bluuebunny/crossref_metadata_2025_split huggingface dataset:
Curricula, Teaching Methods, and Success Metrics of Clinician–Scientist Training Programs: A Scoping Review
Authors: Li Queenie K.W. , Wollny Krista , Twilt Marinka , Walsh Catharine M. , Bright Katherine , Dimitropoulos Gina , Pires Linda , Pritchard Lesley , Samuel Susan , Tomfohr-Madsen Lianne 
Published: August 2022

Purpose
To describe the literature on clinician–scientist training programs to inform the development of contemporary and inclusive training models.

Method
The authors conducted a scoping review, searching the PubMed/MEDLINE, CINAHL, and Embase databases from database inception until May 25, 2020. Studies presenting primary research that described and evaluated clinician–scientist training programs were identified for data abstraction. On the basis of deductive and inductive methods, information about program characteristics, curricula, teaching strategies, and success metrics was extracted. The extracted variables were analyzed using descriptive statistics.

Results
From the initial 7,544 citations retrieved and 4,974 unique abstracts screened, 81 studies were included. Of the 81 included studies, 65 (80.2%) were published between 2011 and 2020, 54 (66.7%) were conducted in the United States, and 64 (79.0%) described programs that provided broad clinician–scientist training. Few programs provided funding or protected research time or specifically addressed needs of trainees from underrepresented minority groups. Curricula emphasized research methods and knowledge dissemination, whereas patient-oriented research competencies were not described. Most programs incorporated aspects of mentorship and used multiple teaching strategies, such as direct and interactive instruction. Extrinsic metrics of success (e.g., research output) were dominant in reported program outcomes compared with markers of intrinsic success (e.g., career fulfillment).

Conclusions
Although programs are providing clinician–scientists with practical skills training, opportunities exist for curricular and pedagogic optimization that may better support this complex career path. Training programs for clinician–scientists can address contemporary issues of wellness and equity by reconsidering metrics of program success and evolving the core tenets of their education models to include equity, diversity, and inclusion principles and patient-oriented research competencies.
Barriers to Care for Nursing Home Residents With Substance Use Disorders: A Qualitative Study
Authors: Yang Meredith , Beiting Kimberly J. , Levine Stacie 
Published: August 2022

Objectives
Over the past decade, the numbers of older adults with opioid and substance use disorders (OUD/SUD) have increased. As this population enters nursing homes (NHs) in increasing numbers, it is crucial to consider their capacity to manage issues related to OUD/SUD. This study aimed to examine current NH protocols for care coordination of residents with OUD/SUD as well as facility-related barriers to providing care to this vulnerable population within the NH.

Methods
Twenty-four semistructured interviews were conducted with NH staff including directors of nursing, administrators, nurses, and physicians in July 2020. Staff were recruited from 11 different post–acute care and long-term care facilities located in urban and suburban communities of Chicago. Interviews were conducted virtually (via teleconference platform or by telephone) and subsequently coded using ATLAS.ti 8 (ATLAS.ti Scientific Software Development GmbH, Berlin, Germany) using constant comparative method.

Results
Qualitative analyses identified 3 themes around NH barriers to care for residents with SUD/OUD: (1) staff preparedness, (2) staff perceptions of addiction, and (3) overall lack of resources. Results revealed a strong need for the development of consistent policies, as well as standardized, educational interventions for NH staff that target SUD/OUD management in this vulnerable population.

Conclusions
The evaluation and impact of persons with SUD/OUD entering NHs are an important topic that requires further study. More resources and staff training are necessary to ensure that residents with SUD/OUD have access to appropriate care within these settings.
Descriptive Epidemiology of Upper Extremity Septic Arthritis in Children—Review of a Retrospective Multicenter Database
Authors: Li Ying , Sanborn Ryan M. , Cook Danielle , Baldwin Keith D. , Beebe Allan C. , Denning Jaime R. , Goldstein Rachel Y. , Janicki Joseph A. , Johnson Megan E. , Truong Walter H. , Shore Benjamin J. ,   Children’s Orthopaedic Trauma and Infection Consortium for Evidence-Based Studies (CORTICES)
Published: August 2022

Background:
There is limited information on the presentation and management of upper extremity septic arthritis (UESA) in children. Our purpose was to report on the characteristics and short-term treatment outcomes of pediatric UESA from a multicenter database.

Methods:
Patients with UESA were identified from a multicenter retrospective musculoskeletal infection database. Demographics, laboratory tests, culture results, number of surgeries, and complications were collected.

Results:
Of 684 patients with septic arthritis (SA), 68 (10%) patients had UESA. Septic arthritis was most common in the elbow (53%), followed by the shoulder (41%) and wrist (4%). The median age at admission was 1.7 years [interquartile range(IQR, 0.8-8.0 y)] and 66% of the cohort was male. Blood cultures were collected in 65 (96%) patients with 23 (34%) positive results. Joint aspirate and/or tissue cultures were obtained in 66 (97%) patients with 49 (72%) positive results. Methicillin-sensitive Staphylococcus aureus (MSSA) was the most common causative organism overall, but Streptococcus was the most common pathogen in the shoulder. Sixty-six (97%) patients underwent irrigation and debridement, with 5 (7%) patients requiring 2 surgeries and 1 patient (1%) requiring 3 surgeries. The median length of stay was 4.9 days (IQR, 4.0-6.3 d). Thirty-one (46%) children had adjacent musculoskeletal infections and/or persistent bacteremia. No patients experienced venous thromboembolism, and 4 patients with associated osteomyelitis experienced a musculoskeletal complication (3 avascular necrosis, 1 pathologic fracture). One child had re-admission and 3 children with associated osteomyelitis had a recurrence of UESA. Comparison between elbow and shoulder locations showed that children with septic arthritis of the shoulder were younger (4.6 vs. 1.0 y, P=0.001), and there was a difference in minimum platelet count (280 vs. 358 ×109 cells/L, P=0.02).

Conclusions:
UESA comprises 10% of cases of septic arthritis in children. The elbow is the most common location. Shoulder septic arthritis affects younger children. MSSA is the most common causative organism in UESA, but Streptococcus is common in shoulder septic arthritis. Irrigation and debridement result in excellent short-term outcomes with a low complication rate. Re-admissions and repeat surgical interventions are rare.

Level of Evidence:
Level IV, prognostic.
The Symptoms and Information Needs of Chinese Adults After Stem Cell Transplantation
Authors: Chen Mei-Hui , Teng Chieh-Lin Jerry , Huang Hui-Mei , Chao Yann-Fen C. 
Published: August 2022

Background:
Allogeneic hematopoietic stem cell transplantation (allo-HSCT) can be accompanied by physical and emotional adversities for adult patients that may lower their quality of life during the first year following the transplant.

Objective:
To identify the physical and emotional distress after allo-HSCT, health information needs, and quality of life of adult allo-HSCT patients at key points during the first year following the transplantation.

Methods:
This cross-sectional study design included 65 patients post allo-HSCT treatment at 1 of 4 time periods: 30 days, 31–100 days, and 101–365 days. We assessed their distressing symptoms, health information needs, and quality of life.

Results:
We found that participants in each time period had different symptoms and information needs. Five symptoms differed significantly by time period: oral mucositis, diarrhea, nausea, hair loss, and fever (P < .05). Health information needs related to activities, drug information, blood reports, and preventive measures, dietary preventive measures, active preventive measures, symptom management, and infection control methods also differed significantly by time period.

Conclusions:
Adult post allo-HSCT patients experience varying physical and mental distress in different time periods and with varying quality of life during the first year following the transplant. The health information which the patients reported lacking also differed by time period.

Implications for Practice:
Healthcare providers must provide sufficient information to allo-HSCT transplant patients according to their needs at each time period and take measures to alleviate the symptoms related to the allo-HSCT to improve patients’ quality of life.

What is Foundational:
Two new promising measures, the Symptom Distress Severity Questionnaire and the Health Information Needs Questionnaire, were assessed in this study and found to have high internal consistency and concurrent validity with an established symptom measure.
Caregiver Burden of Cancer Patients Related to Cognitive Decline at End of Life
Authors: Takao Ayumi , Yamamoto Sena , Arao Harue 
Published: August 2022

Background:
Cognitive decline in cancer patients at the end of life makes it difficult for caregivers to manage symptoms and decide on cancer care.

Objective:
To define caregiver burden in relation to cancer patients with cognitive decline at the end of life.

Methods:
We use Walker and Avant’s eight-step concept analysis. We searched the MEDLINE, CINAHL, and Web of Science databases for relevant articles published between 2000 and 2020.

Results:
Caregiver burden for comorbid cancer and cognitive decline patients is defined as the pressure experienced by families in a multidimensional way due to the two deteriorating diseases in their process of facing the loss even before the deaths of patients and fulfilling their responsibilities as a family without knowing the patients’ own intentions. The antecedents included physical needs of caregiving, the cognitive decline of the patient, and whether the patient was dying. The consequences included caregivers’ physical and psychological health deterioration, decreasing caregivers’ coping abilities, and deterioration in the quality of death.

Conclusions:
This concept analysis indicated that the caregiver burden population should consider the characteristics of cancer and cognitive decline in interventions.

Implications for Practice:
Nurses should assess patients’ physical, psychosocial, and spiritual needs from various perspectives in advance to coordinate holistic care and prevent complications. Sharing the patient and caregiver’s history is important when discussing the patient’s wishes with the caregiver.

Foundational:
Caregivers in this population experience heavy responsibilities, multidimensional pressures, and the loss of patients before death. They are often required to be proxy decision-makers.
Toward Transformative Engagement: Ethical and Effective Clinical-Research Partnerships in Cancer Care Nursing
Authors: Whitney Clare , Canale Elise , Zinck Lindsey 
Published: August 2022

Background:
Clinical nurses have the potential to conduct impactful practice-focused research, enhancing institutional research cultures and improving patient outcomes. However, collaboration between clinical nurses and academic nurse scientists can be challenging and resource intensive.

Objective:
Describe how transformative clinical-research partnership facilitates achieving mutual goals for clinical nurses and academic nurse scientists.

Methods:
The Virtual Supportive Cancer Care Research (ViSuCaRe) Study, a multisite, mixed-method study, was conducted through a clinical-research partnership to explore the experience of patients and clinicians engaging in supportive cancer care via telehealth during the COVID-19 pandemic.

Results:
We describe research and quality improvement products and identify how the ViSuCaRe Study addressed three common challenges to clinical-research partnerships. (1) Study conception, construction, and development prioritized frontline clinical staff involvement; (2) Data collection and analysis engaged clinical partners in recruitment, interviewing, data management, coding, and theory-building; (3) Subsequent analyses, products, and dissemination efforts emerged from evolving needs of clinical partners and shifted in accordance with their arising priorities.

Conclusions:
Using an approach to collaboration centered on transformative engagement offers clinical nurses and academic nurse scientists.

Implications for Practice:
Frontline clinical staff should have consistent and meaningful roles in developmental, analytic, and dissemination-directing processes. Supporting clinical nurses’ engagement in research activities will enable them to identify and address problems that impact practice, enhance research cultures, and promote evidence-based practice.

Foundational:
Using a model of transformative engagement, rooted in community engagement, allows nurses to carry out collaborative practice-focused research. Clinical-academic partnerships offer an economical approach to enhancing clinical nurses’ research capacities.
Self-reported Professional Competence Among Swedish Contact Nurses in Cancer Care: A Cross-sectional Study
Authors: Bjuresäter Kaisa , Olsson Cecilia , Larsson Maria , Nilsson Jan 
Published: August 2022

Background:
Since 2011, patients in Swedish cancer care have been offered a contact nurse (CN). The CN role is to improve patient participation, care continuity, and provide information and manage patients’ symptoms and needs across the whole continuum of the cancer pathway. A competence profile for the CN role is yet to be developed, and it is important to assess CNs’ self-reported competence to assure that they are well equipped for the role.

Objectives:
To assess self-reported professional competence among contact nurses working in Swedish cancer care and relate the findings to education level and clinical experience.

Methods:
The Nurse Professional Competence scale short form (35 items) was used to assess the nurses’ professional competence. Data were collected through a web-based survey in 2017 in 2 regional cancer centers in Sweden.

Results:
One hundred eight CNs participated in the study and reported highest scores in “value-based nursing care” and lowest scores in “development, leadership, and organization of nursing care.” Higher age, extended clinical work experience, and academic degree were significantly associated with higher competence.

Conclusions:
CNs with extensive work experience and CNs with an academic degree reported higher scores concerning their generic competence. There is a need in future studies to assess CNs’ specific competence in cancer care.

Implications for Practice:
There is room for improvement in the competence development of CNs, primarily in the areas of leadership and organization of nursing care.

What is Foundational:
CNs’ competence regarding leadership and organization should be improved, preferably as part of academic education.
Aquablation in men with benign prostate hyperplasia: A systematic review and meta-analysis
Authors: Chen David C. , Qu Liang , Webb Howard , Qin Kirby , Chislett Bodie , Xue Alan , Khaleel Sari , De Jesus Escano Manuel , Chung Eric , Adam Ahmed , Bolton Damien , Perera Marlon 
Published: August 2022

Abstract

Objective
The aim of the study is to investigate improvements in lower urinary tract symptoms in men with benign prostatic hyperplasia (BPH) treated with prostatic Aquablation.

Materials and methods
We performed a literature search of clinical trials using the MEDLINE, Embase, and Cochrane Library databases and retrieved published works on Aquablation for the treatment of BPH up to August 2021. Unpublished works, case reports, conference proceedings, editorial comments, and letters were excluded. Risk of bias was assessed using the ROBINS-I tool. Raw means and mean differences were meta-analyzed to produce summary estimates for pre-versus post-International Prostate Symptom Scores, maximum flow rate, and male sexual health questionnaire value changes. An inverse-variance weighted random effects model was used.

Results
Seven studies were included in this review (n = 551 patients) that evaluated various urological parameters. At 3 months, the International Prostate Symptom Scores raw mean difference from baseline was −16.475 (95% confidence interval [CI], −15.264 to −17.686; p < 0.001), with improvements sustained for 12 months. Similarly, maximum flow rate improved by +1.96 (95% CI, 10.015 to 11.878; p < 0.001) from pre to post at 3 months postoperatively. In addition, the male sexual health questionnaire change pooled effect size was −0.55 (95% CI, −1.621 to 0.531; p = 0.321) from preintervention to postintervention at 3 months. Meta-analyses of some outcomes showed large statistical heterogeneity or evidence of publication bias.

Conclusions
Aquablation seems to improve lower urinary tract symptoms in men with BPH while providing relatively preserved sexual function. Further research is required to confirm these preliminary results.
An independent practice validation of the Prostate Imaging Reporting and Data System version 2 scoring system and the introduction of PDP (prostate-specific antigen density × PI-RADSv2) score to assist with further risk assessment
Authors: Patel Parth U. , Bock David , Hettinger Christian A. 
Published: August 2022

Abstract

Objectives
To provide concise information to clinicians on how to better interpret multiparametric magnetic resonance imaging for prostate cancer risk stratification.

Materials and methods
We analyzed 2 separate cohorts. For patients receiving a Prostate Imaging Reporting and Data System version 2 (PI-RADSv2) score of 1 or 2, we reviewed the charts of 226 patients who underwent multiparametric magnetic resonance imaging of the prostate ordered from 2015 to 2017 to determine who developed clinically significant prostate cancer (csPCa) by August 27, 2020. For patients receiving PI-RADSv2 a score of 3, 4, or 5, we reviewed the results of 733 fusion biopsies on solitary lesions. Statistical analysis was used to further determine risk factors for csPCa.

Results
Ten percent of men with PI-RADSv2 a score of 1 eventually developed csPCa. Seven percent with a score of 2 were eventually diagnosed with csPCa. Only 1 of 226 with a score of 1 or 2 developed metastasis. For PI-RADSv2 scores of 3, 4, and 5, csPCa was detected in 16%, 45%, and 67% of fusion biopsies. Peripheral zone (PZ) PI-RADSv2 score of 4 or 5 and prostate-specific antigen density (PSA-D) were significant predictors of csPCa on multivariable analysis. Using a PSA-D × PI-RADSv2 score of ≤0.39, we identified 38% of men with a PI-RADSv2 score of 3 in the PZ or 3, 4, or 5 in the transition zone who could have avoided a benign biopsy.

Conclusions
The vast majority of patients with PI-RADSv2 scores 1 and 2 can be safely monitored with close surveillance. Lesions with PI-RADSv2 scores of 4 and 5 in the PZ should be biopsied. Peripheral zone lesions with a PI-RADSv2 score of 3 and transition zone lesions with 3, 4, or 5 can be risk-stratified using the PSA-D × PI-RADSv2 score to determine who may safely avoid a biopsy and who should proceed to fusion biopsy.
Resistance Training in Patients With Coronary Artery Disease, Heart Failure, and Valvular Heart Disease
Authors: Bjarnason-Wehrens Birna , Schwaab Bernhard , Reiss Nils , Schmidt Thomas 
Published: August 2022

Purpose:
Current guidelines recommend individually adapted resistance training (RT) as a part of the exercise regime in patients with cardiovascular diseases. The aim of this review was to provide insights into current knowledge and understanding of how useful, feasible, safe, and effective RT is in patients with coronary artery disease (CAD), heart failure (HF), and valvular heart disease (VHD), with particular emphasis on the role of RT in elderly and/or frail patients.

Review Methods:
A review based on an intensive literature search: systematic reviews and meta-analyses published in 2010 or later; recent studies not integrated into meta-analyses or systematic reviews; additional manual searches.

Summary:
The results highlight the evaluation of effects and safety of RT in patients with CAD and HF with reduced ejection fraction (HFrEF) in numerous meta-analyses. In contrast, few studies have focused on RT in patients with HF with preserved ejection fraction (HFpEF) or VHD. Furthermore, few studies have addressed the feasibility and impact of RT in elderly cardiac patients, and data on the efficacy and safety of RT in frail elderly patients are limited. The review results underscore the high prevalence of age-related sarcopenia, disease-related skeletal muscle deconditioning, physical limitations, and frailty in older patients with cardiovascular diseases (CVD). They underline the need for individually tailored exercise concepts, including RT, aimed at improving functional status, mobility, physical performance and muscle strength in older patients. Furthermore, the importance of the use of assessment tools to diagnose frailty, mobility/functional capacity, and physical performance in the elderly admitted to cardiac rehabilitation is emphasized.
Effect of Intense Pulsed Light Therapy in Dry Eye Disease Caused by Meibomian Gland Dysfunction: A Systematic Review and Meta-Analysis
Authors: Miao Sen , Yan Ran , Jia Yusong , Pan Zhiqiang 
Published: August 2022

Background:
This study aimed to systematically evaluate the effect of intense pulsed light (IPL) therapy in patients harboring dry eye disease caused by meibomian gland dysfunction (MGD) based on qualified studies.

Methods:
The electronic databases, including PubMed, Cochrane, and Embase, were searched using keywords to identify available publications updated to November 2021. Relative risk or weighted mean difference combined with 95% confidence interval was used to synthesize the outcomes of included studies. The meta-analysis included 15 randomized controlled trials with 1,142 patients (2,284 eyes).

Results:
The results revealed that IPL could significantly decrease the ocular surface disease index (OSDI), standard patient evaluation of eye dryness (SPEED), artificial tear usage, tear film lipid layer, meibomian gland quality (MGQ), meibomian gland expression (MGX), and corneal fluorescein staining (CFS) while increase tear break-up time (TBUT) and noninvasive tear break-up time (NIBUT) compared with sham. Compared with MGX, IPL+MGX markedly decreased the SPEED, CFS, and tear meniscus height (TMH), but with increased TBUT. Compared with MGX, IPL showed significant effect in increasing the OSDI and TBUT, but decreasing the TMH and NIBUT. However, no significant differences were seen between IP+MGX and MGX in OSDI, MGQ, and MGX, nor between IPL and MGX in OSDI, SPEED, and TBUT.

Conclusion:
We identified that the application of IPL alone or IPL combined with MGX elicited superior clinical effect for improving the eye function and symptoms in the treatment of MGD-related dry eye disease, which is considered available for wide clinical application.