bluuebunny/crossref_metadata_2025 huggingface dataset:
Racial, Income, and Marital Status Disparities in Hospital Readmissions Within a Veterans-Integrated Health Care Network
Authors: Moore Crystal Dea , Gao Kelly , Shulan Mollie
Published: June 2013

Hospital readmission is an important indicator of health care quality and currently used in determining hospital reimbursement rates by Centers for Medicare & Medicaid Services. Given the important policy implications, a better understanding of factors that influence readmission rates is needed. Racial disparities in readmission have been extensively studied, but income and marital status (a postdischarge care support indicator) disparities have received limited attention. By employing three Poisson regression models controlling for different confounders on 8,718 patients in a veterans-integrated health care network, this study assessed racial, income, and martial disparities in relation to total number of readmissions. In contrast to other studies, no racial and income disparities were found, but unmarried patients experienced significantly more readmissions: 16%, after controlling for the confounders. These findings render unique insight into health care policies aimed to improve race and income disparities, while challenging policy makers to reduce readmissions for those who lack family support.
Systematic review of health data quality management and best practices at community and district levels in LMIC
Authors: Ndabarora Eléazar , Chipps Jennifer A , Uys Leana
Published: June 2013

Research findings have reported lack of reliable health data and poor management for district health information systems in low and middle-income countries (LMIC). This paper aims to review the literature on problems with health data quality management and health information evidences and evidences of best practices and use at community and district levels in LMIC, with a view to making recommendations for future research. Research citations, conference proceedings and diseases surveillance reports from 2000–2011 were accessed in PubMed, Medline, LISTA (EBSCO), CINAHL, Cochrane, and Google. Relevant studies were selected, the methodologies critiqued and synthesized. The researchers accessed 1383, and 38 were reviewed by three reviewers. Poor quality health data, low level of health information use, and poor management of health information systems were found. These findings hinder evidence-based decisions based and planning at community and district levels in LMIC. Though poor practices were found, improved health care services delivery with improved health data efficiency was found to be possible.
Demand and support for enterprise applications integration in Nigeria
Authors: Ehikhamenor Fabian A. , Bamitale Adebayo A. , Owens-Ibie Osamudiamen
Published: June 2013

The demand and support for enterprise applications integration (EAI) in Nigeria was investigated. The findings show that the demand and support for EAI are driven by a number of factors, including concern for data/information integration, a common interface for all enterprise applications, improved communication and faster data transfer, real-time data capture and access to information across various networks, as well as data and information integrity across various systems. The IT companies in Nigeria are following the progress of technology and are poised to respond to it in their approaches to EAI solutions. Their future approaches will be influenced to the greatest extent by progress in Graphical User Interface (GUI) and then by developments in Enterprise Resource Planning (ERP), Operating Systems, Software as a Service (SaaS), Parameterization of applications for easy customization, Applications Service Provision, and Open Source Systems in that order. They believe that Nigeria has the greatest capacity in Software as a Service (SaaS) and Software as Secured Service (SaSS). A growing number of companies are using open source tools in developing and implementing EAI solutions, and this is an indication of a market that is taking on its own character but also a subscription to the democratization of software access. The popularity of SQL Server and its varieties, closely followed by Oracle and Java/Javascript, as EAI tools in Nigeria is probably a reflection of their prominence on the international scene.
Online environmental activism and Internet use in the Indonesian environmental movement
Authors: Kurniawan Nanang Indra , Rye Ståle Angen
Published: June 2013

This article investigates the use of the Internet among Indonesian environmental non-governmental organizations (ENGOs) and how this use influences the mobilizing structure of the environmental movement. The discussion is informed by an explorative study of nineteen Indonesian ENGOs working in the domain of forest protection. The study reveals that the Internet empowers the environmental activism of these organizations by enhancing opportunities for political participation. A main finding in the article is that well-established organizations with well-developed international networks benefit the most from the use of the Internet in their activism. However, smaller organizations with more informal charters seemed to have a better capacity to connect unconnected communities to the global flow of information.
Electronic records preservation in China – An exploratory inquiry
Authors: Liu Yuenan (Linda)
Published: June 2013

Electronic records in China are defined as records that are created by digital devices and in a digital environment, exist in digital formats, rely on digital devices such as computers for reading and processing, and can be transmitted via communication networks. As a subset of electronic records, archival electronic records are those, based on their reference and use values, determined as needing to be preserved as archives. A gap was identified by reviewing literature that, although there are projects being conducted in a number of archival institutions, a systematic and standardized approach towards archival preservation of electronic records is currently lacking in China. In order to lay the foundation on which such an approach can be built, the present study was conceived to gain a comprehensive understanding of the preservation of archival electronic records in both the provincial and secondary provincial archives throughout the country. Relying on survey methodology and the OAIS reference model as the guiding theoretical framework, the study collected and analyzed data from a large number of archival institutions in China. As the first of its kind conducted in the geographical area of the Mainland China in terms of scope and subject matter, the investigation yielded empirical discoveries that over half of investigated archives had ingested electronic records with non-uniform and insufficient long-term preservation mechanisms. The study also pointed out that the issues surrounding electronic records management in records creating agencies were considered most challenging for long-term preservation, and that a national strategy with a top-down approach was called for, which could take full advantage of the Chinese archival system. It is believed that the findings generated by this study will be instructive and beneficial to the other types of archives in China and to the archival functions that operate internationally in similar or comparable environments.
The effect of organizational social factors on employee performance and the mediating role of knowledge sharing: focus on e-government utilization in Mongolia
Authors: Park Min Jae , Dulambazar Tumurpurev , Rho Jae Jeung
Published: June 2013

In a knowledge-based society, government organizations become more knowledge-intensive. Most governments which have not yet implemented effective knowledge management systems for government organizations have indicated concern about increasing the impact of knowledge sharing to promote the success of e-government implementation, and they have tried to determine what types of organizational social factors influence knowledge sharing among government employees. To provide insight into these concerns, this paper presents an empirical study of how major organizational social enabling factors influence knowledge sharing among employees by conducting surveys in a number of central government organizations that implement e-government strategies in Mongolia. The research model was analyzed using the partial least squares (PLS) method. This study also investigates the mediating effects of knowledge sharing between the organizational social factors and employee performance with the moderating role of the e-government facilitating conditions. Leadership, reward and trust were revealed in this research as the components of the strongest foundation for knowledge sharing. The results also show that knowledge sharing plays a mediating role between these organizational social factors and performance. Moreover, this study finds that facilitating conditions play a key role as enablers of organizational performance improvements. These findings present important implications for policymakers to improve strategic planning for e-government implementation through investments that utilize the necessary facilitating conditions with sufficient knowledge sharing among employees of government so as to create a more conductive environment for improving organizational performance.
Linear Regression Metamodeling as a Tool to Summarize and Present Simulation Model Results
Authors: Jalal Hawre , Dowd Bryan , Sainfort François , Kuntz Karen M.
Published: June 2013

Background/Objective. Modelers lack a tool to systematically and clearly present complex model results, including those from sensitivity analyses. The objective was to propose linear regression metamodeling as a tool to increase transparency of decision analytic models and better communicate their results. Methods. We used a simplified cancer cure model to demonstrate our approach. The model computed the lifetime cost and benefit of 3 treatment options for cancer patients. We simulated 10,000 cohorts in a probabilistic sensitivity analysis (PSA) and regressed the model outcomes on the standardized input parameter values in a set of regression analyses. We used the regression coefficients to describe measures of sensitivity analyses, including threshold and parameter sensitivity analyses. We also compared the results of the PSA to deterministic full-factorial and one-factor-at-a-time designs. Results. The regression intercept represented the estimated base-case outcome, and the other coefficients described the relative parameter uncertainty in the model. We defined simple relationships that compute the average and incremental net benefit of each intervention. Metamodeling produced outputs similar to traditional deterministic 1-way or 2-way sensitivity analyses but was more reliable since it used all parameter values. Conclusions. Linear regression metamodeling is a simple, yet powerful, tool that can assist modelers in communicating model characteristics and sensitivity analyses.
Exploring the Impact of Expertise, Clinical History, and Visual Search on Electrocardiogram Interpretation
Authors: Wood Greg , Batt Jeremy , Appelboam Andrew , Harris Adrian , Wilson Mark R.
Published: June 2013

Background: The primary aim of this study is to understand more about the perceptual-cognitive mechanisms underpinning the expert advantage in electrocardiogram (ECG) interpretation. While research has examined visual search processes in other aspects of medical decision making (e.g., radiology), this is the first study to apply the paradigm to ECG interpretation. The secondary aim is to explore the role that clinical history plays in influencing visual search behavior and diagnostic decision making. While clinical history may aid diagnostic decision making, it may also bias the visual search process. Methods: Ten final-year medical students and 10 consultant emergency medics were presented with 16 ECG traces (8 with clinical history that was not manipulated independently of case) while wearing eye tracking equipment. The ECGs represented common abnormalities encountered in emergency departments and were among those taught to final-year medical students. Participants were asked to make a diagnosis on each presented trace and report their level of diagnostic confidence. Results: Experts made significantly faster, more accurate, and more confident diagnoses, and this advantage was underpinned by differences in visual search behavior. Specifically, experts were significantly quicker at locating the leads of critical importance. Contrary to our hypothesis, clinical history had no significant effect on the readers’ ability to detect the abnormality or make an accurate diagnosis. Conclusions: Accurate ECG interpretation appears dependent on the perceptual skill of pattern recognition and specifically the time to fixate the critical lead(s). Therefore, there is potential clinical utility in developing perceptual training programs to train novices to detect abnormalities more effectively.
Nutritional Policy Changes in the Supplemental Nutrition Assistance Program
Authors: Basu Sanjay , Seligman Hilary , Bhattacharya Jay
Published: June 2013

Background. Some experts have proposed limiting the use of Supplemental Nutrition Assistance Program (SNAP) benefits, for calorie-dense foods or subsidizing SNAP purchases of healthier foods. Objective. To estimate health effects and cost-effectiveness of banning or taxing sugar-sweetened beverages (SSBs) or subsidizing fruits and vegetables purchased with SNAP. Design. Microsimulation. Data Sources. National Health and Nutrition Examination Survey, US Department of Agriculture Quarterly Food-at-Home Price Database, and SNAP program data. Target Population: US adults aged 25 to 64 y. Time Horizon. 10 y. Perspective. Governmental. Outcome Measures. Incremental costs, quality-adjusted life-years (QALYs), body mass index, Alternative Healthy Eating Index, Food Security Score, diabetes person-years, and deaths from myocardial infarctions (MIs) and strokes. Results of Base-Case Analysis. Banning SSB purchases using SNAP benefits would be expected to avert 510,000 diabetes person-years and 52,000 deaths from MIs and strokes over the next decade, with a savings of $2900 per QALY saved. A penny-per-ounce tax on SSBs purchased with SNAP dollars would produce higher cost savings due to tax revenues but avert fewer chronic disease deaths. However, some SNAP participants are likely to preferentially purchase SSBs through their disposable income, indirectly reducing their food security. A 30% produce subsidy would be expected to avert 39,000 diabetes person-years and 4600 cardiovascular deaths over 10 y without effects on food security. Results of Sensitivity Analysis. Results are sensitive to the intake elasticities of SSBs and produce. Limitations. Input data did not provide information on heterogeneity in response to price changes within the SNAP-using population. Conclusions. SNAP restrictions on SSBs could lower chronic disease mortality, but further testing should examine indirect effects on disposable income and food security. Subsidizing produce could confer fewer benefits or risks but at higher cost.
Motion planning and reactive control on learnt skill manifolds
Authors: Havoutis Ioannis , Ramamoorthy Subramanian
Published: June 2013

We address the problem of encoding and executing skills, i.e. motion tasks involving a combination of specifications regarding constraints and variability. We take an approach that is model-free in the sense that we do not assume an explicit and complete analytical specification of the task – which can be hard to obtain for many realistic robot systems. Instead, we learn an encoding of the skill from observations of an initial set of sample trajectories. This is achieved by encoding trajectories in a skill manifold which is learnt from data and generalizes in the sense that all trajectories on the manifold satisfy the constraints and allowable variability in the demonstrated samples. In new instances of the trajectory-generation problem, we restrict attention to geodesic trajectories on the learnt skill manifold, making computation more tractable. This procedure is also extended to accommodate dynamic obstacles and constraints, and to dynamically react against unexpected perturbations, enabling a form of model-free feedback control with respect to an incompletely modelled skill. We present experiments to validate this framework using various robotic systems – ranging from a three-link arm to a small humanoid robot – demonstrating significant computational improvements without loss of accuracy. Finally, we present a comparative evaluation of our framework against a state-of-the-art imitation-learning method.
Retrospective analysis of 102 cases of solid pseudopapillary neoplasm of the pancreas in China
Authors: Wang Li-Jie , Bai Li , Su Dan , Zhang Ting-Ting , Mao Zhi-Yuan , Guo Xiao-Chuan , Jiao Shun-Chang
Published: June 2013

Objective

Clinicopathological features and surgical outcomes in patients with solid pseudopapillary neoplasm (SPN) of the pancreas were analysed.

Methods

Data regarding clinicopathological features, surgery and outcome for patients with SPN were retrospectively collected and analysed. Patients were followed-up by telephone interview.

Results

The study included 102 patients (89 females/13 males), 99 of whom underwent surgical resection. A total of 89 patients (87.3%) were followed-up (mean duration 26.98 months, range 2–95 months); 86 (96.6%) had no relapse or metastasis.

Conclusions

Surgical resection is the primary therapy for SPN, and results in a good prognosis.
Experiencing earworms: An interview study of Involuntary Musical Imagery
Authors: Williamson Victoria J. , Jilka Sagar R.
Published: June 2013

Involuntary musical imagery (INMI) is a ubiquitous cognitive phenomenon. The present study comprises six intensive interviews that examine the subjective phenomenology of INMI for individuals of varying musical experience. Grounded theory analysis was used to establish themes regarding both the form and feelings ascribed to INMI episodes. All the respondents felt that their INMI experiences had high fidelity including some complex musical arrangements. INMI form could be unstable over time according to cognitive demands. Individuals with musical experience reported concurrent sensations of visual and motor imagery as well as involuntary extemporizations of their INMI. Motivators for positive and negative appraisals of INMI were identified such as nostalgia and entertainment, and repetitive cycling with loss of control, respectively. We discuss interpretations from auditory memory theory and develop hypotheses for future INMI empirical investigation.
Occipital nerve stimulation for intractable chronic cluster headache or migraine: A critical analysis of direct treatment costs and complications
Authors: Mueller Oliver , Diener Hans-Christoph , Dammann Philipp , Rabe Kasja , Hagel Vincent , Sure Ulrich , Gaul Charly
Published: June 2013

Background

Occipital nerve stimulation (ONS) has been shown to be effective for selected patients with intractable headache disorders. We performed a prospective critical evaluation of complications and direct treatment costs.

Methods

Twenty-seven patients with chronic cluster headache (CCH, n = 24) or chronic migraine (CM, n = 3) underwent a trial phase with bilateral ONS and subsequent implantation of a permanent generator (IPG), if responsive to treatment according to predefined criteria. Procedural and long-term complications as well as direct treatment costs of neuromodulation therapy of ONS were recorded over a mean follow-up period of 20 months (range 5–47 months).

Results

Twenty-five of 27 patients (93%) responded to treatment. Twenty-one complications in 14 patients were identified, necessitating reoperation in 13 cases. Overall treatment costs were €761,043, including hardware-related costs of €506,019, costs for primary hospital care of €210,496, and complications related to hospitalization costs of €44,528. This results in a per case-based cost of €9445 for hospitalization and €18,741 for hardware costs, totaling €28,186.

Conclusion

ONS for treatment of refractory CCH and CM is a cost-intensive treatment option with a significant complication rate. Nevertheless, patients with refractory primary headache disorders may experience substantial relief of pain attacks, and headache days, respectively.
Analysis of 16,192 Anterior Cruciate Ligament Reconstructions From a Community-Based Registry
Authors: Maletis Gregory B. , Inacio Maria C.S. , Funahashi Tadashi T.
Published: June 2013

Background:

Orthopaedic registries have shown value in tracking and surveillance of patients, implants, and outcomes associated with procedures. No current anterior cruciate ligament reconstruction registry (ACLRR) exists in the United States.

Purpose:

To describe the current cohort captured by an institutional ACLRR and describe the outcomes observed in the registered patients and how findings from the ACLRR are disseminated.

Study Design:

Cohort study; Level of evidence, 2.

Methods:

The anterior cruciate ligament reconstructions (ACLRs) registered between February 2005 and September 2011 by 244 surgeons in 48 medical centers were evaluated. The ACLRR collected data intra- and postoperatively using paper forms and electronic medical records. The ACLRR cohort was longitudinally followed and outcomes were prospectively ascertained. Outcomes (ie, revisions, subsequent operations, venous thromboembolism, and surgical site infections) were adjudicated via chart review. Descriptive statistics are used to describe the cohort and Kaplan-Meier curves to evaluate survival.

Results:

During the study period, 16,192 ACLRs (15,101 primary and 1091 revisions) with a median follow-up of 1.6 years (interquartile range, 0.7-2.8 years) were registered. Male patients received 64% of both primary and revision ACLRs. The mean age at surgery was 29.5 years (SD, 11.4 years) for primary and revision reconstructions. Cartilage injuries were noted in 25.2% of primary and 37.5% of revision ACLRs, and meniscal injuries were identified in 60.8% and 53.2%, respectively. Autografts were used in 57.6% of primary ACLRs and 20.9% of revisions. Allografts were used in 42.4% of primaries and 78.8% of revisions. In primary ACLR, the most common femoral and tibial fixation types were interference screws (42.2% and 79.7%, respectively). Fixation type distribution was nearly identical in primaries and revisions. Of the primary ACLRs, 3.7% had subsequent operations on the same knee and 1.7% on the contralateral knee. Deep surgical site infection developed in 0.3% of primaries and 0.8% of revisions. Symptomatic deep vein thromboses were seen in 0.2% of both primaries and revisions. The overall revision rate was 1.7%. Lower rates of graft survival were identified in younger patients and those with allografts.

Conclusion:

Large, community-based ACLRRs are useful in informing participating surgeons of current treatment practices, prevalence of concurrent injuries, and outcomes associated with the procedures. Information from the ACLRR can be used to develop interactive patient and surgeon tools that can be used to optimize patient care.
Diagnosis and Management of Symptomatic Muscle Herniation of the Extremities
Authors: Kramer Dennis E. , Pace J. Lee , Jarrett Delma Y. , Zurakowski David , Kocher Mininder S. , Micheli Lyle J.
Published: June 2013

Background:

There is a paucity of published literature on diagnosis and surgical management of muscle herniation of the extremities, with most reported cases involving military personnel and men aged 18 to 40 years.

Hypothesis/Purpose:

The purpose of this study is to describe the presentation, diagnosis, and results of fasciotomy for symptomatic muscle herniation in young athletes. We hypothesize that fasciotomy can be a safe and effective treatment option that allows the majority of athletes to return to sports.

Study Design:

Case series; Level of evidence, 4.

Methods:

From 2001 to 2011, 26 athletes (19 women; 11 runners) with a mean age 19.0 ± 4.0 years (range, 14.2-28.4 years) underwent fasciotomy for symptomatic muscle herniation at the authors’ institution. Retrospective chart review recorded pertinent patient data and clinical course. Questionnaires were sent to all patients to assess satisfaction with surgery, ability to return to sports, and residual symptoms.

Results:

Muscle hernias were classified as primary (n = 8, 31%), postsurgical (n = 8, 31%), and associated with underlying untreated chronic exertional compartment syndrome (n = 10, 38%). The tibialis anterior muscle (n = 12, 46%) was most commonly involved. The mean time from onset of symptoms to surgery was 15.1 ± 8.6 months (range, 3-38 months). Dynamic ultrasound (5/6 patients, 83%) was more accurate than magnetic resonance imaging (3/18, 17%) at identifying the hernia. At median follow-up of 28 months (range, 12-127 months), 17 patients (65%) had returned to sports. Seventeen patients (65%) completed the postoperative questionnaire; 14 reported being satisfied with their results (82%). Mild residual symptoms were common (9 of 17 respondents, 53%), especially in runners (5 of 7, 71%), all of whom were satisfied with surgery. Patients with a postsurgical muscle herniation took the longest to return to sports and were the least likely to return to sports, had the highest rate of dissatisfaction with surgery, and were most likely to have persistent symptoms not improved by surgery.

Conclusion:

Fasciotomy is a safe surgical option for symptomatic muscle herniation in young athletes. Many patients are able to return to sports and most are satisfied with surgery. Residual symptoms are common, especially in runners. Patients with postsurgical muscle herniations may have the worst clinical outcome.
Age, Graft Size, and Tegner Activity Level as Predictors of Failure in Anterior Cruciate Ligament Reconstruction With Hamstring Autograft
Authors: Kamien Przemyslaw M. , Hydrick Josie M. , Replogle William H. , Go Linda T. , Barrett Gene R.
Published: June 2013

Background:

Patient age, Tegner activity level, and graft size could be factors that influence the outcome of anterior cruciate ligament reconstruction (ACLR) with hamstring autografts.

Hypothesis:

Decreased graft size, higher Tegner activity score, and younger age are associated with an increased failure rate of ACLR, represented by continued knee laxity and revision surgery.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

A total of 98 patients who had undergone ACLR with hamstring tendon autografts between 2000 and 2007 were identified from a computerized relational database. Inclusion criteria consisted of a minimum of 2 years of follow-up, all age groups, and all activity levels. Exclusion criteria consisted of treatment with other grafts or previous ligament surgery, previous ACL repairs, bilateral ACL injuries, and associated ligament tears. Failure was defined as a 2+ Lachman result, positive pivot shift, and 5-mm difference or more on KT-1000 arthrometer measurement.

Results:

Fifteen of the 98 ACLRs (15.3%) were defined as failures. Of the failures, 12 of 48 (25%) occurred in patients aged 25 years and younger, whereas 3 of 50 (6%) occurred in patients older than 25 years. There was a statistically significant association when comparing failure rate and age groups ( P = .009); however, a significant association was not found between graft size and failure rate in the entire study population ( P = .135) or within the different age groups (age ≤25 years vs >25 years) based on failure rate ( P = .390 and P = .165, respectively). No statistical significance was found when Tegner activity level and failure rate were compared in the overall study population ( P = .463) or within age groups (≤25 years, P = .707; >25 years, P = .174).

Conclusion:

In this study population, younger patients (≤25 years) demonstrated a higher failure rate compared with the over-25 age group. A statistically significant difference was not found in terms of graft size and activity level correlating with failure rate in ACL reconstruction with hamstring autograft.
Keystroke Logging in Writing Research
Authors: Leijten Mariëlle , Van Waes Luuk
Published: June 2013

Keystroke logging has become instrumental in identifying writing strategies and understanding cognitive processes. Recent technological advances have refined logging efficiency and analytical outputs. While keystroke logging allows for ecological data collection, it is often difficult to connect the fine grain of logging data to the underlying cognitive processes. Multiple methodologies are useful to offset these difficulties. In this article we explore the complementarity of the keystroke logging program Inputlog with other observational techniques: thinking aloud protocols and eyetracking data. In addition, we illustrate new graphic and statistical data analysis techniques, mainly adapted from network analysis and data mining. Data extracts are drawn from a study of writing from multiple sources. In conclusion, we consider future developments for keystroke logging, in particular letter- to word-level aggregation and logging standardization.
Do Clinical Parameters Predict First Planned Extubation Outcome in the Pediatric Intensive Care Unit?
Authors: Laham James L. , Breheny Patrick J. , Rush Amanda
Published: June 2013

Context:

There is absence of evidence-based guidelines to determine extubation readiness in the pediatric intensive care unit (PICU).

Objective:

Evaluate our practice of determining extubation readiness based on physician judgment of preextubation ventilator settings, blood gas analysis, and other factors potentially affecting extubation outcome.

Design:

Prospective cohort study from August 2010 to April 2012.

Setting:

Academic, multidisciplinary PICU.

Patients:

A total of 319 PICU patients undergoing first planned extubation attempt.

Interventions:

None.

Measurements:

Determine the extubation success rate and evaluate factors potentially affecting extubation outcome. The PICU length of stay (LOS) and cost were also recorded. Subgroup analysis was performed based on days of mechanical ventilation (MV).

Results:

A total of 319 consecutive patients underwent first planned extubation attempt with a 91% success rate. Factors associated with extubation failure were the length of MV ( P < .0001, odds ratio [OR] 2.20); age ( P = .02, OR 0.54); preextubation steroids ( P = .04, OR 2.40); and postextubation stridor ( P < .01, OR 3.40). Ventilator settings and blood gas results had no association with extubation outcome with 1 exception, ventilator rates ≤ 8 were associated with extubation failure in patients with ≤1 day of MV. Extubation failure was associated with prolonged PICU LOS and excess cost, with failures staying 14 days longer ( P < .0001) and costing 3.2 time more ( P < .0001) than successes.

Conclusions:

Physician judgment to determine extubation readiness led to a first planned extubation success rate of 91%. Age and the length of MV were primary risk factors for failed extubation. In patients with ≤1 day of MV, our findings suggest that confidence in extubation readiness following weaning to low ventilator rates may not be justified. Furthermore, reliance on preextubation ventilator settings and blood gas results to determine extubation readiness may lead to unnecessary prolongation of MV, thereby increasing the PICU LOS and excess cost. These findings are hypothesis generating and require further study for confirmation.
A review of sternal closure techniques
Authors: Alhalawani Adel MF , Towler Mark R
Published: June 2013

Sternotomy and sternal closure occur prior to and post cardiac surgery, respectively. Although post-operative complications associated with poor sternal fixation can result in morbidity, mortality, and considerable resource utilization, sternotomy is preferred over other methods such as lateral thoracotomy. Rigid sternal fixation is associated with stability and reduced incidence of post-operative complications. This is a comprehensive review of the literature evaluating in vivo, in vitro, and clinical responses to applying commercial and experimental surgical tools for sternal fixation after median sternotomy. Wiring, interlocking, plate-screw, and cementation techniques have been examined for closure, but none have experienced widespread adoption. Although all techniques have their advantages, serious post-operative complications were associated with the use of wiring and/or plating techniques in high-risk patients. A fraction of studies have analyzed the use of sternal interlocking systems and only a single study analyzed the effect of using kryptonite cement with wires. Plating and interlocking techniques are superior to wiring in terms of stability and reduced rate of post-operative complications; however, further clinical studies and long-term follow-up are required. The ideal sternal closure should ensure stability, reduced rate of post-operative complications, and a short hospitalization period, alongside cost-effectiveness.
The Mediating Role of Perceived Cooperative Communication in the Relationship between Interpersonal Exchange Relationships and Perceived Group Cohesion
Authors: Abu Bakar Hassan , Sheer Vivian C.
Published: June 2013

This study develops a multilevel model to advance research on interpersonal exchange relationships among supervisors, subordinates, and coworkers by integrating leader–member exchange (LMX), team–member exchange (TMX), and perceived cooperative communication. The model was tested by using hierarchical linear modeling (HLM) with data obtained from a sample of 375 manager–employee dyads working in 48 groups in Malaysia. At the individual level, LMX was found to be related to TMX; at the team-level, the relationship between the LMX-perceived cohesion link and the TMX-perceived cohesion link was mediated by perceived cooperative communication. These findings validated the proposed model and, in particular, empirically confirmed the central role of communication in LMX processes in workgroups. Practical implications are discussed.
Stories of Suffering with Leprosy and Cancer in Korea
Authors: Baumann Steven L. , Lee Ok Ja , Im Sook-Bin
Published: July 2013

The authors in this article tell the story of the experience of suffering of three persons with cancer in South Korea. Two of the stories are about men who early in their lives were diagnosed with Leprosy (Hansen’s disease) and forced to live most of their lives in a prison- like treatment facility. The third story is of a woman with advanced cancer who ended up in a similar place because she lost both of her children and husband. Parse’s humanbecoming theory and thoughts on human dignity provide the theoretical perspective for this discussion. The conclusion of the article is that largely because of ignorance and fear, people with Hansen’s disease in Korea, as elsewhere, suffer a unique form of betrayal and shame; what they deserve is honor and reverence as they struggle to retain a sense of awe about being human.
Creating an Epiphany with Martha E. Rogers
Authors: Phillips John R.
Published: July 2013

Creating an epiphany or integral manifestation with Martha Rogers is discussed in the context of her science of unitary human beings, Barrett’s power theory, and yinyang. It is shown how Martha’s science is related to an epiphany with her. Questions are raised and speculations are made about an epiphany with Martha living in the universe and about gender.
Nightingale’s Environmental Theory
Authors: Hegge Margaret
Published: July 2013

This author extracts the environmental theory from Florence Nightingale’s writings and recorded experiences. As Nightingale’s experiences broadened to other cultures and circumstances, she generated an ever-widening commitment to redress unjust social policies imperiling human health. She mobilized collaborators, shaped public awareness, and championed the cause of those suffering as a result of unjust policies. Nightingale challenged nurses to create environments where population health is a realistic expectation.
Using Taguchi method to optimise performance and product cost at the conceptual stage of design
Authors: Saravi Mohammad , Newnes Linda B , Mileham Antony R , Goh Yee Mey , Morton Karen
Published: June 2013

The difficulty of obtaining a useful cost estimate at the design stage has long been acknowledged. Data for new products are hardly available and product specifications are often expressed as a range of values; yet, only limited progress has been made to date to improve the quality of the average cost estimate at the conceptual design stage. The aim of this research is to improve the quality of the cost estimate (average cost) at the conceptual stage of design to assist designers to consider cost as a critical factor in selecting the most appropriate design concept. This research investigates the use of Taguchi’s orthogonal array approach to reduce the variation in the product specification (when expressed as a range of values) in order to improve the quality of the average estimated cost for each concept at the conceptual stage of design. A new process has been created, and to validate the process, an industrial case study has been undertaken.
A class act: professional support to people’s organizations in towns and cities of the global South
Authors: Mitlin Diana
Published: June 2013

Grassroots organizations that have sought to scale up improvements to their urban neighbourhoods through engaging the state have found themselves drawn into relationships with professionals. The potentially negative consequences of such engagements have long been recognized. This paper explores the nature of relations between professionals and organizations of the urban poor, identifying and discussing associated relational tensions. It considers the ways in which one alliance of urban poor federations and support NGOs has responded to the challenge to build alternatives within professionalized mainstream urban development practice.
Urbanization and economic growth: the arguments and evidence for Africa and Asia
Authors: Turok Ivan , McGranahan Gordon
Published: June 2013

The relationship between urbanization and development is a vital policy concern, especially in Africa and Asia. This paper reviews the arguments and evidence for whether rapid urban population growth can help to raise living standards. The main finding is that the development effects of urbanization and the magnitude of agglomeration economies are very variable. There is no simple linear relationship between urbanization and economic growth, or between city size and productivity. The potential of urbanization to promote growth is likely to depend on how conducive the infrastructure and institutional settings are. Removing barriers to rural–urban mobility may enable economic growth, but the benefits will be much larger with supportive policies, markets and infrastructure investments. Cities should use realistic population projections as the basis for investing in public infrastructure and implementing supportive land policies. Governments should seek out ways of enabling forms of urbanization that contribute to growth, poverty reduction and environmental sustainability, rather than encouraging (or discouraging) urbanization per se.
‘Shame on you’:  The language, practice and consequences of shame and shaming in asylum seeker advocacy
Authors: Every Danielle
Published: June 2013

The struggle to change negative responses to asylum seekers is becoming more difficult due to global economic insecurity and increasing numbers of people seeking asylum. Effective and persuasive advocacy and activism to shift these opinions and create better outcomes for asylum seekers are critical. As for all social movements, how advocates engage the wider public, particularly those opposed to asylum seeking, is key to gaining support for this project. In this article, I use discourse analysis as a method for identifying both current activist discourses and rhetorical strategies, and how these shape the responses of the opposition. Using letters to the editor, online comments and media articles from a 2010–2011 Australian debate on the relocation of asylum seekers to a small South Australian town, I explore a particular strategy for change used in asylum seeker advocacy: eliciting shame. I identify two ways that shaming is ‘done’ – through expressions of contempt and disgust, and through a comparison of privilege and oppression. However, the analysis of the responses to this shaming demonstrates that, rather than provoking the hoped-for change, shaming actually elicits its opposite: flight or fight responses of denial, avoidance and escalating conflict.
Research data management and libraries: Current activities and future priorities
Authors: Cox Andrew M. , Pinfield Stephen
Published: June 2013

This paper reports research carried out at the end of 2012 to survey UK universities to understand in detail the ways in which libraries are currently involved in research data management and the extent to which the development of research data management services is a strategic priority for them. The research shows that libraries were offering limited research data management services, with highest levels of activity in large research-intensive institutions. There were major challenges associated with skills gaps, resourcing and cultural change. However, libraries are currently involved in developing new institutional research data management policies and services, and see this as an important part of their future role. Priorities such as provision of research data management advisory and training services are emerging. A systematic comparison between these results and other recent studies is made in order to create a full picture of activities and trends. An innovation hype-cycle framework is deployed to understand possible futures and Abbott’s theory of professions is used to gain an insight into how libraries are competing to extend their jurisdiction whilst at the same time working collaboratively with other stakeholders.
Concept determination of human dignity
Authors: Edlund Margareta , Lindwall Lillemor , Post Iréne von , Lindström Unni Å
Published: June 2013

This study presents findings from an ontological and contextual determination of the concept of dignity. The study had a caritative and caring science perspective and a hermeneutical design. The aim of this study was to increase caring science knowledge of dignity and to gain a determination of dignity as a concept. Eriksson’s model for conceptual determination is made up of five part-studies. The ontological and contextual determination indicates that dignity can be understood as absolute dignity, the spiritual dimension characterized by responsibility, freedom, duty, and service, and relative dignity, characterized by the bodily, external aesthetic dimension and the psychical, inner ethical dimension. Dignity exists in human beings both as absolute and relative dignity.
Patients’ perspectives on person-centred participation in healthcare
Authors: Thórarinsdóttir Kristín , Kristjánsson Kristján
Published: June 2013

The aim of this article was to critically analyse the concept of person-centred participation in healthcare from patients’ perspectives through a review of qualitative research findings. In accordance with the integrative review method of Broom, data were retrieved from databases, but 60 studies were finally included in the study. The diverse attributes of person-centred participation in healthcare were identified and contrasted with participation that was not person-centred and analysed through framework analysis. Person-centred participation in healthcare was found to be based on patients’ experiences, values, preferences and needs in which respect and equality were central. It manifested itself via three intertwined phases: the human-connection phase, the phase of information processing and the action phase. The results challenge in many aspects earlier concept analyses of patient participation in addition to illuminating patient participation that is not positively valued by patients.
Relative Age Effect and chi-squared statistics
Authors: Delorme Nicolas , Champely Stéphane
Published: June 2013

Traditionally, the Relative Age Effect (RAE) is determined with a chi-squared goodness-of-fit test based on a theoretical expected distribution of birthdates. This distribution must be that of the parent population, but many authors choose to replace it by a uniform distribution in order to simplify calculations. The consequences of this simplification are: (a) the actual Type 1 risk is no longer controlled at the conventional threshold of significance; (b) this risk increases with the sample size; and (c) the associated goodness-of-fit test is biased. The importance of these problems is tested on a national population and on a population of registered players.
Women and the blogosphere: Exploring feminist approaches to sport
Authors: Antunovic Dunja , Hardin Marie
Published: June 2013

The notion of sports fandom is generally built on the ways men understand and relate to sport. In this research, we explore how women, who come together in an online place, define and understand sport with the goal of better understanding female fandom. Using Coakley’s ((2004) Sports in Society: Issues and Controversies. New York: McGraw-Hill) framework for conceptualizing sport and Lenskyj’s ((1994) Women, Sport, and Physical Activity: Selected Research Themes. Gloucester, ON, Canada: Sport Information Resource Centre for Sport Canada) feminist approaches to competition, we analyzed the profiles of women bloggers who write about sports in two online communities, BlogHer and Women Talk Sports, to examine their relationship to sport from a feminist perspective. The analysis suggests that women’s interest is predominantly reflected, not through consumption, but through participation. In addition, women in these networks complicated dominant ideologies about the role of sport as many of them considered participation and competition as a site for building connections and empowering other women. Finally, women who wrote about sport fandom engaged in the construction of “woman’s perspective” on men’s sports and in advocacy of women’s sports. We argue that these women bloggers offer an alternative approach and, thus, may challenge the masculine understanding of performance-oriented institutionalized sports.
Addressing Challenging Behavior
Authors: Scott Terrance M. , Hirn Regina G.
Published: June 2013

When dealing with children who exhibit challenging behaviors there are no known interventions that work for all students or at all times. Thus, intervention for these students is often implemented in a trial and error manner. This article provides a logic for considering probability as a factor in selecting strategies. Understanding that some interventions are more likely to work than others and the fact that adult behavior is the main impetus for change in student behavior, the key is in considering which teacher behaviors offer the highest probability of student success. Suggestions and examples are provided.
The McKinney–Vento Education for Homeless Children and Youth Program
Authors: Losinski Mickey , Katsiyannis Antonis , Ryan Joseph B.
Published: June 2013

During the 2008–2009 academic school year, nearly a million (956,914) students were reported by school districts as being homeless, a 41% increase over just a 2-year period year. The purpose of this article is to provide a brief overview of national legislative efforts to address the education of children who are homeless, with a particular emphasis on students with disabilities. The McKinney–Vento Act is intended to provide some relief to the many challenges children who are homeless face. The act provides federal funding to the states and establishes requirements that expedite and in fact bypass bureaucratic documentation requirements for school enrollment and help create a stable school environment that provides the opportunity for these students to succeed in school.