bluuebunny/crossref_metadata_2025_split huggingface dataset:
Managing community engagement initiatives in health and social care: lessons learned from Italy and the United Kingdom
Authors: Longo Francesco , Barsanti Sara , Bonciani Manila , Bunea Anita , Zazzera Angelica 
Published: April 2022

Background
Determining the different features and potential impacts of community initiatives aimed at health-related outcomes poses challenges for both researchers and policy makers.

Purpose
This article explores the nature of heterogeneous “community engagement initiatives” (CEIs) considering both their social and organizational features in order to understand the managerial and policy implications to maximize their potential local health and social care-related impacts.

Methodology
A threefold qualitative analysis was conducted: (a) Three frameworks were developed to classify and analyze different CEIs features, building upon the current literature debate; (b) primary data were collected from Italian CEIs; and (c) a comparative cross-case analysis of a total of 79 CEIs in Italy and the United Kingdom was implemented.

Findings
The results show two types of strategic policy and management implications: (a) CEI portfolios are very broad and differentiated; (b) different social networks have diversified social constructs, internal cultures, and organizational features; and (c) there is a consequent need to contextualize relational and steering approaches in order to maximize their potential community added value.

Conclusion
CEIs are fundamental pillars of contemporary welfare systems because of both the changing demography and epidemiology and the disruptive impact of platform economy models. This challenging scenario and the related CEIs involve a complex social mechanism, which requires a new awareness and strengthened competences for public administrations’ steering.

Practice Implications
It is crucial for policy makers and managers to become familiar with all the different CEIs available in order to choose which solution to implement, depending on their potential impacts related to local public health and social care priorities. They also need to select the related effective steering logic.
Rethinking how health care professionals cope with stress: A process model for COVID-19 and beyond
Authors: Harley Jason M. , Montreuil Tina C. , Lou Nigel Mantou , Feldman Liane S. , Fried Gerald M. , Lavoie-Tremblay Mélanie , Bhanji Farhan , Kennedy Heather 
Published: April 2022

Issue
Prior to the COVID-19 pandemic, there was evidence of challenges surrounding the psychological well-being of health care professionals (HCPs). HCPs already frayed psychological ability to cope risks being further compromised by COVID-19-related stresses.

Critical Theoretical Analysis
Most research on stress, psychological distress, and coping among HCPs is done in a piecemeal manner without a theoretical model connecting these different but related phenomena. This critical advancement article aims to apply and extend Wheaton and Montazer’s model of stressors, stress, and distress to the literature on HCPs, generally, and COVID-19, specifically, to summarize past and guide future research on HCPs’ mental health, resilience, and coping. Our model describes how different sources of support buffer the effect of stressors on stress and how coping strategies moderate the effect of stress on psychological distress.

Advance
We extended the model by (a) distinguishing context from the support in HCPs’ environment; (b) distinguishing adaptive from maladaptive coping strategies and their relationships with antecedents and outcomes; (c) describing the adverse impacts that psychological distress has on patients, HCPs, and health services; and (d) describing how such outcomes can become stressors, in turn, further contributing to HCPs’ stress in a vicious cycle.

Practice Implications
Our model provides a broader perspective of HCPs’ work-related mental health and helps guide the creation, implementation, and evaluation of different sources of support and promote adaptive coping strategies. This model helps HCPs, researchers, and health services managers better understand and respond to the well-being crisis HCPs are facing, especially during the pandemic.
Hybrid 23/25-Gauge Direct Perfluorocarbon Liquid—Silicone Oil Exchange
Authors: Elhusseiny Abdelrahman M. , Sanders Riley N. , Ellabban Abdallah A. , Sallam Ahmed B. 
Published: April 2022

Purpose:To describe a novel technique for direct perfluorocarbon liquid (PFCL)-silicone oil exchange that aims to reduce the inherent risk of intraoperative intraocular pressure spike.Methods:We use the conventional setup for passive PFCL–silicone exchange, but intentionally create a mismatch between the passive PFCL aspiration and the active silicone injection that favors the PFCL extrusion. This is achieved by converting one port to a large gauge one—23 or 20-gauge.Results:We did not note the occurrence of high intraocular pressure spikes with this technique as noted by disk pallor or attenuated vessels.Conclusion:A hybrid 23/25-gauge technique for direct PFCL–silicone oil exchange is safe and reduces the risk of intraoperative intraocular pressure spike.
Oxygen-supplemented transepithelial-accelerated corneal crosslinking with pulsed irradiation for progressive keratoconus: 1 year outcomes
Authors: Cronin Brendan , Ghosh Atanu , Chang Clark Y. 
Published: April 2022

Purpose:
To investigate the effects of combining oxygen supplementation with enhanced UV-A light and increased riboflavin permeability in improving the efficacy of epithelium-on crosslinking (epi-on CXL).

Setting:
Private eye clinic in Brisbane, Queensland, Australia.

Design:
Retrospective single-center nonrandomized uncontrolled longitudinal cohort case series.

Methods:
Transepithelial CXL was performed on keratoconic eyes. Applications of an oxygen goggle and pulsed UV-A irradiation (1 second on, 1 second off) were used to enhance oxygen kinetics during epi-on CXL. Additional procedural modifications included the use of benzalkonium chloride and high UV-A irradiance level (30 mW/cm2) to improve the stromal bioavailability of riboflavin and UV-A. The main efficacy outcomes were the changes in mean corrected distance visual acuity (CDVA) and safety over 12 months. Additional refractive and keratometry (K) outcomes were also observed.

Results:
53 eyes (38 patients) were included in this study. 12 months postoperatively, mean CDVA improved from a mean of 0.18 ± 0.2 at baseline to 0.07 ± 0.1 logMAR (P < .0001). No statistically significant change was observed in maximum K (Kmax) and mean K, which were respectively 51.7 ± 5.8 diopters (D) and 46.4 ± 3.85 D at baseline and 51.2 ± 5.7 D (P = .152) and 46.0 ± 3.84 D (P = .06) 12 months postoperatively. Only 3 eyes experienced an increase of more than 2 D in Kmax; however, none of these eyes experienced a CDVA loss. There were no reported infections, corneal scarring, or other severe adverse effects.

Conclusions:
Performing supplemental oxygen epi-on CXL with accelerated, pulsed UV-A irradiation in conjunction with riboflavin permeability enhancers resulted in improved CDVA (P < .0001) and stable keratometry up to 12 months postoperatively with a good safety profile.
Mechanisms of an App-Based Physical Activity Intervention and Maintenance in Community-Dwelling Women
Authors: Fukuoka Yoshimi , Haskell William , Vittinghoff Eric 
Published: April 2022

Background
Understanding the mechanism of interventions that increase physical activity (PA) is critical to developing robust intervention strategies.

Aims
This study aims to examine the mediation effects of hypothesized changes in self-efficacy, social support, and barriers on daily changes in accelerometer-measured steps and the duration of moderate to vigorous PA over 3-month intervention and 6-month maintenance periods with a mobile phone–based PA education program.

Methods
Data were analyzed for a total of 210 physically inactive women who were randomized. The mean (SD) age was 52.4 (11.0) years. The framework of Baron and Kenny and the Sobel test were used to evaluate the proportion of the treatment effect explained by mediation factors.

Results
Postintervention PA changes were mediated by a reduction in self-efficacy and barriers and an increase in social support from friends during the intervention and maintenance periods (P ≤ .05). However, social support from family was significant only during the intervention, but not the maintenance (P = .90). Barriers to PA had the largest mediation effect on the intervention, explaining 13% to 16% of the 3-month intervention effect and 14% to 19% of the 6-month maintenance effect on daily steps and duration of moderate to vigorous PA minutes (P ≤ .05).

Conclusions
Incorporating strategies for overcoming PA barriers and promoting social support for PA is important for the design of interventions for physically inactive women. However, a reduction in self-efficacy was observed in the intervention group at 3 and 9 months as compared with the control group. This unexpected finding requires further investigation.
Responding to the Challenges and Barriers Unique to Rural Appalachian Sexual Assault Nurse Examiner Programs
Authors: Treat Sarah , Vanhook Patricia , Hendrix Lenee’ , Wallace Kelsey , McCook Judy G. 
Published: April 2022

ABSTRACT
The purpose of this article is to explore the opportunities and barriers challenging sexual assault nurse examiners (SANEs) operating in rural and underserved areas. These challenges include the absence of established SANE programs, patient isolation and poverty, inadequate community support, and ensuring program sustainability. While not specific to rural communities, these challenges and barriers are further exacerbated by long-held beliefs and misconceptions that exist in small, close-knit communities. To mitigate these challenges, SANE programs in rural communities are asked to respond with creative and unique solutions. Through strong community partnerships and carefully coordinated efforts, SANE programs can thrive in even the most isolated and economically depressed rural communities.
Physiologic and compositional coronary artery disease extension in patients with takotsubo syndrome assessed using artificial intelligence: an optical coherence tomography study
Authors: Kumar Sant , Chu Miao , Tu Shengxian , Kuku Kayode O. , Kahsay Yirga , Gonzalo Nieves , Salazar Carlos Hernando , Alfonso Fernando , Garcia-Garcia Hector M. 
Published: April 2022

Background
Takotsubo syndrome (TTS) is an acute and reversible ventricular motion abnormality without epicardial coronary obstruction. Optical flow ratio (OFR) is an approach to evaluate the coronary stenosis significance based on three-dimensional optical coherence tomography (3D-OCT). The aim of this study is to utilize OCT and an artificial intelligence plaque characterization model to show the prevalence and composition of atherosclerotic disease in coronary vessels of patients with TTS.

Methods
This is a retrospective and observational study which enrolled patients with TTS who underwent coronary angiography and OCT examination. OCT images were analyzed for tissue characterization and OFR computation using a novel artificial intelligence algorithm.

Results
A total of 37 patients and 49 vessels were studied. All patients were imaged in the left anterior descending coronary artery (LAD) and about two-thirds were also imaged in the left circumflex coronary artery (LCX). Most patients were women (n = 35), and apical was the most common takotsubo type. Tissue composition analysis yielded the following overall plaque types: fibrous (67.1%), lipid (15.5%), and calcium (3.77%). The mean OFR for LAD and LCX was 0.97 ± 0.04 and 0.98 ± 0.02, respectively.

Conclusion
Utilizing automatic plaque characterization on OCT images by artificial intelligence, we found that TTS patients have coronary artery disease (i.e. presence of lipid, calcified, or fibrous tissue). The advent of artificial intelligence methods may allow for large-scale studies of patients with TTS.
Fluvoxamine in Nonhospitalized Patients With Acute COVID-19 Infection and the Lack of Efficacy in Reducing Rates of Hospitalization, Mechanical Ventilation, and Mortality in Placebo-Controlled Trials: A Systematic Review and Meta-Analysis
Authors: Bhuta Sapan , Khokher Waleed , Kesireddy Nithin , Iftikhar Saffa , Beran Azizullah , Mhanna Mohammed , Patel Neha J. , Patel Mitra , Burmeister Cameron , Assaly Ragheb 
Published: April 2022

Background:
Recent clinical trials have investigated the use of fluvoxamine in preventing clinical deterioration in nonhospitalized patients with acute COVID-19 infection via stimulation of sigma-1 receptors, which regulates cytokine production and functional inhibition of acid sphingomyelinase activity, which may prevent infection of epithelial cells with SARS-CoV-2. However, the role of fluvoxamine is currently unclear because of a paucity of studies, particularly because the drug is being repurposed as an immunomodulatory and antiviral agent.

Study Question:
Aim of our meta-analysis was to investigate the efficacy of fluvoxamine in nonhospitalized patients with acute COVID-19 infection.

Data Source:
Comprehensive literature search of PubMed, Embase, Cochrane Library databases, and Web of Science was performed from inception to February 10, 2022, for studies comparing fluvoxamine versus placebo for outpatient management of COVID-19.

Study Design:
The primary outcome of interest was rate of hospitalization. The secondary outcomes were rates of patients requiring mechanical ventilation and mortality. The random-effects model was used to calculate the risk ratios (RR) and confidence intervals (CI). A P value <0.05 was considered statistically significant. Heterogeneity was assessed using the Higgins I2 index.

Results:
Three studies (2 randomized controlled trials and one prospective cohort trial) involving 1762 patients were included in the meta-analysis. In patients who received fluvoxamine compared with placebo, there was no significant difference in rates of hospitalization (RR 0.26, 95% CI, 0.04–1.73, P = 0.16, I2 = 62%), mechanical ventilation (RR 0.73, 95% CI, 0.45–1.19, P = 0.21, I2 = 0%), and mortality (RR 0.67, 95% CI, 0.37–1.22, P = 0.19, I2 = 0%).

Conclusion:
Current evidence does not indicate a significant effect of fluvoxamine on the rates of hospitalization, mechanical ventilation, and mortality of patients with COVID-19 infection.
Symptoms of Paranoia Experienced by Students of Pakistani Heritage in England
Authors: Elahi Anam , McIntyre Jason C. , Thomas Justin , Abernethy Louise , Bentall Richard P. , White Ross G. 
Published: April 2022

Abstract
Individuals belonging to ethnic minority groups are less likely to experience symptoms of psychosis, such as paranoia, if they live in areas with high proportions of people from the same ethnic background. This effect may be due to processes associated with group belonging (social identification). We examined whether the relationship between perceived discrimination and paranoia was moderated by explicit and implicit Pakistani/English identification among students of Pakistani heritage (N = 119). Participants completed measures of explicit and implicit Pakistani and English identity, a measure of perceived discrimination, and a measure of paranoia. Perceived discrimination was the strongest predictor of paranoia (0.31). Implicit identities moderated the relationship between perceived discrimination and paranoia (−0.17). The findings suggest that higher levels of implicit Pakistani identity were most protective against high levels of paranoia (0.26, with low implicit English identity; 0.78, with medium English identity; 1.46, with high English identity). Overall, a complex relationship between identity and paranoia was apparent.
Developing New Clinical Nurse Specialist Educational Opportunities in Ambulatory Care Settings
Authors: Urton Michael S. , Reis Pamela , Cowin Pamela Bailey , Linder Julie Michelle 
Published: April 2022

Purpose
The purpose of this project was to develop an ambulatory clinical practicum for clinical nurse specialist (CNS) students in rural and underserved Eastern North Carolina.

Description of the Program
A 14-week clinical practicum was designed for CNS students who participated in a Health Resources and Services Administration Advanced Nursing Education Workforce grant–sponsored program entitled “Advanced Practice Registered Nurse RURAL Scholars Program.” The objectives of the clinical practicum were to increase student competence in ambulatory care, identify critical knowledge and competencies in CNS ambulatory care, and determine potential opportunities for CNS practice in ambulatory settings.

Outcome
Students demonstrated increased awareness and interest in specific health challenges faced by rural and underserved communities and became aware of services available for individuals with complex healthcare needs. Deficiencies in the CNS curricula regarding ambulatory care were identified by students. Although the value of the CNS in ambulatory practice was appreciated by students, staff, and preceptors alike, opportunities for employment in ambulatory settings in rural and underserved communities continue to remain a challenge.

Conclusion
Student experiences in an ambulatory care CNS clinical practicum support the need for the development of knowledge and competencies in ambulatory care that will allow for the expansion of CNS practice in rural and underserved communities.
The Implementation of the Graduate Nurse Role to Support Nursing Staff During the COVID-19 Pandemic
Authors: Plamondon Cassandra , Peterson Kym , Baker Kathy M. , Barsamian Jenny , Grillo Darcy Ann Marie , Mackinson Lynn , Milano Andrea , Mills Lauren B. 
Published: April 2022

Purpose/Objectives
The purpose is to describe the development and implementation of an onboarding program that successfully oriented and supported graduate nurses (GNs) in their transition to practice during the first COVID-19 pandemic surge.

Description of the Program
The program was developed utilizing Benner's novice-to-expert model with consideration of the Institute of Medicine's report: The Future of Nursing: Leading Change, Advancing Health as an evidence-based theoretical framework and structure. The GN orientation consisted of 3 phases that began upon initial hire into the role and ended after they transitioned into the entry-level registered nurse (RN) role.

Outcomes
Fifteen of the 16 GNs hired passed the NCLEX-RN examination and transitioned to the entry-level RN. After transitioning, GNs were surveyed to assess comfort levels with professional nursing roles and to identify knowledge gaps and areas for improvement. Six categories emerged for discussion: (1) work experience, (2) communication and feedback, (3) support, (4) clinical confidence, (5) workload, and (6) transition challenges. Implications to consider for future programs are to improve communication surrounding the GN role and limiting the number of preceptors during orientation.

Conclusions
A 3-phased approach to orientation was successful in onboarding and supporting GNs in their transition to practice.
Association Between Continuous Kidney Replacement Therapy Clearance and Outcome in Pediatric Patients With Hyperammonemia Not Due to Inborn Error of Metabolism
Authors: Starr Michelle C. , Cater Daniel T. , Wilson Amy C. , Wallace Samantha , Bennett William E. , Hains David S. 
Published: April 2022

OBJECTIVES:
To describe a single-center experience of pediatric patients with hyperammonemia not due to inborn errors of metabolism and determine the association between use of continuous kidney replacement therapy (CKRT) treatment and outcomes.

DESIGN:
Retrospective cohort study.

SETTING:
Tertiary-care children's hospital.

PATIENTS:
All children less than 21 years old admitted to the hospital with hyperammonemia defined as an elevated ammonia levels (>100 µmol/L) not due to inborn error of metabolism.

INTERVENTIONS:
None.

MEASURES AND MAIN RESULTS:
Of 135 children with hyperammonemia, the most common reason for admission was infection in 57 of 135 (42%), congenital heart disease in 20 of 135 (14%), and bone marrow transplantation in 10 of 135 (7%). The overall mortality was 61% (82 of 135), which increased with degree of hyperammonemia (17 of 23 [74%] in those with ammonia >250 µmol/L). After multivariable regression, hyperammonemia severity was not associated with mortality (aOR, 1.4; 95% CI, 0.92–2.1; p = 0.11). Of the 43 patients (32%) receiving CKRT, 21 were prescribed standard clearance and 22 high clearance. The most common indications for CKRT were fluid overload in 17 of 43 (42%) and acute kidney injury or uremia in 16 of 43 (37%). Mean CKRT duration was 13 days. There was no difference between standard and high clearance groups in risk of death (76% vs 86%; p = 0.39), cerebral edema on CT scan (19% vs 27%; p = 0.52), nor decrease in ammonia levels after 24 or 48 hours of CKRT (p = 0.20, p = 0.94). Among those receiving CKRT, we failed to find an association between high clearance and decreased risk of death in multivariable analysis (aOR, 1.2; 95% CI, 0.64–2.3; p = 0.55).

CONCLUSIONS:
In our single-center retrospective study, we failed to find an association between clearance on CKRT and improved survival nor decreased cerebral edema on head imaging. In fact, we failed to find an association between ammonia level and mortality, after controlling for illness severity.
Face Lift Practice Patterns: An American Society of Plastic Surgeons Member Survey, 2000 and 2020. How Much Have We Changed?
Authors: Sinclair Nicholas R. , Kochuba Andrew , Coombs Demetrius M. , Couto Rafael A. , Charafeddine Ali H. , Grow Jacob , Matarasso Alan , Zins James E. 
Published: April 2022

Background:
In 2000, Matarasso et al. performed a survey of American Society of Plastic Surgeons members’ face lift practice patterns. Since that publication, the aesthetic marketplace has changed dramatically, as have ancillary face lift techniques. In an attempt to detail these changes, we repeated that original survey, adding questions to address more recent technical issues and advances. The goal of this report was to define current face lift practice patterns, compare current patterns to the previous ones, and define recent advances.

Methods:
A 38-question survey assessing face lift techniques, perioperative management, complications, and concomitant procedures was electronically distributed to a random cohort of American Society of Plastic Surgeons members. Data were recorded and statistically analyzed utilizing the Pearson chi-square test.

Results:
A total of 251 forms were returned and analyzed. Details of demographics, face lift techniques, ancillary procedures, perioperative care, and complications are presented. Current results were compared to the previously published society member practice patterns delineated in the 2000 Plastic and Reconstructive Surgery publication.

Conclusions:
The basic approach of American Society of Plastic Surgeons members to the face lift operation has not changed dramatically over the past 20 years. The development of operative adjuncts, however, has been positive, including fat grafting techniques, concomitant use of skin resurfacing, and means of minimizing blood loss with tranexamic acid. In certain instances, respondents do not follow evidence-based guidelines for perioperative care. Finally, common complications of practicing members appear to coincide with published retrospective reviews.