bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluating the Inpatient Pediatric Ethical Consultation Service
Authors: Watt Kelsey , Kirschen Matthew P. , Friedlander Joel A. 
Published: March 2018

OBJECTIVES:Pediatric ethical consultation services (ECSs) have been proliferating at medical centers, with little data available on evaluating their implementation. The objective of this study was to evaluate the pediatric ECS and understand the ethical issues occurring within a single quaternary-level pediatric hospital.METHODS:A retrospective chart review of documented ethics consultations at a large pediatric hospital from November 2010 to November 2013 was performed and data was abstracted per the US Department of Veterans Affairs’ Domains of Ethics in Health Care. An anonymous, prospective survey regarding ethical issues encountered was distributed electronically to ∼3500 inpatient staff from November 2013 through January 2014. Ethical domains, demographics, feelings of distress by staff, and location of occurrence data were collected. These data were compared with formally documented ethics consults from the retrospective chart review and ECS activity during the same period.RESULTS:A total of 47 ethics consults were documented between 2010 and 2013, primarily in the domains of end-of-life care (19; 40%) and shared decision-making (17; 36%). Sixty-three staff members (92% female; 42% nurses; 20% attending physicians) logged an encountered ethical issue between November 2013 and January 2014, corresponding to only 5 documented ethics consults in the same time period. Domains included end-of-life care (18; 28.5%), shared decision-making (13; 20.6%), everyday workplace (11; 17.4%), professionalism (8; 12.6%), and resource allocation (7; 11%). Eighty-one percent of subjects reported personal or professional distress.CONCLUSIONS:On the basis of this single-center study in which we reviewed formal documentation, we determined that formal pediatric ECSs are underused, particularly for ethical domains that cause staff members moral distress.
A Quality Improvement Intervention to Improve Inpatient Pediatric Asthma Controller Accuracy
Authors: Hogan Alexander H. , Rastogi Deepa , Rinke Michael L. 
Published: March 2018

OBJECTIVES:
Our objective was to investigate if a rigorous quality improvement (QI) intervention could increase accuracy of pediatric asthma controller medications on discharge from an inpatient hospitalization.

METHODS:
Our interprofessional QI team developed interventions such as improving documentation and creating standardized language to ensure patients were discharged on an appropriate asthma controller medication and improve assessment of asthma symptom control. Each week of 2015–2016, the first 5 patients discharged with status asthmaticus from the pediatric wards were reviewed for documentation of the 6 asthma control questions and accuracy of the discharge controller therapy. Correct discharge medication was defined as being prescribed the age-appropriate medication and dose on the basis of baseline controller therapy, compliance with baseline medication, and responses to asthma control assessment. The weekly proportion of control questions that were accessed and correct controller medications that were prescribed were analyzed by using Nelson rules and interrupted time series.

RESULTS:
A total of 240 preintervention and 252 postintervention charts were reviewed. The primary outcome of the median proportion of patients discharged on appropriate controller therapy improved from 60% in preintervention data to 80% in the postintervention period. The process measure of proportion of asthma control questions that were assessed improved from 43% in the preintervention period to 98% by the final months of the intervention period. Both of these changes were statistically significant as per Nelson’s rules and interrupted time series analyses (P = .02 and P &lt; .001, respectively, for postintervention break).

CONCLUSIONS:
An interdisciplinary QI team successfully improved the accuracy of asthma controller therapy on discharge and the inpatient assessment of asthma control questions.
A Qualitative Investigation into Practitioners’ Perspectives of the Coping-Infused Dialogue through Patient-Preferred Live Music Protocol
Authors: Silverman Michael Joseph 
Published: March 2018

The Coping-Infused Dialogue through Patient Preferred Live Music (CID-PPLM) protocol was designed to integrate receptive music therapy with a discussion of stressors and coping skills. However, to better understand the advantages and disadvantages of the protocol within the contemporary evidence-based practice framework, investigation with protocol practitioners is warranted. The purpose of this study was to understand practitioners’ perspectives of the CID-PPLM protocol. Specific research questions included practitioners’ perspectives of the following: (1) What are potential advantages of the CID-PPLM protocol and how might it function with adult medical patients? (2) What are potential disadvantages of the CID-PPLM protocol and how might it be improved? Five practitioners participated in individual semi-structured interviews. Themes were identified via thematic analysis. Member checking and trustworthiness were used. Participants had positive, as well as constructive, perceptions of the CID-PPLM. Emerging themes included: CID-PPLM provides choice, control, support, and autonomy; CID-PPLM allows for individualized patient responses within a distinct therapeutic interaction; and the CID-PPLM can be restrictive. Emerging themes and sub-themes can be used to modify the CID-PPLM and provide a framework for new protocols to offer clinicians additional flexibility to best serve adult medical patients. Implications, limitations, and suggestions for future research are provided.
Analisis Probabilistic Fracture Mechanics Pada Evaluasi Keandalan Bejana Tekan Reaktor Secara 3-D
Authors: Hartini Entin , Himawan Roziq , Susmikanti Mike 
Published: March 2018

Analisis integritas material sangat diperlukan pada Reactor Pressure Vessel (RPV). Komponen tersebut merupakan pressure boundary yang berfungsi untuk mengungkung material radioaktif. Adanya retak pada dinding dapat mempengaruhi integritas RPV tersebut. Penelitian ini bertujuan melakukan analisis fracture mechanics menggunakan model probabilistik untuk evaluasi keandalan RPV. Model probabilistik digunakan untuk pendekatan karakter random dari kuantitas input seperti sifat mekanik material dan lingkungan fisik. Karakter random dari kuantitas input menggunakan teknik sampling berdasarkan probability density function. Material yang digunakan pada RPV adalah baja feritik (SA 533). Analisis fracture mechanics dilakukan berdasarkan metode elemen hingga (FEM) menggunakan perangkat lunak MSC MARC. Output dari MSC MARC adalah nilai J integral untuk mendapatkan nilai stress intensity factor (SIF) pada evaluasi keandalan bejana tekan reaktor 3D. Hasil perhitungan menunjukan bahwa SIF probabilistik lebih dulu mencapai nilai batas fracture toughness dibanding SIF deterministik. Nilai SIF yang dihasilkan dengan metode probabilistik adalah 95,8 MPa m0,5, sedangkan dengan metode deterministik adalah 91,8 MPa m0,5, rasio crack (a/c) semakin kecil akan dihasilkan nilai SIF yang semakin besar.Kata kunci: Probabilistic fracture mechanics, bejana tekan, 3-D.
Conference Session III: Advocacy. Presented by Kevin Smith, the Dean of Libraries at the University of Kansas.
Authors: Pavy Jeanne Adele 
Published: March 2018

In his presentation on Advocacy at the 2017 Kraemer Copyright Conference, Kevin Smith offered participants suggestions on how to engage various stakeholders on copyright issues. Using a model of advocacy derived from the environmental movement, Smith encouraged participants to acquire a strong understanding of the incentives and barriers that are in play for decision makers involved in this issue, and to tailor one’s approach to the specific audience addressed. Stakeholders bring different perceptions of how to achieve the balancing purpose of copyright and advocates must grasp the motives present on all sides of the issue. He makes the case for telling stories alongside data in presenting a position because narratives are usually more interesting and memorable than the rules and abstract principles they demonstrate. Smith also offered guidance on how to address risk in copyright contexts, and extolled the positive impact created by simply behaving in a respectful and friendly way toward everyone involved in the conversation.
Breakout Session: Leveraging Licensing to Increase Access
Authors: Polchow Michelle 
Published: March 2018

The Affordable Course Materials Initiative (ACMI) is a library-driven program established by University of California, Los Angeles (UCLA), designed to leverage existing library resources, encourage open educational resources (OER) content creation, identify cost-effective digital projects and modify existing license agreements in order to create reduced cost course materials for students, as an alternative to rising commercial textbook costs. The faculty incentivized program encourages instructors to partner with the library to leverage free or low-cost resources, adjusting syllabi and assignments as needed. ACMI’s two-year pilot resulted in convincing evidence that the service supported a broad and diverse range of campus disciplines, achieved substantial cost savings, served as a catalyst for community building with multiple stakeholders, and gained campus administration recognition with an ongoing commitment of financial support to permanently integrate the initiative as an ongoing component of library services.
Transrektal Prostat İğne Biyopsisinin Erektil Fonksiyon Üzerine Etkisi
Authors: Ergün Osman 
Published: March 2018

Amaç:
Transrektal ultrasonografi eşliğinde prostat biyosi işleminin, hastaların
cinsel fonksiyonu üzerine olan etkilerini, işlem öncesinde ve sonrasında farklı
zaman aralıkları ile değerlendirmek.Hastalar ve yöntem: Çalışmaya işlem
öncesi IPSS ve IIEF doldurtulan ve işlem sonrası bu formlar tekrar 1. ve 3.
aylarda doldurtulmuş olan ve biyopsi sonucu prostat kanseri ile uyumlu gelmeyen
80 hasta alındı. IIEF-5’e göre hastaların erektil fonksiyonları 5 kategoriye
ayrıldı; 5-7: ağır erektil disfonksiyon (ED), 8-11: orta ED, 12-16: hafif-orta
ED, 17-21: hafif ED, 22-25: ED olmayan.Bulgular:
Hastaların %45’ i (36/80) üç günden
fazla süren rektal kanama şikayeti bildirdiler. Üç günden uzun süren
hematospermi ve/veya hematüri şikayeti hastaların %78,8’ inde (63/80) gözlemlendi.
Biyopsi öncesi IIEF skor ortalaması 24.29±8.40 idi. Biyopsi sonrası 1. ve 3.
aylardaki IIEF skor ortalamaları sırası ile 20.31±9,6 ve 22.36±8.88 idi
(p&lt;0,05). Biyopsi öncesi ED’ u olmayan hasta grubunda biyopsi sonrası 1. ayda ED
görülme oranı %31.57 (18/57) idi. Bu
oranın 3. ayda %5.26’ ya (3/57) gerilediği tespit edildi. Başlangıçta ED’u
olmayan hasta grubunda biyopsi sonrası görülen ED’un şiddeti, IIEF-5’e göre
17-21 arası olup hafif ED sınıflamasına girmekte idi.

Sonuç:
Biyopsi ilişkili cinsel disfonksiyon ihtimali, prostat biyopsisi geçiren tüm
hastalarda olasıdır. Fakat çalışmamıza dayanarak denebilir ki; biyopsi sonrası
seksüel disfonksiyon, özellikle de erektil disfonksiyon çoğu zaman geçici bir
durumdur.
Groundwater Modeling and Governance: Contesting and Building (Sub)Surface Worlds in Colorado’s Northern San Juan Basin
Authors: Kroepsch Adrianne C. 
Published: March 2018

As groundwater use has surged globally and computing power has grown, groundwater modeling has become a regular feature of subsurface-oriented governance. Our improved ability to “see” underground with models has not, however, generated epistemic consensus on the inner workings of subsurface systems. Here, I ask how and why that is the case. I pursue this line of inquiry in the context of groundwater governance in the American West. Specifically, I trace a decade of groundwater modeling at the heart of a protracted and legally influential groundwater dispute in the state of Colorado to show how models served as mathematical spaces for competing subsurface stakeholders to test and contest opposing visions of groundwater flows, rights, and responsibilities. Drawing from the Science & Technology Studies literature on global climate modeling, I argue that groundwater models are more than simulations of subsurface systems; they are tools of “world building” that embed, enact, and also circumscribe subsurface politics.
The Reagan Administration as the Origin of the Shift from Citizen Building to Consumer Building in American Education
Authors: Davis Alex 
Published: March 2018

Current American education is comprised of and influenced by a myriad of complex legislative, technological, and cultural representations of consumption, however this historic-educational study specifically examines how the Reagan administration discursively initiated the consumerizing educational framework. While existing research studies the neoliberal implications on education, this study addresses the neoliberal reforms under President Reagan within the discursive paradigm of its consumerizing impact. By using Critical Discourse Analysis on a selection of Presidential proclamations, speeches, and national educational reports, this study examines and elucidates how the Reagan administration created the consumerizing framework for American education. By understanding the results through the Frankfurt School concept of integration and expanding on Bowles and Gintis’ educational theory, this study argues that Reagan’s reforms created a consumerizing framework in American education.
Politics and Religion vs. Law and Order in Nigeria: Implications for National and Regional Security.
Authors: Anadi, PhD Sunday K.M. 
Published: March 2018

Since independence in 1960, Nigeria has grappled with the ominous challenge of building a sustainable bridge between its ever increasing populations divided not only along distinct multi-ethnic groups but also between two major diametrically opposed faiths [in content, structure, and tactics]- Christianity and Islam. The study was exploratory in nature, which adopted descriptive adequacy in articulating and examining the underlying alternatives factors that propel national politics and religious violence in Nigeria, thus producing a more comprehensive and total picture of the dynamics of the phenomena under investigation- the understanding of religious violence in Nigeria with minimum distortion. Furthermore, the study adopted a survey method based on the perception of Government officials and Religious leaders regarding religious violence, with a corresponding sample size of 100. The study found that the seeming overwhelming implications of persistent religious violence for Nigeria are three folds; they include; sustained threat to national peace, unity, and security, undermines national political/economic development, as well as socio-cultural and religious harmony and cooperation. In addition, the study found that the present state of religious violence in Nigeria exacerbates bitterness, hatred, and mistrust among the federating units of Nigeria resulting to violent reactions and heightened intra-ethnic and religious clashes, with a volcanic potential to explode into secession by aggrieved groups, internecine civil war, pogroms and/or jihads. Finally, the study recommended that the Nigerian civil society must step up organized and peaceful agitations for fundamental changes in the structure and character of the Nigeria state through a Sovereign National Conference or credible constitution review effort. Also, the Nigerian government and the international community must seize the opportunity of current fragile peace in Nigeria, to implement a number of credible measures aimed at preventing a recurrence of widespread religious conflicts threatening to spill over to a civil war.
Aspectos epistemológicos a luz da teoria antropológica do didático subjacentes ao tema transformação linear
Authors: Matos Fernando Cardoso de , Pereira José Carlos de Souza , Nunes José Messildo Viana , Guerra Renato Borges 
Published: March 2018

Nosso propósito neste artigo foi revelar os aspectos epistemológicos a luz da Teoria Antropológica do Didático estão subjacentes ao tema transformação linear, no livro didático adotado para o ensino de Álgebra Linear no Instituto Federal do Pará, revelando indícios do modelo epistemológico dominante, analisando dois tipos de tarefas. A análise do livro didático é um referencial para a elaboração de conjecturas a respeito do tipo de ensino que está sendo desenvolvido de um determinado saber, em uma determinada instituição. A Teoria nos ajudou a discutir Organização Matemática e Didática do livro, em termos do gênero de tarefas e tipos de tarefas, técnicas e justificações da razão de ser do objeto matemático transformação linear. A razão de ser para se ensinar esse objeto se dá pela aplicação direta da definição, pois os alunos devem se perguntar ao lerem as propostas das tarefas enunciadas pelos autores, para que e porque se estudar tal temática? Algumas tarefas são resolvidas com os conteúdos vistos no ensino médio, como função como tecnologia, não deixando claro ao leitor que é uma transformação de um espaço vetorial em outro. Concluímos que nos tipos de tarefa discutidos foi possível dar indícios do modelo epistemológico dominante, o qual consideramos a utilização direta da definição de transformação linear.
Análise de erros na resolução de problemas matemáticos
Authors: Kliemann Geovana Luiza , Dullius Maria Madalena 
Published: March 2018

Apresenta-se neste trabalho, uma pesquisa desenvolvida no âmbito do Programa Observatório da Educação, com o propósito de auxiliar na melhoria da qualidade dos processos de ensino e aprendizagem da Matemática na Educação Básica. A partir do estudo dos sistemas avaliativos que constituem o escopo de investigação do projeto, verificou-se que o foco destes é a resolução de problemas, desenvolveu-se então várias ações com o objetivo de auxiliar os estudantes no processo de resolução dos mesmos. Uma dessas ações objetivou analisar os erros apresentados por estudantes do 5º ano na interpretação, compreensão e resolução de problemas. Descreve-se três encontros desenvolvidos em seis escolas, com questões retiradas da Prova Brasil realizadas em anos anteriores, com o objetivo de diagnosticar as principais dificuldades apresentadas pelos alunos na resolução dos problemas, além de auxilia-los a verificar possibilidades de superar tais lacunas. Para atingir os objetivos propostos, foi realizado um estudo qualitativo em que os pesquisadores estiveram constantemente envolvidos durante o processo. Após cada encontro, realizou-se uma análise das respostas desenvolvidas, classificando os erros cometidos em diferentes categorias. Verificou-se que a maioria dos estudantes atendidos obteve êxito na resolução dos problemas propostos, e os principais erros apresentados estão relacionados à dificuldade de interpretação.
Presentación
Authors: Litwin Edith 
Published: March 2018

Presentamos en este nuevo número seis trabajos que son fruto de las investigaciones realizadas en el Instituto de Educación de la Universidad ORT y dan cuenta de los resultados que los estudiantes del Master en Educación produjeron en la tarea desempeñada.Estos trabajos se inscriben en el marco de una nueva agenda para el campo de las preocupaciones pedagógicas y didácticas. No le son ajenos los problemas que se suscitan en las aulas contemporáneas y en los contextos críticos en los que la enseñanza se desarrolla. Se emprendieron en diferentes departamentos: Florida, Colonia, Artigas, Rivera, Montevideo; en los diversos niveles de la enseñanza: escuelas primarias, liceos -tanto en el ciclo básico como el Bachillerato Diversificado -en los Institutos de Formación Docente; en escuelas de contexto crítico, en barrios periféricos y en los centros urbanos; en Instituciones de gestión oficial y privada. Ha sido recurrente en todos los trabajos el interés por identificar las condiciones y contextos de la enseñanza y por indagar prácticas, representaciones, concepciones o estilos. En todos los casos, estas indagaciones se caracterizaron por la realización de laboriosos trabajos empíricos en el campo de estudio.
Assessing Evidence-Informed Practices to Reduce Routine Interventions in Labor and Childbirth: Validating the Content of the Keeping Birth Normal Tool
Authors: Darling Florence , Collington Valentina 
Published: March 2018

Background:The overuse of interventions in labor and childbirth increase the risk of mortality and morbidity in women. There are wide variations in the use of routine interventions locally, regionally, and globally. The reasons for this are complex and multifactorial. This study focuses its investigations at the microcosm of practice. It outlines the validation of the content of a new Tool to assess and support the implementation of evidence-informed practices by health-care professionals.Methods:Seven experts and eight women user representatives used a 4-point ordinal scale of relevance to rate 50 items in the Keeping Birth Normal (KBN) Tool. Item-level content validity index (I-CVI), an average scale-level content validity index (S-CVI/Ave), and qualitative comments were used to delete and improve items.Results:Eleven experts analyzed all 50 items. Four experts rated 35–49 items. The initial scale received an S-CVI/Ave of 0.88. Two items were deleted, improvements were made to 45 items, some were merged, and 7 new items were added. The final scale with 36 items received an S-CVI/Ave of 1.0 post item deletion and improvement.Discussion:The items in the KBN Tool are construct relevant and will undergo plausibility testing in a future study. Other forms of validity evidence on response processes and internal structure, which may be gathered, will depend on its further application in practice and research.
Domperidone Versus Metoclopramide: Self-Reported Side Effects in a Large Sample of Breastfeeding Mothers Who Used These Medications to Increase Milk Production
Authors: Hale Thomas W. , Kendall-Tackett Kathleen , Cong Zhen 
Published: March 2018

Introduction: Metoclopramide and domperidone are medications that block dopamine receptors on the lactotrophs, allowing prolactin levels to rise. Both medications are prescribed to boost milk production in mothers with low milk production due to hypoprolactinemia. The Food and Drug Administration has not approved the use of domperidone in the U.S. because of concerns about increased risk of cardiac arrhythmias. Metoclopramide is often recommended instead. Unfortunately, metoclopramide affects the central nervous system (CNS) and increases the risk of both depression and tardive dyskinesia (TD).Method: The present study is an online survey of self-reported side effects of 1,990 mothers, representing 25 countries, who took metoclopramide, domperidone, or both medications to enhance milk production. Data were collected in 2010.Results: The results indicated that side effects, in general, affected only a small percentage of women who took either medication. Women were 3.6 times more likely to report no side effects when taking domperidone vs. metoclopramide. There were no significant differences in cardiac arrhythmias for women who took metoclopramide versus domperidone. Racing heart was more common with metoclopramide. Less than 1% reported these symptoms in both groups. However, CNS effects were significantly more common in women who took metoclopramide. Risk of depression increased by seven times, and symptoms of TD (tremors, involuntary grimaces, and jerking) increased by 4 to 19 times when women took metoclopramide.Discussion: The results of the present study are preliminary, but suggest that cardiac arrhythmias are a rare side effect with both medications. The CNS side effects with metoclopramide are more concerning, particularly depression and TD. It is hoped that the recommendations regarding the relative safety of these medications will be re-examined in light of these findings.