bluuebunny/crossref_metadata_2025 huggingface dataset:
Observations of the Small-Scale Variability of Precipitation Using an Imaging Radar
Authors: Palmer Robert D. , Cheong Boon Leng , Hoffman Michael W. , Frasier Stephen J. , López-Dekker F. J.
Published: July 2010

For many years, spatial and temporal inhomogeneities in precipitation fields have been studied using scanning radars, cloud radars, and disdrometers, for example. Each measurement technique has its own advantages and disadvantages. Conventional profiling radars point vertically and collect data while the atmosphere advects across the field of view. Invoking Taylor’s frozen turbulence hypothesis, it is possible to construct time-history data, which are used to study the structure and dynamics of the atmosphere. In the present work, coherent radar imaging is used to estimate the true three-dimensional structure of the atmosphere within the field of view of the radar. The 915-MHz turbulent eddy profiler radar is well suited for imaging studies and was used in June 2003 to investigate the effects of turbulence on the formation of rain. The Capon adaptive algorithm was implemented for imaging and clutter rejection purposes. In the past several years, work by the authors and others has proven the Capon method to be effective in this regard and to possess minimal computational burden. A simple but robust filtering procedure is presented whereby echoes from precipitation and clear-air turbulence can be separated, facilitating the study of their interaction. By exploiting the three-dimensional views provided by this imaging radar, it is shown that boundary layer turbulence can have either a constructive or destructive effect on the formation of precipitation. Evidence is also provided that shows that this effect can be enhanced by updrafts in the wind field.
Ice-Draft Profiling from Bottom-Mounted ADCP Data
Authors: Shcherbina Andrey Y. , Rudnick Daniel L. , Talley Lynne D.
Published: July 2010

The feasibility of ice-draft profiling using an upward-looking bottom-mounted acoustic Doppler current profiler (ADCP) is demonstrated. Ice draft is determined as the difference between the instrument depth, derived from high-accuracy pressure data, and the distance to the lower ice surface, determined by the ADCP echo travel time. Algorithms for the surface range estimate from the water-track echo intensity profiles, data quality control, and correction procedures have been developed. Sources of error in using an ADCP as an ice profiler were investigated using the models of sound signal propagation and reflection. The effects of atmospheric pressure changes, sound speed variation, finite instrument beamwidth, hardware signal processing, instrument tilt, beam misalignment, and vertical sensor offset are quantified. The developed algorithms are tested using the data from the winter-long ADCP deployment on the northwestern shelf of the Okhotsk Sea.
Regulation of Dental Enamel Shape and Hardness
Authors: Simmer J.P. , Papagerakis P. , Smith C.E. , Fisher D.C. , Rountrey A.N. , Zheng L. , Hu J.C.-C.
Published: July 2010

Epithelial-mesenchymal interactions guide tooth development through its early stages and establish the morphology of the dentin surface upon which enamel will be deposited. Starting with the onset of amelogenesis beneath the future cusp tips, the shape of the enamel layer covering the crown is determined by five growth parameters: the (1) appositional growth rate, (2) duration of appositional growth (at the cusp tip), (3) ameloblast extension rate, (4) duration of ameloblast extension, and (5) spreading rate of appositional termination. Appositional growth occurs at a mineralization front along the ameloblast distal membrane in which amorphous calcium phosphate (ACP) ribbons form and lengthen. The ACP ribbons convert into hydroxyapatite crystallites as the ribbons elongate. Appositional growth involves a secretory cycle that is reflected in a series of incremental lines. A potentially important function of enamel proteins is to ensure alignment of successive mineral increments on the tips of enamel ribbons deposited in the previous cycle, causing the crystallites to lengthen with each cycle. Enamel hardens in a maturation process that involves mineral deposition onto the sides of existing crystallites until they interlock with adjacent crystallites. Neutralization of acidity generated by hydroxyapatite formation is a key part of the mechanism. Here we review the growth parameters that determine the shape of the enamel crown as well as the mechanisms of enamel appositional growth and maturation.
Modeling the impact of security and disaster response on cargo operations
Authors: Leathrum James F. , Mathew Reejo , Mastaglio Thomas W.
Published: July 2010

While significant effort has been expended on the analysis of new security technologies and policies at ports of entry, the effort has focused on the effectiveness of the security, not on the impact of security on commercial operations. This paper addresses the requirements to model the impact of security measures on port operations, using an existing port simulation. The goal of the simulation is to assess different strategies from an economic viewpoint. To contrast different strategies, we need to be able to rapidly prototype the strategies in an existing operational model. Both proactive and reactive security measures are addressed, as well as responses to natural disasters. The modeling techniques required to rapidly incorporate new security strategies into the simulation are identified. Then these capabilities are demonstrated using the Port Simulation (PORTSIM) tool.
Remembering Teachers in a Segregated School: Narratives of Womanist Pedagogy
Authors: Patterson Jean A. , Mickelson Kathryn A. , Hester Michael L. , Wyrick John
Published: July 2010

The authors use womanist caring (Beauboeuf-Lafontant, 2002) as a framework for analyzing data from an oral history project of Douglass School, an all-Black school that existed in the small town of Parsons, Kansas, from 1908-1958. In-depth interviews were conducted with 55 former students who attended the school during the 1920s through when it closed in 1958. The alumni’s memories of their teachers were vivid, powerful, and resonated with the tenets of womanist caring. Although the school closed 50 years ago, we argue that Douglass teachers’ pedagogy has relevance for improving the educational outcomes of African American students in contemporary U.S. schools.
Latent Markov Model for Analyzing Temporal Configuration for Violence Profiles and Trajectories in a Sample of Batterers
Authors: Ip Edward H. , Snow Jones Alison , Heckert D. Alex , Zhang Qiang , Gondolf Edward D.
Published: July 2010

In this article, the authors demonstrate the utility of an extended latent Markov model for analyzing temporal configurations in the behaviors of a sample of 550 domestic violence batterers. Domestic violence research indicates that victims experience a constellation of abusive behaviors rather than a single type of violent outcome. There is also evidence that observed behaviors are highly dynamic, with batterers cycling back and forth between periods of no abuse and violent or controlling behavior. These issues pose methodological challenges for social scientists. The extended latent Markov method uses multiple indicators to characterize batterer behaviors and relates the trajectories of violent states to predictors of abuse at baseline. The authors discuss both methodological refinements of the latent Markov models and policy implications of the data analysis.
Striking a balance? Flexibility and security in collective bargaining
Authors: Ibsen Christian Lyhne , Mailand Mikkel
Published: July 2010

Often neglected in flexicurity studies is the question of how collective bargaining contributes to the development of flexicurity, despite the continued resilience of this form of regulation in many European countries. The article compares sector-level bargaining and flexicurity in the printing and electrical contracting industries of Denmark, Spain and the UK to assess this link. In line with prior research, the article finds that Danish agreements contribute significantly to flexicurity. Somewhat against conventional expectations, however, are findings in the UK and Spain. In the UK, agreements contribute significantly despite a hostile context for collective bargaining. In Spain, due to the heavy influence of legislation the contribution is more modest but nevertheless notable. This overall finding gives strong evidence for the proposed link. The article goes on to discuss if a positive contribution is facilitated by certain institutional and relational conditions.
Permanent employee investment and social exchange and psychological cooperative climate among temporary employees
Authors: Kuvaas Bård , Dysvik Anders
Published: July 2010

This study investigated the mediating role of the psychological climate for cooperation in the client organization on the relationship between temporary employees’ perceived investment in permanent employee development in the client organization, and exchange perceptions and exchange outcomes, among 2022 temporary employees. After controlling for perceived investment in the temporary employees themselves, the results suggest that the psychological climate for cooperation in the client organization partly mediated the relationship between temporary employees’ perceived investment in permanent employee development and social exchange perception, and fully mediated the relationship between temporary employees’ perceived investment in permanent employee development and economic exchange perception. Moreover, social exchange perception was positively related to work quality, work effort and organizational citizenship behaviour, whereas economic exchange perception was negatively related to work effort and organizational citizenship behaviour.
Forgiveness and the Need to Belong
Authors: Barnes Collin D. , Carvallo Mauricio , Brown Ryan P. , Osterman Lindsey
Published: July 2010

People who experience a strong need to belong might be particularly inclined to forgive wrongdoings to preserve social bonds. Three studies that utilized different methods and measures of forgiveness consistently demonstrated this is not the case. The authors found that individuals high in the need to belong report practicing forgiveness with less frequency and value it no more than those low in the need to belong (Study 1). In Study 2, they found that satisfying the need to belong led participants to express greater willingness to forgive hypothetical offenses compared to participants in a control group. Finally, in Study 3, the authors linked the need to belong to forgiveness of specific transgressions and found that this negative relationship was mediated by offense-related anger and perceptions of offense severity. These findings suggest that needing to belong paradoxically interferes with forgiveness, even though forgiving could promote the satisfaction of belongingness needs following transgressions.
Breach Begets Breach: Trickle-Down Effects of Psychological Contract Breach on Customer Service
Authors: Bordia Prashant , Restubog Simon Lloyd D. , Bordia Sarbari , Tang Robert L.
Published: July 2010

Adopting a multifoci approach to psychological contract breach (i.e., breach by the organization referent and breach by the supervisor referent), the authors propose a trickle-down model of breach. Results from three studies show that supervisor perceptions of organizational breach are negatively related to supervisor citizenship behaviors toward the subordinate, resulting in subordinate perceptions of supervisory breach. Subordinate breach perceptions are, in turn, negatively related to subordinate citizenship behaviors toward the customer and, ultimately, customer satisfaction. The findings demonstrate the interconnected nature of social exchange relationships at work and draw attention to the effects of breach for other employees and customers.
The visual and visuo-haptic exploration of geometrical shapes increases their recognition in preschoolers
Authors: Kalenine Solène , Pinet Leatitia , Gentaz Edouard
Published: July 2010

This study assessed the benefit of a multisensory intervention on the recognition of geometrical shapes in kindergarten children. Two interventions were proposed, both conducted by the teachers and involving exercises focused on the properties of the shapes but differing in the sensory modalities used to explore them. In the ‘‘VH’’ intervention, the visual and haptic modalities were used to explore the raised shapes while only the visual modality was involved in the ‘‘V’’ (Visual) intervention. We compared the effect of the two interventions on the acquisition of conceptual knowledge about squares, rectangles and triangles in 72 preschoolers. Results showed that children progressed more importantly following VH than V intervention for rectangles and triangles. The addition of the haptic modality in intervention provides beneficial effects by allowing children to better understand what is included in a shape category. Results are discussed in relation to the multimodal coding (in line with embodied theories) and the analytic perception generated by the haptic modality.
Military trauma and social development: The moderating and mediating roles of peer and sibling relations in mental health
Authors: Peltonen Kirsi , Qouta Samir , El Sarraj Eyad , Punamäki Raija-Leena
Published: July 2010

We first examined how war-related traumatic events impact on peer and sibling relations, and how the quality of these relations in turn are associated with children’s mental health, indicating a mediation model. Second, we tested the moderating (protective) effects of good peer and sibling relations in attenuating the link between trauma and mental health. The participants were 227 Palestinian boys and girls aged 10—14 years living in the Gaza Strip. They reported\ their exposure to military trauma, evaluated the qualities of peer relationships (loneliness and friendship) and siblingship (warmth, intimacy, conflict and rivalry), and reported symptoms of PTSD, CDI depression and SDQ psychological distress. The results show that exposure to military trauma was associated with intense rivalry in sibling relations and with low friendship quality especially among girls and younger children. The association between military trauma and symptoms was mediated by poor friendship and rivaling sibling relations. Only sibling relations but not peer relations had a moderating effect, as military trauma was not associated with severe symptoms among children who enjoyed considerable intimacy and warmth and lacked rivalry in their siblingships. We discuss theoretical and practical implications of the roles of peer and sibling relations in helping children in traumatic war conditions.
Empowerment Interventions for Older Adults
Authors: Shearer Nelma B. C. , Fleury Julie , Ward Kathy A. , O’Brien Anne-Marie
Published: July 2010

There has been much discussion regarding the need to empower older adults to make informed health decisions and to test interventions targeting empowerment to promote health among older adults. It has been suggested that an empowerment approach may nurture an older adult’s participation in health care decisions and promote positive health outcomes. The purpose of this article is to report the findings of a critical review of published empowerment intervention studies with community-dwelling older adults. A descriptive literature review was conducted to examine how empowerment is conceptualized across interventions, the guiding theoretical frameworks, the outcomes measured, as well as the health outcomes of these interventions. Based on the findings from this review, recommendations for future empowerment intervention research with older adults as well as implications for practice are proposed.
Properties enhancement of resin impregnated agro waste: oil palm trunk lumber
Authors: ul Haq Bhat Irshad , Abdullah CK , Abdul Khalil HPS , Hakimi Ibrahim M. , Nurul Fazita MR
Published: July 2010

In this study, the kiln-dried oil palm trunk (OPT) was impregnated with phenol formaldehyde (PF) and urea formaldehyde (UF) resin as a matrix using high-pressure vaccum impregnation chamber. Different percentages of resin were loaded in oil palm trunk lumber (OPTL) and compared with kiln-dried OPT and rubberwood (RW). The physical, mechanical, and environmental properties were studied according to BS and ASTM standards. The morphology of resin-loaded OPTL was analyzed by scanning electron microscopy (SEM), while thermal characterization was carried out by thermogravimetric analysis. In general, the OPTL exhibited better values of physical and mechanical properties than dried OPT and OPTL (50% resin loading), which were slightly lower than RW; however, OPTL exhibited good thermal stability compared with dried OPT and RW. Furthermore, the OPTL exhibited a high resistance against termites. The observation of SEM micrograph showed that OPTL with PF resin loading exhibited better morphology than OPTL with UF resin loading, and full penetration of resin into OPT structures was observed.
Adolescents’ Willingness to Access School-Based Support for Nonsuicidal Self-Injury
Authors: Heath Nancy L. , Baxter Alyssa L. , Toste Jessica R. , McLouth Rusty
Published: July 2010

Nonsuicidal self-injury (NSSI) is a prevalent behaviour among youth. School is an opportune setting for intervention with this population, but it is unknown how many youth who engage in NSSI would be willing to access school-based support. The current study surveyed 7,126 middle and high school students. Those that indicated that they engaged in NSSI ( n = 654; 168 boys, 486 girls) responded to follow-up questions regarding the behaviour and willingness to participate in a school-based support program for NSSI. Self-injurers who responded that they would be willing to access help at school ( n = 88; 13.5% of the sample) and a matched group of those who would not be willing were compared on a number of variables. Willingness to access school-based support did not differ by gender or ethnicity but differed between middle and high school students. On indices of NSSI and worries about safety, the adolescents willing to access support reported that they used more methods of injury as well as increased worries about safety in their neighbourhood and sexual harassment.
The Hungarian Foie Gras Boycott
Authors: Gille Zsuzsa
Published: July 2010

In 2008 an Austrian animal rights organization announced a boycott of Hungarian foie gras, arguing that force-feeding geese and ducks constitutes animal cruelty. The case received a lot of media attention and quickly evolved into a bitter conflict. The article scrutinizes the case as an example of postsocialist conflicts around ethics and morality and the concept of common good. The incident demonstrates not only unexpected obstacles for Hungary to be accepted as civilizationally European but also for Hungarian farmers’ ability to act as morally sovereign self-regulating subjects in a neoliberal world.
“Ask for Bread, not Peace”
Authors: Granville Johanna
Published: July 2010

In contrast to restless students in Bucharest, Cluj, Iasi, Timiş oara, and other cities, who tried to organize rallies calling for government reforms in the fall of 1956 but failed, Romanian workers and peasants expressed their feelings about the revolution in nearby Hungary by going on feverish shopping sprees; stockpiling food staples; writing anonymous leaflets and graffiti; spreading rumors; and engaging in arson, vandalism, and physical brawls. The Hungarian crisis aroused in some citizens fears of a World War III, for others a war over Transylvania, and for still others a Hungarian-style revolt in Romania. A survey of published Securitate reports written between 26 October and 23 November 1956 shows that the three most frequent oral comments recorded were those complaining about the economy, those predicting that “what happened in Hungary will happen in Romania,” and those asking “why was the Soviet intervention necessary?” The economic complaints outnumbered the other two types of comments. Political messages, oral and written, spanned the spectrum, from fascist, Iron Guard songs, monarchist comments, to procapitalist slogans. Although most irredentist comments, oral and written, originated from cities in Transylvania, more than half of the incidents of physical aggression, including arson and other acts of sabotage, occurred in non-Transylvanian regions. Although the Securitate sometimes exploited ethnic tensions to gain recruits, Romanian citizens expressed more rage toward the communist dictatorship than against ethnic Hungarians.
Antihypertensive Medication Adherence Among Elderly Chinese Americans
Authors: Hsu Ya-Hui , Mao Chia-Ling , Wey Mercy
Published: July 2010

This study explored the level of antihypertensive medication adherence and examined certain demographic attributes and influential factors in relation to antihypertensive medication nonadherence among Chinese American elders using a descriptive cross-sectional survey design. Findings revealed that 52% of the elderly Chinese Americans adhered to their antihypertensive medications. Gender, education, years of residency in the United States, years of diagnosed hypertension, and perceived safety of taking antihypertensive medications did not contribute to the differences in medication adherence. Forgetfulness, medication adverse effects, language difficulties, and cultural barriers were the influential factors that hinder antihypertensive medication adherence. Developing effective and culturally appropriate strategies for Chinese American elders is recommended.
Conversations Between Carers and People With Schizophrenia: A Qualitative Analysis Using Leximancer
Authors: Cretchley Julia , Gallois Cindy , Chenery Helen , Smith Andrew
Published: July 2010

We examined conversations between people with schizophrenia (PwS) and family or professional carers with whom they interacted frequently. We allocated PwS to one of two communication profiles: Low-activity communicators talked much less than their conversational partners, whereas high-activity communicators talked much more. We used Leximancer text analytics software to analyze the conversations. We found that carers used different strategies to accommodate to the PwS’s behavior, depending on the PwS’s communication profile and their relationship. These findings indicate that optimal communication strategies depend on the PwS’s conversational tendencies and the relationship context. They also suggest new opportunities for qualitative assessment via intelligent text analytics technologies.
Does High Educational Attainment Limit the Availability of Romantic Partners?
Authors: Burt Isaac , Lewis Sally V. , Beverly Monifa G. , Patel Samir H.
Published: July 2010

Research indicates that highly educated individuals endure hardships in finding suitable romantic partners. Romantic hardships affect social and emotional adjustment levels, leading to low self-efficacy in relationship decision making. To address the need for research pertaining to this topic, the authors explored the experiences of eight individuals purposively chosen. Conducting interviews based in qualitative methods, the authors discuss thematic patterns emerging from the study. Constraints such as lack of time and social outlets were barriers to meeting highly desirable mates.
Synonyms in Health Services Research Methodology
Authors: Maciejewski Matthew L. , Weaver Emily M. , Hebert Paul L.
Published: July 2010

There are often multiple discipline-specific terms for a given statistical concept, which can sow confusion in multidisciplinary teams or study sections if researchers are not aware of the synonyms from other disciplines. This article incorporates synonyms and a uniform definition of terminology related to study designs, elements of an equation, and types of bias. Greater multidisciplinary collaboration and exploration of new methods can be facilitated by this methods thesaurus.
Review: Use of Qualitative Methods in Published Health Services and Management Research: A 10-Year Review
Authors: Weiner Bryan J. , Amick Halle R. , Lund Jennifer L. , Lee Shoou-Yih Daniel , Hoff Timothy J.
Published: July 2010

Over the past 10 years, the field of health services and management research has seen renewed interest in the use of qualitative research methods. This article examines the volume and characteristics of qualitative research articles published in nine major health services and management journals between 1998 and 2008. Qualitative research articles comprise 9% of research articles published in these journals. Although the publication rate of qualitative research articles has not kept pace with that of quantitative research articles, citation analysis suggests that qualitative research articles contribute comparably to the field’s knowledge base. A wide range of policy and management topics has been examined using qualitative methods. Case study designs, interviews, and documentary sources were the most frequently used methods. Half of qualitative research articles provided little or no detail about key aspects the study’s methods. Implications are discussed and recommendations are offered for promoting the publication of qualitative research.
Characterizing Declines in Pediatric Antidepressant Use After New Risk Disclosures
Authors: Busch Susan H. , Frank Richard G. , Martin Andres , Barry Colleen L.
Published: July 2010

Steep declines in pediatric antidepressant use were documented following the 2004 release of new safety information associating antidepressants with a risk of suicidality. The authors examine whether declines in pediatric antidepressant use were steeper among individuals with certain clinical or family characteristics. The authors find that declines in antidepressant use were associated with new (as compared with ongoing) treatment episodes. Although rates of antidepressant use were higher among children of college-educated parents prior to risk disclosures, these children were more likely to forgo antidepressant medication than children of less educated parents after risk disclosures. The authors find that both children with and without psychiatric impairment experienced declines in antidepressant medication use following the risk warnings, although the decline occurred more quickly in the latter group. The authors’ findings highlight the need for additional data to assess the effects of risk disclosures on treatment patterns and health outcomes.
Innovative Strategies to Reduce Disparities in the Quality of Prenatal Care in Underresourced Settings
Authors: Lu Michael C. , Kotelchuck Milton , Hogan Vijaya K. , Johnson Kay , Reyes Carolina
Published: July 2010

This study examined what innovative strategies, including the use of health information technology (health IT), have been or can be used to reduce disparities in prenatal care quality in underresourced settings. Based on literature review and key informant interviews, the authors identified 17 strategies that have been or can be used to (a) increase access to timely prenatal care, (b) improve the content of prenatal care, and (c) enhance the organization and delivery of prenatal care. Health IT can be used to (a) increase consumer awareness about the importance of preconception and early prenatal care, facilitate spatial mapping of access gaps, and improve continuity of patient records; (b) support collaborative quality improvement, facilitate performance measurement, enhance health promotion, assist with care coordination, reduce clinical errors, improve delivery of preventive health services, provide decision support, and encourage completeness of documentation; and (c) support data integration and engineer collaborative innovation.
Impact of Medicaid/ SCHIP Disenrollment on Health Care Utilization and Expenditures Among Children: A Longitudinal Analysis
Authors: Jingbo Yu  , Harman Jeffrey S. , Hall Allyson G. , Duncan R. Paul
Published: July 2010

This study examines the impact of disenrolling from Medicaid/State Children’s Health Insurance Programs (SCHIP) on health care utilization and expenditures among children using the 1996-2005 Medical Expenditure Panel Survey data. Changes in expenditures and utilization upon Medicaid/SCHIP disenrollment were examined for two disenrollment groups, children who became uninsured and those who transitioned to private insurance; relative to a control group, those continuously enrolled in Medicaid/SCHIP during the study period. In multivariate analysis, a modified two-part model and difference-in-difference analytic approach were used. The dependent variables were changes in total expenditures and changes in utilization (i.e., well-child visits, physician visits, emergency room visits, hospitalizations, and prescription drug use) from pre- to post-disenrollment round. This study found that losing Medicaid/SCHIP coverage is associated with decreased preventive care utilization among children, regardless of the insurance status post-disenrollment. In addition, children who become uninsured following Medicaid/SCHIP disenrollment may also experience reductions in physician visits and prescription drug use.
Review Paper: The Use of Quality Improvement and Health Information Technology Approaches to Improve Diabetes Outcomes in African American and Hispanic Patients
Authors: Baig Arshiya A. , Wilkes Abigail E. , Davis Andrew M. , Peek Monica E. , Huang Elbert S. , Bell Douglas S. , Chin Marshall H.
Published: July 2010

Differences in rates of diabetes-related lower extremity amputations represent one of the largest and most persistent health disparities found for African Americans and Hispanics compared with Whites in the United States. Since many minority patients receive care in underresourced settings, quality improvement (QI) initiatives in these settings may offer a targeted approach to improve diabetes outcomes in these patient populations. Health information technology (health IT) is widely viewed as an essential component of health care QI and may be useful in decreasing diabetes disparities in underresourced settings. This article reviews the effectiveness of health care interventions using health IT to improve diabetes process of care and intermediate diabetes outcomes in African American and Hispanic patients. Health IT interventions have addressed patient, provider, and system challenges in the provision of diabetes care but require further testing in minority patient populations to evaluate their effectiveness in improving diabetes outcomes and reducing diabetes-related complications.
Changing Access to Emergency Care for Patients Undergoing Outpatient Procedures at Ambulatory Surgery Centers: Evidence From Florida
Authors: Neuman Mark D. , David Guy , Silber Jeffrey H. , Sanford Schwartz J. , Fleisher Lee A.
Published: July 2010

The growth of ambulatory surgery centers (ASCs) as a setting for care in the United States raises unique safety concerns. In contrast to hospital-based outpatient departments (HOPDs), ASCs offer care at varying distances from hospital services potentially required to treat complications. To describe changes over time in the accessibility of hospital services for procedural outpatients, this study examined 4.3 million discharges for seven outpatient procedures frequently performed at ASCs and HOPDs. Between 2005 and 2007, the mean patient-to-emergency department (ED) distance increased by 12.4%. This change, which resulted from both an increase in the share of procedures performed at ASCs and an increase in the distance between ASCs and EDs, occurred predominantly within procedures that carried an elevated odds of hospital admission relative to the lowest risk procedures. Further research defining the risks associated with these changes in access to emergency care is needed to inform future ASC policy development and regulation.
Improving Communication Between Patients and Providers Using Health Information Technology and Other Quality Improvement Strategies: Focus on Low-Income Children
Authors: Ngo-Metzger Quyen , Hayes Gillian R. , Yunan Chen  , Cygan Ralph , Garfield Craig F.
Published: July 2010

Effective communication between providers and patients has been linked to improved outcomes. Previous reviews of quality improvement strategies, including health information technology (health IT), have not focused on the needs of low-income children. The authors conducted a systematic review of the literature on studies of communication surrounding the care of low-income children, with an emphasis on interventions and health IT.The search yielded six studies that focused on low-income children; three of the studies used health IT. Key informant interviews provided insight to the current use of health IT for provider—patient communication in geographically diverse, underresourced settings.The authors identify gaps between existing literature and clinical practice. Future research should focus on the specific impact of health IT in pediatric medicine, particularly in underresourced and safety net settings. These efforts should focus on the use of technological innovations to improve care for low-income children and their families.
Beyond group-level explanations for the failure of groups to solve hidden profiles: The individual preference effect revisited
Authors: Faulmüller Nadira , Kerschreiter Rudolf , Mojzisch Andreas , Schulz-Hardt Stefan
Published: July 2010

The individual preference effect supplements the predominant group-level explanations for the failure of groups to solve hidden profiles. Even in the absence of dysfunctional group-level processes, group members tend to stick to their suboptimal initial decision preferences due to preference-consistent evaluation of information. However, previous experiments demonstrating this effect retained two group-level processes, namely (a) social validation of information supporting the group members’ initial preferences and (b) presentation of the additional information in a discussion format. Therefore, it was unclear whether the individual preference effect depends on the co-occurrence of these group-level processes. Here, we report two experiments demonstrating that the individual preference effect is indeed an individual-level phenomenon. Moreover, by a comparison to real interacting groups, we can show that even when all relevant information is exchanged and when no coordination losses occur, almost half of all groups would fail to solve hidden profiles due to the individual preference effect.
Vascular Surgical Antibiotic Prophylaxis Study (VSAPS)
Authors: Patrick Stone , James Campbell , Ali AbuRahma , Lawson Safley , Mary Emmett , Modak Asmita
Published: July 2010

This prospective, randomized study was performed at a single institution. Low-risk patients undergoing elective vascular procedures were enrolled (August 2007 to June 2009). Participants were randomized into 3 separate arms. They received cefazolin, cefazolin + vancomycin, or cefazolin + daptomycin prior to surgery. In total, 169 patients were included in the analysis. Mean age was 64 (range, 26-85), and the patients’ comorbidities were similar across all groups. Only Szilagyi II and III infections were analyzed. Any infection/methicillin-resistant Staphylococcus aureus (MRSA) infections was seen in 8 (12.9%)/2 (3.23%) in the cefazolin group, 7 (12.5%)/4 (7.14%) in the cefazolin + vancomycin group, and 2 (3.92%)/(0%) in the cefazolin + daptomycin group. In this study, population of low-risk patients undergoing elective vascular procedures, there was a trend toward fewer infectious complications in the cefazolin + daptomycin group. Adding anti-MRSA agents to the current standard prophylaxis regimen does not appear to reduce the incidence of MRSA infection in low-risk patients.
Endovascular Embolization of Iatrogenic Lumbar Artery Pseudoaneurysm Following Extreme Lateral Interbody Fusion (XLIF)
Authors: Santillan Alejandro , Patsalides Athos , Gobin Y. Pierre
Published: July 2010

Iatrogenic lumbar artery pseudoaneurysm is a very rare complication of spinal surgery. To the best of our knowledge, this is the first report of a lumbar artery pseudoaneurysm after extreme lateral interbody fusion (XLIF). The lesion was diagnosed by catheter spinal angiography and was effectively treated with embolization.
A Case of Limb Ischemia Secondary to Paradoxical Embolism
Authors: Miller Seth , Causey Marlin Wayne , Schachter David , Andersen Charles A. , Singh Niten
Published: July 2010

Paradoxical embolism is rarely considered a cause for acute limb ischemia. Although patent foramen ovales (PFOs) are often seen in young patients with stroke, clinicians may not consider evaluation for PFOs in young patients with acute peripheral ischemia. We present a 47-year-old patient presenting with lower extremity ischemia secondary to paradoxical embolism. This case highlights the importance of evaluating for paradoxical embolism in otherwise-unexplained cases of acute limb ischemia.
Long-Term Functional Results for the Surgical Management of Neurogenic Thoracic Outlet Syndrome
Authors: Scali Salvatore , Stone David , Bjerke Aja , Chang Catherine , Rzucidlo Eva , Goodney Phillip , Walsh Daniel
Published: July 2010

Objective: To document long-term functional outcomes in patients treated for neurogenic thoracic outlet syndrome (NTOS). Methods: Records of all patients undergoing treatment for NTOS at our center were reviewed. Patient demographics and co-morbidities were recorded. End-points included symptomatic relief, peri-operative adjunctive procedures, functional outcome and employment continuity. Results: From 1988-2008, 26 patients were operated upon for NTOS. Hallmarks of the diagnosis in operated patients included symptom duration less than 1 year and a positive Roos test. Patients receiving disability and those with cervical spine pathology or carpal tunnel syndrome were not considered for surgery. Mean patient age was 39.2 years (range 14-60 years) with a mean follow-up of 104.4 months. Eleven patients (42.3%) engaged in pre-operative physical therapy programs. 7 of 9 patients (26.9%) received adjunctive peri-procedural scalene block with temporary symptom relief. All patients underwent thoracic outlet decompression by either 1st rib resection [18 total: 8 (44%) transaxillary and 10 (66%) supraclavicular)], cervical rib resection [6 (26.1%)] and/or scalenectomy [12 (46.2%)]. Of the 22 patients available for follow-up, six patients (27.3%) have required continued post-operative narcotic analgesics. Sixteen patients (72.7%) returned to work and reported being at an equivalent or better functional outcome than their pre-operative status. Conclusions: Durable long-term functional outcomes can be achieved predicated on a highly selective approach to the surgical management of patients with NTOS. A majority of operated patients will not require adjunctive procedures or chronic narcotic utilization. Patients who undergo surgery can expect to return to work with little or no functional impairment.
The Coronary Technique for Complex Carotid Artery Stenting in the Setting of Complex Aortic Arch Anatomy
Authors: Solomon B. , Berland T. , Cayne N. , Rockman C. , Veith FJ , Maldonado T.
Published: July 2010

Carotid artery stenting (CAS) remains a viable option for treating carotid artery lesions in high surgical risk patients. We retrospectively reviewed our experience in performing CAS in patients with complex aortic arch anatomy. The ‘‘coronary technique’’ uses an AL1 guiding catheter to engage the origin of the common carotid artery permitting delivery of protection device and stent. In total, 12 patients had complex arch anatomy which precluded access using the standard technique as determined on preoperative imaging. A total of 8 patients with such anatomy underwent femoral artery catheterization with placement of an Amplatz AL1 guide catheter into the common carotid artery. All were able to be successfully treated, with no dissection, neurovascular deficit, or other major complication. Based on this case series, we describe the coronary technique as a safe and viable method for CAS in the setting of complex anatomy which might otherwise preclude CAS.
Endovenous Ablation Plus Microphlebectomy/Sclerotherapy for the Treatment of Varicose Veins: Single or Two-Stage Procedure?
Authors: Schanzer Harry
Published: July 2010

Objective: The purpose of this study was to establish how often after the performance of endovenous ablation (EA), a second stage is required. Methods: Eighty-six consecutive lower extremities in 76 patients treated with laser EA were the cohort of this study. The clinical result after EA at 1 month was classified as excellent (no varicosities), good (major reduction in size), and poor (no change). Need for further intervention (sclerotherapy or microphlebectomy) was determined at the 1-month follow-up. Results: Complete resolution of varicosities after EA was found in 36 extremities (41.8%), reduction in size in 48 extremities (55.8%), and no change in 2 extremities (2.3%). Of the 86 extremities studied, 36 (41.8%) were considered in need of a second stage procedure. Conclusion: After EA, 58.2% of extremities did not require further treatment. These results add further justification to the performance of EA alone as a first stage.
Diabetic Limb Salvage: Too Much of a Good Thing?
Authors: Leon Luis R. , Pacanowski John , Ranellone Erika , Armstrong David
Published: July 2010

Diabetic foot complications exact a significant toll on patients specifically and the health care system in general. Most data suggest that limb preservation generally results in a higher quality (and quantity) of life for the patient and lower overall direct and indirect costs. However, when focusing on a specific patient, significant questions remain. The most significant being: how much effort is too much? The purpose of this manuscript is to present a case that explores this issue.
Centralization Harnessing Volume-Outcome Relationships in Vascular Surgery and Aortic Aneurysm Care Should Not Focus Solely on Threshold Operative Caseload
Authors: Karthikesalingam A. , Hinchliffe R.J. , Poloniecki J.D. , Loftus I.M. , Thompson M.M. , Holt P.J.E.
Published: July 2010

There has been great interest in the setting of threshold operative volumes for safety to guide centralisation of vascular surgical services by healthcare commissioners. This editorial examines the evidence for designing services around a numeric safety threshold in the relationship between volume and outcome in vascular surgery. Thresholds should be aimed at the best outcomes and equity of care. Equity means access to the most up-to-date technology and all the relevant support services for elective and emergency cases. The relationship of volume and outcome with quality is complex, and demands a shift in focus to infrastructural and procedural improvements that drive high-quality services rather than the concentration of planning exclusively around an operative volume threshold.
Diagnosis and Surgical Management of Free-Floating Thrombus Within the Carotid Artery
Authors: Lane Tristan R. A. , Shalhoub Joseph , Perera Ryan , Mehta Amrish , Ellis Mary R. , Sandison Ann , Davies Alun H. , Franklin Ian J.
Published: July 2010

Objective: Free-floating thrombus (FFT) of the carotid artery is a rare condition of currently unknown etiology. Less than 150 cases have been described in the published world literature to date. Design and Setting: We present 6 consecutive cases of carotid FFT, identified prospectively from 5000 carotid duplex scans over a 34-month period in a single tertiary center for vascular surgery. Results: All 6 cases involved the left carotid bifurcation in neurologically symptomatic individuals. In 5 of the 6 cases, FFT occurred in the absence of a significantly stenosing atheromatous plaque and was not associated with an elevation in velocity on duplex. The patients were all treated with surgical thromboendarterectomy, with good result. Conclusions: Duplex imaging can underestimate the degree of stenosis. Free-floating thrombus presents a challenge in diagnosis due to its rapidly evolving nature. The management of FFT by acute thromboendarterectomy appears to be safe and effective in limiting further focal neurological sequelae.
Carotid Stenting and Transcranial Doppler Monitoring: Indications for Carotid Stenosis Treatment
Authors: Gattuso Roberto , Martinelli Ombretta , Alunno Alessia , D'Angeli Ilaria , Felli Marco , Castiglione Anna , Izzo Luciano , Gossetti Bruno
Published: July 2010

Background: Recently, angioplasty and stenting of carotid arteries (CAS) have taken the place of surgery. The aim of our study is to assess the role of transcranial Doppler (TCD) monitoring during CAS to address the embolic complications during the stages of the procedure, with or without embolic cerebral protection devices. Methods: A total of 152 patients were submitted to carotid stenting. All patients were submitted to carotid arteries Duplex scanning. Results: Neurological complications are related to TCD detection of corpuscolate signals in rapid succession. Even if no reduction of the overall incidence rate of microembolic signals (MES) was observed, a decrease in the number of corpuscolate emboli were recorded when a cerebral protection was working. Conclusions: According to our study, even in selected patients on the basis of preoperative diagnostic criteria, CAS is burdened by a nonnegligible risk of subclinical embolic ischemic events detected at TCD and confirmed by diffusion-weighted magnetic resonance imaging (DW-MRI).
Arterial Pressure Gradient of Upper Extremity Arteriovenous Access Steal Syndrome: Treatment Implications
Authors: Reifsnyder Thomas , Arnaoutakis George J.
Published: July 2010

Purpose: Treatment options after arteriovenous fistula (AVF) associated steal include ligation, banding, and distal revascularization-interval ligation (DRIL). The purpose of this study was to evaluate the arterial pressure gradients in upper extremity steal syndrome. Methods: Preoperative arteriography and sequential intra-arterial pressure readings were performed on consecutive AVF patients with hand ischemia. Analysis of variance (ANOVA) with repeated measures analyzed intersubject comparisons, and post hoc analysis identified anatomic locations with highest inflow pressures. Results: Nine patients presented with ischemic hand symptoms after AVF. Pullback arterial pressure measurements revealed gradual increases in systolic and mean pressures as the catheter position was moved proximally from the AVF anastomosis. Post hoc analysis after ANOVA revealed higher axillary artery systolic pressure compared to proximal brachial artery (153 vs 116.8, P = .007). Conclusion: AVF-related steal syndrome decreases arterial inflow pressure of the affected extremity more proximally than previously thought. When performing a DRIL procedure, consideration should be given to placing the anastomosis as proximally as possible.
Percutaneous Drainage of Aortic Aneurysm Sac Abscesses Following Endovascular Aneurysm Repair
Authors: Pryluck D. S. , Kovacs S. , Maldonado T. S. , Jacobowitz G. R. , Adelman M. A. , Charles H. C. , Clark T. W. I.
Published: July 2010

Purpose: To report preliminary experiences with the treatment of aortic aneurysm sac abscesses following prior endovascular aortic aneurysm repair (EVAR) using computerized tomography (CT)-guided percutaneous drainage. Case Reports: Three patients aged 73 to 78 years with aortic aneurysm sac infections following prior EVAR, 2 of which were associated with aortoduodenal fistula, underwent CT-guided percutaneous drainage and catheter placement. One patient had complete resolution of the aortic aneurysm sac abscess following percutaneous drainage; 1 patient was stabilized to eventual extraanatomic bypass, graft explantation, and fistula repair; and 1 patient was temporized to debridement and fistula repair with endograft preservation. Conclusion: CT-guided percutaneous drainage may be a helpful therapy in selected patients for the treatment of aortic aneurysm sac infections following EVAR.