bluuebunny/crossref_metadata_2025_split huggingface dataset:
Optimizing the productivity and placement of NPs and PAs in outpatient primary care sites
Authors: Zaletel Cynthia L. , Madura Brenda , Metzel Julie Miyamasu , Lancaster Rachelle J. 
Published: July 2022

ABSTRACT

Objective:
Organizational leaders must continually assess the productivity, turnover, and vacancies of physician assistants (PAs) and NPs. Optimizing the feasibility, effect, strategic placement, and monitoring increases patient access, improves wait times and affordability, and increases revenue. This quality improvement project sought to develop a systematic, data-driven approach to optimize productivity and placement of NPs and PAs in outpatient primary care sites.

Methods:
Results from this project are reported using the Revised Standards for Quality Improvement Reporting Excellence (SQUIRE) framework. Postformation of a quality improvement team, a gap analysis, and action plans were developed and implemented.

Results:
Priority areas requiring action included the development of an integrated position justification algorithm and tracking form addressing NP and PA placement, establishing consistent patient contact hours, setting workload expectations, and consistently communicating these via an organization-specific situation, background, assessment, and recommendation communication tool.

Conclusions:
Healthcare leaders should leverage the talents of NPs and PAs meeting organizational benchmarks and goals as well as the needs of patients. NP and PA leaders should focus on benchmarking performance and analyzing barriers to optimization. These efforts are most beneficial when multidisciplinary in nature.
Diversity in the Physician Assistant Pipeline: Experiences and Barriers in Admissions and PA School
Authors: Cuenca John Patrick , Ganser Katie , Luck Morgan , Smith Noël E. , McCall Timothy C. 
Published: July 2022

Introduction:
The purpose of this study was to identify perceived barriers faced by physician assistant (PA) students who identified as an underrepresented minority in medicine (URM-med), sexual or gender minority (SGM), coming from low socioeconomic status (low SES), or a person with a disability (PWD).

Methods:
More than 2700 PA students across the United States provided information regarding their PA school application process and program experiences. This study examined differences among URM-med, SGM, low SES, and PWD compared to those who were not in those groups to determine the relationship between these factors and student concerns about bias in the application process, as well as a variety of experiences in PA school.

Results:
Using ordinal logistic regression analyses to examine the odds of experiencing a variety of barriers or experiences in applying to PA school and postmatriculation experiences, results suggested that, among disadvantaged groups within the PA student body, barriers include concerns about bias in the application process, lack of belonging, and the lack of academic and social support.

Discussion:
PA students who identified as URM-med, SGM, low SES, and/or PWD faced barriers as they navigated the path to becoming a PA. To decrease these barriers, emphasis on raising awareness and interest in pursuing a career as a PA should occur early. Programs should work to identify biases within admissions processes, diversify faculty, and identify ways to support minority students once matriculated. Ultimately, increasing the diversity of healthcare providers has the potential to increase access to and quality of care for patients.
Pediatric Patient Diagnosed With Testicular and Peritoneal Mesothelioma Undergoing Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy
Authors: Lamm Amy W. , Hayes Andrea , Sutherland Richard 
Published: July 2022

AbstractMalignant mesotheliomas are aggressive neoplasms, which are rare, especially in the pediatric population. Unlike malignant mesotheliomas most commonly seen in adults, those of the peritoneum and testicle in children do not appear to be as strongly associated with direct asbestos exposure and have an unpredictable biologic behavior requiring individual treatment strategies. There may, however, be an association between children with malignant mesothelioma and asbestos-exposed household members. Herein, we report a very rare case of a 15-year-old male adolescent who presented with testicular pain, redness, and swelling and was found to have testicular malignant mesothelioma with retroperitoneal nodal and peritoneal metastases.
Snip the Tip
Authors: Highton Mary , Joseph Rachel , Dyer Natasha , Haydon Danielle 
Published: July 2022

Abstract
Male circumcision originated as a covenant of God with Abraham in biblical times. This practice is rooted in the Jewish and Islamic religions as both claim ancestry with Abraham. Although neonatal male circumcision was mostly performed in these cultures, it became a common practice in the United States in the 1800s. As this is not medically necessary, the frequency of male circumcision is decreasing in some parts of the world, although circumcision in older men is increasing because of the health benefits reported. Although there are several techniques to perform the procedure, pain management during and after the procedure is important. The nurse must ensure that the infant is the right candidate for the procedure, support the parental decision, and monitor the infant for any complications. Research around male circumcision on the long-term effects, reduction of complications, and economic and health benefits earlier in life may be important.
Moyamoya Disease
Authors: S.D. Shani , Sudhir B. Jayanand 
Published: July 2022

Abstract
Moyamoya disease is a rare disease that causes progressive narrowing of the intracranial internal carotid arteries, resulting in reduced blood supply to the brain, leading to strokes. It is a major cause of childhood stroke. A 10-year-old boy presented with recurrent left-hemispheric transient ischemic attack and seizures. On evaluation, the child was diagnosed as having bilateral moyamoya disease. The child was prescribed antiplatelets and antiepileptics and advised to drink 2 liters of water a day and to avoid dehydration. He was admitted for an elective revascularization surgery. Left-side superficial temporal artery to middle cerebral artery bypass with encephaloduroarteriomyosynangiosis was done. The child was monitored in the postoperative neurosurgery intensive care unit for 1 day for any postprocedure complications. Postoperative course was uneventful, and the child was discharged on the sixth postoperative day with instruction to continue antiplatelets and antiseizure medications. The outcome of cerebral revascularization in moyamoya disease is good, with reduction in ischemic events and seizures. Postoperative nursing care in neurosurgery units is important in preventing complications and achieving better outcomes.
Effect of Helicobacter pylori Infection on Macromineral and Trace Element Status—Systematic Review and Meta‐Analysis
Authors: Simões Ana M. , Araújo Daniela , Teixeira Pedro M. , Antunes Henedina 
Published: July 2022

Objectives:To explore the effect of Helicobacter pylori (Hp) infection on zinc, copper, calcium, magnesium, phosphorus, and iodine status in the pediatric population.Methods:A protocol was registered on PROSPERO. A literature search was conducted on Embase, PubMed MEDLINE, and Web of Science, from inception to September 2020, including all studies in English, Spanish, and Portuguese languages. Reference lists were manually searched. Primary studies describing at least one micronutrient status in Hp‐positive and Hp‐negative or control children were included. PRISMA recommendations were applied. Pooled mean differences (MDs) and 95% confidence intervals were estimated using a random‐effects model. A total of 1011 citations were screened. Six cross‐ sectional studies were included. No publications regarding phosphorus and iodine were identified.Results:Included studies in meta‐analyses comprised an overall age range of 4–18 years, with Hp positivity ranging between 29.5% and 72.3%. These meta‐analyses demonstrated a lack of evidence of an association between Hp‐positive and Hp‐negative or control children regarding serum zinc (vs Hp‐negative: MD −1.36 µg/dL; vs control: MD 326.22 µg/dL), copper (MD −0.83 µg/dL), and calcium (MD 0.09 mg/dL) status. Considerable heterogeneity was recognized, except for calcium analysis (I2 = 0%). Meta‐analysis for magnesium was not performed. Five studies presented a low risk of bias.Conclusions:The study demonstrated a lack of evidence of an effect of Hp infection on serum zinc, copper, and calcium status. Studies concerning magnesium, phosphorus, and iodine status are warranted. Furthermore, larger and well‐controlled studies are recommended.
Profiles of Symptom Suffering and Functioning in Children and Adolescents Receiving Chemotherapy
Authors: Cheng Lei , Reeve Bryce B. , Withycombe Janice S. , Jacobs Shana S. , Mack Jennifer W. , Weaver Meaghann , Mann Courtney M. , Waldron Mia K. , Maurer Scott H. , Baker Justin N. , Wang Jichuan , Hinds Pamela S. 
Published: July 2022

Background
Some children and adolescents receiving chemotherapy experience few symptom-related adverse events, whereas others experience multiple adverse events. If oncology nurses could identify patients likely to have pronounced chemotherapy-related adverse events, tailored supportive care could be matched to these patients’ symptom burdens.

Objective
The aim of this study was to identify symptom profiles in children and adolescents before and after chemotherapy, and the sociodemographic and psychological factors associated with profile classification and change.

Methods
Participants ranging from 7 to 18 years (n = 436) completed 6 Patient-Reported Outcomes Measurement Information System pediatric symptom measures within 72 hours preceding (T1) and 1 to 2 weeks after (T2) chemotherapy. Profile membership and change were determined by latent profile/latent transition analyses. Associations with profiles and profile transitions were examined using multinomial logit models and logistic regression.

Results
Three symptom suffering profiles were identified at T1 and T2: high, medium, and low. The high symptom suffering profile included the fewest participants (T1, n = 70; T2, n = 55); the low symptom suffering profile included the most participants (T1, n = 200; T2, n = 207). Of the participants, 57% remained in the same profile from T1 to T2. Psychological stress was significantly associated with T1 and T2 profile classifications and profile transition; age was associated with profile classification at T1.

Conclusion
Three symptom suffering profiles existed in a sample of pediatric patients undergoing chemotherapy, indicating that children and adolescents have differing cancer treatment experiences.

Implications for Practice
Oncology nurses could screen pediatric oncology patients for their symptom suffering profile membership and subsequently prioritize care efforts for those with a high suffering profile.
Telehealth Interventions in Head and Neck Cancer Patients
Authors: Caputo Mathew P. , Rodriguez Carmen S. , Padhya Tapan A. , Mifsud Matthew J. 
Published: July 2022

Background
Head and neck cancer (HNC) and its treatments often result in adverse effects that impair a patient’s quality of life. Although intensive rehabilitative strategies can be used, their applicability can be limited due to patient-specific and socioeconomic barriers. Telehealth interventions represent a possible novel approach to increase access to these services and improve posttreatment quality of life in the HNC population.

Objective
The objective of this systematic review was to identify studies investigating telemedicine-based interventions for HNC patients to determine whether there is a consensus concerning the cost-effectiveness, clinical utility, and accessibility of this model for rehabilitation.

Methods
PubMed, EMBASE, Web of Science, and CINAHL were used to identify literature without time limit for publication. A critical appraisal of individual sources was conducted by 2 reviewers. Sixteen studies met inclusion criteria.

Results
Studies related to telehealth interventions in the HNC population are limited. Salient themes included feasibility of telehealth as an intervention, effects on self-management and knowledge, impact on quality of life, physical and psychiatric symptoms, and cost.

Conclusion
Although the current literature presents promising data, indicating that telehealth interventions may be both effective and cost-efficient in the management of HNC patients, more research is needed to definitively elucidate their role in management.

Implications for Practice
Telehealth interventions are valuable for clinicians as an alternative to expand access to care across the cancer continuum, to strengthen patients’ knowledge and consequently their self-management, and to provide continuity of services as well as for remote monitoring of symptoms and response to treatment.
Associations of Health-Related Quality of Life and Sleep Disturbance With Cardiovascular Disease Risk in Postmenopausal Breast Cancer Survivors
Authors: Vasbinder Alexi , Zaslavsky Oleg , Heckbert Susan R. , Thompson Hilaire , Cheng Richard K. , Saquib Nazmus , Wallace Robert , Haque Reina , Paskett Electra D. , Reding Kerryn W. 
Published: July 2022

Background
Breast cancer (BC) survivors are at an increased risk of long-term cardiovascular disease (CVD), often attributed to cancer treatment. However, cancer treatment may also negatively impact health-related quality of life (HRQoL), a risk factor of CVD in the general population.

Objective
We examined whether sleep disturbance, and physical or mental HRQoL were associated with CVD risk in BC survivors.

Methods
We conducted a longitudinal analysis in the Women’s Health Initiative of postmenopausal women given a diagnosis of invasive BC during follow-up through 2010 with no history of CVD before BC. The primary outcome was incident CVD, defined as physician-adjudicated coronary heart disease or stroke, after BC. Physical and mental HRQoL, measured by the Short-Form 36 Physical and Mental Component Summary scores, and sleep disturbance, measured by the Women’s Health Initiative Insomnia Rating Scale, were recorded post BC. Time-dependent Cox proportional hazards models were used starting at BC diagnosis until 2010 or censoring and adjusted for relevant confounders.

Results
In 2884 BC survivors, 157 developed CVD during a median follow-up of 9.5 years. After adjustment, higher Physical Component Summary scores were significantly associated with a lower risk of CVD (hazard ratio, 0.90 [95% confidence interval, 0.81-0.99]; per 5-point increment in Physical Component Summary). No associations with CVD were found for Mental Component Summary or Insomnia Rating Scale.

Conclusion
In BC survivors, poor physical HRQoL is a significant predictor of CVD.

Implications for Practice
Our findings highlight the importance for nurses to assess and promote physical HRQoL as part of a holistic approach to mitigating the risk of CVD in BC survivors.
Central sensitization in opioid use disorder: a novel application of the American College of Rheumatology Fibromyalgia Survey Criteria
Authors: Hall O. Trent , Teater Julie , Rood Kara M. , Phan K. Luan , Clauw Daniel J. 
Published: July 2022

Abstract

Introduction:
Central sensitization (CS) involves dysfunctional central nervous system pain modulation resulting in heightened pain perception. Central sensitization is not commonly assessed among patients with opioid use disorder (OUD), despite the fact that pain has been implicated in the development, maintenance, and relapse of OUD and chronic opioid use may produce opioid-induced hyperalgesia. Central sensitization is a plausibly important mechanism underlying the complex relationship between OUD and chronic pain. However, this premise is largely untested.

Methods:
Participants with OUD (n = 141) were recruited from an academic addiction treatment center in Columbus, Ohio. An established surrogate measure of CS, the American College of Rheumatology 2011 Fibromyalgia Survey Criteria, was administered using electronic survey. Participants also responded to questions about pain interference (Brief Pain Inventory), quality of life (RAND-36), and items regarding pain beliefs and expectations of pain and addiction treatment. Descriptive analyses, Spearman rho correlations, and Mann–Whitney U tests were performed.

Results:
Hypothesized relationships were confirmed between degree of CS, pain interference, and health-related quality of life. Degree of CS was also positively correlated with greater endorsement of pain as a reason for the onset, maintenance, and escalation of OUD; treatment delay; and OUD relapse. Participants with the American College of Rheumatology 2011 Fibromyalgia Survey Criteria ≥13 had significantly greater endorsement of pain as a reason for delaying OUD treatment, continuing and increasing opioid use, and precipitating OUD relapse.

Conclusions:
This study provides early evidence CS may underlie previously observed connections between clinically salient features of chronic pain and OUD, potentially informing future mechanistic research and precision treatment.
Change in Substance Use and the Effects of Social Distancing on Health-Related Quality of Life and Depressive Symptoms During the COVID-19 Pandemic in People Living With and Without HIV
Authors: Schaaf Reja E. A. , Verburgh Myrthe L. , Boyd Anders , Wit Ferdinand W. , Nieuwkerk Pythia T. , Schim van der Loeff Maarten F. , Reiss Peter ,   for the AGEhIV Study Group
Published: July 2022

Background:
Little is known about the impact of social distancing on health-related quality of life and depressive symptoms in older people with HIV during the COVID-19 pandemic.

Setting:
HIV-positive and HIV-negative AGEhIV Cohort Study participants.

Method:
In September-November 2020, participants completed questionnaires on social distancing, change in substance use, health-related quality of life (EQ-6D, including EQ-VAS), and depressive symptoms (PHQ-9). Associations between social distancing and (1) EQ-VAS or (2) PHQ-9 score ≥10 (clinically relevant depressive symptoms) were analyzed using fractional and binomial logistic regression, respectively.

Results:
Two hundred fourteen HIV-positive and 285 HIV-negative participants were analyzed. 77.4% found social distancing important and 66.9% reported good adherence to these measures, without significant differences between HIV-positive and HIV-negative participants. In both groups, <5% reported increased smoking or recreational drug use, but more HIV-positive (12.2%) than HIV-negative (4.9%) participants (P = 0.005) reported increased/more frequent alcohol use. Median EQ-VAS was slightly lower in HIV-positive (80 IQR = 73–90) than HIV-negative (84 IQR = 75–90) participants (P = 0.041). The prevalence of clinically relevant depressive symptoms was similar (HIV-positive, 8.4% and HIV-negative, 8.8%). Worrying about contracting COVID-19 and having ≥3 (vs no) comorbidities were associated with lower EQ-VAS and finding social distancing easy with higher EQ-VAS. Worrying about contracting COVID-19 and younger than 60 years (vs ≥65) were associated with higher odds of clinically relevant depressive symptoms. HIV status was associated with neither outcome.

Conclusions:
Initially during the COVID-19 pandemic in the Netherlands, a similar majority of HIV-positive and HIV-negative participants reported adhering to social distancing. Irrespective of HIV status, concerns about contracting COVID-19 negatively affected participants' perceived current health and increased risk of depressive symptoms.
Perception of Treatment Success and Impact on Function with Antibiotics or Appendectomy for Appendicitis
Authors: Thompson Callie M. , Voldal Emily C. , Davidson Giana H. , Sanchez Sabrina E. , Ayoung-Chee Patricia , Victory Jesse , Guiden Mary , Bizzell Bonnie , Glaser Jacob , Hults Christopher , Price Thea P. , Siparsky Nicole , Ohe Kristin , Mandell Katherine A. , DeUgarte Daniel A. , Kaji Amy H. , Uribe Lisandra , Kao Lillian S. , Mueck Krislynn M. , Farjah Farhood , Self Wesley H. , Clark Sunday , Drake F. Thurston , Fischkoff Katherine , Minko Elizaveta , Cuschieri Joseph , Faine Brett , Skeete Dionne A. , Dhanani Naila , Liang Mike K. , Krishnadasan Anusha , Talan David A. , Fannon Erin , Kessler Larry G. , Comstock Bryan A. , Heagerty Patrick J. , Monsell Sarah E. , Lawrence Sarah O. , Flum David R. , Lavallee Danielle C. ,   Writing Group for the CODA Collaborative
Published: July 2022

Objective:
To compare secondary patient reported outcomes of perceptions of treatment success and function for patients treated for appendicitis with appendectomy vs. antibiotics at 30 days.

Summary Background Data:
The Comparison of Outcomes of antibiotic Drugs and Appendectomy trial found antibiotics noninferior to appendectomy based on 30-day health status. To address questions about outcomes among participants with lower socioeconomic status, we explored the relationship of sociodemographic and clinical factors and outcomes.

Methods:
We focused on 4 patient reported outcomes at 30 days: high decisional regret, dissatisfaction with treatment, problems performing usual activities, and missing >10 days of work. The randomized (RCT) and observational cohorts were pooled for exploration of baseline factors. The RCT cohort alone was used for comparison of treatments. Logistic regression was used to assess associations.

Results:
The pooled cohort contained 2062 participants; 1552 from the RCT. Overall, regret and dissatisfaction were low whereas problems with usual activities and prolonged missed work occurred more frequently. In the RCT, those assigned to antibiotics had more regret (Odd ratios (OR) 2.97, 95% Confidence intervals (CI) 2.05–4.31) and dissatisfaction (OR 1.98, 95%CI 1.25–3.12), and reported less missed work (OR 0.39, 95%CI 0.27–0.56). Factors associated with function outcomes included sociodemographic and clinical variables for both treatment arms. Fewer factors were associated with dissatisfaction and regret.

Conclusions:
Overall, participants reported high satisfaction, low regret, and were frequently able to resume usual activities and return to work. When comparing treatments for appendicitis, no single measure defines success or failure for all people. The reported data may inform discussions regarding the most appropriate treatment for individuals.

Trial Registration:
Clinicaltrials.gov Identifier: NCT02800785.