bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development of Quality Measures for Pediatric Agitation Management in the Emergency Department
Authors: Hoffmann Jennifer A. , Johnson Julie K. , Pergjika Alba , Alpern Elizabeth R. , Corboy Jacqueline B. 
Published: January 2022

ABSTRACT

Objective:
Pediatric mental health emergency department (ED) visits that involve restraints for agitation are increasing. Quality measures are used to assess and improve healthcare quality. Our objective was to develop quality measures for pediatric ED agitation management informed by multidisciplinary perspectives.

Methods:
A multidisciplinary panel developed quality measures for pediatric ED agitation management through the modified Delphi method. Panelists ranked measures in importance and feasibility on a 9-point scale during 2 survey rounds, with a teleconference discussion between surveys. Consensus was defined by >75% of panelists ranking a quality measure highly (≥7) in importance and a median feasibility score of ≥4.

Results:
Panelists included 36 physicians, nurses, social workers, security, child life specialists, hospital data analysts, and parents. The panel reached consensus on 20 quality measures. Measures with the highest percentage of scores with importance ≥7 were related to adverse medication events, patients restrained, staff/patient injuries, reescalation plans, presence of an algorithm to standardize care, formal staff training on deescalation techniques, time to medication administration, and room safety.

Conclusions:
Twenty quality measures that incorporate multidisciplinary perspectives were developed for pediatric ED agitation management. Once operationalized and field tested, these measures may be used to assess and improve healthcare quality for pediatric agitation.
An Integrated Point-of-Care Ultrasound Curriculum: An Evidence-Based Approach
Authors: Breunig Michael , Huckabee Michael , Rieck Katie M. 
Published: January 2022

Abstract
Point-of-care ultrasound (POCUS) has been demonstrated to improve students' medical knowledge and clinical exam skills and advances patient care through numerous diagnostic and therapeutic applications. Despite the growing use of ultrasound in medical education and clinical practice, few physician assistant (PA) programs have successfully integrated POCUS education into their curricula. This manuscript describes an evidence-based approach for integrating POCUS education throughout a 2-year PA curriculum, with the goal of serving as a useful guidepost for other PA programs as they strive to incorporate this valuable skill into their curricula.
A Clinical Year PACKRAT Score That Identifies Risk of Physician Assistant National Certifying Examination Failure: A 10-Year Analysis
Authors: Stream Charles 
Published: January 2022

Purpose
A 10-year analysis to identify a Physician Assistant Clinical Knowledge Rating and Assessment Tool (PACKRAT) score that identifies students at risk of poor performance on the Physician Assistant National Certifying Examination (PANCE) was performed.

Methods
A total of 712 student PACKRAT scores were analyzed to identify a score that would indicate those students at risk of failing the PANCE.

Results
Students with scores of 145 or lower were identified as a risk after the completion of clinical rotations. Remediation to strengthen knowledge deficits was implemented for those with scores of 145 or lower.

Conclusion
After 9 years of remediating those students identified as at-risk according to their PACKRAT score, the program's average PANCE pass rate increased from 92.1% to 96.7% with pass rates of 100% over the last 2 years.
Urgent Care: A Valuable New Setting for Training Physician Assistant Students
Authors: Addington Tiffany , Johnson Jennifer , Montalbano Amanda 
Published: January 2022

Purpose
The purpose of this study was to assess physician assistant (PA) students' perceptions of using a pediatric urgent care clinic for their pediatric acute care experience.

Methods
PA students were surveyed on completion of their pediatric urgent care rotations (June 2017 to March 2020). Positive perception was ≥4 on a 5-point scale or ≥80% on agreement for dichotomous variables. Qualitative question responses were open coded for positive themes and opportunities for improvement.

Results
Of the 32 students, 29 (90.6%) completed evaluations. Students reported an overall positive perception: patient care, 4.66 (standard deviation [SD] 0.61); system-based practice, 4.76 (SD 0.44); professionalism, 4.90 (SD 0.31); medical knowledge, 4.90 (SD 0.31); and practice-based learning and improvement, 4.66 (SD 0.61). However, interpersonal and communication skills were rated positively on only 65.5% of the evaluations.

Conclusions
An academic pediatric urgent care clinic was regarded positively by PA students as a novel setting to complete a pediatric acute care rotation, but students required more opportunities to work collaboratively.
Long-acting amylin analogues for the management of obesity
Authors: Mathiesen David S. , Bagger Jonatan I. , Knop Filip K. 
Published: January 2022

Purpose of review
To summarize recent developments of long-acting amylin analogues for the treatment of obesity and to outline their mode of action.

Recent findings
Amylin is a pancreatic hormone acting to control energy homeostasis and body weight. Activity at the calcitonin and amylin receptors in the area postrema seems to – at least partly – be responsible for these effects of amylin. Both preclinical and early-stage clinical studies investigating long-acting amylin receptor analogues demonstrate beneficial effects on body weight in obesity. Cagrilintide, a novel amylin analogue suitable for once-weekly administration, is in phase II clinical development and has shown promising body weight reducing effects alone and in combination with the glucagon-like peptide 1 receptor agonist semaglutide.

Summary
Long-acting amylin analogues have emerged as a possible pharmacotherapy against obesity, but more studies are needed to support the utility and long-term effects of this strategy in relevant populations.
“Individualized Care” From the Viewpoint of Turkish Patients and Oncology Nurses
Authors: Altinisik Muge , Arikan Fatma 
Published: January 2022

Background
Cancer is a chronic disease that leads to major life changes for individuals because it affects physical, psychological, social, and spiritual aspects. It is important that nursing care is able to respond to different individual needs regarding the challenges experienced by cancer patients.

Objective
The aim of this study was to evaluate the concept of individualized care as perceived by oncology patients and nurses working in oncology clinics.

Methods
This descriptive, cross-sectional study was conducted at a medical oncology clinic in Turkey. Participants were oncology nurses (n = 23) and cancer patients (n = 180) discharged after treatment. The data were collected using the Patient-Nurse Identification Form, Individualized Care Scale (ICS-A, ICS-B), and Individualized Care Scale-Nurse.

Results
Nurses’ perceptions of individualized care were more positive than those of patients. Patients’ age, marital status, education level, income level, and disease characteristics did not have an effect on their awareness of interventions supporting their individuality or on their perceptions of individualized care. More years of employment in the nursing profession and in oncology had a positive effect on individualization of patient care.

Conclusion
Perceptual differences between patients and nurses exist; individualized care plans may be needed to minimize the differences.

Implications for Practice
These study outcomes can guide individualized care for cancer patients.
Opportunities for Poetic Analysis in Qualitative Nursing Research
Authors: Tarbi Elise C. , Morgan Brianna 
Published: January 2022

Background
The voices of people living with serious, life-limiting illnesses are often underrepresented in research. Furthermore, a biomedical bias toward treatment and stigma associated with illness prevents healthcare providers from engaging with topics critical for people living with serious illness, such as existential communication and inner strength. Poetry is an established method of analysis and dissemination in qualitative research but is underutilized by nursing researchers.

Objectives
The purpose of this article is to demonstrate the inherent opportunities in using poetry in nursing research to highlight the voices and issues of people whose experiences are outside the assumed norms of the biomedical paradigm.

Methods
We apply methods of poetic analysis to qualitative data sets that highlight the voice of people living with serious illness—in naturally occurring palliative care conversations and dyadic interviews of people with dementia and their care partners. Methods of poetic analysis include poetic transcription and voice poems.

Results
Methods of poetic analysis allowed us to engage with the data reflexively to intensify and evoke the deeper meaning of narratives. Poetic analysis served to center the participant’s voices by using their own words to demonstrate themes. Poems are a uniquely accessible method of disseminating complex findings, as poems relay layered cognitive and emotional meaning resonant of universal human experiences in a concise and relatable format.

Discussion
Especially in circumstances where participant’s voices are underrepresented, poetic analysis enables nurse researchers to challenge normative assumptions and reimagine a difference-centered society. Our findings offer opportunities to incorporate poetry into clinical and research nursing training to better meet the needs of the populations we serve.
Relationship of Psychological Characteristics to Daily Life Ischemia: An Analysis From the National Heart, Lung, and Blood Institute Psychophysiological Investigations in Myocardial Ischemia
Authors: Dasa Osama , Mahmoud Ahmed N. , Kaufmann Peter G. , Ketterer Mark , Light Kathleen C. , Raczynski James , Sheps David S. , Stone Peter H. , Handberg Eileen , Pepine Carl J. 
Published: January 2022

ABSTRACT

Objective
Cardiac ischemia during daily life is associated with an increased risk of adverse outcomes. Mental stress is known to provoke cardiac ischemia and is related to psychological variables. In this multicenter cohort study, we assessed whether psychological characteristics were associated with ischemia in daily life.

Methods
This study examined patients with clinically stable coronary artery disease (CAD) with documented cardiac ischemia during treadmill exercise (n = 196, mean [standard deviation] age = 62.64 [8.31] years; 13% women). Daily life ischemia (DLI) was assessed by 48-hour ambulatory electrocardiophic monitoring. Psychological characteristics were assessed using validated instruments to identify characteristics associated with ischemia occurring in daily life stress.

Results
High scores on anger and hostility were common in this sample of patients with CAD, and DLI was documented in 83 (42%) patients. However, the presence of DLI was associated with lower anger scores (odds ratio [OR] = 2.03; 95% confidence interval [CI] = 1.12–3.69), reduced anger expressiveness (OR = 2.04; 95% CI = 1.10–3.75), and increased ratio of anger control to total anger (OR = 2.33; 95% CI = 1.27–4.17). Increased risk of DLI was also associated with lower hostile attribution (OR = 2.22; 95% CI = 1.21–4.09), hostile affect (OR = 1.92; 95% CI = 1.03–3.58), and aggressive responding (OR = 2.26; 95% CI = 1.25–4.08). We observed weak inverse correlations between DLI episode frequency and anger expressiveness, total anger, and hostility scores. DLI was not associated with depression or anxiety measures. The combination of the constructs low anger expressiveness and low hostile attribution was independently associated with DLI (OR = = 2.59; 95% CI = 1.42–4.72).

Conclusions
In clinically stable patients with CAD, the tendency to suppress angry and hostile feelings, particularly openly aggressive behavior, was associated with DLI. These findings warrant a study in larger cohorts, and intervention studies are needed to ascertain whether management strategies that modify these psychological characteristics improve outcomes.
Sleep, Positive Affect, and Circulating Interleukin-6 in Women With Temporomandibular Joint Disorder
Authors: Hunt Carly A. , Mun Chung Jung , Owens Michael A. , Lerman Sheera F. , Kunatharaju Shriya , Tennen Howard A. , Buenaver Luis F. , Campbell Claudia M. , Haythornthwaite Jennifer A. , Smith Michael T. , Finan Patrick H. 
Published: January 2022

ABSTRACT

Objective
Systemic inflammation is commonly observed in idiopathic chronic pain conditions, including temporomandibular joint disorder (TMD). Trait positive affect (PA) is associated with lower inflammation in healthy controls, but those effects may be threatened by poor sleep. The associations between PA with proinflammatory cytokine activity and potential moderation by sleep in chronic pain are not known. We thus investigated the association between PA and circulating interleukin-6 (IL-6) and moderation of that association by sleep in a sample of women with TMD and sleep difficulties.

Methods
Participants (n = 110) completed the insomnia severity index and provided blood samples at five intervals throughout an evoked pain testing session. They then completed a 14-day diary assessing sleep and affect, along with wrist actigraphy.

Results
There was not a significant main effect of PA on resting or pain-evoked IL-6 (b = 0.04, p = .33). Diary total sleep time (b = −0.002, p = .008), sleep efficiency (b = −0.01, p = .005), sleep onset latency (b = 0.006, p = .010), and wake after sleep onset (b = 0.003, p = .033) interacted with PA to predict IL-6, such that PA inversely predicted IL-6 at higher levels of total sleep time and sleep efficiency and at lower levels of sleep onset latency and wake after sleep onset. Surprisingly, when sleep was poor, PA predicted greater IL-6.

Conclusions
The potential salutary effects of PA on resting IL-6 erode when sleep is poor, underscoring the importance of considering sleep in conceptual and intervention models of TMD.
Stress Measurement in Primary Care: Conceptual Issues, Barriers, Resources, and Recommendations for Study
Authors: Wulsin Lawson R. , Sagui-Henson Sara J. , Roos Lydia G. , Wang Diana , Jenkins Brooke , Cohen Beth E. , Shah Amit J. , Slavich George M. 
Published: January 2022

ABSTRACT

Objective
Exposure to stressors in daily life and dysregulated stress responses are associated with increased risk for a variety of chronic mental and physical health problems, including anxiety disorders, depression, asthma, heart disease, certain cancers, and autoimmune and neurodegenerative disorders. Despite this fact, stress exposure and responses are rarely assessed in the primary care setting and infrequently targeted for disease prevention or treatment.

Method
In this narrative review, we describe the primary reasons for this striking disjoint between the centrality of stress for promoting disease and how rarely it is assessed by summarizing the main conceptual, measurement, practical, and reimbursement issues that have made stress difficult to routinely measure in primary care. The following issues will be reviewed: a) assessment of stress in primary care, b) biobehavioral pathways linking stress and illness, c) the value of stress measurements for improving outcomes in primary care, d) barriers to measuring and managing stress, and e) key research questions relevant to stress assessment and intervention in primary care.

Results
On the basis of our synthesis, we suggest several approaches that can be pursued to advance this work, including feasibility and acceptability studies, cost-benefit studies, and clinical improvement studies.

Conclusions
Although stress is recognized as a key contributor to chronic disease risk and mortality, additional research is needed to determine how and when instruments for assessing life stress might be useful in the primary care setting, and how stress-related data could be integrated into disease prevention and treatment strategies to reduce chronic disease burden and improve human health and well-being.
Governance for Patient Safety: A Framework of Strategy Domains for Risk Management
Authors: Buja Alessandra , Damiani Gianfranco , Manfredi Mariagiovanna , Zampieri Chiara , Dentuti Elena , Grotto Giulia , Sabatelli Giuseppe 
Published: January 2022

Background
Adverse events in healthcare are primarily due to system failures rather than individuals. Risk reduction strategies should therefore focus on strengthening systems, bringing about improvements in governance, and targeting individual practices or products. The purpose of this study was to conduct a scoping review to develop a global framework of management strategies for sustaining a safety-oriented culture in healthcare organizations, focusing on patient safety and the adoption of good safety-related practices.

Methods
We conducted a search on safety-related strategies in 2 steps. The first involved a search in the PubMed database to identify effective, broadly framed, cross-sector domains relevant to clinical risk management strategies in healthcare systems. In the second step, we then examined the strategies adopted by running a scoping review for each domain.

Results
Our search identified 8 strategy domains relevant to patient safety: transformational leadership, patient engagement, human resources management quality, innovation technology, skills certification, education in patient safety, teamwork, and effective communication.

Conclusions
This scoping review explores management strategies key to healthcare systems’ efforts to create safety-oriented organizations. Improvement efforts should focus particularly on the domains identified: combined together, they would nurture an overall safety-oriented culture and have an impact on preventable adverse events.
Postdischarge Adverse Events Among Neonates Admitted to the Neonatal Intensive Care Unit
Authors: Tsilimingras Dennis , Natarajan Girija , Bajaj Monika , Agarwal Prashant , Lua Jorge , Deriemacker Amanda , Zuair Areeg , Misra Dawn , Janisse James , Zhang Liying , Schnipper Jeffrey 
Published: January 2022

Objectives
We aimed to determine the rate of postdischarge adverse events (AEs), classify the types of postdischarge AEs, and identify risk factors for postdischarge AEs among neonates admitted to the neonatal intensive care unit (NICU).

Study Design
This was a prospective cohort study of neonates admitted to the NICU from February 2017 through June 2019. We enrolled 170 neonates from a level 4 NICU who were being discharged home and whose parents can speak English and could be contacted after discharge. The main outcome of the study was postdischarge AEs based on structured telephone interviews, health record review, and adjudication by 2 blinded, trained physicians using a previously established methodology.

Results
Fourteen percent of 170 neonates admitted to the NICU experienced postdischarge AEs, with 48% being either preventable or ameliorable. Adverse drug events and procedural complications comprised most of the AEs (48%), but most of the preventable and ameliorable AEs were due to management, therapeutic, or diagnostic errors. Seventy-nine percent of neonates who suffered an AE experienced either a readmission to the hospital or an emergency department visit. Neonates admitted to a level 4 NICU from another NICU (level 1, 2, or 3) (adjusted odds ratio, 3.62; 95% confidence interval, 1.27–12.60; P = 0.01) and those 28 to 36 weeks (adjusted odds ratio, 11.38; 95% confidence interval, 1.67–127.98; P = 0.01) had a significantly higher risk of AEs at discharge.

Conclusions
Neonates discharged from a level 4 NICU were at high risk for experiencing postdischarge AEs. The identification of AE types and risk factors can be used to guide efforts to develop interventions to improve neonatal patient safety during the postdischarge period.
Prevalence of Inflammatory Back Pain in a Low-Income Population
Authors: de Oliveira Jobson Lopes , Maciel da Silva Guilherme Ferreira , Nogueira Igor Albuquerque , Azevedo Artur Queirós , Baraliakos Xenofon , Rocha Francisco Airton Castro 
Published: January 2022

Background
Inflammatory back pain (IBP) is a major criterion in identifying axial spondyloarthritis. Whether socioeconomic issues impact prevalence of IBP assessed using standardized questionnaires has not been assessed. We determined IBP prevalence and performance of IBP questionnaires in a low-income, low-literacy population.

Methods
Individuals were interviewed in Fortaleza, Brazil, for the prevalence of IBP using Calin's, Berlin, and ASAS IBP questionnaires; monthly family income (US dollars), literacy (>/≤8 school years [SYs]), and smoking habit (present/absent) were registered.

Results
Two hundred nineteen individuals were included (mean age, 38.2 ± 12.9 years), 110 (50.2%) men, 58 (26.4%) White, and 38 (17.3%) smokers. Overall, 152 (69.4%) declared <US $720 (mean local income) earnings, and 64 (29.2%) had ≤8 SYs. Chronic back pain was declared by 134 (61%) with 32 (14.6%), 25 (11.9%), and 63 (28.3%) fulfilling ASAS, Berlin, and Calin's IBP criteria, respectively. Chronic back pain or IBP prevalence was similar regardless of ethnicity, smoking habit, income, or literacy with IBP prevalence higher among women (p = 0.006).

Conclusions
This is the first report on IBP prevalence in a low-income, low-literacy population. Chronic back pain was highly prevalent with almost 15% having IBP using ASAS criteria. Inflammatory back pain prevalence looked similar using ASAS and Berlin criteria; values were higher using Calin's criteria. Literacy or income did not influence IBP prevalence in this population, which was higher among women. The higher prevalence of IBP using Calin's criteria in this population should be taken into account as it might impact studies aiming to determine prevalence of axial spondyloarthritis in clinical studies in this scenario.
Caudal Septal Deviation
Authors: Wiederkehr Iris , Kawabata Yuya , Tsumiyama Shinya , Hosokawa Yu , Iimura Jiro , Otori Nobuyoshi , Miyawaki Takeshi 
Published: January 2022

Objective
Caudal septal deviation (CSD) correction during septorhinoplasty is challenging, and various surgical modifications and evaluations remain controversial. This study aimed to introduce an objective evaluation method based on computed tomography (CT) images to measure the effectiveness of septorhinoplasty for CSD treatment.

Methods
We retrospectively analyzed preoperative and postoperative CT images of patients who had undergone functional open septorhinoplasty by the plastic surgery and otorhinolaryngology teams between January and September 2019. Using OsiriX Lite (Pixmeo, Switzerland), CSD was calculated as the distance between the septum midline and palatal plane. Deformation was categorized as C-shaped unilateral or S-shaped bilateral deviations. The change in the distance between preoperative and postoperative images was considered because of surgical intervention.

Results
Twenty patients (mean age, 35 years; 13 males [65%], 7 females [35%]) were included. The median deviation was 3.01 mm (range, 0.45–7.34 mm) preoperatively and 1.6 mm (range, 0.5–2.86 mm) postoperatively, indicating a reduction of 1.26 mm (median, P < 0.05) due to surgical intervention. C- and S-shaped deviations were seen preoperatively in 9 (45%) and 11 (55%) patients and postoperatively in 6 (30%) and 14 (70%) patients, respectively. The mean ± SD time of analysis was 7 ± 2.1 minutes.

Conclusions
Caudal septal deviation showed significant changes from preoperative to postoperative CT images, based on the distance between the actual septum midline and the constructed straight septum. This allowed effective evaluation of surgical efficacy for septum straightening. Although additional studies are needed, this method allows clearer stratification of surgical outcomes.