bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Lived Experience of DACA Recipients Who Are US Nursing Program Graduates and Their Pathways to Professional Licensure: A Phenomenological Study
Authors: Richardson Deborah C. , Welch Susan 
Published: May 2022

Abstract

AIM
This phenomenological study explored the experiences of Deferred Action for Childhood Arrivals (DACA) recipients who are nursing program graduates in the United States and their pathways to professional licensure.

BACKGROUND
DACA is a federal program facilitating lawful employment and higher education to qualified US immigrants. Understanding the experience of DACA recipients who have become registered nurses will inform nurse educators’ advocacy to create a more diverse nursing workforce.

METHOD
DACA recipients (n = 17) who were US nursing program graduates were interviewed to explore the phenomenon of a pathway to professional licensure.

RESULTS
The pathway to professional licensure emerged within four themes: pursuing the dream, finding support, figuring it out, and advocating for others.

CONCLUSION
To contribute to a diverse nursing workforce, the authors recommend that nurse educators advocate for policies to support DACA recipients who graduate from US nursing programs to achieve professional nursing licensure.
Evaluating the Effect of Pre-Exam Adaptive Quizzing on Nursing Student Exam Scores
Authors: Parcell Hillary , Morton Kelly , Froble Dana , Sheaves Crystal 
Published: May 2022

Abstract
Adaptive quizzing as a course requirement is presumed to proactively engage students to learn effectively while also promoting the mastery of course content. This study evaluates the strength of correlation between adaptive quizzing as a pre-exam course requirement and course exam success. Results showed a positive correlation between the number of adaptive quizzes completed and mastery level attained on course exam scores in the adaptive quizzing program.
Course of Headaches and Predictive Factors Associated With Analgesia Failure Following Spontaneous Subarachnoid Hemorrhage: A Prospective Cohort Study
Authors: Bouchier Baptiste , Demarquay Geneviève , Dailler Frédéric , Lukaszewicz Anne-Claire , Ritzenthaler Thomas 
Published: May 2022

Background:
Headache is the most common presenting symptom of spontaneous subarachnoid hemorrhage and managing this acute pain can be challenging. The aim of this study was to describe the course of headaches and factors associated with analgesic failure in patients with spontaneous subarachnoid hemorrhage.

Methods:
We conducted a prospective observational study in patients admitted to a neurocritical care unit (between April 2016 and March 2017) within 48 hours of spontaneous subarachnoid hemorrhage. Headache intensity was assessed using a Numerical Pain Rating Scale (NPRS) ranging from 0 to 10. Analgesic failure was defined as any day average NPRS score >3 after 72 hours of hospitalization despite analgesic treatment.

Results:
Sixty-three patients were included in the analysis. Thirty-six (56.25%) patients experienced at least 1 episode of severe headache (NPRS ≥7), and 40 (63.5%) patients still reported moderate to severe headache on the final day of the study (day 12). Forty-six (73.0%) patients required treatment with opioids and 37 (58.7%) experienced analgesic failure. Multivariable analysis showed that analgesic failure was associated with smoking history (odds ratio [OR]=4.31, 95% confidence interval [CI]: 1.23-17.07; P=0.027), subarachnoid blood load (OR=1.11, 95% CI: 1.01-1.24; P=0.032) and secondary complications, including rebleeding, hydrocephalus, delayed cerebral ischemia, hyponatremia, or death (OR=4.06, 95% CI: 1.17-15.77; P=0.032).

Conclusions:
Headaches following spontaneous subarachnoid hemorrhage are severe and persist during hospitalization despite standard pain-reducing strategies. We identified risk factors for analgesic failure in this population.
Performance of Statistical Indicators in the Objective Detection of Speech-Evoked Envelope Following Responses
Authors: Urichuk Matthew , Easwar Vijayalakshmi , Scollie Susan , Purcell David 
Published: May 2022

Objectives:
To assess the sensitivity of statistical indicators used for the objective detection of speech-evoked envelope following responses (EFRs) in infants and adults.

Design:
Twenty-three adults and 21 infants with normal hearing participated in this study. A modified/susa∫i/speech token was presented at 65 dB SPL monoaurally. Presentation level in infants was corrected using in-ear measurements. EFRs were recorded between high forehead and ipsilateral mastoid. Statistical post-processing was completed using F-test, Magnitude-Square Coherence, Rayleigh test, Rayleigh-Moore test, and Hotelling’s T2 test. Logistic regression models assessed the sensitivity of each statistical indicator in both infants and adults as a function of testing duration.

Results:
The Rayleigh-Moore and Rayleigh tests were the most sensitive statistical indicators for speech-evoked EFR detection in infants. Comparatively, Magnitude-Square Coherence and Hotelling’s T2 also provide clinical benefit for infants in all conditions after ~30 minutes of testing, whereas the F-test failed to detect responses to EFRs elicited by vowels with accuracy greater than chance. In contrast, the F-test was the most sensitive for vowel-elicited response detection for adults in short tests (<10 minute) and performed comparatively with the Rayleigh-Moore and Rayleigh test during longer test durations. Decreased sensitivity was observed in infants relative to adults across all testing durations and statistical indicators, but the effects were largest in low frequency stimuli and seemed to be mostly, but not wholly, caused by differences in response amplitude.

Conclusions:
The choice of statistical indicator significantly impacts the sensitivity of speech-evoked EFR detection. In both groups and for all stimuli, the Rayleigh test and Rayleigh-Moore tests have high sensitivity. Differences in EFR detection are present between infants and adults regardless of statistical indicator; however, these effects are largest for low-frequency EFR stimuli and for amplitude-based statistical indicators.
Resident physicians’ advice seeking and error making: A social networks approach
Authors: Katz-Navon Tal , Naveh Eitan 
Published: May 2022

Background
Resident physicians are especially at risk of being involved in medical errors because they bear tremendous responsibility for patient care yet are still in the process of learning and mastering their profession. To increase knowledge and gain information, they create a professional-instrumental network, that is, the deliberate initiation of advice ties with senior physicians.

Purpose
We aim to explore whether and how residents’ networking with senior physicians is associated with their error rates. Specifically, we aim to identify whether the centralities of residents (advice seekers) and senior physicians (advice givers) in the social network are associated with residents’ error rates.

Methodology
We surveyed 142 resident physicians working in 22 wards in two general hospitals about whom and how frequently they consult using a sociometric technique. Information about errors made in a 3-month period was collected independently.

Results
Residents made less errors when they sought advice from few senior physicians but consulted more frequently with focal senior physicians (those whom many other advice seekers frequently consult). However, when residents sought advice from many senior physicians, their frequency of consultation with focal senior physicians was not associated with their number of errors. These effects were more pronounced for residents at the beginning of their residency period.

Conclusions
Results of this study provide evidence of a specific association between resident physicians’ consultation patterns and their error rates.

Practice Implications
Results inform ward managers about ways to leverage opportunities and remove constraints for residents to ask for advice and for focal physicians to provide it.
The Effects of Partial Immersion Aquatic Intervention on Perceived Physical Competence and Quality of Life in Children With Severe Cerebral Palsy
Authors: Shelef Niv 
Published: May 2022

Background and Purpose:The efficiency of free sitting on function and reaching is restricted in those skills during activities of daily living (ADL) for children with severe cerebral palsy (CP). No longitudinal study so far has examined the stability of perceived competence (PC) and quality-of-life (QOL) domains for this population following water and land intervention environments more than 12 months of follow-up.Case Description:A mixed-methods multiple case design was employed. Five children with severe bilateral spastic CP subtypes (male: n = 4; female: n = 1) aged 10 to 15.4 years (mean = 11.7 years old, SD = 2.1), Gross Motor Function Classification System level IV, participated in the study.Intervention:The innovative “partial immersion approach” (PIA) uses Archimedes' principle to create a restorative therapeutic chair. This therapeutic chair enhances learned functional skills during sitting adaptation in an aquatic environment. It enables the adjustment of weight-bearing by 30 mm, which is transferred to a land environment for practice.Outcomes:All participants experienced adaptation improvement in ADL skills and task movement during free sitting on land and demonstrated quantitative psychological enhancement of PC, with a total increase of 70.60% (161 points) for all participants and a mean increase of 17.65% (40.25 points). Childrenʼs subjective qualitative responses were reinforced by comparing them with proxy objective reports. Each qualitative category that emerged was verified by quantitative data and matched positively and corresponded with major domains across data of QOL instruments.Discussion:Generalization from the findings is limited. The PIA regulates the percentage of weight-bearing from unloading-water toward loading-land and modified the environment for each childʼs needs. This customized environment improved the psychological enhancement of PC and QOL of the participants with severe CP. The successes were retained at the follow-up assessment 12 months after intervention, as participants still exhibited ADL motor acquisition of sitting skills.
Ai Chi for Balance, Pain, Functional Mobility, and Quality of Life in Adults
Authors: Dunlap Emily , Lambeck Johan , Ku Pei-Hsin , Gobert Denise 
Published: May 2022

Background:
Ai Chi is a specific form of mindful aquatic intervention related to Qigong and Tai Chi. Although evidence suggests that Qigong and Tai Chi are effective in reducing pain and improving balance, functional mobility, and quality of life (QOL), limited studies have explored the therapeutic benefits of Ai Chi.

Purpose:
To summarize available research on Ai Chi for balance, pain, functional mobility, and QOL in adults.

Methods:
Systematic search included PubMed, CINAHL, Health Source Nursing, PsycINFO, and SPORTDiscus databases. Selection criteria included randomized controlled trials (RCTs), nonrandomized controlled trials (NRCTs), and cohort studies with Ai Chi as the main intervention for adults with report of at least one standardized outcome measure for balance, pain, functional mobility, or QOL.

Results:
Twenty-two articles, with a total of 710 participants, met the inclusion criteria including 11 RCTs, 5 NRCTs, and 6 cohort studies. The age of participants ranged from 20 to 75 years. The most frequent study population was persons with Parkinson disease. This review also included studies with other populations such as adults with fibromyalgia, multiple sclerosis, chronic stroke, chronic low back pain, balance deficits, intellectual disability, and knee osteoarthritis, as well as healthy adults. Ai Chi intervention treatment dosage varied from 20 to 60 minutes, 1 to 12 times per week, for 1 to 20 weeks. Comparison groups included alternative aquatic interventions, land-based exercise, acupuncture, and nonintervention control. Six of the 22 studies were considered moderate to high quality.

Discussion:
The qualitative analysis reveals a number of favorable results with benefits from Ai Chi intervention and can guide future research.

Conclusions:
Heterogeneity between all studies precludes conclusive findings of results about the efficacy of Ai Chi from this review. Current evidence suggests a need for better designed controlled trials with a larger sample size to carefully control for bias and judiciously select outcomes.
Association of Preadmission Factors With Physician Assistant Student Diversity
Authors: Luck Morgan 
Published: May 2022

Purpose
A new physician assistant (PA) program accreditation standard requires institutional support for PA student diversity. Therefore, preadmission factors associated with diversity should be identified to inform decision-making. The purpose of this study was to explore associations between preadmission factors of interest and percentages of underrepresented minority (URM) students in PA programs.

Methods
Physician Assistant Education Association (PAEA) survey responses from 169 PA programs were analyzed by using simultaneous multiple regression. The variables included the standardized testing requirement of the Graduate Record Examinations (GRE), undergraduate preprofessional phase, public or private institution, writing sample requirement, mission statement inclusive of care for underserved populations, and local racial or ethnic demographics.

Results
GRE score requirements were found to be negatively associated with percentages of African American and total non-White, non-Asian students (p < .05). Local URM racial and ethnic population demographics were shown to be positively associated with African American, Hispanic, and total non-White, non-Asian students (p < .05). Undergraduate preprofessional phase, type of institution, writing sample requirement, and mission statement supportive of underserved populations did not show significant associations with URM diversity.

Conclusions
Faculty and administration members who are involved in decision-making in PA admissions processes should consider the potentially negative impact of a GRE requirement as it relates to the percentages of African American and total non-White, non-Asian matriculants. Educational institutions might also consider exploring new PA program development in geographic areas with supportive local demographics as an approach to achieving more student diversity.
Aquatic Exercise and Its Effect on Participation, Quality of Life, and Falls Self-efficacy in Older Adults: A Pilot Study
Authors: Michaels Natalie Norman , Espiritu Elena Wong , Broecker Megan , Gonyea Stephanie , Hendricks Tori , McClintock Kelli , Sanders Katherine , Stelbasky Danielle 
Published: May 2022

Background:
Falls are extremely common in the older adult population, and fear of falling has been cited as one of the main reasons older adults may choose not to participate in social activities. Exercising in the water can provide support from buoyancy that helps reduce this fear, leading to increased participation in meaningful activities.

Purpose:
The purpose of this mixed-methods research study was to determine whether participation in an aquatic exercise program was an effective way to increase falls self-efficacy, social participation, and quality of life in older adults.

Methods:
Twelve adults, aged 62 to 77 years, participated in 1-hour aquatic exercise sessions, twice per week for 4 weeks. Participants completed a demographic questionnaire, and 3 pre/posttest measures: the Keele Assessment of Participation (Keele), the Falls Efficacy Scale-International (FES-I) for falls self-efficacy, and the World Health Organization's Quality of Life Scale (WHOQOL-BREF) for quality of life. They also completed an expectations check sheet and one open-ended question asking about the meaning and effect of the program.

Results:
Although there were no significant differences found between pre/posttest scores on the Keele, there was a statistically significant difference in reported falls self-efficacy with respect to ability to climb and descend stairs (P = .046). There was also a statistically significant difference on the WHOQOL-BREF for access to available information (P = .025) and for participant satisfaction with ability in performing activities of daily living (P = .046), as well as a significant increase in the number of anticipated benefits versus the number of gained benefits (P = .032). Qualitatively, participants reported improved body functions, increased social interactions, and experiencing enjoyment and motivation with the change in activity. Relevance: Participation in aquatic exercise may have positive effects on falls self-efficacy, social participation, and quality of life in older adults. This was a small sample size, however, and further research is recommended.
Association Between Trait Energy and Fatigue and Aquatic Functional Tests: An Exploratory Study
Authors: Boolani Ali , Allen Amy , Barrios Nathalie , Sames Carol 
Published: May 2022

Background:
Recent studies have reported energy and fatigue as two separate moods. Interestingly, a recent study reported associations between over-ground functional assessments scores in older adults and feelings of energy, but no significant association between functional status and feelings of fatigue.

Purpose:
The purpose of this exploratory study is to assess an association between trait mental and physical energy and fatigue and functional assessments in an aquatic setting.

Methodlogy:
Participants (n=16) in a community aquatic exercise program completed a series of functional assessments; 30-second aquatic sit-to-stand, 7.64-m aquatic walk, and 6-minute walk (6MWT). Assessments for the participants were performed on the first day of aquatics exercise and every 12 weeks thereafter between September 2019 and March 2020. Trait mental and physical energy and fatigue were measured prior to the assessments using the Mental and Physical State and Trait Energy and Fatigue Scales. Using a Wilcoxon rank test, we determined that there were no significant differences between the baseline and 12-week assessments for all trait moods and all functional assessments. Using the Spearman's rho bivariate correlation, we determined that those who reported a higher trait physical energy walked further during the 6MWT and completed the 7.64-m walk quicker.

Results:
Our findings indicate that the relationship between feelings of physical energy and functional status is also true in an aquatic setting.

Conclusion:
Clinicians can utilize the findings of our study to design holistic programs that may increase functional status and feelings of physical energy in populations of adults with chronic diseases.
Research Report: Efficacy and Safety of a Novel Aquatic Device for Children With Postural Dysfunction
Authors: Breighner Joshua , Saavedra Sandra , Snowdon Donna 
Published: May 2022

Background and Purpose:
Children with postural dysfunction often enjoy aquatic activities but are limited in their ability to play and interact in the water due to limited motor control and safety concerns. The purpose of this study was to explore the benefits of postural contexts provided by a novel aquatic device (Water Strider) in children with postural dysfunction. Providing stable vertical support is hypothesized to improve overall environmental interactions/social engagement and increase safety, autonomy, and motivation for movement (kicking and reaching).

Methods:
The proposed device provided external support that could be modified on the basis of user-specific level of head and trunk control. Feasibility, safety, and efficacy of the device were tested for 9 children (aged 2-8 years) with postural dysfunction (7 with cerebral palsy). For this purpose, a 10-minute aquatic trial for baseline aquatic activities along with use of the Water Strider was performed for comparison with video behavior coding to quantify arm and leg movements, assistance, and hazardous events (water in eyes or water in mouth).

Results:
Total assistance required significantly decreased from baseline (100%) to the Water Strider (21%; F
1,8 = 384.4, P ≤ .001), and significantly fewer instances where children were found to have water in their mouth occurred across all participants (baseline: 12 events; Water Strider: 0 events). Significant increase in total leg movement/reciprocal kicking (F
1,8 = 8.84, P < .001; F
1,8 = 11.1, P = .003) and decrease in arm movements (F
1,8 = 0.036, P < .001) with relation to the level of trunk control were also observed.
Towards a system-level causative knowledge of pollinator communities
Authors: Saavedra Serguei , Bartomeus Ignasi , Godoy Oscar , Rohr Rudolf P. , Zu Penguan 
Published: May 2022

Pollination plays a central role in both crop production and maintaining biodiversity. However, habitat loss, pesticides, invasive species and larger environmental fluctuations are contributing to a dramatic decline of pollinators worldwide. Different management solutions require knowledge of how ecological communities will respond following interventions. Yet, anticipating the response of these systems to interventions remains extremely challenging due to the unpredictable nature of ecological communities, whose nonlinear behaviour depends on the specific details of species interactions and the various unknown or unmeasured confounding factors. Here, we propose that this knowledge can be derived by following a probabilistic systems analysis rooted on non-parametric causal inference. The main outcome of this analysis is to estimate the extent to which a hypothesized cause can increase or decrease the probability that a given effect happens without making assumptions about the form of the cause–effect relationship. We discuss a road map for how this analysis can be accomplished with the aim of increasing our system-level causative knowledge of natural communities.
This article is part of the theme issue ‘Natural processes influencing pollinator health: from chemistry to landscapes’.
Pollinator selection against toxic nectar as a key facilitator of a plant invasion
Authors: Egan Paul A. , Stevenson Philip C. , Stout Jane C. 
Published: May 2022

Plant compounds associated with herbivore defence occur widely in floral nectar and can impact pollinator health. We showed previously thatRhododendron ponticumnectar contains grayanotoxin I (GTX I) at concentrations that are lethal or sublethal to honeybees and a solitary bee in the plant's non-native range in Ireland. Here we further examined this conflict and tested the hypotheses that nectar GTX I is subject to negative pollinator-mediated selection in the non-native range, but that phenotypic linkage between GTX I levels in nectar and leaves acts as a constraint on independent evolution. We found that nectar GTX I experienced negative directional selection in the non-native range, in contrast to the native Iberian range, and that the magnitude and frequency of pollinator limitation indicated that selection was pollinator-mediated. Surprisingly, nectar GTX I levels were decoupled from those of leaves in the non-native range, which may have assisted post-invasion evolution of nectar without compromising the anti-herbivore function of GTX I (here demonstrated in bioassays with an ecologically relevant herbivore). Our study emphasizes the centrality of pollinator health as a concept linked to the invasion process, and how post-invasion evolution can be targeted toward minimizing lethal or sub-lethal effects on pollinators.This article is part of the theme issue ‘Natural processes influencing pollinator health: from chemistry to landscapes’.