bluuebunny/crossref_metadata_2025_split huggingface dataset:
Occupational performance coaching for stroke survivors (OPC-Stroke): Understanding of mechanisms of actions
Authors: Kessler Dorothy , Egan Mary Y , Dubouloz Claire-Jehanne , McEwen Sara , Graham Fiona P 
Published: March 2018

Introduction Occupational performance coaching modified for stroke survivors is a promising new intervention to improve occupational performance post stroke. In the intervention, following client-centred occupational goal-setting, clients are led through strengths-based problem-solving and experimentation. Emotional support, individualized education and goal-focused problem-solving are hypothesized as key elements. Examination of clients’ experiences is necessary to better understand how occupational performance coaching modified for stroke survivors works, and improve its potential effectiveness. Method A descriptive qualitative study was embedded in a pilot randomized controlled trial. Semi-structured interviews were completed with seven participants in the treatment arm who received occupational performance coaching modified for stroke survivors. Qualitative content analysis was used for analysis. Findings Three categories were identified related to participants’ experiences of occupational performance coaching modified for stroke survivors: (a) the coaching was helpful; (b) the coaching provided opportunity for insightful reflection and (c) a different approach was preferred. Findings also lend support to the critical role of hypothesized key components and theorized mechanisms of action, and demonstrate the overarching role of the therapeutic relationship and the contribution of personal characteristics. Conclusion The revised theoretical understanding of occupational performance coaching modified for stroke survivors provides a valuable framework for communicating the actions that occupational therapists take in enabling occupation and emphasizes the role of the therapeutic relationship in client-centred approaches to improving occupational performance post stroke.
Use of an Anti-Infective Medication Review Process at Hospital Discharge to Identify Medication Errors and Optimize Therapy
Authors: Su Christy P. , Hidayat Levita , Rahman Shafiqur , Venugopalan Veena 
Published: March 2018

Background: Medication reconciliation is a major patient safety concern, and the impact of a structured process to evaluate anti-infective agents at hospital discharge warrants further review. Objective: The aim of this study was to (1) describe a structured, multidisciplinary approach to review anti-infectives at discharge and (2) measure the impact of a stewardship-initiated antimicrobial review process in identifying and preventing anti-infective-related medication errors (MEs) at discharge. Methods: A prospective study to evaluate adult patients discharged on anti-infectives was conducted from October 2013 to May 2014. The antimicrobial stewardship program (ASP) classified interventions on anti-infective regimens into predefined ME categories. Results: Forty-five patients who were discharged on 59 anti-infective prescriptions were included in the study. The most common indications for anti-infective regimens at discharge were pneumonia (22%, n = 10), bacteremia (18%, n = 8), and skin and soft tissue infections (16%, n = 7). An ME was identified in 42% (n = 19/45) of anti-infective regimens. Seventy percentage of ASP team recommendations were accepted which resulted in an avoidance of MEs in 68% (n = 13/19) of patients with an ME prior to discharge. Conclusion: This study describes the outcomes of a stewardship-initiated review process in preventing MEs at discharge. Developing a systematic process for a multidisciplinary ASP team to review all anti-infectives can be a valuable tool in preventing MEs at hospital discharge.
From Cultural to Creative Industries: Theory, Industry and Policy Implications
Authors: Cunningham Stuart 
Published: March 2018

This paper presents a rationale for distinguishing between notions of cultural and creative industries which has implications for theory, industry and policy analysis. I do this from the standpoint of a researcher and analyst and also from a position of a corporate involvement in a substantial project to grow and diversify a regional economy through the development of its creative industries. This project is a ‘creative industries precinct’ in inner suburban Brisbane involving my university, Queensland University of Technology, the Queensland state government through its Department of State Development, a variety of industry players, and retail and property developers. There is theoretical purchase in distinguishing the two terms, in part to put further flesh on the bones of claims about the nature of the knowledge-based economy and its relation to culture and creativity. Shifts in the nature of the industries usually described by the terms also need to be captured effectively, as do different policy regimes that come into play as regulation of and support for cultural and creative industries.
Borrowing from Libraries
Authors: Burns Maureen 
Published: March 2018

What can we learn from the experience of libraries in dealing with technological change? How can this help us to rethink communications futures? This paper rehearses various histories of libraries. White tracing the shift from an emphasis on collection to an emphasis on dispersal, it explores the ways in which libraries operate as governmental technology. The experience of libraries in dealing with technological change has been continually to create another order from a new chaos. This is what we borrow.
SBS-TV and its Amazing World
Authors: Davies Chris Lawe 
Published: March 2018

This paper looks at a particular moment in the history of SBS-TV — the 1994–95 corporate image campaign, ‘The World is an Amazing Place’. The corporate image campaign redirected all promotional funds away from program publicity to try to ‘re-position’ SBS as an urbane advertising vehicle, and at the same time to double its market share. At the time, it was a kind of ‘do-or-die mission — spurred to some extent by the need to see advertising as the only means SBS had of making up for government allocations which never seemed to match the network's aspirations. SBS did not achieve the increased share through the campaign; the question is whether, in re-positioning itself, the network compromised its public service role.
Commercial Radio 1999: New Networks, New Technologies
Authors: Collingwood Peter 
Published: March 2018

It is six years since the Keating Labor government's deregulation of commercial radio in Australia opened up opportunities for commercial radio networking, invited substantial overseas investment (and consequently, linkages with overseas media organisations) and virtually closed down the public regulation of content on radio. From any perspective, it remains important to understand precisely how ownership, production and distribution systems mesh with historically particular social and cultural formations. In addressing that context, this essay asks three questions: Citizen Kane issues aside, how have management decisions on networking influenced program quality? Second, how important is geography in this? And third, is technology driving the process?
Preoperative Evaluation of Paragangliomas of the Neck with Duplex Ultrasonography
Authors: Zang William , Blebea John , Molz April R. 
Published: March 2018

Objective Paragangliomas in the neck are infrequent tumors that most frequently require surgical resection. Their diagnosis is possible with duplex ultrasonography, which can also assist in suggesting the usefulness of preoperative endovascular embolization. Case Report A 53-year-old woman was seen with a mildly symptomatic left neck mass. An extracranial cerebrovascular duplex ultrasound examination revealed a mass near the carotid bifurcation. It seemed to be splaying the internal and external carotid arteries and was highly vascularized with multiple small feeding vessels. This suggested a carotid body paraganglioma. An MRI, CT scan, and angiogram were supportive of a diagnosis of a carotid body tumor. Because of its rich vascularity, preoperative embolization was performed. The patient was subsequently taken to surgery, and the mass was successfully excised. Pathologic microscopic examination confirmed a carotid body paraganglioma. Conclusion The diagnosis of a carotid body paraganglioma is possible with duplex ultrasonography. The size of the tumor and the finding of multiple small vessels feeding the tumor can assist in suggesting the usefulness of preoperative embolization to reduce operative blood loss.
Arterial Duplex Surveillance of Implanted Nitinol Stents in the Femoropopliteal Segment for Relief of Lower Extremity Ischemia
Authors: Schwartz Joy R. , Mewissen Mark W. , Gosset James B. , Pipia Janice R. , Marty Adrienne M. , Lanza Debra J. , Higginbotham Shirley Y. , Collier Will 
Published: March 2018

Purpose To evaluate the role of duplex scanning as an imaging tool in surveillance of the natural history of femoropopliteal arterial segments treated with self-expandable nitinol stents. Methods From March 1999 to December 2001, 92 limbs in 84 patients were treated with self-expanding stents in the femoropopliteal (FP) segment for the relief of chronic limb ischemia. Follow-up studies included color duplex ultrasonography (CDU) and ankle/brachial indices (ABIs) in 57 limbs. Duplex criteria used to determine the presence of a significant in-stent stenosis was an increase in the peak systolic velocity within the stent of >100% from the proximal segment. The presence of a hemodynamically significant stenosis was then correlated with the concurrent ABI. Results Eleven in-stent stenoses were documented in 11 limbs. In those patients, the mean decrease in ABI was 0.29, ranging from 0.13 to 0.50. In 46 patients with a <50% stenosis identified on CDU, the mean change in ABI was by comparison not significant. Conclusions From these data, the degree of in-stent stenosis (>50%) by duplex ultrasonographic criteria correlates well with a significant stenosis within a stented segment of the femoropopliteal artery. It seems that CDU is an ideal noninvasive imaging tool to objectively surveillance stent patency.
The Use of Segmental Femoropopliteal Duplex Scanning for Initial Vascular Laboratory Testing of Patients with Peripheral Arterial Disease
Authors: Dunican Annmarie , Patterson Robert , Scissons Robert , Gillis Joseph , Weyman Albert , Hopkins Robert 
Published: March 2018

Introduction —Segmental femoropopliteal duplex scanning in conjunction with ankle plethysmographic waveforms and ankle/brachial indices (ABI) was evaluated as an alternative to traditional physiologic testing for the initial vascular laboratory evaluation of patients with lower extremity peripheral arterial disease (PAD). To assess the potential of this evaluation, patients with PAD were evaluated in the vascular laboratory with (1) pulse volume recording and segmental pressures (SPVR) and (2) femoropopliteal duplex imaging with pulsed Doppler waveform analysis and bilateral ankle plethysmographic waveforms and ABI (SDuplex). Methods. —SPVR and SDuplex data were prospectively obtained from 39 patients and 72 limbs. Separate technologists performed the physiologic and duplex examinations independently. Angiograms performed within 90 days were used as the gold standard for evaluating results from both procedures. Results from both examinations were interpreted for severe (>50% diameter reduction) inflow and superior femoral artery (SFA) disease. A McNemar test was performed on the SPVR and SDuplex paired data, and direct (hands-on) examination time was calculated for both procedures. Results. —Angiograms were available for 20 of 72 (28%) of the limbs evaluated and demonstrated no significant differences between both methods for evaluating inflow (femoral or above) disease, yet SDuplex was superior to SPVR for evaluating SFA disease. McNemar test data also suggested that SDuplex was superior to SPVR in diagnosing severe disease at the SFA level. The average time for SPVR examination performance was 28 minutes and 31 minutes for SDuplex with ABI and ankle waveforms. Conclusions. —SDuplex was superior to SPVR for evaluating SFA disease. No noteworthy differences in direct (hands-on) examination times for both procedures suggest the additional benefit of enhanced reimbursement. With superior SFA accuracy, more site-specific information, and greater reimbursement potential, SDuplex should be considered an alternative to the traditional physiologic examination for evaluating patients with lower extremity PAD.
Mycotic Pseudoaneurysm following Carotid Intervention
Authors: Beedie Felicia F. , Carter Kathleen A. , Nelms Courtney , Chaler Dulcie , DeMasi Richard J. , Meier George H. , Sprouse Richard 
Published: March 2018

Introduction Pseudoaneurysm formation is a rare complication following carotid artery revascularization with a low estimated occurrence of 0.15 to 0.6%. This may result from percutaneous intervention, trauma, or infection. Patients may present with pain and swelling as well as a pulsatile cervical mass. Case Report A 56-year-old male with a history of multiple carotid endarterectomies and an interposition synthetic graft presented with a recurrent high-grade stenosis. The patient underwent a balloon angioplasty and stent placement in the internal carotid artery. Two months postintervention, the patient presented with swelling and tenderness at the incision site. Color duplex ultrasound (CDU) was performed, demonstrating a 1.7 × 1.8 cm perigraft collection without evidence of flow. The patient returned in 2 weeks with increased swelling and discomfort. This prompted a repeat CDU, demonstrating a 3.7 × 3.9 cm hypoechoic, perigraft collection, now doubled in size from the previous exam. An abscess was confirmed by needle aspiration and positive culture results. He was admitted and underwent 6 weeks of antibiotic therapy. Upon discharge, the patient returned for a follow-up CDU. A perigraft collection with arterial flow was now present that had not previously been noted. Angiography confirmed extraluminal flow at the level of the carotid stent. The patient underwent operative debridement with excision of the infected graft and repair of the pseudoaneurysm. Conclusions Carotid artery interventions have a very low incidence of infection. The occurrence of an infected or mycotic pseudoaneurysm following carotid intervention is extremely rare. CDU is a vital tool in detecting thrombosed versus active pseudoaneurysms, which may help guide appropriate therapeutic decisions.
Nonvascular Conditions of the Lower Extremities that May Mimic Arterial or Venous Disease: A Review
Authors: Brown Cathy M. , Roper Laura D. , Maynard Maureen M. , Back M. 
Published: March 2018

Introduction Noninvasive lower extremity arterial evaluations comprised 34% (1381/4104) of our vascular laboratory's patient volume in the year 2002. Often, patients presented with one or more symptoms suggestive of arterial disease; however, their vascular study results indicated a degree of arterial disease that was incongruent with their symptoms. It is necessary for the vascular technologist to understand the differential diagnoses that mimic the symptoms of arterial insufficiency. This clinical review describes other nonatherosclerotic disorders affecting the lower extremities. These include reflex sympathetic dystrophy syndrome (RSDS), lumbar spinal stenosis (LSS), gout, diabetic peripheral neuropathy, Charcot foot, and osteomyelitis ( Table 1 ). Our goal is to briefly describe these clinical possibilities to enhance understanding.
Fibromuscular Dysplasia of the Carotid Artery: Diagnosis with Duplex Ultrasonography
Authors: Zhou Wei , Bush Ruth L. , Lin Peter H. , Hodge Megan D. , Felkai Deborah D. , McCollum Charles H. , Noon George , Lumsden Alan B. 
Published: March 2018

Purpose The diagnosis of carotid artery fibromuscular dysplasia is usually made with conventional angiography performed to evaluate a suspected carotid stenosis. The ultrasound findings with fibromuscular dysplasia have not been well described. This study was performed to assess the characteristics of carotid artery fibromuscular dysplasia with duplex ultrasonography. Methods The hospital records for all patients who had carotid duplex ultrasonography were reviewed from January 2000 to October 2003. Patients with findings suspicious for fibromuscular dysplasia formed the basis of this study. The patient demographics, their presenting symptoms, and ultrasound findings were analyzed. Results Carotid duplex studies were performed on 9157 patients during the study period. The presumptive diagnosis of fibromuscular dysplasia was made in 13 female patients (1.2%), with a mean age of 67 ± 10 years (range, 52-79 years). Patients were referred for asymptomatic carotid bruits ( n = 10, 77%) or transient ischemic attack ( n = 3, 23%). Both mid and distal internal carotid artery involvement were seen in five patients (38%), whereas eight patients (62%) had disease isolated to the distal internal carotid artery. Bilateral carotid artery involvement occurred in eight patients (62%). A consistent finding in all patients was multiple areas of alternating focal thickening with thin, dilated arterial walls. Other sonographic findings included velocity increases (mean, 181 cm/sec; range, 135-318 cm/sec), color flow disturbance, and scarcity of plaque in the suspected arterial segment. Magnetic resonance angiography or carotid angiography was performed on seven (54%) patients, confirming the ultrasound diagnoses. One symptomatic patient was successfully treated with open graduated endoluminal dilatation. One patient with asymptomatic carotid bruit underwent carotid stent placement for rapid progression of the disease. No disease progression was seen on follow-up duplex examination in the remaining group, and no patient became symptomatic. Conclusions Fibromuscular dysplasia should be suspected in female patients with high-grade mid to distal carotid artery stenosis without significant atherosclerotic disease. This study demonstrates the usefulness of duplex ultrasound as both a screening test and diagnostic examination for carotid artery fibromuscular dysplasia. Follow-up is warranted in these patients.
Traumatic Renal Transplant Subcapsular Hematoma: Diagnosis by Duplex Ultrasound
Authors: Tuvell Nancy , Sorrell Kathryn 
Published: March 2018

Introduction Subcapsular renal hematomas result from a hemorrhage within the kidney that is contained by its fibrous capsule. In some cases, enlarging or acute hematomas may compress the renal parenchyma and result in ischemia or impaired renal function. In the renal transplant recipient or a patient with a solitary kidney, this situation requires immediate identification and aggressive intervention to preserve renal function. Patient A 54-year-old renal transplant recipient was seen in our vascular laboratory with complaints of severe pain over his transplanted kidney, hematuria, and an elevated creatinine level. His recent history was significant for a minor automobile accident in which his seatbelt engaged over the site of his transplant in the right iliac fossa. Findings Gray-scale imaging revealed a reniform collection surrounding the lateral surface of the kidney, displacing and compressing the renal parenchyma. Resistive indices were elevated at 1.0 throughout the transplant. At the hilum of the kidney, color Doppler documented a high-velocity flow jet in the main renal vein with a continuous Doppler flow pattern. On the basis of these findings, the patient was taken to the operating room for emergent evacuation of the hematoma. A follow-up duplex ultrasonography on the first postoperative day revealed a significant decrease in the size of the hematoma. The resistive indices and the renal vein flow returned to normal. Conclusion Duplex ultrasonography provided an accurate diagnosis of the subcapsular hematoma and its hemodynamic impact on the transplanted kidney.
The American Vascular Association Screening Program: Rationale, Method, Guidelines, and Progress
Authors: Lavenson George S. 
Published: March 2018

Introduction The Society of Vascular Surgery, in partnership with the Society for Vascular Ultrasound (SVU), established a National Vascular Screening Program thru the American Vascular Association (AVA). The program screens for the immediate causes of stroke, abdominal aortic aneurysms (AAA), and peripheral vascular disease. Detection of these conditions while the patient still is asymptomatic allows for early management and avoidance of the devastating events they can cause. Methods A quick carotid scan is used for detection of carotid artery disease, an EKG rhythm strip for atrial fibrillation, blood pressure determination for hypertension, a quick abdominal scan for AAA, and ankle/brachial indices for peripheral vascular disease. The SVU position on screening, recommending credentialed technologists and accredited laboratories, is used in the AVA screening program, and reporting only the presence or absence of disease has been recommended. Results The AVA program, and three other programs reported, screened 6,073 seniors. It is estimated that the carotid screenings alone prevented 30 strokes and saved $12,061,400,000 in stroke costs. Conclusion The AVA screening program, with quality ensured by the SVU guidelines, has the potential to prevent a major number of strokes and deaths. Recommendation is for extension of the screening program and for efforts to obtain Medicare funding for the screening.
Examining the Brachial Artery Reactivity Curve Measured by B-Mode Ultrasound in the Buffalo Cardio-Metabolic Occupational Police Stress (BCOPS) Pilot Study
Authors: Joseph Parveen Nedra , Dorn Joan , Violanti John M. , Andrew Michael E. , Riley Ward A. 
Published: March 2018

Brachial artery reactivity was assessed in the Buffalo Cardio-Metabolic Occupational Police Stress (BCOPS) Pilot Study using B-mode ultrasound. Carotid artery intima-media thickness (CIMT), a known subclinical predictor of cardiovascular disease, also was examined in relation to brachial artery reactivity. A continuous scan was performed on the artery for 8 min (1 min of baseline, 4 min of cuff inflation at 40 mmHg greater than systolic pressure, 3 min after cuff release). The sample for analysis (n = 78; 43 men, 35 women) consisted of active-duty police officers from a larger sample in the BCOPS pilot study. Means and standard deviations (SDs) stratified by gender were calculated, along with Pearson's correlations between brachial variables, and with CIMT. Arterial diameters (baseline, pre-cuff release, peak) were significantly different ( p < 0.001) between men and women. Peak arterial dilation occurred at 50.77 ± 21.97 sec (49.67 ± 20.22 cardiac cycles) after cuff deflation in men, and 44.66 ± 24.07 sec (44.57 ± 20.36 cardiac cycles) after cuff deflation in women. Mean common carotid artery IMT and mean maximum IMT of all carotid sites were significantly correlated ( p < 0.01) in men (r = 0.691) and women (r = 0.450). Brachial reactivity measures were inversely correlated with CIMT in women, and in contrast, positively correlated in men.