression models, and the satisfaction survey was analyzed using descriptive statistics.

Results:
One hundred twenty nine patients were included in the final analysis, with 85 patients in the VR group and 44 patients in the control group. During the procedure, patients in the VR group reported significantly lower average fear scores (P<0.001) and anxiety scores (P=0.003) as compared with controls. There were no differences between the groups in fear and anxiety scores before and after the procedure, or pain scores before, during, or after the procedure. Overall, patients and caregivers in the VR group reported high satisfaction scores, with 97% of patients and 95% of caregivers recommending this intervention to others.

Conclusion:
VR technology was found to be an effective distraction tool to improve fear and anxiety during cast removal procedures. Findings build on a body of evidence that supports the use of distraction tools in clinics, specifically pediatric orthopaedics, to improve fear and anxiety. The distraction tools can be easily translated into current practices.

Level of Evidence:
Level I.
Pain and Spirituality Among Women With Advanced Breast Cancer
Authors: Miller Megan , Greenwalt Kyle , Lehto Rebecca , Wu Horng-Shiuann , Moser Jason , Wyatt Gwen 
Published: August 2022

Background:
Women with advanced breast cancer often experience significant pain. Previous studies indicate that spirituality may serve as a resource to alter pain perceptions; yet, the role of spirituality in pain management has not been examined as a lived experience among this population.

Objective:
This study qualitatively explored how women with advanced breast cancer describe their experiences with spirituality, pain, and how they perceived their spirituality as influencing their pain.

Interventions/Methods:
Guided by Self-transcendence Theory, a phenomenological approach was taken. Women were recruited via tumor registry mailings through a community cancer center. Face-to-face semistructured interviews (N = 9) were conducted. An inductive, interpretive data analysis approach was used, using open-coding thematic analysis conducted by 2 investigators.

Results:
Participants were Caucasian and Christian, with a mean age of 61 years. Findings revealed the complex, multidimensional nature of pain and broad encompassing experiences of spirituality. Themes included: (1) spirituality provides positive cognitive framing to help face pain; (2) spirituality elicited supportive emotions such as peace and tranquility despite pain; (3) spiritual practices serve as pain self-management tools; and (4) connection with others and service activities (aspects of spirituality) help women cope with pain.

Conclusions:
While various routes were mentioned, most women found spirituality to alter pain experiences in supportive ways. Greater attention to spirituality may open new avenues of research and expand insights for development of nurse-designed pain management interventions.

What is Foundational:
Women with advanced stage breast cancer identify pain as a total (physical, cognitive and emotional) experience that needs another total experience to overcome it. Spirituality is an intentional total experience that quiets the mind, and keeps the women in the present moment with a positive cognitive frame and altered positive emotional states including peace and tranquility.
Cross-cultural Adaptation and Psychometric Evaluation of the Persian Version of the Leuven Questionnaire for Patient Self-care During Chemotherapy
Authors: Nejat Nazi , Rafiei Fatemeh , Ebrahimabadi Maryam 
Published: August 2022

Background:
Patients with cancer undergoing chemotherapy frequently experience treatment side-effects that range in degrees of severity. Self-care is important for success in treatment and reducing patients’ suffering secondary to treatment side effects. Using a valid and reliable questionnaire is the first step in assessing patients’ self-care status.

Objectives:
To translate, adapt, and psychometrically test the Leuven questionnaire for Patient Self-care during Chemotherapy (L-PaSC) in Iranian adult oncology patients.

Methods:
This cross-sectional study was conducted with 154 patients in treatment for cancer. A cross-cultural adaptation of the instrument (translation, synthesis, back translation, synthesis of back-translation, expert committee review, and pretesting) was completed. Content and face validities of the adapted version L-PaSC were evaluated by expert committee review; reliability was evaluated through Spearman correlation coefficient, Interclass Correlation Coefficient (ICC), and Cronbach’s alpha. Data were analyzed using the SPSS-16 software.

Results:
The face validity of the questionnaire was acceptable (mean score: 1.75). The content validity ratio (CVR) and content validity index (CVI) were 0.89 and 0.98, respectively. The Spearman correlation coefficient, ICC, and Cronbach’s alpha value for the questionnaire were 0.94, 0.97, and 0.97, respectively.

Conclusion:
The Persian version (L-PaSC-P) has the potential to support a comprehensive assessment of cancer patients’ self-care during chemotherapy.

Implications for Practice:
Clinician insights regarding patients’ self-care status may help to give support to the self-care efforts which in turn may help to reduce side-effects, improve quality of life and even slow disease progression. Measurement of patients’ self-care status during chemotherapy can provide important information on patients’ well-being.

What is Foundational:
A translation, using well-established methods, of the Leuven questionnaire for Patient Self-Care during Chemotherapy (L-PaSC) with Iranian adult oncology patients produced a new and validated, reliable translation in Persian, LPaSC-P, which will be used to enhance clinician understanding and support of patient self-care activities.
Managing Family Building Concerns After Cancer
Authors: Gorman Jessica R. , Smith Ellie , Drizin Julia H. , Lyons Karen S. , Harvey S. Marie 
Published: August 2022

Background:
Young adult breast cancer survivors (YABCS) and their partners commonly experience distress related to changes in their family building options.

Objective:
To explore how YABCS and their partners appraised and managed family building after cancer to inform approaches to support these couples.

Methods:
We conducted separate telephone interviews with 25 YABCS and their male partners. We used thematic analysis to examine individual interviews followed by analysis of responses within and across couples.

Results:
Themes were: (1) Purposeful discussion about family building plans with each other; (2) Balancing family building desires and priorities that do not always align; (3) Partners providing emotional and instrumental support for survivors; (4) Working toward finding a solution together; (5) Perception of limited choice; (6) Combination of time in life and cancer circumstance; (7) Access to financial resources and fertility care; and (8) Motherhood self-identity, social expectations, and assumptions.

Conclusions:
Open communication facilitated shared appraisal and management of family building plans, which were influenced by both the cancer experience and stage of life. Participants emphasized a lack of choice and autonomy, describing ways that structural factors and social expectations around biological motherhood disrupted family building plans.

Implications for Practice:
YABCS couples navigating family building would benefit from counseling focused on communication and consideration of each partner’s priorities based on circumstances, social expectations, and access to resources.

What Is Foundational:
Interpersonal, contextual, and structural factors are important considerations when developing strategies to comprehensively support couples navigating the complexities of family building after cancer.
Determining the component-based operative time learning curve for robotic-assisted radical prostatectomy
Authors: Ambinder David , Wang Shu , Siddiqui Mohummad Minhaj 
Published: August 2022

Abstract

Objectives
To determine the learning curve (LC) of total operative time and the discrete components of the robotic-assisted radical prostatectomy (RARP) for a recent robotic fellowship‐trained urologic surgeon.

Materials and methods
We performed a retrospective analysis of RARP procedures performed by a single new attending surgeon from August 2015 to April 2019. Patients' demographics and operative details were assessed. Total operative time was divided and prospectively recorded in 7 parts: (a) docking robot, (b) dissecting seminal vesicles (SVs) (c) dissecting endopelvic fascia (EPF), (d) incising bladder neck (BN), (e) completing the dissection, (f) lymph node dissection, and (g) urethrovesical anastomosis (UVA) and robot undocking. Cumulative sum analysis was used to ascertain the LC for total operative time and the 7 parts of the procedure.

Results
One hundred twenty consecutive RARPs were performed. The LC was overcome at 25 cases for total operative time, 13 cases for docking the robot, 33 cases for dissecting SVs, 31 cases for dissecting EPF, 46 cases for incising BN, 38 cases for prostate dissection, 25 cases for lymph node dissection, and 52 cases for UVA. Total operative time was decreased 22.8% (p < 0.0001) and time for robot docking, dissecting SVs, dissecting EPF, incising BN, completing prostate dissection, lymph node dissection, and UVA were decreased 16.7%, 30.5%, 29.5%, 36.2%, 37.3%, 32.2%, and 26.9%, respectively (all p < 0.05).

Conclusions
We observed a 25-case LC for a fellowship-trained urologist to achieve stable operative performance of RARP surgery. Procedural components demonstrated variable LCs including the UVA that required upward of 52 cases.
Role of multiparametric magnetic resonance imaging in the diagnosis and staging of urinary bladder cancer
Authors: Shalaby Essam A. , Mohamed Ahmed R. , Elkammash Tarek H. , Abouelkheir Rasha T. , Housseini Ahmed M. 
Published: August 2022

Abstract

Objectives
To assess the role of multiparametric magnetic resonance imaging (mp-MRI) in the diagnosis and staging of urinary bladder cancer (BC).

Materials and methods
Fifty patients diagnosed with bladder masses underwent mp-MRI study. The results of 3 image sets were analyzed and compared with the histopathological results as a reference standard: T2-weighted image (T2WI) plus dynamic contrast-enhanced (DCE), T2WI plus diffusion-weighted images (DWI), and mp-MRI, including T2WI plus DWI and DCE. The diagnostic accuracy of mp-MRI was evaluated using receiver operating characteristic curve analysis.

Results
The accuracy of T2WI plus DCE for detecting muscle invasion of BC was 79.5% with a fair agreement with histopathological examination (κ = 0.59); this percentage increased up to 88.6% using T2WI plus DWI, with good agreement with histopathological examination (κ = 0.74), whereas mp-MRI had the highest overall accuracy (95.4%) and excellent agreement with histopathological data (κ = 0.83). Multiparametric MRI can differentiate between low- and high-grade bladder tumors with a high sensitivity and specificity of 93.3% and 98.3%, respectively.

Conclusions
Multiparametric MRI is an acceptable method for the preoperative detection and accurate staging of BC, with reasonable accuracy in differentiating between low- and high-grade BC.
Culturally Responsive Practices in Treatment of Substance Use Disorders
Authors: Fox LaVonne , Heitkamp Thomasine 
Published: August 2022

This article highlights the limitations of culturally relevant care for Indigenous people in the prevention, treatment, and recovery of substance use disorders. It provides recommendations for consideration that expand the capacity for cultural humility. The “one-size-fits-all” approach to providing services, employed by most health and human service providers who are non-Indigenous, has failed. These limitations are often because of a lack of understanding of the larger historical and cultural context of Indigenous people. The authors emphasize the importance of health and human service providers' acquisition of the requisite knowledge about the impact of colonization and trauma that guides a trauma-informed approach to treatment.
Sixteen suggestions are provided to serve as a guide when serving Indigenous populations. They include expanding the body of literature on evidence-based practices to include the voice of Indigenous populations through the application of a Community-Based Participatory Action Research approach. Critical to achieving these outcomes is an expansion of the number of behavioral health providers who are Indigenous through the adoption of pedagogical practices that better serve the educational needs of this population. In addition, expanding the capacity of the preservice workforce to understand the impact of colonialization and cultural genocide is paramount. The goal is to prevent the perpetuation of negative attitudes and beliefs that result in addiction treatment providers becoming frustrated with the outcome and blaming the patient. These suggestions, based on the literature, will maximize positive outcomes and can be adapted by a broad spectrum of providers of substance use disorder services.
Do Social Support, Self-Efficacy, Emotional Quality of Life, and Sociodemographic Factors Associate With Substance Use?
Authors: Bayindir Cevik Ayfer , Uykucu Armutcuoglu Gamze , Öztabak Esra Meryem , Kasapoglu Elcin Sabahat 
Published: August 2022

Abstract
Substance use among university students is a common problem in the world. However, there are insufficient data on its prevalence among health school students. Similarly, there are very few studies about the use of substances by health students in Turkey. These studies have been mostly limited to the use of alcohol and tobacco. To the best of our knowledge, no previous studies have examined the substance use among students studying at health-related departments. This study investigated the pattern of substance abuse and its relationship with social support, self-efficacy, emotional quality of life, and sociodemographic factors in health profession students. Data of the cross-sectional and correlational study were collected via WhatsApp. Participants completed a student information form, the Substance Abuse Proclivity Scale, the Drug Abuse Screening Test, the Multidimensional Scale of Perceived Social Support, the SF-36 Emotional Quality of Life Index, and the Self-Efficacy for Protecting from Substance Abuse Scale. Of the participants, 63.6% (n = 823) had a high proclivity for substance abuse. Students most frequently used cigarettes and cannabis, one of the narcotic drugs. Substance abuse and proclivity increased as the emotional quality of life, social support, and self-efficacy decreased (p < .05). Substance abuse proclivity and drug use were higher in men, immigrants, smokers and alcohol users, those with a trauma history, and those separated from their family (p < .05). Health education reduces substance use (p < .05). It is required to make attempts to prevent and eliminate substance abuse in health profession students.
Enhanced recovery after surgery in patients undergoing laparoscopic common bile duct exploration: A retrospective study
Authors: Li Guowei , Zhang Junjie , Cai Jianfeng , Yu Zusheng , Xia Qunfeng , Ding Wei 
Published: August 2022

Summary
Few reports have focused on the use of enhanced recovery after surgery (ERAS) in laparoscopic common bile duct exploration (LCBDE) to promote the postoperative recovery of patients with choledocholithiasis. Therefore, this study aimed to explore the advantages and safety of ERAS in patients who underwent LCBDE. From December 2016 to February 2020, 86 and 84 patients were retrospectively enrolled in the control and ERAS groups, respectively. The perioperative insulin resistance index, perioperative C-reactive protein level, time of postoperative analgesic use, time of postoperative first flatus, time of abdominal drainage tube removal, time of liver function recovery, and postoperative complications were analyzed between the two groups. The insulin resistance index (1, 3, and 5 days postoperatively) and C-reactive protein level (1, 3, 5, and 7 days postoperatively) in the ERAS group were significantly lower than those in the control group (all P < .05). In terms of the postoperative rehabilitation efficacy, the time of postoperative activity of the patient, time of postoperative first flatus, time of postoperative analgesic use, time of abdominal drainage tube removal, time of postoperative T-tube closing, and length of postoperative hospital stay in the ERAS group were significantly shorter than those in the control group (all P < .05). Additionally, the overall incidence of postoperative complications in the ERAS group had a decreasing trend when compared with that in the control group (P = .05). ERAS can reduce the postoperative stress response and postoperative complications of patients undergoing LCBDE, promote rehabilitation and shorten the length of postoperative hospital stay and therefore has good social and economic benefits.
Exploring the Relationship Between Attachment and Pathological Personality Trait Domains in an Outpatient Psychiatric Sample
Authors: Radetzki Phillip , Wrath Andrew J. , McWilliams Lachlan , Olson Trevor , Adams Stephen , De Souza Dawn , Lau Bienca , Adams G. Camelia 
Published: August 2022

Abstract
The current study investigates the relationship between insecure attachment and pathological personality trait domains in a sample of psychiatric outpatients. Participants (N = 150) completed measures for attachment and personality. Bivariate correlations and multiple regression analyses investigated the extent to which insecure attachment and personality pathology were associated. Insecure attachment positively correlated with overall personality pathology, with attachment anxiety having a stronger correlation than attachment avoidance. Distinct relationships emerged between attachment anxiety and negative affectivity and attachment avoidance and detachment. Insecure attachment and male sex predicted overall personality pathology, but only attachment anxiety predicted all five trait domains. Insecure attachment might be a risk factor for pathological personality traits. Assessing attachment in clinical contexts and offering attachment-based interventions could benefit interpersonal outcomes.
Mental Health Public Stigma in US Jewish Communities
Authors: Gearing Robin E. , Brewer Kathryne B. , Smith Limor , Carr L. Christian , Roe David 
Published: August 2022

Abstract
Stigma is a multifaceted barrier for individuals living with mental illness, contributing to negative stereotypes, prejudice, and discrimination, and is underinvestigated in minority ethnic groups. This study examines the stigma within the US Jewish communities, specifically the following: a) differences in public stigma dimensions based on mental illness (e.g., major depressive disorder, anxiety disorder, schizophrenia, or alcohol use disorder) and sex; and b) whether participant characteristics influence the public stigma. A community-based sample of 317 self-identified Jewish individuals participated in an experimental randomized vignette survey on stigma and help-seeking beliefs toward various mental illness. Findings indicate differences in stigma based on stigmatized individuals' sex and diagnosis as well as participants' demographics. Schizophrenia and alcohol use disorder were stigmatized similarly, with lower stigma for depression and the least stigma toward anxiety. Of interest, younger males have the most treatability and professional efficacy stigma, and tailored stigma-reducing interventions are recommended.
Nasal Airway Function After Prophylactic Intranasal Surgery for Excessive Maxillary Superior Repositioning: A Retrospective Cohort Study Using the Nasal Obstruction Symptom Evaluation Scale
Authors: Özcan Elif M. , Can Serhat , Aydil Bariş , Varol Altan 
Published: August 2022

Purpose:
The purpose of this study is to evaluate the degree of nasal airway function after simultaneous intranasal corrective surgery and bimaxillary surgery in patients with excessive superior maxillary repositioning.

Materials and Methods:
A retrospective cohort study was conducted on consecutive LeFort I superior repositioning patients who also underwent simultaneous intranasal surgery to prevent airway obstruction between 2015 and 2019. The Nasal Obstruction Symptom Evaluation (NOSE) scale was administered to all participants before the operation and after 1 year.

Results:
Fifteen patients (n=12 females; n=3 males) among 440 bimaxillary orthognathic surgery patients were enrolled with inclusion criteria of maxillary impaction between 8 and 12 mm. All subjects underwent at least LeFort I osteotomy, septoplasty, bilateral inferior turbinectomy, and bilateral sagittal split osteotomy. Two patients received custom-made total joint prosthesis. The primary outcome variable investigated was nasal function. The mean preop Nasal Obstruction Symptom Evaluation score was 24.33 and the mean postop score was 5.

Conclusions:
Intranasal procedures performed simultaneously with 8 mm or more maxillary impaction improves postoperative functional outcome in terms of nasal airway patency and breathing. Partial inferior turbinectomies and septoplasty should be performed consistently to avoid nasal obstruction if the impaction of upper jaw exceeds 8 mm.