bluuebunny/crossref_metadata_2025 huggingface dataset:
Continuity: A Person or a Process?
Authors: McAllister Mary
Published: November 2011

YOU ARRIVE FOR YOUR SHIFT IN THE NICU. YOU SEE THAT you are assigned to care for an infant who had surgery months ago and has been in the unit for what seems like forever. Amazingly, you’ve never cared for this infant and his family before. What gives? How are you to know what this little one likes or doesn’t like? What will it be like to meet his family for the first time? Is there anyone around who knows them well?
Evidence-Based Review of Retinopathy of Prematurity Prevention in VLBW and ELBW Infants
Authors: DiBiasie AnnMarie
Published: November 2011

Retinopathy of prematurity (ROP) continues to be a significant complication in preterm neonates despite advances in neonatal care. Very low birth weight and extremely low birth weight infants continue to suffer from the sequelae of premature birth, including ROP. Controversy and uncertainty surround prevention of ROP. Possible preventive strategies include the use or restriction of oxygen therapy; steroid therapy; changes in blood transfusion protocols; reduced exposure of the retina to light; and administration of nutritional factors, indomethacin, and D-penicillamine. This article reviews recent studies that have proved or disproved the effectiveness of these preventive measures. It also identifies the implications of the study results for clinical practice and makes recommendations for future research.
News of The Academy of Neonatal Nursing
Authors: Brott Shirley
Published: November 2011

“The conference was topnotch and well-rehearsed,” says Ginny McCann, Nurse Educator at Women’s and Infants Hospital in Providence, Rhode Island. “I always judge a conference on what new ‘pearls’ (of wisdom) I have taken away and this year there were many. I was most impressed with Dr. Susan Ludington’s research regarding quiet sleep fostering brain development through the use of Kangaroo Care.” Jay Goldsmith’s lecture on oxygen targeting and improvement in respiratory care was also center stage for many attendees including Jody Ridky, RN, of Clarksville, Maryland, “Imagine significantly decreasing ROP and CLD by changes in practice!” (For more information on these subjects, go to “Neurophysiologic Assessment of Neonatal Sleep Organization: Preliminary Results of a Randomized, Controlled Trial of Skin Contact With Preterm Infants” in Pediatrics 117(5): 909–923, and “What is on the Horizon for Neonatal Resuscitation?” NeoReviews, 2001, E51–57.)
News of The Academy of Neonatal Nursing
Authors: Brott Shirley
Published: November 2011

Upon of the retirement of Charles Rait, RN, MSEd, PNC, Debbie Fraser Askin, RNC, MS, has agreed to work with ANN’s Executive Committee to move the Academy forward. Ms. Askin’s connection to the journal, as well as her clinical practice position at St. Boniface Hospital, Winnipeg, and teaching position at the University of Manitoba, give her a strong background in education with application to clinical practice.
It’s a Small World
Authors: Askin Debbie Fraser
Published: November 2011

THIS TITLE EITHER HARKENS BACK TO YOUR favorite Disney ride or makes you want to close the journal right now. What brings me to write under such a corny banner? Well, it started when my 15-year-old was telling me about the philanthropy committee she sits on at school and the report she was writing outlining which charities she thought the school’s fundraising should support. This followed hot on the heels of a story in the local paper about a high school that had worked for four years to build a school in Africa. All this led me to think about philanthropy in nursing and what our role might be in the global village.
Upping the Ante: How Does the Need for Evidence-Based Practice Influence Neonatal Network® Articles?
Authors: Askin Debbie Fraser
Published: November 2011

WE DON’T PRACTICE IN THE SAME WAY WE DID 25 YEARS ago. Then, we did a lot of things because that was the way we always did them, or because the unit policy said we must, or because someone just came back from a conference and that’s how they were doing it down there (up there, over there…). Today we implement practice changes based on a review of the existing evidence, based on the results of a meta-analysis, or as a result of multicentered benchmarking work.
Postnatal Corticosteroids in the Treatment of Chronic Lung Disease in the Preterm Infant: Past, Present, and Future
Authors: Nye Julie
Published: November 2011

Over the past 20 years, corticosteroid use in the preterm infant has fallen in and out of favor. Steroids were introduced in the 1980s as a mode of preventing and treating chronic lung disease (CLD) in the preterm infant population. This use has been targeted toward low birth weight infants who are unable to wean off the ventilator. Dose, duration, and timing of treatment with dexamethasone, the steroid typically used in NICUs, has varied. This article examines why the medication has fallen out of favor and whether postnatal corticosteroids still have a place in preventing and treating CLD.
Infant Intraosseous Infusion
Authors: DeBoer Scott , Russell Terri , Seaver Michael , Vardi Amir
Published: November 2011

Neonatal health care providers are fortunate that the umbilical cord generally provides easy intravenous (IV) access for newborn patients. Outside of the immediate newborn period, however, it may be impossible to obtain peripheral or umbilical IV access in critically ill newborns. Intraosseous (IO) infusion is not widely used in the neonatal population, but is a viable option when IV access cannot be established quickly. This article examines IO infusion devices and placement sites and addresses assessment and care of the infant receiving IO fluids and medications.
Bone Mineral Metabolism in the Neonate: Calcium, Phosphorus, Magnesium, and Alkaline Phosphatase
Authors: Williford Amy , Pare Linda , Carlson Gabrielle
Published: November 2011

CALCIUM, PHOSPHORUS, AND magnesium are the major minerals of the skeleton. All are essential for tissue structure and function. The physiology and metabolism of these minerals are interrelated and influenced by numerous other nutrients and hormones. In the third trimester of fetal development, approximately 80 percent of calcium, phosphorus, and magnesium are built up; thus, the premature infant lacks all or part of this period of rapid mineral accretion. In the neonate, 99 percent of calcium, 80 percent of phosphorus, and 60 percent of magnesium are stored in the bone.1 Bone mineral metabolism and homeostasis are influenced by maternal, gestational, and postnatal factors. Bone mineral imbalances present both short- and long-term consequences for the neonate. One long-term consequence is osteopenia, or undermineralized bones.2 The frequency of osteopenia is significantly increased for infants born at <28 weeks gestation, those requiring long-term parenteral nutrition, and those requiring long-term medical therapies such as diuretics.3
Brain Type Natriuretic Peptide
Authors: Nash Patricia
Published: November 2011

BRAIN TYPE NATRIURETIC PEPTIDE, also called B-type natriuretic peptide (BNP), has emerged as a valuable diagnostic and prognostic marker in the assessment of heart failure in adults.1–7 Serum BNP levels have also been shown to differentiate pulmonary from cardiac causes of dyspnea and to be useful as a screening tool for ventricular hypertrophy, ventricular diastolic dysfunction, transplant rejection, and risk for sudden death in adult patients with congestive heart failure (CHF).3,7,8 In pediatric patients, BNP levels have been found to increase with a hemodynamically significant ventricular septal defect and to correlate with the volume of the shunt and the left ventricular end diastolic volume.7 Recently, BNP levels have been investigated for use in determining the hemodynamic significance of a patent ductus arteriosus (PDA) in preterm neonates.3,7,9–11 They have also been studied for use in the diagnosis and management of persistent pulmonary hypertension in term and near-term infants.6 This article reviews BNP terminology, structure, physiology, measurement, and potential utility in the NICU.
Letters
Authors: Russell A.
Published: November 2011

I have reached the grand old age of 60 years and have decided to retire from nursing and my beloved neonates. Because of this decision I will not be renewing my Neonatal Network® subscription.
Documentation Do’s and Don’ts
Authors: Twiggs Smalls Harriett
Published: November 2011

TO SAY THAT THE MEDICAL RECORD is one of the most important parts of a lawsuit would be an understatement. No matter how good a witness you are, a jury or a judge will give more weight to a written record. The medical record is the documented history of a patient’s medical condition and care. Without it, diagnoses, continuity of care, and treatment could and would suffer. When treatment fails or goes awry, that same document can give clues about what possibly went wrong, but it can also tell what was done and done right.
News of The Academy of Neonatal Nursing
Authors: Brott Shirley
Published: November 2011

Come join us in sunny Phoenix! Conference planners have organized a fantastic lineup of professionals from across the U.S. to share the latest in neonatology and neonatal nursing for the 9th National Neonatal Nurses Conference. A sample of our speakers include Susan Ludington, CNM, PhD, FAAN, famous for her 1970s groundbreaking work in infant stimulation and in kangaroo care in the 1980s. She will share her newest studies regarding neonatal neurointensive care and how your care affects the infant’s brain. Biostatistician Dr. Mary Z. Mays will help guide the way to clinical decision making based on journal data with tools to determine whether evidence is statistically significant and clinically meaningful in her Monday afternoon workshop, “Statistics for Clinicians.” Preconference workshops include simulation techniques, pharmacology, leadership skills… and so much more! Check out the full conference schedule by going to academyonline.org or neonatalnetwork.com, and register today!
Human-Milk Feeding after NICU Discharge
Authors: Wheeler Barbara
Published: November 2011

Purpose:Difficulty with breastfeeding is common, and challenges are particularly pronounced for mothers of ill or preterm infants. This study explores the breastfeeding experiences of mothers of these at-risk infants to determine their breastfeeding patterns and to better understand reasons they prematurely stop breastfeeding and/or human-milk feeding (HMF).

Design:A qualitative, longitudinal, descriptive design was used.

Sample:The sample consisted of 144 mothers whose preterm or ill infants were cared for in either an NICU or an intermediate care nursery in a large central Canadian city; 112 mothers completed data collection to six weeks after their infants were discharged from the hospital.

Main Outcome Variable:The main outcome variable was continued breastfeeding or HMF of formerly ill or preterm infants at one and six weeks after their discharge from the hospital.

Results:Of infants who were being fed mother’s milk when discharged from the hospital, 71 percent continued to receive at least some mother’s milk at six weeks after discharge. Mothers reported that their own physical and emotional problems, infant health concerns, and lack of time and support were reasons for discontinuing provision of human milk.
Educational Interventions to Reduce the Rate of Central Catheter–Related Bloodstream Infections in the NICU: A Review of the Research Literature
Authors: Semelsberger Carrie
Published: November 2011

Catheter–related bloodstream infections (CR-BSIs) are a significant cause of morbidity and mortality in the NICU, occurring at rates ranging from 11.3 per 1,000 catheter days in infants <1,000 g to 4 per 1,000 catheter days in infants >2,500 g. Cost-effective and successful educational interventions aimed at nurses have been shown to decrease CR-BSIs with adults, but no such studies address neonatal nurses. This literature review examined how educational interventions could help neonatal nurses reduce infection rates in patients with central venous catheters. Four databases were searched: PubMed, CINAHL, Cochrane, and OVID. Of ten studies that measured CR-BSIs before and after educational interventions, nine showed a postintervention reduction in the rate of CR-BSIs of 40 percent or greater (eight demonstrating statistically significant reductions), and the tenth reported a reduction rate of 21 percent. All of the educational programs had additional intervention components, so it is not possible to ascribe all the success to the education, but this review suggests that this topic needs to be studied with the NICU population.
Findings from the National Institute of Nursing Research Related to Neonatal Care: 2009 Update
Authors:   National Institute of Nursing Research; National Institutes of Health; Department of Health and Human Services
Published: November 2011

NINR supports a wide range of research devoted to neonatal health and the outcomes of neonatal care, as well as professional and institutional issues important to nurses. The studies presented here focus on issues of prematurity, parenting concerns, and perinatal loss.
Dedicated with Gratitude, to all Neonatal Network® Volunteers
Authors: Rait Suzanne
Published: November 2011

2010• “FASTER THAN A SPEEDING BULLET…” Neonatal Network® is now in its 29th year of publication. Our daughter who we rocked in the cradle while handling those first articles and subscriptions has graduated from college and is now an administrative assistant in our office. Neonatal nursing has remained the same in many ways: nurses working as a team to care for premature infants, unit camaraderie, learning and doing, mentoring, caring and sharing. And, in many ways it has changed: research that once was all medical and that took place in laboratories, has been enhanced by nursing research in the units; developmental care enhances outcomes; evidence-based practice is beginning to come into its own.
Cardiac Assessment in the Neonatal Population
Authors: Federspiel Mary Clay
Published: November 2011

Congenital heart defects are not uncommon among neonatal patients. Although most are benign, the prompt identification of a life-threatening anomaly is essential for rapid intervention and a positive treatment outcome. Cardiac defects may be identified in the newborn nursery with thorough and systematic physical assessment, including inspection, palpation, auscultation, and measurement of blood pressure and oxygen saturations. The ability of the nurse to identify irregular findings during physical assessment aids rapid identification and treatment.
July August 2010 News of the Academy
Authors: Brott Shirley
Published: November 2011

Congratulations to ANN’s loyal conference attendees who have earned free conference tuition. We salute you!
Off-label Medication Use in the NICU
Authors: Bell Susan Givens
Published: November 2011

MANY INFANTS CARED FOR IN the NICU receive at least one drug that is used off label.1 This column explains what off-label use means, describes the Best Pharmaceuticals for Children Act and the Pediatric Research Equity Act, and discusses implications for practice.
NICU Procedures Are Getting Sweeter: Development of a Sucrose Protocol for Neonatal Procedural Pain
Authors: Mokhnach Larisa , Anderson Marilyn , Glorioso Rachelle , Loeffler Katie , Shinabarger Kelly , Thorngate Lauren , Yates Marna , Diercks Kristi , Berkan Maureen , Hou Shwu-Shin , Millar April , Thomas Karen , Walker Wendy , Zbirun Ilona
Published: November 2011

Neonates in the neonatal intensive care nursery experience multiple, painful, tissue-damaging procedures daily. Pain among neonates is often underestimated and untreated, producing untoward consequences. A literature review established strong evidence supporting the use of sucrose as an analgesic for minor procedural pain among neonates. A review of unit practices and nurses’ experiential evidence initiated the production of a standardized protocol in our unit at the University of Washington Medical Center NICU in Seattle.

Nursing practices surrounding sucrose use differed widely in dose, timing, and patient application. We carefully evaluated evidence documenting the effectiveness as well as the safety of sucrose administration and wrote a protocol and practice standards for our primarily premature patient population. This article describes the development and execution of a standardized, nurse-implemented, sucrose protocol to reduce procedural pain.
The Things I Know
Authors: Wallace Tamara
Published: November 2011

Editor’s Note: “The Things I Know” marks the kick-off for our Anniversary Year issues. Please see the facing page for the call for Anniversary materials.
Induced Hypothermia for Neonatal Hypoxic-Ischemic Encephalopathy: Pathophysiology, Current Treatment, and Nursing Considerations
Authors: Cooper DeLinda Jo
Published: November 2011

Hypoxic-ischemic encephalopathy (HIE) can lead to devastating neurodevelopmental consequences such as cerebral palsy, seizure disorders, and significant developmental delays. HIE in the newborn is often the result of a hypoxic event, such as uterine rupture, placental abruption, or cord prolapse. Biphasic brain injury occurs in HIE. The first phase involves activation of the sympathetic nervous system as a compensatory mechanism. The second phase, known as reperfusion brain injury, occurs hours later. Induced hypothermia, a neuroprotective strategy for treating HIE, targets the second phase to prevent reperfusion injury. NICU nurses are in a unique position to detect patient instability and to maintain the therapeutic interventions that contribute to the healing process. This article highlights the significant role nurses play in the management of infants diagnosed with HIE who are treated with induced hypothermia.
Tracheostomy in Infants: Parent Education for Home Care
Authors: Joseph Rachel A.
Published: November 2011

Children with tracheostomies are increasingly discharged home for continued care by their parents. Nurses are responsible for providing these parents with the extensive education required for a smooth and successful transition to home care. This article is intended to help neonatal and pediatric nurses to effectively prepare the parents of an infant with a tracheostomy to provide safe, quality care to their child after being discharged from an acute care setting to their home. This article discusses the knowledge, attitudes, and skills the parents are required to acquire prior to the infant’s discharge. Home ventilation, airway management, suctioning, tracheostomy care, emergency management, safe home environment, equipment for continuous or intermittent ventilation, and supplies necessary for care are some of the topics discussed.
Neutral Head Positioning in Premature Infants for Intraventricular Hemorrhage Prevention: An Evidence-Based Review
Authors: Malusky Sheila , Donze Ann
Published: November 2011

With the advancement of neonatal medicine during the past several decades, premature and critically ill infants are living past the neonatal period and surviving. The survival of these infants at smaller birth weights and younger gestational ages puts them at an increased risk for intraventricular hemorrhages (IVHs). Although shifts in cerebral perfusion have been linked to the development of these brain bleeds, many seemingly benign care activities have been linked to changes in cerebral blood flow patterns, possibly contributing to IVHs. The purpose of this article is to evaluate the current evidence to determine if the practice of midline positioning for infants born less than 32 weeks gestation for possible IVH prevention is supported by the literature. Many of the researchers involved in these studies attributed the consequential venule leakage of blood to occlusion of the jugular venous drainage system following a turn in the position of the head. Additionally, the articles that examined the connection between the effects of head tilting on brain hemodynamics attributed changes on the infants’ potential inability to autoregulate cerebral blood flow adequately. Both of these findings were linked to the development of IVHs. Based on physiologic data and expert opinion, the authors found support in the literature and recommend implementing a plan of care that includes midline head positioning for premature infants.
Nsaka Sunsum (Touching the Spirit): A Pedagogy and Process of Black Educational Excellence
Authors: Nobles Wade W. , Adeleke Nobles Zetha Chinaza
Published: November 2011

The real crisis in Black education is a crisis of culture. It is a crisis of culture because culture, as the medium wherein life is defined and developed, is where the meaning of being human is found. Culture, though multifaceted, is where human beings give fundamental expression to their meaning, possibility and potential. Hence, the crisis in Black education is found in the organized structure and process of education that has absolutely no regard for the African meaning of being human nor respect for educational requisites of reproducing and refining African possibilities and potentials as cultural phenomena. In response to the lack of cultural congruency in the education of Black children, this article identifies the specific cultural ideas and techniques designed to establish a teaching and learning environment wherein a teaching/learning process is created to help the teacher to connect deeply with the spirit (essence) of the child so as to animate, arouse, affect and/or influence the students exalted feelings, thoughts or actions in the service of learning.
Implicit a posteriori error estimation using patch recovery techniques
Authors: Horváth Tamás , Izsák Ferenc
Published: November 2011

We develop implicit a posteriori error estimators for elliptic boundary value problems. Local problems are formulated for the error and the corresponding Neumann type boundary conditions are approximated using a new family of gradient averaging procedures. Convergence properties of the implicit error estimator are discussed independently of residual type error estimators, and this gives a freedom in the choice of boundary conditions. General assumptions are elaborated for the gradient averaging which define a family of implicit a posteriori error estimators. We will demonstrate the performance and the favor of the method through numerical experiments.
Environmental Signals and Regulatory Pathways That Influence Exopolysaccharide Production in Rhizobia
Authors: Janczarek Monika
Published: November 2011

Rhizobia are Gram-negative bacteria that can exist either as free-living bacteria or as nitrogen-fixing symbionts inside root nodules of leguminous plants. The composition of the rhizobial outer surface, containing a variety of polysaccharides, plays a significant role in the adaptation of these bacteria in both habitats. Among rhizobial polymers, exopolysaccharide (EPS) is indispensable for the invasion of a great majority of host plants which form indeterminate-type nodules. Various functions are ascribed to this heteropolymer, including protection against environmental stress and host defense, attachment to abiotic and biotic surfaces, and in signaling. The synthesis of EPS in rhizobia is a multi-step process regulated by several proteins at both transcriptional and post-transcriptional levels. Also, some environmental factors (carbon source, nitrogen and phosphate starvation, flavonoids) and stress conditions (osmolarity, ionic strength) affect EPS production. This paper discusses the recent data concerning the function of the genes required for EPS synthesis and the regulation of this process by several environmental signals. Up till now, the synthesis of rhizobial EPS has been best studied in two species, Sinorhizobium meliloti and Rhizobium leguminosarum. The latest data indicate that EPS synthesis in rhizobia undergoes very complex hierarchical regulation, in which proteins engaged in quorum sensing and the regulation of motility genes also participate. This finding enables a better understanding of the complex processes occurring in the rhizosphere which are crucial for successful colonization and infection of host plant roots.
MicroRNAs miR-27a and miR-143 Regulate Porcine Adipocyte Lipid Metabolism
Authors: Wang Tao , Li Mingzhou , Guan Jiuqiang , Li Penghao , Wang Huiyu , Guo Yanqin , Shuai Surong , Li Xuewei
Published: November 2011

MicroRNAs (miRNAs) are non-coding small RNAs that play roles in regulating gene expression. Some miRNAs have been classed as epigenetic regulators of metabolism and energy homeostasis. Previous reports indicated that the miRNAs miR-27a and miR-143 were involved in lipid metabolism in human and rodents. To determine the roles of porcine miR-27a and miR-143 in adipocyte lipid metabolism, porcine adipocytes were cultured and allowed to induce differentiation for 10 days. The lipid-filled adipocytes were then transfected with miRNA mimics and inhibitors. We measured how the indicators of adipogenesis and adipolysis in porcine adipocytes were affected by the over-expression and by the inhibition of both miR-27a and miR-143. The results indicated that the over-expression of miR-27a could accelerate adipolysis releasing significantly more glycerol and free fatty acids than the negative control (P < 0.001), while the mimic of miR-143 expression, promoted adipogenesis by accumulating more triglycerides (P < 0.001) in the adipocytes. In addition, we demonstrated that there was good correlation (r > 0.98, P < 0.001) between the indicators of adipolysis in cell lysates and in the culture medium.
Hepatitis C Virus Evasion Mechanisms from Neutralizing Antibodies
Authors: Lorenzo Caterina Di , Angus Allan G. N. , Patel Arvind H.
Published: November 2011

Hepatitis C virus (HCV) represents a major public health problem, affecting 3% of the world’s population. The majority of infected individuals develop chronic hepatitis, which can progress to cirrhosis and hepatocellular carcinoma. To date, a vaccine is not available and current therapy is limited by resistance, adverse effects and high costs. Although it is very well established that cell-mediated immunity is necessary for viral clearance, the importance of host antibodies in clearing HCV infection is being increasingly recognized. Indeed, recent studies indicate that neutralizing antibodies are induced in the early phase of infection by patients who subsequently clear viral infection. Conversely, patients who do not clear the virus develop high titers of neutralizing antibodies during the chronic stage. Surprisingly, these antibodies are not able to control HCV infection. HCV has therefore developed mechanisms to evade immune elimination, allowing it to persist in the majority of infected individuals. A detailed understanding of the mechanisms by which the virus escapes immune surveillance is therefore necessary if novel preventive and therapeutic treatments have to be designed. This review summarizes the current knowledge of the mechanisms used by HCV to evade host neutralizing antibodies.
Substance Abuse in Older Adults: Policy Issues
Authors: Gage Susan , Melillo Karen Devereaux
Published: November 2011

By 2020, it is projected that the number of older adults needing treatment for drug and alcohol addictions will increase dramatically. Although Medicare covers treatment for mental health issues, copayments can be prohibitive for those with lower incomes. The Positive Aging Act, an amendment to the Public Health Service Act, is a policy alternative that could address substance abuse in the older adult population by (a) demonstrating ways of integrating mental health services for older adults into primary care settings, and (b) supporting the establishment and maintenance of interdisciplinary geriatric mental health outreach teams in community settings where older adults reside or receive social services. Increasing funding to states to emphasize primary care provider education on the detection, evaluation, and treatment of substance abuse problems of older adults has the potential to better meet the substance abuse needs of this population. Educating primary care providers, including gerontological nurses, to recognize signs of substance abuse in this population and providing age-appropriate treatment options is critically important but will require funding beyond what is currently available.
Aging and Living with HIV/AIDS
Authors: Jang Hannah , Anderson Peter G. , Mentes Janet C.
Published: November 2011

With individuals either living longer with the disease or contracting it at a later stage in life, HIV/AIDS can no longer be regarded as just a young person’s disease. In fact, people older than 50 will represent 50% of HIV/AIDS cases by 2015. The intersection of aging and HIV/AIDS is explored in this article through the use of an individual example highlighting typical age-related issues encountered in living with a chronic HIV infection and two of the more common comorbid conditions. Nursing implications for managing these conditions—depression and dyslipidemia—as well as other considerations for providing care to older adults with HIV/AIDS are addressed.
The Critical Difference Assignment: An Innovative Instructional Method
Authors: Utterback Virginia Ann , Davenport Deborah , Gallegos Belinda , Boyd Enola
Published: November 2011

Nurse educators are faced with the challenge of developing and evaluating learning methods that promote knowledge acquisition, problem solving, and the development of clinical judgment to meet today’s expectations of new graduates. Clinical judgment is at the heart of decision making and drives nursing action. It encompasses perceptions and intellectual processing of information through mental operations of reasoning, resulting in appropriate actions. An instructional method, entitled the Critical Difference Assignment, aimed at developing clinical judgment has been developed and piloted at a southwestern university. This instructional method requires students in small groups to engage in intellectual processing of case study information using mental operations of reasoning to discriminate between two case studies through a process of comparing and contrasting the data.
A Prebaccalaureate PhD Option: Shaping The Future of Research-Focused Doctoral Education
Authors: Nehls Nadine , Barber Gale
Published: November 2011

The future of PhD education in nursing is at a crossroads. Our current practice of primarily enrolling post-master’s students with years of clinical experience is not producing an adequate number of graduates who are able to make significant and sustained contributions to nursing research. Therefore, it is timely to consider educational innovations that encourage a different population of students to consider doctoral research training. A prebaccalaureate or early-entry option to the PhD in nursing is a means toward this end. At the University of Wisconsin-Madison, a select group of prenursing students and students beginning the nursing major are offered an early admission to PhD education. A key component of the Early Entry PhD Option is immediate and intensive research training with an established nurse faculty researcher. In this article, the authors describe the curriculum of a prebaccalaureate, research-focused doctoral option and its early results.
Debunking Misconceptions About Weight Loss Surgery
Authors: Van Etten Deborah , Grimaldi Diane
Published: November 2011

The recent and steady rise in the U.S. obesity index has resulted in a consumer-driven market for more effective treatment interventions for the morbidly obese population. Given the relatively poor outcomes associated with traditional approaches for treating obesity, such as diet programs, behavioral modification, and pharmacotherapy, weight loss surgical procedures represent a safe and effective option for those who meet selection criteria. To provide optimal treatment and consumer education, psychiatric nurses need to be well informed about the psychological and physiological aspects of these surgical procedures. This article clarifies six common misconceptions related to weight loss surgery.
THE ESSENCE OF LOW-ENERGY AFFORDABLE HOUSING DESIGN STRATEGIES
Authors: Noguchi Masa
Published: November 2011

Nearly one-third of the Scottish population is struggling to heat their home properly today. There is an urgent need for the delivery of low-energy affordable homes. However, the homebuilding industry has no systematic way to deliver such unconventional homes, although the UK government has set out a bold “green” target that all newly-built homes be carbon neutral by 2016. Accordingly, this paper explores the status quo of today's affordable homes being built in Scotland; and secondly, it extends the scope to the review of successfully commercialized low- to zero-energy affordable housing developments in Canada. This study emphasizes the significant impact of design choices on the delivery of low- to zero-energy affordable housing, including housing orientations and configurations; construction materials and systems, including renewable energy technologies; and internal planning, with due consideration to the time-related sun positions and the internal space day-lighting and heat gain potentials. In addition, the paper argues that the absence of clear definitions as to housing quality and affordability, and the lack of industry capacity for technical knowledge learning activities, are potential obstacles that limit the spread of sustainable zero-carbon homes in Scotland today. Moreover, the effect of the design charrette approach being practiced in Canada on the homebuilding decision making process was reviewed, with the aim of providing a base for further discussion on the applicability of Canadian low-energy affordable housing design techniques to sustainable zero carbon homes of the future in Scotland.
In Search of Effective Granulization with DTRS for Ternary Classification
Authors: Zhou Bing , Yao Yiyu
Published: November 2011

Decision-Theoretic Rough Set (DTRS) model provides a three-way decision approach to classification problems, which allows a classifier to make a deferment decision on suspicious examples, rather than being forced to make an immediate determination. The deferred cases must be reexamined by collecting further information. Although the formulation of DTRS is intuitively appealing, a fundamental question that remains is how to determine the class of the deferment examples. In this paper, the authors introduce an adaptive learning method that automatically deals with the deferred examples by searching for effective granulization. A decision tree is constructed for classification. At each level, the authors sequentially choose the attributes that provide the most effective granulization. A subtree is added recursively if the conditional probability lies in between of the two given thresholds. A branch reaches its leaf node when the conditional probability is above or equal to the first threshold, or is below or equal to the second threshold, or the granule meets certain conditions. This learning process is illustrated by an example.
On Machine Symbol Grounding and Optimization
Authors: Kramer Oliver
Published: November 2011

From the point of view of an autonomous agent the world consists of high-dimensional dynamic sensorimotor data. Interface algorithms translate this data into symbols that are easier to handle for cognitive processes. Symbol grounding is about whether these systems can, based on this data, construct symbols that serve as a vehicle for higher symbol-oriented cognitive processes. Machine learning and data mining techniques are geared towards finding structures and input-output relations in this data by providing appropriate interface algorithms that translate raw data into symbols. This work formulates the interface design as global optimization problem with the objective to maximize the success of the overlying symbolic algorithm. For its implementation various known algorithms from data mining and machine learning turn out to be adequate methods that do not only exploit the intrinsic structure of the subsymbolic data, but that also allow to flexibly adapt to the objectives of the symbolic process. Furthermore, this work discusses the optimization formulation as a functional perspective on symbol grounding that does not hurt the zero semantical commitment condition. A case study illustrates technical details of the machine symbol grounding approach.
Experimental Investigations on the Contour Generation of a Reconfigurable Stewart Platform
Authors: Kumar G. Satheesh , Nagarajan T.
Published: November 2011

Reconfiguration of Stewart platform for varying tasks accentuates the importance for determination of optimum geometry catering to the specified task. The authors in their earlier work (Satheesh et al., 2008) have indicated the non availability of an efficient holistic methodology for determining the optimum geometry. Further, they have proposed a solution using the variable geometry approach through the formulation of dimensionless parameters in combination with generic parameters like configuration and joint vector. The methodology proposed provides an approach to develop a complete set of design tool for any new reconfigurable Stewart platform for two identified applications viz., contour generation and vibration isolation. This paper details the experimental investigations carried out to validate the analytical results obtained on a developed Stewart platform test rig and error analysis is performed for contour generation. The experimental natural frequency of the developed Stewart platform has also been obtained.
Transparency and Accountability in Public Procurement of Essential Medicines in Developing Countries
Authors: Kotwani Anita
Published: November 2011

Pharmaceuticals are an integral component of a health care system; any weakness in governance of the pharmaceutical system negatively impacts health outcomes, especially in developing countries. It is believed that procurement on the concept of essential medicine list and transparency leads to improved efficiency and access to medicines, as has been described for the Delhi model. However, transparency is only the first step; accountability and sustainability are also needed. Information systems create opportunities for transparency and openness through the disclosure of information and improve decision-making and efficiency along the medicine supply chain. With the lessons learned from experiences of many developing countries, technical guidance and tools developed by international agencies, a transparent, accountable, sustainable public procurement system is possible but high-level political commitment is needed to mandate and enforce the system.
The Cochrane Students Journal Club and Creating a Secondary Learning Resource for Gathering and Appraising Evidence
Authors: Chandra Shivika , Shah Naman K. , Sriganesh Vasumathi
Published: November 2011

In the current era of evidence-based healthcare, online learning resources provide accessible and affordable training and teaching resources to stimulate the next generation of medical professionals. In the first of a series of qualitative case studies on the Cochrane student’s journal club, the authors evaluate and portray the outcomes in each of its patient-focused, evidence-based learning activities. This study illustrates an exercise centered on the hypothetical case of a patient treated for Plasmodium vivax presenting with a suspected relapse.
Rain Simulation in Dynamic Scenes
Authors: Puig-Centelles Anna , Sunyer Nicolau , Ripolles Oscar , Chover Miguel , Sbert Mateu
Published: November 2011

Rain is a complex phenomenon and its simulation is usually very costly. In this article, the authors propose a fully-GPU rain simulation based on the utilization of particle systems. The flexibility of CUDA allows the authors to include, aside from the rainfall simulation, a system for the detection and handling of the collisions of particles against the scenario. This detection system allows for the simulation of splashes at the same time. This system obtains a very high performance because of the hardware programming capabilities of CUDA.
A Framework for the Quality Evaluation of MDWE Methodologies and Information Technology Infrastructures
Authors: Domínguez-Mayo Francisco José , Escalona María José , Mejías Manuel , Ramos Isabel , Fernández Luis
Published: November 2011

Diverse development web methodologies currently exist in the field of Model-Driven Web Engineering (MDWE), each of which covers different Levels of Abstraction on Model-Driven Architecture (MDA): Computation Independent Model (CIM), Platform Independent Model (PIM), Platform Specific Model (PSM), and Code. Given the high number of methodologies available, it has become necessary to define objective evaluation tools to enable development teams to improve their methodological environment and help designers of web methodologies design new effective and efficient tools, processes and techniques. Since proposals are constantly evolving, the need may arise not only to evaluate the quality but also to find out how it can be improved. This paper presents an approach named QuEF (Quality Evaluation Framework) oriented towards evaluating, through objectives measures, the quality of information technology infrastructure, mainly in MDWE methodology environments.
3D Model-Based Semantic Categorization of Still Image 2D Objects
Authors: Petre Raluca-Diana , Zaharia Titus
Published: November 2011

Automatic classification and interpretation of objects present in 2D images is a key issue for various computer vision applications. In particular, when considering image/video, indexing, and retrieval applications, automatically labeling in a semantically pertinent manner/huge multimedia databases still remains a challenge. This paper examines the issue of still image object categorization. The objective is to associate semantic labels to the 2D objects present in natural images. The principle of the proposed approach consists of exploiting categorized 3D model repositories to identify unknown 2D objects, based on 2D/3D matching techniques. The authors use 2D/3D shape indexing methods, where 3D models are described through a set of 2D views. Experimental results, carried out on both MPEG-7 and Princeton 3D models databases, show recognition rates of up to 89.2%.
JavaSPI
Authors: Avalle Matteo , Pironti Alfredo , Pozza Davide , Sisto Riccardo
Published: November 2011

This paper presents JavaSPI, a “model-driven” development framework that allows the user to reliably develop security protocol implementations in Java, starting from abstract models that can be verified formally. The main novelty of this approach stands in the use of Java as both a modeling language and the implementation language. The JavaSPI framework is validated by implementing a scenario of the SSL protocol. The JavaSPI implementation can successfully interoperate with OpenSSL, and has comparable execution time with the standard Java JSSE library.
Determination Method of Organophosphorus Pesticide Residues in Fishs by GPC-GC-PFPD
Authors: Li Bin , Zeng Fan Gang , Ma Wei Fang , Dong Qi Chun , Fan Hai Tao , Deng Chuan Feng
Published: November 2011

The 10 organophosphorus pesticides in fish can be rapidly extracted and separated by gel permeation chromatography, and the lipin and organophosphorus pesticides of fish can be seperated. The interfering matters can be well eliminated in this condition, and analysis is more rapid than other methods. The residues of 10 organophosphorus pesticides at same time can be identified and quantified simultaneously by GC-PFPD. This method is simple, rapid, and the average recovery ratios were 71.7%-80.9%.Good repeatability was obtained in all the cases with relative standard deviations (RSDs) lower 11%, and limit of detection was0.0003-0.004 mg·kg-1.
Sleep Stage Classification Based on EEG Signals by Using Improved Hilbert-Huang Transform
Authors: Shen Xue Li , Fan Ying Le
Published: November 2011

Research on automatic sleep staging based on EEG signals has a significant meaning for objective evaluation of sleep quality. An improved Hilbert-Huang transform method was applied to time-frequency analysis of non-stable EEG signals for the sleep staging in this paper. In order to settle the frequency overlapping problem of intrinsic mode function obtained from traditional HHT, wavelet package transform was introduced to bandwidth refinement of EEG before the empirical mode decomposition was conducted. This method improved the time-frequency resolution effectively. Then the intrinsic mode functions and their marginal spectrums would be calculated. Six common spectrum energies (or spectral energy ratios) were selected as characteristic parameters. Finally, a probabilistic nearest neighbor method for statistical pattern recognition was applied to optimal decision. The experiment data was from the Sleep-EDF database of MIT-BIH. The classification results showed that the automatic sleep staging decisions based on this method conformed roughly with the manual staging results and were better than those obtained from traditional HHT obviously. Therefore, the method in this paper could be applied to extract features of sleep stages and provided necessary dependence for automatic sleep staging.
Collision Simulation Analysis for Space Flexible Probe-Cone Docking Mechanism
Authors: Han Wei , Huang Yi Yong , Zhang Xiang , Chen Xiao Qian
Published: November 2011

The nature of buffer system is a very important factor of determining the dynamic properties for the success of docking operation in space. The current buffer system is too large and highly complicated, which is not suitable for microspacecraft for On Orbit Servicing (OOS). In this paper, a new type of probe-cone docking mechanism with flexible docking cone as buffer system was presented, and the impact force was simulated using the explicit finite element code, LS-DYNA. Then, the time history of the impact process such as the velocity of docking probe and the docking cone’s displacement was computed under the given impact velocity and initial deviation. In the end, the influence of the wall thickness of docking cone on the impact force was analyzed. The conclusion that the flexible docking cone can greatly help to reduce the maximum impact force by more than 50% provides a basis for the engineering design of the buffer system.
Laser Smoothing Device for Airborne 3-D Focal Imaging LiDAR
Authors: Ge Xian Ying , Chen Si Ying , Zhang Yin Chao , Chen He , Guo Pan , Chen Wen Bo , Bu Zhi Chao , Chen Sheng Zhe
Published: November 2011

Airborne 3-D focal imaging LiDAR can take images in a very short gating time (3~5ns), so it can shield background noise instantaneously. Since the area of laser irradiated surface is about when the detected distance is about 3km, to ensure high imaging quality the laser beam needs to be smoothed before it arrives the ground. In this paper, based on self-developed airborne 3-D focal imaging LiDAR system, a beam homogenization device by using lens array method is presented for the detection range from 1km to 3km. The experimental result indicates that the smoothing rate can reach 89%. Subsequent tests in LiDAR system show that the homogenization device is reliable and effective.
Study on Fractal Elastic Damage Constitutive Law for Concrete Material under Static Load
Authors: Xie Ming , Zheng Shan Suo
Published: November 2011

The stochastic properties and discreteness of macroscopic property for concrete appear on mechanical property and fracture surface. In consideration of stochastik and discreteness of fracture surface, a class of mesoscopic damage mechanics model of concrete based on spring model, are put forward to understand the real damage evolution characteristics of concrete at the level of constitutional law. A kind of spring-slipper model is introduced to reflect the elastic-plastic damage behavior. It has been confirmed that fracture surface of concrete has self-affine fractal characteristic only on a certain spatial scale, but the actual fracture surface of concrete is a stochastic surface with multi-fractal characteristics. Uniaxial test was operated, combined with the Computerized Tomography test of concrete, to study the evolution of crack surface from mesoscopic level to macroscopic level. Compared with the existing damage constitutive law and experimental results preliminarily, the feasibility of fractal damage constitutive law is verified.