bluuebunny/crossref_metadata_2025_split huggingface dataset:
N19 Improving the standard of care for patients with IBD - translating the N-ECCO Consensus Statements
Authors: Kjaer-Mikkelsen E , Hindhede A , Bager P 
Published: January 2022

Abstract

Background
In 2018 the Second N-ECCO Consensus Statements were published in JCC and presented at the ECCO Congress. The statements aim to show the ‘ideal’ standard of care for patients with IBD and support IBD nursing practice. The statements comprise several sections: Fundamental IBD Nursing, Advanced IBD Nursing, and The benefit of an IBD Nurse. The Statements are presented in English and are available via the ECCO webpage. In order to raise awareness of the Statements and allow the Statements to be used in IBD nursing practice in Denmark, we aimed to translate the statements and to evaluate how the translated version were used.

Methods
Translation of statements into Danish by a physician who also is a journalist. Supported by the last author of the Statements (Bager). Distribution of the Statements to the Danish Community of IBD nurses. Open e-survey asking IBD nurses about the Danish version.

Results
Translation were done in autumn 2020. Promotion and distribution were done in spring 2021. This included 2 video recordings explaining the aim of the statements and how they could be used. Furthermore, the statements became online via our national organisation for IBD-nurses.
The survey was launched in autumn 2021. As of November 22th. 2021, 16 nurses from across Denmark have responded. A large majority knew about the Danish version and aimed to use the Statements. However, implementation of the statements was delayed due to the covid-pandemic and a 10 weeks long strike among nurses in the summer of 2021. Furthermore, the responders highlighted the statements of most clinical importance. The top 5 most important statements were; 1) Fundamental IBD Nursing, 2) Impact of IBD on patients’ lives, 3) The Advanced IBD Nurse caring for complex patients, 4) The Advanced IBD Nursing assessment, and 5) Patient information and education.

Conclusion
Translation of the Second N-ECCO Consensus Statements into Danish was appreciated by IBD nurses in Denmark. A majority aimed to include the statements in the development of IBD nursing in clinical practice.
Running During Pregnancy and Postpartum, Part A: Why Do Women Stop Running During Pregnancy and Not Return to Running in the Postpartum Period?
Authors: James Megan L. , Moore Isabel S. , Donnelly Gráinne M. , Brockwell Emma , Perkins Joanna , Coltman Celeste E. 
Published: January 2022

Background:
In the absence of complications or contraindications, running is recognized as a safe mode of exercise for women who ran before pregnancy. Despite this, participation in running decreases during pregnancy and postpartum, with limited research conducted to examine why women who were runners before pregnancy cease running during pregnancy and do not return postpartum.

Objectives:
To understand the experiences of women who have recently given birth and were runners before pregnancy, specifically reasons for not running during pregnancy or returning to running postpartum, as well as postpartum running concerns.

Study Design:
Observational, cross-sectional, mixed methods.

Methods:
In total, 883 postpartum females completed an online questionnaire related to running habits, reasons for not running during pregnancy, not returning to running postpartum, and concerns returning to running postpartum. Most questions were closed-ended, with opportunity to provide free-text responses. Descriptive statistics of close-ended questions and thematic analysis of free-text responses were conducted.

Results:
Women did not run during pregnancy due to nausea/morning sickness, fatigue, fear of or experience of miscarriage and anxiety, nervousness, and fear. Women had not returned to running postpartum due to experience of symptoms/pain and complications postpartum and were concerned about leaking urine, vaginal heaviness, and not knowing how to return safely. Pelvic floor concerns were prevalent throughout pregnancy and postpartum.

Conclusion:
There is a need for evidence-based guidance for women to return to running postpartum gradually and safely. This includes greater pelvic health education and support, including access to treatment. Importantly, return-to-running guidance postpartum needs to be considered as an ongoing and longitudinal process.
Fever management in acute brain injury
Authors: Bogossian Elisa Gouvea , Taccone Fabio Silvio 
Published: January 2022

Purpose of review
Fever is common after acute brain injury and is associated with poor prognosis in this setting.

Recent findings
Achieving normothermia is feasible in patients with ischemic or hemorrhagic stroke, subarachnoid hemorrhage and traumatic brain injury. Pharmacological strategies (i.e. paracetamol or nonsteroidal anti-inflammatory drugs) are frequently ineffective and physical (i.e. cooling devices) therapies are often required. There are no good quality data supporting any benefit from therapeutic strategies aiming at normothermia in all brain injured patients when compared with standard of care, where mild-to-moderate fever is tolerated. However, recent guidelines recommended fever control in this setting.

Summary
As fever is considered a clinically relevant secondary brain damage, we have provided an individualized therapeutic approach to treat it in brain injured patients, which deserved further validation in the clinical setting.
Pain Prevalence Among Children Visiting Pediatric Emergency Departments
Authors: Míguez-Navarro María Concepción , Escobar-Castellanos María , Guerrero-Márquez Gloria , Rivas-García Aristides , Pascual-García Patricia ,   the Clinical Working Group of Analgesia and Sedation of the Spanish Society for Pediatric Emergencies (SEUP)
Published: January 2022

Objectives
The main purpose of this study was to investigate the prevalence, characteristics, and intensity of children's pain in emergency departments. The secondary purpose was to evaluate the interobserver agreement regarding the level of pain perceived by professionals, parents, and children.

Methods
This was a multicenter, survey-based research study on 0- to 18-year-old patients visiting 1 of the 15 hospitals that form part of the Working Group on Analgesia and Sedation of the Spanish Society of Pediatric Emergency Medicine between October and December 2018. The surveys recorded pain presence, intensity, characteristics, and location.

Results
The study included 1216 surveys. At the time of the interview, 646 patients were experiencing pain, a prevalence of 53.1% (95% confidence interval, 50.3%–55.9%), with 25.38% reporting mild, 36.68% moderate, and 37.46% intense pain. Among the patients, 29.9% had abdominal pain and 14.1% pain in their legs.
The pain lasted less than 24 hours in 48.2% of the patients, whereas only 3.0% experienced pain during more than 15 days. The parents of 50.7% of the children had provided an analgesic at home.
Interrater agreement regarding pain levels was k = 0.35 between professionals and children, k = 0.38 between children and parents, and k = 0.17 between parents and professionals. For children unable to cooperate, the agreement between professional/child and the parents was k = 0.11.

Conclusions
Pain is a common symptom among emergency department patients, and its evaluation should therefore be obligatory. We found low interrater agreement on pain levels between patients, professionals, and parents, which confirms how difficult it is to accurately evaluate pain intensity.
Combining Isocitrate Dehydrogenase Inhibitors With Existing Regimens in Acute Myeloid Leukemia
Authors: Lachowiez Curtis , DiNardo Courtney D. , Stein Etyan 
Published: January 2022

Abstract
Identification of recurrent mutations in isocitrate dehydrogenase genes (IDH1 and IDH2) in patients with acute myeloid leukemia (AML) coupled with an understanding of the pathologic role these mutant IDH isoforms impart in leukemogenesis resulted in the development of IDH1 and IDH2 inhibitors comprising a novel, molecularly defined class of targeted therapies for the treatment of AML. This review herein describes the unique cellular pathophysiology and vulnerabilities in IDH-mutated AML; the clinical development, efficacy, and known resistance mechanisms to first-generation IDH inhibitors; summarizes the literature surrounding combination therapies incorporating targeted or cytotoxic therapies with IDH inhibitors in patients with IDH-mutated AML; and identifies future challenges and areas of active ongoing investigation within this molecular subgroup.
The Evolving Role of Allogeneic Stem Cell Transplant in the Era of Molecularly Targeted Agents
Authors: Kinsella Francesca , Craddock Charles 
Published: January 2022

Abstract
Allogeneic stem cell transplantation (allo-SCT) is an increasingly important treatment strategy in fit adults with acute myeloid leukemia (AML). Increased donor availability and a steady reduction in transplant-related mortality (TRM) over the last 2 decades have transformed access to the curative potential of allo-SCT. The identification of patients with AML in first complete remission who will benefit from allo-SCT requires a dynamic assessment of the risk of disease relapse and TRM. Increased accuracy in predicting both relapse risk and transplant toxicity has allowed recommendations for allo-SCT to become increasingly personalized. Notwithstanding its now central position in the treatment algorithm of patients with AML, there, however, has been little progress in reducing the main cause of transplant failure, which remains disease relapse. Novel molecularly targeted therapies have the potential to augment the curative potential of nontransplant therapies, and this may influence the proportion of newly diagnosed fit patients deemed to be allomandatory. At the same time, the ability of such therapies to improve transplant outcomes, either by reducing TRM or the risk of relapse, has the potential to further embed allo-SCT as a key therapeutic modality in AML.
A Quality Improvement Initiative to Improve Patient Safety Event Reporting by Residents
Authors: Herchline Daniel , Rojas Christina , Shah Amit A. , Fairchild Victoria , Mehta Sanjiv , Hart Jessica 
Published: January 2022

Introduction:
Residents play a key role in patient care at academic medical centers and have unique insights into safety improvement opportunities. At our institution, <1% of safety events were reported by resident trainees. The primary objective of this quality improvement (QI) initiative was to increase the monthly incidence of event reporting by pediatric residents by 20% from baseline within 12 months.

Methods:
A QI team used the model for improvement to identify barriers to submitting safety event reports. The team used multiple intervention cycles to increase knowledge and promote engagement in event reporting. Interventions included educational tip sheets, a hospital-wide Morbidity and Mortality (M&M) conference, peer recognition and acknowledgment by senior leadership for report submission, and an interactive reporting activity. The outcome measure was monthly number of reports filed by residents. The process measure was the number of unique residents submitting a report each month. Time to complete a report was a balancing measure.

Results:
The number of reports placed by residents increased significantly, with a centerline shift from 15 to 29 reports per month (statistical process control chart—Fig. 3). The number of unique residents submitting reports increased from 10 to 22 per month. The time to complete a report was unchanged.

Conclusions:
Engaging residents in patient safety initiatives through education, experiential learning, and recognition can increase safety event reporting by residents. Future planned interventions include enhancing safety event reporting technology, developing patient safety faculty and resident champions, and increasing transparency regarding outcomes of safety event reports.
A Standardized Peer Review Program Improves Assessment and Documentation of Child Sexual Abuse
Authors: Starling Suzanne P. , Martinez Kimberly A. , Frasier Lori D. 
Published: January 2022

Introduction:
The objective was to assess the impact of interventions associated with ongoing expert peer review on the quality of child abuse medical providers’ written and photograph documentation in child sexual abuse cases.

Methods:
Pediatricians participated in a HIPAA compliant blind peer review process on a web platform developed to provide the American Board of Pediatrics maintenance of certification. Participants submit sequential photograph and written documentation of child sexual abuse examinations over 1 year. Documentation includes genital examination descriptions and interpretation of findings. Reviewers evaluate the photographic quality and written documentation of examination findings utilizing a numerical rating system. Each case cycle is reviewed by one of four experts in child abuse who received training in a uniform evaluation process. Reviewers follow each case throughout three cycles of documentation, selecting from several interventions that have been customized to address the quality issues noted. The third and final cycle includes summary comments from the reviewer.

Results:
Forty-one participants completed the program at the time these data were collected. A paired t test analysis of the combined scores of the three measures, such as Image Quality, Quality of Written Documentation, and Accuracy of Exam Interpretation, showed a statistically significant improvement (P < 0.001) between the first and last sets. In addition, each of the individual measures was statistically significant between the first and last case sets with a P value of <0.05 for each.

Conclusion:
Peer review with interventions customized to address quality issues improved the quality of the assessment and documentation of child sexual abuse evaluations.
Behavioral and Psychological Aspects of the Physician Experience with Deimplementation
Authors: McDaniel Corrie E. , House Samantha A. , Ralston Shawn L. 
Published: January 2022

Introduction:
Deimplementation, or the structured elimination of non-evidence–based practices, faces challenges distinct from those associated with implementation efforts. These barriers may be related to intrinsic psychological factors, as perceptions and emotions surrounding the discontinuation of established practices appear to differ from those associated with practice adoption. This study aims to explore barriers and facilitators experienced by pediatric clinicians engaging in deimplementation projects.

Methods:
We used behavioral economics concepts to inform our qualitative study design following a theory-informed inductive approach. We conducted semistructured interviews with participants from two national quality improvement collaboratives where the primary outcomes were deimplementation measures. Using purposeful sampling, we recruited project leaders at institutions in the top and bottom quartiles from within each collaborative. Finally, we conducted a thematic analysis using a combination of inductive and deductive coding.

Results:
In total, we interviewed participants from 12 high-performing sites and 7 low-performing sites. Participants identified nine concepts associated with successful deimplementation practice and three psychological barriers that impacted behavior change: (1) loss, (2) fear, and (3) action bias. Participants further identified four overarching strategies for mitigating the identified psychological barriers, including (1) making allowance for nonconformism; (2) permission to change; (3) normalizing; and (4) reframing.

Conclusion:
There is potential for more effective deimplementation through the proactive incorporation of an awareness of specific psychological barriers of loss, fear, and action bias, as well as specific mitigation strategies to address the psychocognitive experience.
Reduction in incidents during COVID-19 in a Secure Children’s Home: an opportunity for learning
Authors: McKeown Annette , MacMillan Gemma , Watkins Ella , Caveney Domanic , Smith Anna , Kennedy Patrick Jack , Atkins Rachel , Lee Robyn 
Published: January 2022

Purpose
The COVID-19 pandemic is unprecedented for young people within the UK. The pandemic has presented particular challenges for vulnerable children and young people. For example, a recent study in the UK indicated that 83% of young people with existing mental health conditions said the pandemic had made their condition worse (Young Minds, 2020). To date, the impact upon populations such as young people in Secure Children’s Homes (SCHs) is unknown. This study aims to elucidate this area.

Design/methodology/approach
SCHs provide a safe, supportive environment for vulnerable young people who frequently present with multiple and complex needs. Young people residing within a SCH may be residing at the setting because of a Secure Accommodation Order under a Section 25 Order of the Children’s Act (1989) or for criminal justice reasons, i.e. serving a Remand period or custodial sentence. Preliminary research compared a baseline period to a follow-up period after the commencement of COVID-19 national lockdown measures within a SCH in the North of England to develop understanding of the impact for young people.

Findings
A significant decrease in overall incidents (t (5) = −6.88, p < 0.001), restraints (t (5) = −9.07, p < 0.001) and other incidents including assaults occurred during follow-up. The SECURE STAIRS framework supports trauma-informed care and enhances support within the setting. Consistent with the framework, provision of formulation meetings was significantly increased within the follow-up period (Welsh’s t (74) = −2.74, p < 0.001). Reflections and future recommendations are outlined.

Originality/value
The unanticipated results highlight the value of examining incident data within secure environments and could lead to effective practice changes for practitioners working within this domain. This research also demonstrates how frameworks such as SECURE STAIRS can be beneficial for vulnerable young people during periods of change and stress in mitigating some of the potential negative effects. The implementation of such frameworks within SCHs is still novel and thus evaluative research is valuable.
“Defund the police:” Perceptions among protesters in the 2020 March on Washington
Authors: Cobbina‐Dungy Jennifer , Chaudhuri Soma , LaCourse Ashleigh , DeJong Christina 
Published: January 2022

AbstractResearch summary: Using qualitative interviews, this study examines how protesters with varying levels of commitment to the Black Lives Matter movement perceive the slogan defund the police. Findings indicate while a small number had reservations regarding the term, the vast majority of protesters associate defunding as a two‐step process that starts with reduction of police budgets, followed by reallocation of these resources toward much needed services in the very communities the departments serve. Findings also revealed prior engagement with the Black Lives Matter movement, and the level of commitment of participants did play an important role in being able to provide nuanced context to the call for action.Policy implications: Implementation of reduction of police budgets indicates a need to reimagine the role and function of police in most affected communities. In addition, there is a need to reinvest in local resources that would provide the much needed support toward marginalized communities. Further, social movement organizations should partner with corporate brands and advertising agencies to effectively promote their goals and slogans toward a diverse range of audience in media.
Does Restricting Managers' Discretion through GAAP Impact the Usefulness of Accounting Information in Debt Contracting?†
Authors: Cheng Lin , Jaggi Jacob , Young Spencer 
Published: January 2022

ABSTRACTWe examine whether restricting managers' discretion through GAAP impacts the usefulness of accounting information in debt contracting. Our study informs standard setters and regulators regarding the debt contracting implications of limiting managers' discretion via accounting standards. We predict and find that under more restrictive standards, lenders make more non‐GAAP modifications to GAAP‐based performance measures, suggesting that restrictions of managers' discretion reduce the usefulness of accounting information. We perform two additional analyses to enhance identification. First, in line‐item‐level analysis, we document a positive relation between the exclusion of specific nonrecurring items from contractual definitions of earnings and the number of restrictions in the GAAP standards that apply to each specific item each year. Second, using difference‐in‐differences tests around standard changes, we find that the propensity to exclude items varies positively with changes in the restrictiveness of related standards. Moreover, we predict and find that restrictive standards are also positively associated with loan spreads but significantly less so when lenders adjust GAAP numbers in loan contracts. Overall, this study improves our understanding of how attributes of accounting standards impact the usefulness of accounting information.
Miniaturization eliminates detectable impacts of drones on bat activity
Authors: Kuhlmann Kayla , Fontaine Amélie , Brisson‐Curadeau Émile , Bird David M. , Elliott Kyle H. 
Published: January 2022

Abstract

Advances in operational simplicity and cost efficiency have promoted the rapid integration of unoccupied aerial vehicles (UAVs) into ecological research, yet UAVs often disturb wildlife, potentially biasing measurements. Studies of UAV effects on wildlife to date have focused on UAV trajectory or distance; however, UAV size and noise could be critical variables influencing wildlife responses.

Bats are cryptic aerial species that are difficult to survey using conventional means, and so we tested the effectiveness of drone‐based acoustic surveys for bats. We recorded the number of acoustic bat detections with and without a UAV present. We used three small, commercial rotary UAVs varying in size and noise intensity (249, 907, 1,380 g).

Larger and louder UAVs deterred significantly more bats, with no effect of take‐off distance on bat activity. The smallest and quietest UAV model had a similar change in bat activity compared with control measurements. Drone noise increased with drone size, but all drones emitted in a similar range of frequencies that overlapped with the larger bat species that were also those most impacted by the UAV. During the 5‐minute surveys, there was no evidence of bat habituation to UAVs although bats returned quickly once the UAV survey ended.

We urge wildlife researchers to consider drone size during wildlife surveys. Smaller and quieter models have negligible impacts on wildlife, eliminating the impact of drones on wildlife in some cases.