bluuebunny/crossref_metadata_2025_split huggingface dataset:
Roles and Perceptions of Nurses During Implementation of a Medication Treatment for Opioid Use Disorder National Initiative
Authors: Radmall Ashley O. , Calder Spencer , Codell Nodira , Kelley Alan Taylor , Hawkins Eric , Jones Audrey L. , Hagedorn Hildi J. , Reynolds Mary Anne , Gordon Adam J. 
Published: May 2022

Abstract

Background
In the United States, a national priority exists to improve access to medication treatment for opioid use disorder (MOUD). Nurses can be an essential component of that care. We examined the perceptions and evolving roles of nurses in a national Veterans Health Administration (VHA) initiative designed to improve MOUD access within general medical settings.

Methods
From April 15, 2021, to June 16, 2021, we recruited nurses participating in VHA's Stepped Care for Opioid Use Disorder Train the Trainer Initiative—a national program intending to implement MOUD in general medical settings—to participate in an interview about their roles, perceptions, and experiences. The respondents answered our inquiries through an interview or responded to an email solicitation with written responses, which were then recorded, transcribed, and independently coded to identify themes.

Results
Nurses from 10 VHA facilities participated in an interview (n = 7) or completed the questionnaire (n = 4). Inadequate staffing, high patient-to-provider ratios, and time constraints were identified as barriers to MOUD care. Mentorship activities, existing VHA informational resources, and patients' willingness to accept treatment were identified as facilitators of MOUD care. The Stepped Care for Opioid Use Disorder Train the Trainer Initiative processes were acknowledged to promote role confidence, which in turn increased job satisfaction and empowered nurses to become content experts. Respondents often identified nurses as local lead facilitators in MOUD care.

Conclusions
In a national initiative to implement MOUD within general medical settings, nurses identified several barriers and facilitators to MOUD implementation. Nurses play vital collaborative care roles in enhancing access to MOUD.
When Moods and Behaviors Do Not Add Up
Authors: Larrieu-Jimenez Patricia , Salani Deborah 
Published: May 2022

Abstract
This case report presents a 40-year-old man presenting with mixed mental health symptoms including depression, anxiety, euphoria, sleep cycle disturbances, and alcohol use over several years. Multiple providers see the patient in varying specialties, initially focusing on depression, anxiety, and, later, substance use. Alcohol misuse can shadow underlying mental disorders. Therefore, early recognition and collaborative management are imperative to unveil the possibility of comorbid mental health disorders.
The Association Between Self-reported Sleep Quality and Self-care in Adults With Heart Failure
Authors: Spedale Valentina , Fabrizi Diletta , Rebora Paola , Luciani Michela , Alvaro Rosaria , Vellone Ercole , Riegel Barbara , Ausili Davide 
Published: May 2022

Background
Sleep disturbance is one of the most common symptoms among patients with heart failure (HF), and it may affect the ability of patients to perform self-care. There is a lack of evidence on the association between sleep quality and its components and self-care in adults with HF.

Objective
The aim of this study was to evaluate the association between sleep quality and its components and self-care in adults with HF.

Methods
This study is a secondary analysis of baseline data from the MOTIVATE-HF study, a randomized controlled trial on patients with HF and their caregivers. Only patients' data were analyzed in this study (n = 498). Sleep quality and self-care were evaluated with the Pittsburgh Sleep Quality Index and the Self-Care of Heart Failure Index v6.2, respectively.

Results
A habitual sleep efficiency of 75% to 84% was associated with lower self-care maintenance compared with a habitual sleep efficiency of 85% or greater (P = .031), as was taking sleep medications once or twice a week compared with less than once a week (P = .001). A frequency of daytime dysfunction less than once a week was associated with lower self-care management compared with a frequency of daytime dysfunction of 3 or more times a week (P = .025). Taking sleep medications less than once a week was associated with lower self-care confidence compared with taking sleep medications 3 or more times a week (P = .018).

Conclusion
Poor sleep quality is frequently reported by patients with HF. Sleep efficiency, sleep medications, and daytime dysfunction may influence self-care more than the other sleep quality components.
Associations Between Different Self-reported Social Risks and Neighborhood-level Resources in Medicaid Patients
Authors: Miller-Rosales Chris , McCloskey Jodi , Uratsu Connie S. , Ralston James D. , Bayliss Elizabeth A. , Grant Richard W. 
Published: May 2022

Background:
Adverse social conditions are a key contributor to health disparities. Improved understanding of how social risk factors interact with each other and with neighborhood characteristics may inform efforts to reduce health disparities.

Data:
A questionnaire of 29,281 patients was collected through the enrollment of Medicaid beneficiaries in a large Northern California integrated health care delivery system between May 2016 and February 2020.

Exposures:
Living in the least resourced quartile of neighborhoods as measured by a census-tract level Neighborhood Deprivation Index score.

Main Outcomes:
Five self-reported social risk factors: financial need, food insecurity, housing barriers, transportation barriers, and functional limitations.

Results:
Nearly half (42.0%) of patients reported at least 1 social risk factor; 22.4% reported 2 or more. Mean correlation coefficient between social risk factors was ρ=0.30. Multivariable logistic models controlling for age, race/ethnicity, sex, count of chronic conditions, and insurance source estimated that living in the least resourced neighborhoods was associated with greater odds of food insecurity (adjusted odds ratio=1.07, 95% confidence interval: 1.00–1.13) and transportation barriers (adjusted odds ratio=1.20, 95% confidence interval: 1.11–1.30), but not financial stress, housing barriers, or functional limitations.

Conclusions and Relevance:
We found that among 5 commonly associated social risk factors, Medicaid patients in a large Northern California health system typically reported only a single factor and that these factors did not correlate strongly with each other. We found only modestly greater social risk reported by patients in the least resourced neighborhoods. These results suggest that individual-level interventions should be targeted to specific needs whereas community-level interventions may be similarly important across diverse neighborhoods.
Predicting High-risk and High-cost Patients for Proactive Intervention
Authors: Gao Jian , Moran Eileen , Higgins Donald S. , Mecher Carter 
Published: May 2022

Background:
It is well known that 20% of the patients incur 80% of health care costs and many diseases and complications can be prevented or ameliorated with prompt intervention. One of the well-recognized strategies for cost reduction and better outcomes is to predict or identify high-risk and high-cost (HRHC) patients for proactive intervention.

Objective:
The objective of this study was to develop a predictive model that can be used to identify HRHC patients more accurately for proactive intervention.

Methods:
This is an observational study using fiscal year (FY) 2018 administrative data to predict FY 2019 total cost at the patient level. All 5,676,248 patients who received care in both FYs 2018 and 2019 from the Veterans Health Administration were included in the analyses. The Veterans Health Administration Corporate Data Warehouse was our main data source. With split-sample analyses, 3 sets of patient comorbidities and 5 statistical models were assessed for the highest predictive power.

Results:
The Box-Cox regression using comorbidities designated by the expanded CCSR (Clinical Classifications Software Refined) groups as predictors yielded the highest predictive power. The R
2 reached 0.51 and 0.37 for the transformed and raw scale cost, respectively.

Conclusions:
The predictive model developed in this study exhibits substantially higher predictive power than what has been reported in the literature. The algorithm based on administrative data and a publicly available patient classification system can be readily implemented by other value-based health systems to identify HRHC patients for proactive intervention.
“A Different Normal”: Living With Cancer During the COVID-19 Pandemic in Australia
Authors: Kerr Lucille , Ilangakoon Chanika , Russo Philip 
Published: May 2022

Background
The COVID-19 pandemic has seen mass disruptions to healthcare globally. People with cancer are in a vulnerable position, and treatment teams may be anxious in making decisions that try to balance risks associated with malignant disease with those of potential exposure to COVID-19. In addition, palliative care is likely to have experienced significant burdens during the pandemic. As a result of COVID-19 disturbances, people with cancer and their caregivers may have increased stressors and therefore poor outcomes.

Objective
The aim of this study was to explore the experiences of people with cancer and their caregivers during the COVID-19 pandemic, with the aim to inform future oncology practice during infectious crises.

Methods
This qualitative study had 2 stages. Stage 1 involved key informant interviews (n = 16) conducted with healthcare professionals working in cancer care. These were used to inform the stage 2 interview guide for participants who had cancer or were caregivers of someone with cancer (n = 19). Data were thematically analyzed using NVivo.

Results
Five interconnected themes were identified from the interviews: uncertainty and vulnerability, constraints and restrictions, isolation and disconnection, burdens and stressors, and adaptability and resilience. Across themes, complexity and diversity in experience were demonstrated.

Conclusions
The findings suggest cancer concerns outweigh those associated with the COVID-19 pandemic. Many difficulties experienced by healthcare professionals and people with cancer during the COVID-19 pandemic were related to social isolation.

Implications for Practice
Provision of psychosocial and spiritual telehealth services should be increased. It is important during times of crisis to pay attention to those who are most vulnerable.
The Journey: Parental Expectations and Perceptions of Therapy Services for Children With Down Syndrome
Authors: Early Diana , Thompson Mary , Simpkins Susan , Luedtke-Hoffmann Kathleen , Poskey Gail 
Published: May 2022

Purpose:
The researchers sought to identify and describe parents' expectations and perceptions of therapy services received by their children with Down syndrome.

Methods:
This study used a qualitative descriptive approach conducted in 2 phases: individual semi-structured parent interviews followed by focus groups. Analysis of interview transcripts served as the basis for development of codes, categories, and themes describing parents' beliefs, values, and opinions of their children's therapy.

Results:
Within the metaphor of The Journey, 3 major themes emerged: Where are we going? Who's driving the car? What I really need for this trip.

Conclusions:
Parents value the principles of family-centered care and want a partnership with therapists in caring for their children. Therapists can help parents of children with Down syndrome navigate their children's therapy services by establishing a relationship of trust and by communicating with respect, understanding, and compassion.
Pediatric Assessments for Preschool Children in Digital Physical Therapy Practice: Results From a Scoping Review
Authors: Trottier Nathalie , Hurtubise Karen , Zischke Cherie , Camden Chantal 
Published: May 2022

Purpose:
To examine and map the extent and scope of pediatric physical therapy assessments previously used in the digital context.

Methods:
A 6-step evidence-based scoping methodological framework was used. Articles containing assessments conducted by a physical therapist using technology to assess a child aged 0 to 5 years were included and synthesized using descriptive statistics and thematic analysis.

Results:
Eighteen studies identifying 25 assessments were eligible. Asynchronous observational developmental instruments administered in the child's natural environment to those at risk or presenting with neurodevelopmental conditions were the most common. There is a need for detailed procedures and training for caregivers and clinicians.

Conclusion:
Limited research exists on the use of pediatric physical therapy assessments for young children with musculoskeletal and cardiorespiratory conditions in a digital context. The development of new instruments or modifications of existing ones should be considered and be accompanied by detailed administration protocols and user guides.
Glucose dysregulation and repolarization variability markers are short-term mortality predictors in decompensated heart failure
Authors: Piccirillo Gianfranco , Moscucci Federica , Carnovale Myriam , Corrao Andrea , Di Diego Ilaria , Lospinuso Ilaria , Sciomer Susanna , Rossi Pietro , Magrì Damiano 
Published: May 2022

Objective
As recently reported, elevated fasting glucose plasma level constitutes a risk factor for 30-day total mortality in acutely decompensated chronic heart failure (CHF). Aim of this study was to evaluate the 30-day mortality risk in decompensated CHF patients by fasting glucose plasma level and some repolarization ECG markers.

Method
A total of 164 decompensated CHF patients (M/F: 94/71; mean age, 83 ± 10 years) were studied; Tend (Te), QT interval (QT) and 5 min of ECG recordings were obtained, studying mean, SD and normalized index of the abovementioned ECG intervals. These repolarization variables and fasting glucose were analyzed to assess the 30-day mortality risk among these patients.

Results
Thirty-day mortality rate was 21%, deceased subjects showed a significant increase in N terminal-pro-brain natriuretic peptide (P < 0.001), higher sensitivity cardiac troponin, fasting glucose, creatinine clearance, QTSD, QTVN, Te mean, TeSD and TeVN than the survivals. Multivariable regression analysis reported that fasting glucose (hazard ratio, 1.59; 95% confidence interval, 1.09–2.10; P < 0.01), Te mean (hazard ratio, 1.03; 95% confidence interval, 1.01–1.05; P < 0.01) and QTSD (hazard ratio, 1.17; 95% confidence interval, 1.01–1.36; P < 0.05) were significantly related to higher mortality risk, whereas only fasting glucose (hazard ratio, 1.84; 95% confidence interval, 1.12–3.02; P < 0.05) and Te mean (hazard ratio, 1.07; 95% confidence interval, 1.02–1.11; P < 0.01) were associated to cardiovascular mortality.

Conclusion
Data suggest that two simple, inexpensive, noninvasive markers, as fasting glucose and Te, were capable to stratify the short-term total and cardiovascular mortality risk in acutely decompensated CHF.
Incorporating Genetics Services into Adult Kidney Disease Care
Authors: Bogyo Kelsie , Vena Natalie , May Halie , Rasouly Hila Milo , Marasa Maddalena , Sanna-Cherchi Simone , Kiryluk Krzysztof , Nestor Jordan , Gharavi Ali 
Published: May 2022

AbstractStudies have shown that 1 in 10 adults with chronic kidney disease has a genetic component to their disease. However, genetic services in adult nephrology are limited. An adult Kidney Genetics Clinic was established within the nephrology division at a large urban academic medical center to increase access to genetic services and testing in adults with kidney disease. Between June 2019 through December 2021, a total of 363 patients were referred to the adult Kidney Genetics Clinic. Of those who completed genetic testing, a positive, diagnostic finding was identified in 27.14% and a candidate diagnostic finding was identified in 6.67% of patients, while a non-diagnostic positive finding was identified in an additional 8.57% of patients, resulting in an overall yield of 42.38% for clinically relevant genetic findings in tested patients. A genetic diagnosis had implications for medical management, family member testing, and eligibility for clinical trials. With the utilization of telemedicine, genetic services reached a diverse geographic and patient population. Genetic education efforts were integral to the clinic’s success, as they increased visibility and helped providers identify appropriate referrals. Ongoing access to genomic services will remain a fundamental component of patient care in adults with kidney disease.
HMGB1 correlates with severity and death of COVID-19 patients
Authors: Vicentino Amanda Roberta Revoredo , Fraga-Junior Vanderlei da Silva , Palazzo Matheus , Tasmo Natalia Recardo Amorim , Rodrigues Danielle A. S. , Barroso Shana Priscila Coutinho , Ferreira Samila Natiane , Borges Anna Cristina Neves , Allonso Diego , Fantappié Marcelo Rosado , Scharfstein Julio , Oliveira Ana Carolina , Vianna-Jorge Rosane , Vale André Macedo , Coutinho-Silva Robson , Savio Luiz Eduardo Baggio , Canetti Claudio , Benjamim Claudia Farias 
Published: May 2022

ABSTRACTSARS-CoV-2, the causative agent of the ongoing COVID-19, has spread worldwide since it was first identified in November 2019 in Wuhan. Since then, it was already demonstrated an exuberant inflammation, cytokine storm, endothelium dysfunction, platelets hyperactivation and aggregation, following T cell exhaustion leading to severe multi-organ damage and death of COVID-19 patients. Here, we sought to identify molecular biomarkers of disease severity in a Brazilian cohort of COVID-19 patients by measuring the serum levels of endogenous danger signals. Our data revealed that ICU patients that are critically ill, at the early hyperinflammatory phase of COVID-19 (around 12-25 days after hospital admission) display higher serum levels of the classical alarmin HMGB1. Serum levels of HMGB1 were positively correlated with cys-leukotrienes, D-dimer, AST, and ALT. Notably, we verified that HMGB1 levels above 125.4 ng/mL is the cut off that distinguishes the patients that are at higher risk of death. Serum levels of extracellular ATP, PGE2, LTB4, cys-LTs, and tissue factor were also elevated in the serum of ICU patients. In conclusion, we propose that serum levels of HMGB1 serve as prognostic biomarker of risk of death in patients suffering from severe COVID-19.
Research Letter: Incidence of SARS-CoV-2 infection among unvaccinated US adults during the Omicron wave
Authors: Alejo Jennifer L. , Chiang Teresa PY , Mitchell Jonathan , Abedon Aura T. , Jefferis Alexa A. , Werbel William , Massie Allan B. , Makary Martin A. , Segev Dorry L. 
Published: May 2022

AbstractAs of 4/20/2022, approximately 23% of the eligible US population was unvaccinated. We studied COVID-19 infections during the Omicron (B.1.1.529) wave in unvaccinated US adults, stratified by pre-Omicron antibody levels. Anti-spike serologic testing was performed prior to the Omicron wave in the United States (9/23/21-11/5/21) and participants were surveilled to determine incident COVID-19. Only 12% of those who entered the wave with antibodies reported a test-confirmed COVID-19 infection, compared to 35% of those without antibodies prior to the Omicron wave. Effectiveness of these anti-RBD antibodies in this unvaccinated population was 67%. Among people with antibodies, titer did not appear to be associated with risk of test-confirmed Omicron infection.
Clinical assessment and voxel-based morphometry study of untreated Adult Attention deficit hyperkinetic disorders patients
Authors: Morsy Sara , Ghozy Sherief , Morsy Ahmed , Dmytriw Adam A. , Kallmas Kevin , Naveed Sadiq 
Published: May 2022

AbstractPurposeAdult ADHD is one of the most undiagnosed diseases mainly because of the misperception that ADHD is a childhood disease. In this study, we assess the characteristic features of adult ADHD using clinical assessment and structural Magnetic resonance imaging (sMRI)MethodsWe obtained structural MRI data from the UCLA Consortium for Neuropsychiatric Phenomics for 21 untreated adult ADHD patients and 21 age and gender propensity-matched control patients. For clinical assessment, we compared the scores of Barrat impulsivity score, Dickman impulsivity inventory II, and Eysenck’s Impulsivity Inventory. We then compared grey matter volume (GMV) between ADHD and control patients using a two-sample t-test. We also assessed the correlation between different clinical assessments and GMV.ResultsBased on our results, adult ADHD showed significantly higher impulsivity scores, however, no significant difference in functional impulsivity scores or empathy summary scores. For sMRI, there was a significant decrease of GMV of the left cuneus in female ADHD patients. For clinical assessment scales, only the motor impulsiveness subdomain showed a significant positive correlation with the GMV of the left precuneus.ConclusionsIn this study, we assessed the characteristic sMRI features and clinical assessment scores for untreated adult ADHD. Our results show that a study with a bigger sample size can identify diagnostic features for adult ADHD.
Universality of Universal Health Coverage: a Scoping Review
Authors: Endalamaw Aklilu , Gilks Charles F , Ambaw Fentie , Assefa Yibeltal 
Published: May 2022

AbstractBackgroundUniversal health coverage (UHC) is achieved in the primary healthcare pathways. UHC is about population coverage, services coverage and financial protection. Tracer indicators are used to measure the progress towards UHC. There is inadequate evidence that assess the extent of the universality of UHC. Evidence is, therefore, needed to map the existing literature and summarize the issues covered in the dimensions of UHC.MethodsA systematic search was carried out in the Web of Science and PubMed databases. Hand searches were also conducted to find articles from Google Scholar, the World Bank Library, the World Health Organization Library, the United Nations Digital Library Collections, and Google. Articles on UHC coverage, financial risk protection, quality of care, and inequity were included. A stepwise approach was used to identify and select relevant studies, conduct data charting, collation and summarization, as well as report results. Simple descriptive statistics and narrative synthesis were used to present the findings.ResultsForty-seven papers were included in the final review. One-fourth of the articles (25.5%) were from the African region and 29.8% were from lower-middle-income countries. More than half of the articles (54.1%) used a quantitative research approach. Of included articles, coverage was assessed by 53.2% of articles; financial risk protection by 27.7%, inequity by 25.5% and quality by 6.4% of the articles as their main research objectives or mentioned in result section. Most (42.5%) of articles investigated health promotion and 2.1% palliation and rehabilitation services. Policy and health care level and cross-cutting barriers were identified in the progress of UHC.ConclusionsThe results of the study showed that majorities of evidence were from Africa’s region. Methodologically, the quantitative approach was a more frequently used research design to investigate UHC. Palliation and rehabilitation health care services need attention in the analysis of the progress towards UHC. The finding of the current evidence is noteworthy to focus on quality and inequity of health services in the future UHC research. Comprehensive evidence is needed to fully understand and progressively realize UHC.