bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reverse Remodeling Following Valve Replacement in Coexisting Aortic Stenosis and Transthyretin Cardiac Amyloidosis
Authors: Nitsche Christian , Koschutnik Matthias , Donà Carolina , Radun Richard , Mascherbauer Katharina , Kammerlander Andreas , Heitzinger Gregor , Dannenberg Varius , Spinka Georg , Halavina Kseniya , Winter Max-Paul , Calabretta Raffaella , Hacker Marcus , Agis Hermine , Rosenhek Raphael , Bartko Philipp , Hengstenberg Christian , Treibel Thomas , Mascherbauer Julia , Goliasch Georg 
Published: July 2022

Background:
Dual pathology of severe aortic stenosis (AS) and transthyretin cardiac amyloidosis (ATTR) is increasingly recognized. Evolution of symptoms, biomarkers, and myocardial mechanics in AS-ATTR following valve replacement is unknown. We aimed to characterize reverse remodeling in AS-ATTR and compared with lone AS.

Methods:
Consecutive patients referred for transcatheter aortic valve replacement (TAVR) underwent ATTR screening by blinded 99mTc-DPD bone scintigraphy (Perugini Grade-0 negative, 1–3 increasingly positive) before intervention. ATTR was diagnosed by DPD and absence of monoclonal protein. Reverse remodeling was assessed by comprehensive evaluation before TAVR and at 1 year.

Results:

One hundred twenty patients (81.8±6.3 years, 51.7% male, 95 lone AS, 25 AS-ATTR) with complete follow-up were studied. At 12 months (interquartile range, 7–17) after TAVR, both groups experienced significant symptomatic improvement by New York Heart Association functional class (both
P
<0.001). Yet, AS-ATTR remained more symptomatic (New York Heart Association ≥III: 36.0% versus 13.8;
P
=0.01) with higher residual NT-proBNP (N-terminal pro-brain natriuretic peptide) levels (
P
<0.001). Remodeling by echocardiography showed left ventricular mass regression only for lone AS (
P
=0.002) but not AS-ATTR (
P
=0.5). Global longitudinal strains improved similarly in both groups. Conversely, improvement of regional longitudinal strain showed a base-to-apex gradient in AS-ATTR, whereas all but apical segments improved in lone AS. This led to the development of an apical sparing pattern in AS-ATTR only after TAVR.

Conclusions:
Patterns of reverse remodeling differ from lone AS to AS-ATTR, with both groups experiencing symptomatic improvement by TAVR. After AS treatment, AS-ATTR transfers into a lone ATTR cardiomyopathy phenotype.
Qualitative Study of Long‐Term Cardiac Arrest Survivors’ Challenges and Recommendations for Improving Survivorship
Authors: Presciutti Alex , Siry‐Bove Bonnie , Newman Mary M. , Elmer Jonathan , Grigsby Jim , Masters Kevin S. , Shaffer Jonathan A. , Vranceanu Ana‐Maria , Perman Sarah M. 
Published: July 2022

Background
Cardiac arrest survivorship refers to the lived experience of long‐term survivors of cardiac arrest and the many postdischarge challenges they experience. We aimed to gather a nuanced understanding of these challenges and of survivors' perceptions of ways to improve the recovery process.

Methods and Results
We conducted 15 semistructured, one‐on‐one interviews with cardiac arrest survivor members of the Sudden Cardiac Arrest Foundation; the interviews were conducted by telephone and recorded and transcribed verbatim. We used thematic analysis, informed by the Framework Method, to identify underlying themes regarding cardiac arrest survivorship challenges and recommendations to improve cardiac arrest survivorship. Regarding challenges, the overarching theme was a feeling of unpreparedness to confront postarrest challenges because of lack of resources, education, and appropriate expectations for recovery. Regarding recommendations, we uncovered 3 overarching themes including systemic recommendations (eg, providing appropriate resources and expectations, educating providers about survivorship, following up with survivors, including caregivers in treatment planning), social recommendations (eg, attending peer support groups, spending time with loved ones, providing support resources for family members), and individual coping recommendations (eg, acceptance, resilience, regaining control, seeking treatment, focusing on meaning and purpose).

Conclusions
We described common challenges that survivors of cardiac arrest face, such as lacking resources, education, and appropriate expectations for recovery. Additionally, we identified promising pathways that may improve cardiac arrest survivorship at systemic, social, and individual coping levels. Future studies could use our findings as targets for interventions to support and improve survivorship.
The Oregon District Shooting: Reviewing the Pre-Hospital Protocols and the Role of the Resident During a Multiple Casualty Event
Authors: Walk Casey T. , Ross Ashleigh , Kranker Lindsey , Whitmill Mellissa , Ballester Michael , Parikh Priti P. , Semon Gregory , Ekeh Akpofure P. 
Published: July 2022

Background: Review of multiple casualty events (MCEs) protocols in an academic trauma center and more importantly role of residents in management of MCEs has not been discussed. Also, no real-world examples have been described. This study reviews utilization of multiple casualty protocols by the area hospitals and EMS along with role of residents in one such real-world MCE Methods: A mass shooting event in the Oregon District in Dayton, Ohio from 2019 was reviewed. MCE protocols from a Level I trauma center were reviewed as well as patient outcomes and role of residents. Results: A total of 10 casualties were observed and 38 patients presented to hospitals throughout the city. There were 25 patients presented to the Level I trauma center, 1 to the Level II trauma center, and 12 to the Level III trauma centers in the community. Surgical and Emergency residents performed initial triage upon arrival to the ED, managed resuscitation, and performed various procedures under supervision of attending staff. A total of 5 patients required emergent surgery and 4 patients required tourniquets. All patients that were presented to the hospitals survived. Conclusion: MCEs are going to continue, and healthcare systems should have protocols in place. Residents are a valuable resource to hospital systems that provide trauma services. Creation of a protocol with the assistance of EMS will allow first responders to utilize resources available. We recommend testing of this protocol, as an MCE in your area may not be a matter of if, but when.
Does eradication of superficial vein incompetence after superficial vein thrombosis reduce the risk of recurrence and of deep vein thrombosis? A pilot study evaluating clinical practice in Örebro county, Sweden
Authors: Åström Håkan , Blomgren Lena 
Published: July 2022

Background Elective eradication of superficial vein incompetence (SVI) is advocated after superficial vein thrombosis (SVT) to prevent venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), and to prevent recurrent SVT. However, this practice currently lacks evidence and not all SVT patients are referred. Method Pilot study based on retrospective review of medical records for patients in Örebro county, Sweden; diagnosed with SVT during 2019. Patients in primary care without venous intervention were compared with patients from a vascular service treated with eradication for SVI, regarding prevalence of VTE and recurrent SVT during one-year follow-up. Results Out of 236 records reviewed, 97(41%) were included, 44 in the vascular care, and 53 in primary care. Erroneous diagnosis and coding were common causes for exclusion. The groups differed in ultrasound verified SVT 25(47.2%) and 35(79.5%) ( p = .001), LMWH treatment 13(24.5%) and 24(54.5%) ( p = .002), and history of prior SVT 19(35.8%) and 31(70.5%) ( p = .001). There was no difference in the incidence of VTE during follow-up, 1(1.9%) and 1(2.3%) ( p = 1.000), or recurrent SVT, 7(13.2%) and 6(13.6%), respectively ( p = .951). Conclusions This pilot study cannot confirm if elective eradication of SVI after SVT reduces the risk of VTE and recurrent SVT, however, the incidence of VTE was low in both groups. Limitations of the study are the small sample size and the lack of duplex ultrasound in all cases in both groups at diagnosis and at follow-up. Further prospective studies on homogenous populations are needed.
Written and computer simulation on the moral sensitivity of nurses
Authors: Parchami Faezeh , Jackson Alun C , Sharifi Farshad , Parsapoor Alireza , Bahramnezad Fatemeh 
Published: July 2022

Background: Moral sensitivity is the first step towards ethical decision-making. This sensitivity should form a basic attitude in healthcare team members, particularly nurses, toward providing effective and ethical care. This is highlighted in intensive care units (ICUs) where close attention should be paid to patient rights and moral or ethical decision-making. Objective: The present study aimed at determining and comparing the effect of written simulation and computer simulation of a virtual patient on the development of moral sensitivity of ICU nurses. Research design: Randomized controlled trial with one control arm and two experimental arms. Participants and content: This study involved 204 ICU nurses working in hospitals affiliated to Tehran University of Medical Sciences, Tehran, Iran, from 2019 to 2021 using a random allocation method. The participants were allocated to three groups comprising virtual patient computer simulation, written simulation, and the no simulation control group. After training based on a Patient Rights Charter, five scenarios, with themes reflecting the clauses of the Patient’s Rights Charter, were written as a computer program and text for the computer simulation and written simulation groups, respectively. Finally, nurses' moral sensitivity was assessed using the Lützén moral sensitivity questionnaire as pre- and post-tests (immediately and 2 months after the intervention). Ethical considerations: Ethical permission was obtained for the study. All the participants signed the informed consent before the study onset. Results: The study results showed a significant difference in moral sensitivity among the three groups before the intervention ( p = 0.003). Immediately after the intervention compared to pre-intervention, the three groups showed no significant differences in this regard ( p = 0.056), however a significant difference among the three groups was found 2 months post-intervention ( p < 0.001).
Nonverbal Synchrony: An Indicator of Clinical Communication Quality in Racially-Concordant and Racially-Discordant Oncology Interactions
Authors: Hamel Lauren M. , Moulder Robert , Ramseyer Fabian T. , Penner Louis A. , Albrecht Terrance L. , Boker Steven , Eggly Susan 
Published: July 2022

Objectives The aim of this cross-sectional study was to apply a novel software to measure and compare levels of nonverbal synchrony, as a potential indicator of communication quality, in video recordings of racially-concordant and racially-discordant oncology interactions. Predictions include that the levels of nonverbal synchrony will be greater during racially-concordant interactions than racially-discordant interactions, and that levels of nonverbal synchrony will be associated with traditional measures of communication quality in both racially-concordant and racially-discordant interactions. Design This is a secondary observational analysis of video-recorded oncology treatment discussions collected from 2 previous studies. Setting Two National Cancer Institute-designated Comprehensive Cancer Centers and another large urban cancer center. Participants Participants from Study 1 include 161 White patients with cancer and 11 White medical oncologists. Participants from Study 2 include 66 Black/African-American patients with cancer and 17 non-Black medical oncologists. In both studies inclusion criteria for patients was a recent cancer diagnosis; in Study 2 inclusion criteria was identifying as Black/African American. Main outcome measures Nonverbal synchrony and communication quality. Results Greater levels of nonverbal synchrony were observed in racially-discordant interactions than in racially-concordant interactions. Levels of nonverbal synchrony were associated with indicators of communication quality, and these associations were more consistently found in racially-discordant interactions. Conclusion This study advances clinical communication and disparities research by successfully applying a novel approach capturing the unconscious nature of communication, and revealing differences in communication in racially-discordant and racially-concordant oncology interactions. This study highlights the need for further exploration of nonverbal aspects relevant to patient-physician interactions.
Psychometric properties of a short self-report measure of rule-breaking behaviour among adolescents: findings from the Ungdata survey
Authors: Heradstveit Ove , Nilsen Sondre Aasen , Breivik Kyrre , Bakken Anders , Haug Thomas , Stormark Kjell Morten 
Published: July 2022

Background: The aim of the present study was to examine the factor structure and reliability of a six-item scale of rule-breaking behaviour, and to test for measurement invariance across gender, age, survey year and geographical location. Methods: Data were from three yearly cross-sectional and population-based collections of the Ungdata surveys (2017 to 2019) including a total of 297,102 Norwegian adolescents aged approximately 13 to 19 years. Measurements included respondent’s rule-breaking behaviour, time, gender, age and geographical location. Results: Confirmatory factor analyses demonstrated that a one-factor solution of the rule-breaking behaviour scale had good fit to data (comparative fit index 0.98; Tucker–Lewis index 0.96; root mean square error of approximation 0.049 (95% confidence interval 0.048, 0.050)), with factor loadings ranging from 0.60 to 0.81 for all items (mean factor loading 0.72). Similar results were found across survey years for both genders. Several multiple group confirmatory factor analyses showed indications of measurement invariance for the scale across gender, age groups, geographical locations and survey years. The ordinal alpha and omega coefficients for internal consistency of the scale were both 0.86. Conclusions: The six-item scale for self-reported rule-breaking behaviour demonstrated good psychometric properties and appears to constitute a reliable measure of adolescent rule-breaking behaviour for use in population-based surveys in a Norwegian setting.
Towards Tobacco-Free Generation: implementation of preventive tobacco policies in the Nordic countries
Authors: Linnansaari Anu , Ollila Hanna , Pisinger Charlotta , Scheffels Janne , Kinnunen Jaana M. , Rimpelä Arja 
Published: July 2022

Aims: Europe’s Beating Cancer Plan set a goal of creating a Tobacco-Free Generation in Europe by 2040. Prevention is important for achieving this goal. We compare the Nordic countries’ preventive tobacco policies, discuss the possible determinants for similarities and differences in policy implementation, and provide strategies for strengthening tobacco prevention. Methods: We used the World Health Organization Framework Convention on Tobacco Control (WHO FCTC) to identify the key policies for this narrative review. We focused on Articles 6, 8, 9, 11, 13 and 16 of the WHO FCTC, and assessed the status of the required (core) and recommended (advanced) policies and their application to novel tobacco and nicotine products. Information on the implementation of strategies, acts and regulations were searched from global and national tobacco control databases, websites and scientific articles via PubMed and MEDLINE. Results: The WHO FCTC and European regulations have ensured that the core policies are mostly in place, but also contributed to the shared deficiencies that are seen especially in the regulations on smokeless tobacco and novel products. Strong national tobacco control actors have facilitated countries to implement some advanced policies – even as the first countries in the world: point-of-sale display bans (Iceland), outdoor smoking bans (Sweden), flavour bans on electronic cigarettes (Finland), plain packaging (Norway), and plain packaging on electronic cigarettes (Denmark). Conclusions: Collaboration and participation in reinforcing the European regulations, resources for national networking between tobacco control actors, and national regulations to provide protection from the tobacco industry’s interference are needed to strengthen comprehensive implementation of tobacco policies in the Nordic countries.
‘You’re in a new game and you don’t know the rules: Preparing carers to care’
Authors: Atkinson Teresa , Bray Jennifer , Williamson Tracey 
Published: July 2022

Aim Being an informal carer for a person living with dementia can be a demanding role which can have detrimental effects on personal well-being and affect a person’s ability to provide care for their loved one. This evaluation of support courses, offered by a leading UK charity dedicated to dementia family carers, highlights the impact of training to support the caring role. Setting Participants completed booklets at the training venue and subsequently online or by post. Interviews with participants took place by telephone. Participants: 84 participants completed booklets containing measures which generated quantitative data whilst 19 family carers participated in qualitative telephone interviews. Design A mixed methods approach was taken using booklets of validated measures to capture quantitative data, including capture of demographic information, together with semi-structured interviews conducted by telephone which were recorded, transcribed and subsequently analysed using thematic analysis. Results Overall, both the quantitative and qualitative analysis demonstrate that attending the carers support courses had a positive impact on carers with improvements being maintained over time. Outcomes indicated that carers generally remained in a better physical, mental and emotional situation than that experienced before the course. Conclusion Being prepared for the trajectory of the caring role when providing care for a person living with dementia can help informal carers to be better prepared, better supported and better informed. Evidence gained from this evaluation demonstrates the impact of the courses and adds to the current weak evidence base relating to dementia courses aimed at preparing carers to care.
Nurses’ intention to stay in the work environment in acute healthcare: a systematic review
Authors: Al Yahyaei Asma , Hewison Alistair , Efstathiou Nikolaos , Carrick-Sen Debbie 
Published: July 2022

Background With staffing shortages affecting increasing numbers of health services globally, and predictions that shortages will worsen in the future, there is broad consensus that leaders at all levels must do more to support and develop current employees. However, the wide range of attributes of a healthy work environment identified in the literature and the financial implications of creating healthy work environments make it challenging to determine which elements of the nursing work environment are the most important in terms of workforce sustainability. This is a significant gap in our knowledge, and there is no consensus in the literature regarding definition and explanation of work environment factors in a way that facilitates prioritisation. Objectives The aim of this review was to synthesise and evaluate the evidence of the factors which may have an effect on intention to stay and role of the work environment in enhancing nurses’ intention to stay in the work environment in acute healthcare. Design and methods This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guidelines. A comprehensive search was performed for relevant articles published between 1990 and December 2017 using the following electronic databases: Allied and Complementary Medicine Database (AMED), Excerpta Medica dataBASE (EMBASE), ProQuest Nursing & Allied Health Source, ProQuest theses and dissertations, Cumulative Index to Nursing and Allied Health Literature (CINAHL) Plus, MEDLINE (Ovid) and PsycINFO. The reviewers independently screened the abstracts and full texts, extracted data, and assessed the methodological quality of the included papers using appropriate tools. Results A total of 4968 studies were screened by title, abstract, and full-text review, and 29 studies were included in this review. The identified determinants of nurses’ intention to stay were grouped into four main categories: individual indicators (personal and professional), organisation/profile, work environment, and patient-related. Several working environment variables identified in this review were significantly associated with the nurses’ intention to stay. Conclusion Despite the limitations of this review, the evidence indicates that attention to meso-level variables such as organisational characteristics and work environment is vital if the working environment is to improve and nurses’ intention to stay is to increase. The multifaceted nature of the concept of intention to stay makes it difficult to present definitive conclusions based on the findings of this review. However, the identified theoretical models were instrumental in differentiating intention to stay from other concepts such as intention to leave, turnover and retention, theoretically, and operationally.
What are the benefits and challenges of mentoring in midwifery? An integrative review
Authors: Wissemann Krystyl , Bloxsome Dianne , De Leo Annemarie , Bayes Sara 
Published: July 2022

Aim: The aim of this review was to synthesize best available evidence on mentoring programmes for midwives who have worked within the clinical setting for more than 1 year. Background: Lack of job satisfaction, stress, burnout and limited managerial support contributes to midwifery workforce attrition and the ongoing global shortage of midwives. Mentoring may be one way to improve staff retention, leading to positive clinical and organizational outcomes. Design: A five-step integrative review approach, based on a series of articles published by the Joanna Briggs Institute for conducting systematic reviews, was used to develop a search strategy, selection criteria, method for quality appraisal and the extraction and synthesis of data. Methods: Relevant articles were sought from the following databases: Cumulative Index to Nursing and Allied Health Literature, MEDLINE, PubMed, MIDIRS and Scopus. The search and screening process was guided by the Preferred Reporting Items for Systematic Reviews and Meta Analysis 2009 checklist. Narrative analysis was used to develop four main categories derived from the results from the included studies. Results: Eight studies were included in this review from which four themes were developed that are relevant to mentoring in midwifery; the impact on midwives’ direct environment, their immediate relationships with peers and management, and the overarching influence of the organization directly impact the accessibility and support midwives receive in mentoring programmes. Conclusion: To enhance staff retention in the workforce, midwives require support from the wider organization in which they work. Relevance to clinical practice: Understanding midwives’ perspectives of mentoring programmes will directly influence the development of midwifery-specific mentoring programmes, which may lead to improved staff retention in the midwifery workforce.