bluuebunny/crossref_metadata_2025 huggingface dataset:
Ecological restoration of cleared agricultural land in Gondwana Link: lifting the bar at ‘Peniup’
Authors: Jonson Justin
Published: December 2010

Summary  Large scale ecological restoration in a highly heterogeneous and species‐rich landscape requires big commitment to fine scale planning. In the southwest of Western Australia, in the Fitz‐Stirling area of Gondwana Link, the Peniup Restoration project aimed to improve on such works. A multi‐faceted approach was employed to re‐establish a self‐replicating biologically diverse plant system, ecologically informed in its design and consistent with the heterogeneous mosaic of plant associations found in the surrounding landscape. Outcomes from the project included a 950‐ha restoration map composed of nine newly developed soil landscape/vegetation associations. A new 6 m wide direct seeding machine was developed to improve delivery and spatial configuration of establishing plants. These two developments were put to the test in 2008 through a 250 ha biodiverse carbon‐funded restoration effort. This paper summarises the approaches used and initial results of those works.
Vitamin D as a possible independent predictor of bone mineral density in Estonian adults: a cross‐sectional population‐based study
Authors: Kull M. , Kallikorm R. , Lember M.
Published: December 2010

Background:  Vitamin D insufficiency and deficiency are prevalent worldwide, with the highest prevalence in the northern countries due to the lack of ultraviolet exposure. The individual effect of vitamin D on bone mineral density (BMD) has been studied but the results are inconclusive.

Aim:  The aim of our study was to investigate the effect of vitamin D on BMD in a random population‐based cohort of Estonian adults.

Methods:  A cross‐sectional population‐based study. A total of 273 individuals free of diseases or states known to affect bone or vitamin D metabolism participated in the study. We measured BMD, vitamin D and parathyroid hormone concentrations (in winter and in summer). Several co‐variables were included in the regression analysis, including age, smoking, alcohol consumption, body mass index, physical activity, fresh milk consumption, caffeinated beverage consumption, lean tissue mass and total body fat percentage, and in women the number of children and breastfeeding history.

Results:  We show that summer vitamin D independently correlates with BMD in lumbar spine, trochanter and total body regions (P < 0.05 to 0.01). Subgroup analysis for women showed that summer vitamin D predicts independently lumbar spine (P < 0.05) and in men total body BMD (P < 0.01). Lean tissue mass and fat mass were additional contributors of the BMD (P < 0.001).

Conclusion:  In addition to body composition indices, vitamin D could be an independent contributor of BMD in several skeletal regions in men and women.
Comparison of empirical continuous positive airway pressure (CPAP) treatment versus initial portable sleep monitoring followed by CPAP treatment for patients with suspected obstructive sleep apnoea
Authors: To K. W. , Chan W. C. , Chan T. O. , Ngai J. , Tung A. , Ng S. , Choo K. L. , Hui D. S.
Published: December 2010

Background:  Polysomnography is labour‐intensive for diagnosing obstructive sleep apnoea (OSA). We compared two algorithms for initiating continuous positive airway pressure (CPAP) treatment for patients with suspected OSA.

Methods:  Symptomatic OSA patients were randomised into either algorithm I or II. Algorithm I consisted of an empirical CPAP trial whereas algorithm II utilised an Apnea Risk Evaluation System, a wireless device applied on the forehead, for establishing a diagnosis before a CPAP trial for 3 weeks. Primary outcome was success of CPAP trial, defined as CPAP usage > 4 h/night and willingness to continue CPAP. Subjective usefulness of CPAP, accuracy of Apnea Risk Evaluation System versus polysomnography and CPAP adherence at 6 months were secondary end‐points.

Results:  Altogether 138 patients in algorithm I and 110 patients in algorithm II completed the CPAP trial. There were no significant differences between these algorithms with respect to the primary end‐point. The sensitivity and specificity of algorithm I versus II as a diagnostic test for OSA were 0.3, 0.8 versus 0.31, 1.00 respectively. In predicting CPAP adherence at 6 months, the likelihood ratio positive for algorithms I and II was 2.7 and 5.27 respectively. The mean (SE) time taken from the first consultation to the end of CPAP trial in algorithm I and algorithm II was 60 (2) and 98 (5) days, respectively, P < 0.01.

Conclusion:  An ambulatory approach with portable sleep monitoring for diagnosing OSA before a CPAP trial can identify more patients who would adhere to CPAP at 6 months than empirical CPAP treatment alone.
Insulin resistance and coronary flow velocity reserve in patients with autosomal dominant polycystic kidney disease
Authors: Turkmen K. , Tufan F. , Alpay N. , Kasıkcıoglu E. , Oflaz H. , Ecder S. A. , Ecder T.
Published: December 2010

Background:  Cardiovascular problems are a major cause of morbidity and mortality in patients with autosomal dominant polycystic kidney disease (ADPKD).

Aim:  The aim of this study was to investigate coronary flow velocity reserve (CFVR) as a marker of endothelial dysfunction, carotid intima media thickness (CIMT) as a marker of subclinical organ damage and insulin resistance (IR) as a cardiovascular risk factor in patients with ADPKD.

Methods:  Twenty‐two normotensive ADPKD patients with well‐preserved renal function and 19 healthy subjects were included in the study. Creatinine clearances were calculated by the Cockcroft–Gault formula. The homeostasis model of IR (HOMA‐IR) was used to measure IR. CIMT was measured by high‐resolution vascular ultrasound. CFVR was calculated as the ratio of hyperaemic to baseline diastolic peak velocities by echocardiography.

Results:  There was no significant difference between the two groups regarding age, gender, body mass index, systolic and diastolic blood pressures, cholesterol and triglyceride levels. However, CIMT and HOMA‐IR were significantly increased and CFVR was significantly decreased in patients with ADPKD compared with healthy subjects.

Conclusions:  The findings of decreased CFVR, increased CIMT and increased IR suggest that cardiovascular risk is elevated even in the early stages of ADPKD.
Inability of single resting arterial blood gas to predict significant hypoxaemia in chronic obstructive pulmonary disease
Authors: Trauer J. M. , Gielen C. , Trauer T. , Steinfort C. L.
Published: December 2010

Background:  While point measurement of resting arterial partial pressure of oxygen (PaO2) is the traditional gold‐standard for assessment of oxygenation in chronic obstructive pulmonary disease (COPD), 24‐h oximetry may identify further patients with clinically significant hypoxaemia. We aimed to describe the relationship between these two parameters and identify other correlated variables.

Methods:  All patients registered with the Barwon Health Hospital Admission Risk Program from 1 March to 31 October 2008 for the diagnosis of COPD were identified. The main inclusion criteria were obstructive spirometry, clinical stability and moderate resting hypoxaemia (PaO2 56–70 mmHg). All patients underwent 24‐h oximetry, arterial blood gas, spirometry, anthropometry and telephone questionnaire, and 23 patients also completed polysomnography.

Results:  Inclusion criteria were met in 35 of 287 patients. Mean recording time was 23.5 h, representing 97% of intended oximetry time. Nineteen patients (54%) spent greater than 30% of recorded oximetry time below 90%. There was a moderate inverse correlation between time below 90% saturations and PaO2 (r=−0.40, P= 0.02), with body mass index (BMI) the only other independent predictor of the primary outcome identified (r= 0.39, P= 0.02). Correlations were similar for waking hours considered separately. However, for sleeping oximetry, BMI and age were the only independent predictors of time below 90%. Polysomnography demonstrated a high prevalence of rapid eye movement‐related hypoventilation and obstructive sleep apnoea syndrome.

Conclusions:  Many patients with moderate hypoxaemia on resting PaO2 desaturate significantly on ambulatory oximetry. The correlation between PaO2 and proportion of saturations below 90% is moderate and similar to BMI, but this pattern does not hold during sleeping hours.
Mortality and its predominant causes in a large cohort of patients with biopsy‐determined inflammatory myositis
Authors: Limaye V. , Hakendorf P. , Woodman R J. , Blumbergs P. , Roberts‐Thomson P.
Published: December 2010

Background:  There is a paucity of literature on the patterns and predictors of mortality in idiopathic inflammatory myopathies (IIM).

Aims:  To determine the patterns and predictors of mortality in a South Australian cohort of patients with biopsy‐proven IIM.

Methods:  The living/deceased status (and for deceased patients the causes of death) of patients with histologically determined IIM was determined from the Births, Deaths and Marriages Registry. Standardised mortality ratios (SMR) were generated compared with the age/gender matched South Australian population. The effect of presence/absence of the components of the Bohan and Peter criteria on risk ratios (RR) for mortality was determined. The effect of comorbidities and autoantibodies on mortality was investigated.

Results:  The SMR for mortality in IIM was 1.75 and was significantly increased in all disease subgroups, being highest in patients with dermatomyositis (2.40). Dominant causes of death were cardiovascular disease (31%), infections (22%) and malignancy (11%). Risk factors for death were age at time of biopsy (hazard ratio 1.05), ischaemic heart disease (RR 2.97, P < 0.0001), proximal weakness at diagnosis (RR 1.8, P= 0.03), definite diagnosis of IIM per the Bohan and Peter criteria (RR 2.14, P < 0.0001), and the absence of autoantibodies (RR 1.9, P < 0.001).

Conclusions:  Patients with IIM are at 75% increased risk for mortality, and cardiovascular diseases account for the commonest causes of death. This study suggests a thorough cardiovascular evaluation of these patients is indicated, and raises the possibility that targeted interventions such as the use of aspirin or statins may improve outcomes in IIM.
Treatment and monitoring of coagulation abnormalities in children undergoing heart surgery
Authors: Arnold Philip
Published: December 2010

Bleeding is a considerable clinical problem during and after pediatric heart surgery. While the primary cause of bleeding is surgical trauma, its treatment is often complicated by the presence of coagulopathy. The principle causes of coagulopathy are discussed to provide a context for treatment. The role of laboratory and point of care tests, which aim to identify the cause of bleeding in the individual patient, is also discussed. An attempt is made to examine the current evidence for available therapies, including use of blood products and, more recently proposed, approaches based on human or recombinant factor concentrates.
Lived experiences of internationally educated nurses in hospitals in the United States of America
Authors: Jose M. M.
Published: December 2010

JOSE M. M. (2011) Lived experiences of internationally educated nurses in hospitals in the United States of America. International Nursing Review58, 123–129

Aim:  The overall goal of this study was to elicit and describe the lived experiences of internationally educated nurses (IENs) who work in a multi‐hospital medical centre in the urban USA.

Background:  Since World War Two, US health care agencies have addressed the nursing shortage by hiring IENs. While other countries have produced substantial research findings about their IENs, much less research has been done about IENs in the USA. Findings from the limited US studies suggest that more research is needed and first‐hand reports of lived experiences must be added.

Methods:  Using a phenomenology of practice study design and Giorgi's principles of data analysis, narratives from the guided interviews with 20 new immigrant IENs who had migrated from the countries of the Philippines, Nigeria and India to the USA, were collected and studied for themes.

Findings and discussion:  Six themes that emerged from the stories of IENs together describe a trajectory of lived experiences that the IENs encountered during their adjustments to living and working in the USA. The emergent themes weredreams of a better life, a difficult journey, a shocking reality, rising above the challenges, feeling and doing better and ready to help others. Study findings are similar to studies done in other countries and highlight the needs of IENs.

Conclusion:  The study findings provide important first‐hand insights from the subjective perspectives of the IENs in US hospitals and will guide recruitment and retention of a diverse nursing workforce. Findings will enrich orientation and transition programs for IENs as well as strengthen the cohesiveness of a diverse nursing workforce in the USA.
Nurses' and nursing students' attitudes towards late abortions
Authors: Ben Natan M. , Melitz O.
Published: December 2010

BEN NATAN M. & MELITZ O. (2011) Nurses' and nursing students' attitudes towards late abortions. International Nursing Review58, 68–73

Aim:  The aim of the present study is to compare the attitudes of nursing students and nurses working in maternity wards towards late abortions performed after the 16th week of pregnancy and to identify the factors influencing their attitudes.

Methods:  A quantitative design was employed in this descriptive study, using two convenience samples: 100 nurses working in the maternity ward of a large hospital and 100 nursing students from a nursing school in Israel. The self‐report questionnaire was specially designed for purposes of this study.

Findings:  Results showed that the nurses had less prejudicial attitudes towards late abortions than the nursing students. Overall, the participants had a more positive attitude towards late abortions in the following cases: (1) risk of malformation or developmental disability, (2) pregnancy as a result of rape, and (3) danger to the life of the mother. There was a weak negative connection between the participants' number of children and their attitudes towards late abortions. In addition, there was a significant relationship found between the level of religious observance and attitudes towards late abortions, as negative attitudes increased with higher religious observance. Indeed, the level of religious observance was found to be the most significant predictor of the participants' attitudes towards late abortions.

Conclusion:  Differences in attitudes were found between nursing students and nurses providing care to patients undergoing late abortions. Their personal religious beliefs, as well as the reason for the abortion, were found to be influential in determining their attitudes.
Implicit Prices of Indigenous Bull Traits in Crop‐Livestock Mixed Production Systems of Ethiopia*
Authors: Kassie Girma T. , Abdulai Awudu , Wollny Clemens
Published: December 2010

Abstract:  This study examines the bull trait preferences of cattle buyers and estimates the relative willingness to pay for the preferred attributes. Data were generated using choice experiment method in five markets in central Ethiopia. Standard and Heterogeneity in Mean (H‐M) Random Parameters Logit (RPL) models were used to analyze buyers’ preferences for traits, while kernel density estimators were employed to examine the distribution of the willingness to pay for the individual traits. The results show that cattle buyers of central Ethiopia assign high values for good traction potential, big body size, disease resistance, calf vigor, and for places of origin when choosing bulls in the market. The preferences cattle buyers have for these attributes do vary essentially due to differences in occupation, education and age. The main implication of the findings is the necessity of identification and reckoning of trait preferences while designing crossbreeding efforts meant to sustain development of cattle production. Comprehensive and informed approach in this regard will also contribute in reducing the erosion of the genetic diversity of the indigenous animal genetic resources.
An Analysis of Welfare Changes in Zimbabwe*
Authors: Kwenda Prudence
Published: December 2010

Abstract:  This paper presents a brief account of welfare changes in Zimbabwe along the income and education dimensions between 1995 and 2003. Using sequential dominance procedures, we find that education attainment substantially improved over time. However, these gains did not necessarily translate into poverty reduction, rather welfare over the joint distribution of income and education dramatically deteriorated. These results are robust for all education partitions, income thresholds and a broad class of welfare indices. A further inquiry into the factors underlying this apparent disconnection between education and income using decomposition techniques reveals that the increase in poverty incidence cannot be attributed to household characteristics but is reflective of the broader socio‐economic trends prevailing at the time. The decline in economic growth contributed tremendously to the decline in welfare while inequality changes account for a small proportion.
Fertility in Sub‐Saharan African Countries with Consideration to Health and Poverty*
Authors: Jeon Yongil , Rhyu Sang‐Young , Shields Michael P.
Published: December 2010

Abstract:  Fertility has begun to fall in sub‐Saharan Africa but it remains high on average and particularly for a few countries. This paper examines African fertility using a panel data set of 47 sub‐Saharan countries between 1962 and 2003. Fixed and random country effect estimates are made in models where the explanatory variables are suggested by the theory of the demographic transition as modified by Caldwell (1982). Special attention is paid to the economic status of women, urbanization, the poverty level, and the health of the population including total health expenditures and the prevalence of HIV/AIDS. The results support Caldwell's hypothesis and are generally supportive of hypothesis that a fertility transition is occurring. HIV/AIDS is found to have a negative impact on fertility.
Child labour and youth enterprise: Post‐war urban infrastructure and the ‘bearing boys’ of Freetown (Respond to this article at http://www.therai.org.uk/at/debate)
Authors: Shepler Susan
Published: December 2010

This article focuses on the ‘bearing boys’ of Freetown, Sierra Leone to investigate the tension between child labour as an evil and child agency as a good, between post‐war reconstruction by a ‘weak state’ and people's (children's in particular) everyday creativity in the face of state failure. Freetown was one of the last safe places in the country during the civil war in Sierra Leone, and throughout the nineties people flooded into the capital. It is estimated that the population swelled from a pre‐war figure of 500,000 to a post‐war figure of almost two million. As Freetown got more and more crowded, many elements of the urban infrastructure were strained. In particular, clean ‘pump water’ is increasingly hard to come by for many residents of the city. ‘Bearings’ are one way that young Sierra Leoneans are addressing this water crisis. These are wooden carts designed and built by Freetown youth specifically to ferry around the city five‐gallon containers, the yellow plastic ‘bata’ commonly used to carry water. The bearing boys offer a way to talk about what the ‘weak state’ means in practice. They are responding to the collapsed urban infrastructure by creating their own new forms of money‐making endeavour, regulating themselves, and carving out a space for youth entrepreneurial and expressive activity in response to new post‐war economic and social needs.
Relying on one's tribe: A snippet of life in Basra since the 2003 invasion (Respond to this article at http://www.therai.org.uk/at/debate
Authors: Al‐Mohammad Hayder
Published: December 2010

One of the major ways of dealing with problems and difficulties in Basra is through recourse to one's tribe to mediate, resolve and sometimes even protect an individual or family. In this paper I turn to an ethnographic instance to highlight both the importance and capriciousness of tribes with respect to providing help when it is required.
692. PHAIUS HEKOUENSIS
Authors: Tsukaya Hirokazu , Nakajima Mutsuko , Wu Su‐Gong
Published: December 2010

A new species of Phaius (Orchidaceae), Phaius hekouensis Tsukaya, M. Nakajima & S. K. Wu, from Ma Chang Village, Kunming, China is described and illustrated. Phaius hekouensis is easily distinguishable from other members of the genus Phaius, having a combination of characteristics such as a tall erect, stem with elongated internodes, and large, yellow flowers with a lip having a short spur at the base and free from the column. The original habitat was near the border between China and Vietnam, suggesting high species biodiversity in this border region.
694. ABUTILON PITCAIRNENSE
Authors: Smyth Noeleen , Waldren Steve , Kingston Naomi
Published: December 2010

Abutilon pitcairnense Fosberg (Malvaceae) is currently extinct in the wild. It is endemic to Pitcairn Island, in the South Central Pacific. Islander Carol Warren refound it in 2002, after a period of over 20 years, during which time it was presumed extinct. The history of its collection and naming, its taxonomy, a botanical description and the first botanical illustrations of Abutilon pitcairnense are provided from plants flowering at the National Botanic Gardens of Ireland, Glasnevin, Dublin in January 2010, the former and current location on Pitcairn Island, former habitat photograph, and cultivation requirements are discussed.
695. SALVIA CAYMANENSIS
Authors: Clubbe Colin , Corcoran Marcella , Hamilton Martin , DaCosta‐Cottam Mat
Published: December 2010

Originally described by Charles Frederick Millspaugh in 1900, Salvia caymanensis Millsp. & Uline, the cayman sage, is known only from Grand Cayman, a Caribbean UK Overseas Territory; it was thought extinct in the wild until its rediscovery in 2007. Although the species is secure ex situ, its in situ future remains uncertain and it has been red listed as critically endangered. S. caymanensis is illustrated, its botanical history described and conservation measures discussed.
HAVING KNOW‐HOW: INTELLECT, ACTION, AND RECENT WORK ON RYLE'S DISTINCTION BETWEEN KNOWLEDGE‐HOW AND KNOWLEDGE‐THAT
Authors: SAX GREG
Published: December 2010

Stanley and Williamson reject Ryle's knowing‐how/knowing‐that distinction charging that it obstructs our understanding of human action. Incorrectly interpreting the distinction to imply that knowledge‐how is non‐propositional, they object that Ryle's argument for it is unsound and linguistic theory contradicts it. I show that they (and their interlocutors) misconstrue the distinction and Ryle's argument. Consequently, their objections fail. On my reading, Ryle's distinction pertains to, not knowledge, but an explanatory gap between explicit and implicit content, and his argument for it is sound. I defend the distinction's necessity in explaining human action and show that it propels a fruitful explanatory program.
ST. THOMAS AQUINAS ON DEATH AND THE SEPARATED SOUL
Authors: TONER PATRICK
Published: December 2010

Since St. Thomas Aquinas holds that death is a substantial change, a popular current interpretation of his anthropology must be mistaken. According to that interpretation – the ‘survivalist’ view – St. Thomas holds that we human beings survive our deaths, constituted solely by our souls in the interim between death and resurrection. This paper argues that St. Thomas must have held the ‘corruptionist’ view: the view that human beings cease to exist at their deaths. Certain objections to the corruptionist view are also met.
A Corporate Geography of Canada: Insights into a Multi‐Jurisdictional Model of Corporate Governance
Authors: GRAY TAYLOR R.
Published: December 2010

Comparative corporate governance has long focused on national models of corporate governance with particular attention paid to the balance of influence between divergent path dependence and convergent global market forces. Within this debate, the Canadian model of corporate governance has received little attention and has long been assumed to be an extension of the U.S. model. An analysis of the corporate geography of Canada demonstrates that the path‐dependent forces of Canada's resource‐dependent economic development remain a principal determinant in contemporary corporate Canada. Continued resource dependence in combination with a system of asymmetric federalism has led to a distinctively multi‐jurisdictional model of corporate governance. As corporate interests are provincially distinct because of the heterogeneous distribution of natural resources and markets across Canada, this model may lead to provincial lock‐in and an associated degree of managerial entrenchment.
On the V(I)Erge: Jean‐Luc Nancy, Christianity, and Incompletion
Authors: Fritz Peter Joseph
Published: December 2010

This article explores how Jean‐Luc Nancy attempts to gain critical traction on Christianity by proscribing thinking of completion. First, it describes Nancy's deconstruction of Christianity as stemming from his aesthetic redirection of Heidegger's thinking of finitude. Second, it further details Nancy's noetic declension of Heidegger via Kant and Lyotard, where the imagination and aesthetic communication are deemed impossible. Third, it examines Nancy's treatment of paintings of the Virgin Mary who, for Nancy, exemplifies his brand of incompletion. Nancy's work on Mary reveals both the oversights and the insights of his deconstruction of Christianity, which Catholic theology should seriously engage.
Alston's Anti‐Justificationism as a Strategy to Resolve the Conflict Between Internalism and Externalism
Authors: Mobini Mohammad Ali
Published: December 2010

After a justificationist period, William P. Alston has tried to eliminate justification from the epistemology of belief. He introduced a list of epistemic desiderata all of which contribute to the positive status of beliefs and none of which has an exclusive and decisive role so that it could be isolated as the property of being justified. Careful examination reveals, however, that this list includes fewer desiderata than advertised. Truth‐conducive desiderata are most important for Alston, and these are five; during his discussion, however, Alston reduces these desiderata to only one, the reliability of process, which has an externalist character. Besides this desideratum, there is one other group of desiderata, all of which have an internalist character. What Alston has in fact done, then, through the presentation of his anti‐justificationist list, is to separate externalist and internalist elements for the positive status of belief and to give an independent role to each. Since Alston regards the truth‐conducive group as the most important, however, and since he has failed to show a real pluralism in this group, we may conclude that he continues to have a monistic approach to the evaluation of beliefs, which belies his alleged pluralism.
Heritage Tourism in the Caribbean: The Politics of Culture after Neoliberalism
Authors: SCHER PHILIP W.
Published: December 2010

As neoliberalism has taken root in the Caribbean, heritage tourism has grown enormously. Using examples drawn from the Trinidad Carnival, this article shows how culture becomes a marketing force in the wake of increasingly difficult economic times in the Caribbean. As selling culture increases in importance for the overall economic health of Caribbean economies, it becomes, more and more, the focus of Caribbean states and state agencies and a basis for state sovereignty. Drawing on Foucault's notion of biopower, the article draws a connection between the increasing importance of cultural performances for state revenue and government intervention into those performances.
Subprime Lending and Real Estate Prices
Authors: Pavlov Andrey , Wachter Susan
Published: December 2010

This article establishes a theoretical and empirical link between the use of aggressive mortgage lending instruments, such as interest‐only, negative‐amortization or subprime mortgages, and the underlying house prices. Such instruments, which come into existence through innovation or financial deregulation, allow more borrowing than otherwise would occur in previously affordability‐constrained markets. Within the context of a model with an endogenous rent‐buy decision, we demonstrate that the supply of aggressive lending instruments temporarily increases the asset prices in the underlying market because agents find it more attractive to own or because their borrowing constraint is relaxed, or both. This result implies that the availability of aggressive mortgage lending instruments magnifies the real estate cycle and the effects of fundamental demand shocks. We empirically confirm the predictions of the model using recent subprime origination experience. In particular, we find that regions that receive a high concentration of aggressive lending instruments experience larger price increases and subsequent declines than areas with low concentration of such instruments. This result holds in the presence of various controls and instrumental variables.
Further Evidence on the Capital Structure of REITs
Authors: Harrison David M. , Panasian Christine A. , Seiler Michael J.
Published: December 2010

This study examines the determinants of real estate investment trust (REIT) capital structure decisions from 1990 to 2008. Using a broad sample of 2,409 firm‐year observations, we find that asset tangibility is positively related to leverage, whereas profitability and market‐to‐book ratios are negatively related. Additional evidence suggests that firm debt capacity varies systematically with the unique operating and financing mechanisms employed by REITs. These results are robust across both aggregate firm debt levels and marginal security issuance decisions. Finally, our results provide further insight into competing capital structure theories, generally supporting empirical predictions derived from the market timing and trade‐off theories, although failing to support pecking order theory predictions.
Processing Technologies for High‐Permittivity Thin Films in Capacitor Applications
Authors: Brennecka Geoff L. , Ihlefeld Jon F. , Maria Jon‐Paul , Tuttle Bruce A. , Clem Paul G.
Published: December 2010

Capacitor technologies are as varied as the applications that they enable, but one of the common themes in advanced capacitors for consumer electronics is a desire for increased capacitance in smaller areas/volumes. The heroic advances of discrete capacitor manufacturers have kept pace with the increasing demands of miniaturization, but a time is quickly approaching when it appears that powder‐based fabrication techniques simply will not be able to achieve desired layer thicknesses and capacitance densities. Here, we review the current state of the art and recent advances in the processing science and technology of high‐permittivity thin films with a focus on industrially scalable solution‐based fabrication processes of perovskite ferroelectric systems that appear to offer the greatest promise for the fabrication of future nanoscale capacitors.
Intra‐ and Interobsever Reliability of Sonographic Assessment of the Optic Nerve Sheath Diameter in Healthy Adults
Authors: Bäuerle Jochen , Lochner Piergiorgio , Kaps Manfred , Nedelmann Max
Published: December 2010

BACKGROUND

The use of an ultrasound‐based evaluation of the optic nerve sheath diameter (ONSD) has previously been demonstrated for detecting raised intracranial pressure. In order to be feasible in clinical workup, the test qualities of transorbital ultrasonography need to be determined. The aim of this study was therefore to establish normal values and to assess the intra‐ and interobserver reliability of this method.

METHODS

Using a 9‐3 MHz linear array transducer, the ONSD of 40 healthy subjects was independently measured by 2 investigators.

RESULTS

Depicting the optic nerve and its sheath was possible in all individuals. The mean ONSD was 5.4 ± .6 mm with a range of 4.3‐7.6 mm. The intraobserver reliability analyzed with Cronbach's Alpha was found to be high with values between .92 and .97. Pearson's correlation coefficient between the 2 investigators was .81 on the right side and .84 on the left. There was no correlation between ONSD and age, body mass index, or gender.

CONCLUSIONS

Transorbital B‐mode sonography is a feasible method to assess the ONSD with a high intra‐ and interobsever reliability. Normal values on ONSD are presented in this study that will be useful in future studies on pathological conditions.
Intracranial Hypotension Caused by Dural‐Pleural Fistula
Authors: Chaudhry Mohammed Suhail
Published: December 2010

This report describes a rare complication in a woman who underwent thoracic spinal surgery. One month postoperatively, her rehabilitation was interrupted by the development of a severe headache, nausea, vomiting, and a right‐side occulomotor nerve palsy. Imaging of her brain revealed changes typical of intracranial hypotension, and subsequent imaging of the spine revealed a cerebrospinal fluid (CSF) leak at the site of surgery. The CSF was seen to track into the right pleural space via a dural‐pleural fistula. Surgical repair of the fistula led to a definitive resolution in symptoms, thus highlighting the importance of early recognition of this highly unusual complication. J Neuroimaging 2012;22:208‐209.
Stroke Fast Track Reduces Time Delay to Neuroimaging and Increases Use of Thrombolysis in an Academic Medical Center in Thailand
Authors: Ratanakorn Disya , Keandoungchun Jesada , Sittichanbuncha Yuwares , Laothamatas Jiraporn , Tegeler Charles H.
Published: December 2010

ABSTARCT

Delays between hospital arrival and neuroimaging prevented patients from receiving thrombolysis. We report impact of Stroke Fast Track (SFT) on time to imaging, and rates of recombinant tissue plasminogen activator (rt‐PA) in eligible patients. Characteristics, time intervals, and rates of rt‐PA were evaluated in 464 patients with suspected acute stroke within 7 days (2005–2006). Complete time intervals were available on 380. Median times between emergency room arrival, brain computerized tomography (CT), and CT results were 25 and 45 minutes, respectively, for patients arriving <3 hours from onset, 40, and 65 minutes for those arriving >3 hours, and 35 and 60 minutes for all patients, which is significantly shorter than 2.5 hours to CT in 2004, prior to SFT (P < .0001). Although not different in time to first physician, patients arriving >3 hours had longer times to CT and CT results (P < .001). Overall, 5.5% of ischemic stroke patients received intravenous rt‐PA, including 27.1% of those arriving within 3 hours, which represented 100% of all eligible patients, compared with 0% in 2004. SFT reduced time delay in neuroimaging and increased use of rt‐PA in Thailand. Continuous quality improvement is needed to achieve best results in each setting, and to insure optimal care for acute stroke patients.
Diffusion Tensor Imaging of Corpus Callosum Integrity in Multiple Sclerosis: Correlation with Disease Variables
Authors: Sigal Tal , Shmuel Miron , Mark Dolev , Gil Harari , Anat Achiron
Published: December 2010

BACKGROUND AND PURPOSE

Corpus callosum (CC) is frequently involved in multiple sclerosis (MS). We aimed to investigate the relations between CC microstructure integrity as measured by diffusion tensor imaging (DTI) in relapsing‐remitting MS patients with low neurological disability in comparison with age‐matched healthy subjects and further to identify correlations between DTI‐CC parameters and clinical variables of MS disease activity.

METHODS

CC volume was measured on 3.0T brain MRI by MS Analyze software. DTI metrics acquired along 31 independent directions were obtained and fractional anisotropy (FA), apparent diffusion coefficient (ADC), longitudinal (λ1) and transverse (λ 2, λ 3) diffusivities were measured in MS patients and healthy subjects. Disease activity was assessed by relapse rate and neurolgical disability by the Extended Disability Status Scale (EDSS).

RESULTS

Thirty relapsing‐remitting MS patients and 30 age‐ and sex‐matched healthy subjects were studied. CC volume and DTI metrics differed significantly between MS patients and healthy subjects. In MS patients, all DTI parameters correlated with neurological disability. ADC, longitudinal and transverse diffusivity correlated with disease duration. ADC and the transverse diffusivity correlated with relapse rate.

CONCLUSIONS

CC DTI parameters, especially ADC and transverse diffusivity correlated with disease variables especially with those associated with clinical activity.
Distribution of Emergency Departments According to Annual Visit Volume and Urban–Rural Status: Implications for Access and Staffing
Authors: Muelleman Robert L. , Sullivan Ashley F. , Espinola Janice A. , Ginde Adit A. , Wadman Michael C. , Camargo Jr. Carlos A.
Published: December 2010

Objectives:  Ongoing efforts to improve access to emergency care and emergency department (ED) staffing would benefit from a better understanding of the distribution of EDs in the United States by size and location. This article describes the distribution of U.S. ED visit volumes according to ED urban versus rural status.

Methods:  The authors used the 2007 National Emergency Department Inventories (NEDI)‐USA database to identify all nonfederal U.S. hospitals with EDs and their annual ED visit volumes. One of twelve 2003 Urban Influence Codes was applied to each ED location based on its county. These categories were collapsed into urban counties and three types of rural counties: adjacent to urban, large nonadjacent, and small nonadjacent. The number of emergency physicians (EPs) needed to staff the higher‐volume rural EDs was estimated.

Results:  Of the 4,874 U.S. EDs in 2007, 58% were in urban counties and 42% in rural counties. Among the 2,038 rural EDs, 56% were adjacent to urban, 15% were large nonadjacent, and 29% were small nonadjacent. Of the 1,503 lower‐volume (< 10,000 visit) EDs, 21% were in urban counties. Of the 3,371 higher‐volume (≥ 10,000 visit) EDs, 25% were in rural counties. Of the 857 higher‐volume rural EDs, 66% were adjacent to urban, 22% were large nonadjacent, and 12% were small nonadjacent. The authors estimate that approximately 5,600 EPs are needed to staff these higher‐volume rural EDs.

Conclusions:  There are many lower‐volume EDs in urban areas and higher‐volume EDs in rural areas. Most higher‐volume rural EDs are in rural areas adjacent to urban counties. These data challenge popular assumptions regarding ED visit volumes, locations, and staffing needs.

ACADEMIC EMERGENCY MEDICINE 2010; 17:1390–1397 © 2010 by the Society for Academic Emergency Medicine
A Link to Improve Stroke Patient Care: A Successful Linkage Between a Statewide Emergency Medical Services Data System and a Stroke Registry
Authors: Mears Greg D. , Rosamond Wayne D. , Lohmeier Chad , Murphy Carol , O’Brien Emily , Asimos Andrew W. , Brice Jane H.
Published: December 2010

Objectives:  Regionalization of stroke care, including diversion to stroke centers, requires that emergency medical services (EMS) systems accurately identify acute stroke patients. A barrier to evaluating and improving EMS stroke patient identification is the inability to link EMS data with hospital data for individual patients. We sought to create and validate a linkage of the North Carolina EMS Data System (NC‐EMS‐DS) with data contained in the North Carolina Stroke Care Collaborative (NCSCC) Registry.

Methods:  All NCSCC Registry patients arriving to one of three hospitals by EMS in a 6‐month period were matched against NC‐EMS‐DS. Records were deterministically matched on receiving hospital, hospital arrival date/time, age, and sex. We performed linkage validation by providing each site investigator with a stroke patient list derived from North Carolina Stroke Care Collaborative Registry (NC‐EMS‐DS), matched by individual patient to deidentified data in the NCSCCR. Each site investigator determined the set of true matches by comparing the matched list to a NCSCCR patient identifier key maintained at each site. Incorrect matches were reviewed by the research team to identify methods for future improvement in the matching logic.

Results:  For the three validation hospitals, 753 NCSCC Registry patients arrived by EMS. For these patients, 473 (63%) matches to local EMS records were identified, and 421 (89%) of the matches were verified using full patient identifiers. Most match verification failures were due to incorrect date/time stamp and inability to find a corresponding EMS record.

Conclusions:  Linking EMS records electronically to a stroke registry is feasible and leads to a large number of valid matches. This small validation is limited by EMS data quality. Matching may improve with better EMS documentation and standardized facility documentation.

ACADEMIC EMERGENCY MEDICINE 2010; 17:1398–1404 © 2010 by the Society for Academic Emergency Medicine
Inter‐hospital Communications and Transport: Turning One‐way Funnels Into Two‐way Networks
Authors: Rokos Ivan C. , Sanddal Nels D. , Pancioli Arthur M. , Wolff Catherine , Gaieski David F.
Published: December 2010

The Inter‐hospital Communications and Transport workgroup was charged with exploring the current status, barriers, and data necessary to optimize the initial destination and subsequent transfer of patients between and among acute care settings. The subtitle, “Turning Funnels Into Two‐way Networks,” is descriptive of the approach that the workgroup took by exploring how and when smaller facilities in suburban, rural, and frontier areas can contribute to the daily business of caring for emergency patients across the lower‐acuity spectrum—in some instances with consultant support from academic medical centers. It also focused on the need to identify high‐acuity patients and expedite triage and transfer of those patients to facilities with specialty resources. Draft research recommendations were developed through an iterative writing process and presented to a breakout session of Academic Emergency Medicine’s 2010 consensus conference, “Beyond Regionalization: Integrated Networks of Emergency Care.” Priority research areas were determined by informal consensus of the breakout group. A subsequent iterative writing process was undertaken to complete this article. A number of broad research questions are presented.

ACADEMIC EMERGENCY MEDICINE 2010; 17:1279–1285 © 2010 by the Society for Academic Emergency Medicine
Categorization, Designation, and Regionalization of Emergency Care: Definitions, a Conceptual Framework, and Future Challenges
Authors: Kocher Keith E. , Sklar David P. , Mehrotra Abhishek , Tayal Vivek S. , Gausche‐Hill Marianne , Myles Riner R.
Published: December 2010

This article reflects the proceedings of a breakout session, “Beyond ED Categorization—Matching Networks to Patient Needs,” at the 2010 Academic Emergency Medicine consensus conference, “Beyond Regionalization: Integrated Networks of Emergency Care.” It is based on concepts and areas of priority identified and developed by the authors and participants at the conference. The paper first describes definitions fundamental to understanding the categorization, designation, and regionalization of emergency care and then considers a conceptual framework for this process. It also provides a justification for a categorization system being integrated into a regionalized emergency care system. Finally, it discusses potential challenges and barriers to the adoption of a categorization and designation system for emergency care and the opportunities for researchers to study the many issues associated with the implementation of such a system.

ACADEMIC EMERGENCY MEDICINE 2010; 17:1306–1311 © 2010 by the Society for Academic Emergency Medicine
Administrative Challenges to Regionalization
Authors: Pilgrim Randy , Martinez Ricardo , Jouriles Nicholas , Hufstetler Greg , Wise Pat , Wise Robert , Acker Joe , Soremekun Olan A. , Carrier Emily
Published: December 2010

The ideal emergency care system delivers the right care to the right patient at the right time and yields appropriate patient outcomes at a sustainable overall cost. Transforming the current system of emergency care into the Institute of Medicine’s vision of a coordinated, regionalized, and accountable emergency care system requires careful consideration of administrative challenges and barriers. Left unaddressed, certain processes, systems, and structures may prevent integration efforts or threaten long‐term viability.

ACADEMIC EMERGENCY MEDICINE 2010; 17:1359–1363 © 2010 by the Society for Academic Emergency Medicine
Regionalization and Emergency Care: The Institute of Medicine Reports and a Federal Government Update
Authors: Carr Brendan G. , Asplin Brent R.
Published: December 2010

The 2010 Academic Emergency Medicine consensus conference on regionalization in emergency care began with an update on the Institute of Medicine (IOM) reports on the Future of Emergency Care. This was followed by two presentations from federal officials, focusing on regionalization from the perspective of the White House National Security Staff and the Emergency Care Coordination Center. This article summarizes the content of these presentations. It should be noted that this summary is the perspective of the authors and does not represent the official policy of the U.S. government.

Academic Emergency Medicine 2010; 17: 1351–1353 © 2010 by the Society for Academic Emergency Medicine
Geographic Information Systems and Emergency Care Planning
Authors: Carr Brendan G. , Addyson Daniel K.
Published: December 2010

Rapid access to emergency care can be life‐saving, and geography is an important determinant of access to care. In this article, the authors review the organization of emergency care in the United States and describe the use of geographic information systems (GIS) to describe and solve health‐related problems. The distribution of and access to medical resources, especially in the case of time‐sensitive conditions, embodies the core concepts of geography—the relationship between place, time, and physical phenomena. The authors propose the expanded use of GIS in the development of the emergency care system and suggest that a transparent inventory of emergency care resources, coupled with an understanding of how access to appropriate care influences outcomes, can inform the creation of a regionalized, coordinated, and accountable emergency care system.

ACADEMIC EMERGENCY MEDICINE 2010; 17: 1274–1278 © 2010 by the Society for Academic Emergency Medicine
Dolosigranulum pigrum causing biomaterial‐associated arthritis
Authors: JOHNSEN BJØRN ODD , RØNNING ELSE JOHANNE , ONKEN ANNETTE , FIGVED WENDER , JENUM PÅL A.
Published: December 2010

Johnsen BO, Rønning EJ, Onken A, Figved W, Jenum PA. Dolosigranulum pigrum causing biomaterial‐associated arthritis. APMIS 2010; 119: 85–7.

Dolosigranulum pigrum is a gram‐positive, catalase‐negative bacteria rarely associated with disease. We report a case of biomaterial‐associated arthritis in an immunocompetent patient caused by D. pigrum. The organism was isolated from a synovial biopsy specimen and its identity confirmed by 16S rRNA gene sequencing.