bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluating library service quality at the Aga Khan University library: Application of a total quality management approach
Authors: Gathoni Nasra , Van der Walt Thomas 
Published: December 2017

The purpose of this paper is to report on an investigation of the service quality of the Aga Khan University library in Kenya. The total quality management philosophy which forms the basis of this report has been demonstrated by the use of SERVQUAL, a user-based assessment tool, in the evaluation of service quality. The research was conducted among 123 Aga Khan University library users – nursing and medical faculty and nursing and medical students – with an aim to investigate the quality of its services based on the satisfaction of library users with the services and as expressed by and based on users’ expectations and perceptions. The data was gathered through the SERVQUAL structured questionnaire and a 63% response rate was realized. The findings generally established that the expectations of Aga Khan University library users are higher than their perceptions. The results also show that there are service quality gaps in a number of services offered by the library. This research is deemed important as there is lack of information showing libraries in Kenya having involved library users in service quality evaluation through the use of objective and user-based tools. Thus this paper may lead to libraries in Kenya embracing objective measurement tools for the evaluation of library service quality. It is hoped that this article will contribute to a better understanding of philosophies such as total quality management in an academic library environment in developing countries, users’ expectations and perceptions of quality.
Simplifying Breast Imaging Reporting and Data System classification of mammograms with pure suspicious calcifications
Authors: Menezes Gisela LG , Winter-Warnars Gonneke AO , Koekenbier Eva L , Groen Emma J , Verkooijen Helena M , Pijnappel Ruud M 
Published: December 2017

Objectives To investigate the risk of malignancy following stereotactic breast biopsy of calcifications classified as Breast Imaging Reporting and Data System (BI-RADS) 3, 4, and 5. Methods The study included women with pure calcifications (not associated with masses or architectural distortions) who underwent stereotactic breast biopsy at the Dutch Cancer Institute between January 2011 and October 2013. Suspicious calcifications (Breast Imaging Reporting and Data System 3, 4, or 5) detected on mammography were biopsied. All lesions were assessed by breast radiologists and classified according to the BI-RADS lexicon. Results Overall, 473 patients underwent 497 stereotactic breast biopsies. Sixty-six percent (326/497) of calcifications were classified B4, 30% (148/497) B3, and 4% (23/497) B5. Of the 226 (45%) malignant lesions, there were 182 pure ductal carcinoma in situ, 22 mixed ductal carcinoma in situ and invasive carcinomas (ductal or lobular), 21 pure invasive carcinomas, and one angiosarcoma. Malignancy was found in 32% (95% confidence interval [CI] 0.24 to 0.39) of B3, 49% (95% CI 0.43 to 0.54) of B4, and 83% (95% CI 0.61 to 0.95) of B5 calcifications. Conclusions Considering the high predictive value for malignancy in B3 calcifications, we propose that these lesions should be classified as suspicious (B4), especially in a screening setting.
Limitation of therapeutic effort experienced by intensive care nurses
Authors: Velarde-García Juan Francisco , Luengo-González Raquel , González-Hervías Raquel , Cardenete-Reyes César , Álvarez-Embarba Beatriz , Palacios-Ceña Domingo 
Published: December 2017

Background: Nurses who practice limitation of therapeutic effort become fully involved in emotionally charged situations, which can affect them significantly on an emotional and professional level. Objectives: To describe the experience of intensive care nurses practicing limitation of therapeutic effort. Method: A qualitative, phenomenological study was performed within the intensive care units of the Madrid Hospitals Health Service. Purposeful and snowball sampling methods were used, and data collection methods included semi-structured and unstructured interviews, researcher field notes, and participants’ personal letters. The Giorgi proposal for data analysis was used on the data. Ethical considerations: This study was approved by the Ethical Research Committee of the relevant hospital and by the Ethics Committee of the Rey Juan Carlos University and was guided by the ethical principles of voluntary enrollment, anonymity, privacy, and confidentiality. Results: In total, 22 nurses participated and 3 themes were identified regarding the nurses’ experiences when faced with limitation of therapeutic effort: (a) experiencing relief, (b) accepting the medical decision, and (c) implementing limitation of therapeutic effort. Conclusion: Nurses felt that, although they were burdened with the responsibility of implementing limitation of therapeutic effort, they were being left out of the final decision-making process regarding the same.
Remaining in the nursing profession: The relevance of strong evaluations
Authors: Kristoffersen Margareth , Friberg Febe 
Published: December 2017

Background: Why nurses remain in the profession is a complex question. However, strong values can be grounds for their remaining, meaning nurses evaluate the qualitative worth of different desires and distinguish between senses of what is a good life. Research question: The overall aim is to explore and argue the relevance of strong evaluations for remaining in the nursing profession. Research design: This theoretical article based on a hermeneutical approach introduces the concept strong evaluations as described by the Canadian philosopher Charles Taylor and provides examples of nurses’ experiences in everyday nursing care drawn from a Norwegian empirical study. Participants and research context: Data collected in the original study consisted of qualitative interviews and qualitative follow-up interviews with 13 nurses. The research context was the primary and secondary somatic and psychiatric health service, inside as well as outside institutions. Ethical consideration: The article uses data from an original empirical study approved by the Norwegian Social Science Data Services. Information was given and consent obtained from the participants. Findings: Remaining in the nursing profession can be understood as revolving around being a strong evaluator. This has been concretized in issues of being aware of different incidents in life and having capacities as a nurse. Discussion: Why nurses remain is discussed in relation to how nurses have shaped themselves by reflecting on what is of significance in their life. However, being a strong evaluator cannot be seen as the casual condition for remaining. Conclusion: Remaining in the nursing profession is obviously not a contingent matter, rather it is a matter concerned with the qualitative worth of different desires and values. Nurses’ awareness of a life choice impacts on whether they remain or not. Consequently, nurses may need to articulate and reflect on their priorities for remaining.
Caring for elder patients: Mutual vulnerabilities in professional ethics
Authors: Nordström Karin , Wangmo Tenzin 
Published: December 2017

Background: Neglect and abuse of elders in care institutions is a recurring issue in the media. Elders in care institutions are vulnerable due to their physical, cognitive, and verbal limitations. Such vulnerabilities may make them more susceptible to mistreatment by caregivers on whom they are heavily dependent. Objectives: The goal was to understand caregivers’ concerns about ensuring correct and proper treatment, as well as their experiences with neglect and abuse of older patients. This article examines resources and challenges of professional ethics within the care setting. Research design: A study was conducted to explore the quality of care provided to older patients in nursing homes, geriatrics institutions, and ambulant care in the northwest region of Switzerland. Participants and research context: A total of 23 semi-structured interviews were conducted with nursing staff of varying experience levels. Ethical considerations: Ethical approval was granted by the competent regional ethics commission, Ethikkomission Nordwest-und Zentralschweiz EKNZ [Ethics Commission Northwest and Central Switzerland] (2014-015). Findings: Three themes emerged from our data analysis: professional identity, professional context, and professional relationships. Our findings indicate mutual vulnerabilities within these three themes, characterizing the interactions between nursing staff and older patients. Study participants believe that incidences of error, neglect, and abuse are consequences of their own vulnerability since they are not able to meet the demands of an overstraining work situation. Discussion: Different aspects of this mutual vulnerability are described and critically discussed as challenges for professional ethics. Conclusion: Early education, continuous training as well as better management and response from the institution are necessary to maintain professionalism while handling mutual vulnerabilities.
The rate of mental health service use in New Zealand as analysed by ethnicity
Authors: Tapsell Rees , Hallett Charlene , Mellsop Graham 
Published: December 2017

Objectives: To compare by ethnicity the rates of apparent new referrals and admissions to mental health services for selected major diagnostic groupings. Method: Using a Ministry of Health database covering all referrals and admissions to New Zealand’s Mental Health services in 2014 and who had not been patients in the preceding six years, population adjusted rates of presentation were calculated and compared across the two major New Zealand ethnic groupings. Results: Population corrected rates of apparently new cases of schizophrenia are more than twice as common in Māori as in non-Māori. Major depression is also significantly more common in Māori. That same trend was not evident for bipolar patients. Conclusions: These ethnically associated apparent differences in the rates of schizophrenia and depression need both confirmation and explanation.
Variability amongst urine toxicology amphetamine readings with concurrent administration of fenofibrate
Authors: Dadlani Navin , Farrar Anna , Jones Graham 
Published: December 2017

Objective: The aim of this study was to highlight that concurrent administration of the common lipid-lowering agent fenofibrate may lead to false-positive amphetamine results in often-used immunoassay-based urine drug screens. It also aimed to show that there are significant moral and clinical challenges associated with the interpretation of such results amongst psychiatric inpatients. Conclusions: It is evident that different pathology laboratories may utilise different commercial urine drug-screen immunoassays in their toxicology analysis, with variability in the test specificities. Despite the relatively high prevalence of substance misuse in the population of psychiatric inpatients, there exists a need for increased vigilance towards the possibility of false-positive amphetamine results owing to likely cross-reactivity of fenofibrate with the test reagents. In cases where there is uncertainty when correlating clinically, or where false positives are suspected, gold-standard urine-sample analysis by mass spectrometry should be considered, particularly when the consequences for patients may include restrictive measures.
Fetal Alcohol Syndrome Disorder: diminished responsibility and mitigation of sentence
Authors: Scott Russ 
Published: December 2017

Objective: The objective of this study was to consider the implications of a recent Western Australia Court of Appeal decision in which an indigenous youth who had been sentenced for the manslaughter of his neonate child was later diagnosed with Fetal Alcohol Syndrome Disorder. Conclusion: The increased use of the 2016 Australian guide to the diagnosis of fetal alcohol spectrum disorder should be encouraged to enable clinicians to not only diagnose and manage Fetal Alcohol Syndrome Disorder, but also counsel families to prevent it.
Cracks in the Ceiling? Historical and Contemporary Trends of African American Deans of Schools of Social Work
Authors: Banks Leon , Hopps June Gary , Briggs Harold E. 
Published: December 2017

This article presents data from an exploratory study of the demographic and published scholarship profiles of the deans and university provosts of the top 50 schools of social work as ranked by the 2016 U.S. News and World Report ratings. Method: The authors used an exploratory design to conduct a content analysis of the demographic and scholarship characteristics of the deans and provosts of the 50 top schools of social work. Results: The data show that the majority of deans and provosts of the top 50 schools of social work are Caucasian. The frequency of mentions of African Americans and other ethnically diverse groups in published articles by deans is uneven. Implications: This study highlights recommendations to enhance the opportunities for deanships among racially diverse faculty and to guide further research that explores the reasons for lack of racially diverse candidates selected as deans of schools of social work.
Congenital Hypothalamic “Hamartoblastoma” Versus “Hamartoma”: Suggestions for Neuropathologic Terminology Emanating From a Mid-gestational Autopsy Case of Pallister-Hall Syndrome
Authors: Dunham C , McFadden D , Dahlgren L , Butler B , Hamilton S , McKinnon M 
Published: December 2017

Pallister-Hall syndrome (PHS) is a rare malformative disorder that is due to truncating functional repressor mutations in GLI3. Since the seminal publication in 1980, hypothalamic tumors have been recognized to be a cardinal feature of PHS. In their original description of the neuropathologic features of PHS, Clarren et al. coined the term “hamartoblastoma” to characterize what they deemed to be a dual malformative and neoplastic mass of the hypothalamus. In subsequent published cases/series of PHS, the term “hamartoma” was often substituted for hamartoblastoma given what appeared to be a benign natural history of this lesion. Additional confusion in the literature has ensued since most hypothalamic hamartomas (HH) encountered on the clinical neuropathology service are “isolated” in nature (ie, no other congenital malformations) and present in a very different and stereotypical fashion with gelastic seizures and/or precocious puberty. While genomic investigations of isolated HH have begun to uncover a mutational profile of these cases, GLI3 mutations have only been recognized in a small subset of isolated HH. Herein, we describe the autopsy findings from a 21-week gestational age fetus with features of PHS. Moreover, we provide a detailed description of the hypothalamic tumor affecting this fetus and propose a novel subclassification of HH, distinguishing syndromic from isolated forms based upon the presence or absence of neocortical-like areas.
GPU-based computational modeling of magnetic resonance imaging of vascular structures
Authors: Jurczuk Krzysztof , Kretowski Marek , Bezy–Wendling Johanne 
Published: December 2017

Magnetic resonance imaging (MRI) is one of the most important diagnostic tools in modern medicine. Since it is a high-cost and highly-complex imaging modality, computational models are frequently built to enhance its understanding as well as to support further development. However, such models often have to be simplified to complete simulations in a reasonable time. Thus, the simulations with high spatial/temporal resolutions, with any motion consideration (like blood flow) and/or with 3D objects usually call for using parallel computing environments. In this paper, we propose to use graphics processing units (GPUs) for fast simulations of MRI of vascular structures. We apply a CUDA environment which supports general purpose computation on GPU (GPGPU). The data decomposition strategy is applied and thus the parts of each virtual object are spread over the GPU cores. The GPU cores are responsible for calculating the influence of blood flow behavior and MRI events after successive time steps. In the proposed approach, different data layouts, memory access patterns, and other memory improvements are applied to efficiently exploit GPU resources. Computational performance is thoroughly validated for various vascular structures and different NVIDIA GPUs. Results show that MRI simulations can be accelerated significantly thanks to GPGPU. The proposed GPU-based approach may be easily adopted in the modeling of other flow related phenomena like perfusion, diffusion or transport of contrast agents.
Accuracy of a point-of-care luteinizing hormone test for help in distinguishing between sexually intact and ovariectomized or castrated domestic cats
Authors: Krecic Matthew R , DiGangi Brian A , Griffin Brenda 
Published: December 2017

Objectives The aim of this study was to determine the accuracy of a commercial luteinizing hormone (LH) test as an aid in distinguishing between sexually intact and ovariectomized or castrated domestic cats. Methods Convenience serum samples collected from sexually intact female and male cats (n = 67) undergoing elective sterilization surgery and archived sera from ovariectomized and castrated cats (n = 54) were tested for LH using a commercial diagnostic assay. Test results were compared with the known reproductive status of the cats. Additionally, sera from sexually intact (n = 54) and ovariectomized (n = 94) queens were collected at specific times of the year to evaluate possible seasonal effects on test results. Results Overall test sensitivity was 89.3% (95% confidence interval [CI] 82.3–94.2%), specificity was 92.6% (95% CI 87.1–96.2%) and accuracy was 91.1%. Analysis of results of female cats (n = 216) – sexually intact (n = 87) and ovariectomized (n = 129) – yielded a test sensitivity of 90.8% (95% CI 82.7–96.0%), a specificity of 92.3% (95% CI 86.2–96.2%) and accuracy of 91.7%. Analysis of the results of male cats (n = 53) – sexually intact (n = 19) and neutered (n = 34) – yielded test a sensitivity of 85.3% (95% CI 68.9–95.1%), a specificity of 94.7% (95% CI 74.0–99.9%) and accuracy of 88.7%. The sera of 10 intact queens unexpectedly yielded positive LH results; two of these cats were in estrus, based on visual inspection at the time of ovariohysterectomy. Test accuracy was 94.6% for those 148 samples collected at specific times of the year, with two samples each over three, 3 month periods yielding false-positive results. Conclusions and relevance The commercial point-of-care LH test is a useful adjunct to historical and physical examination findings for determination of reproductive status in domestic cats. Repeat testing 24 h later should be considered for those female cats with signs of estrus and initial positive test results.
What Is Known About the Psychodermatology Clinic Model of Care? A Systematic Scoping Review
Authors: Zhou Stephanie , Mukovozov Ilya , Chan An-Wen 
Published: December 2017

Background: Psychodermatology focuses on the interaction between skin and mental health. Existing research discusses the recognition and treatment of these disorders. However, little is known about the operational structure of subspecialised psychodermatology clinics. Objective: To identify literature on the structure and logistics of delivering a psychodermatology service. Methods: A systematic search of MEDLINE, PsycINFO, Embase, and Google Scholar was performed. Articles were included if they discussed the concept and organisation of a psychodermatology practice. Results: We identified 693 studies; after screening titles and abstracts, 35 full-text articles were assessed, and 17 were included in the scoping review. Most articles discussed aspects of clinic organisation in general; others discussed management of a clinic in the context of specific diseases or made recommendations on incorporating psychotherapeutic techniques in a solo practitioner setting. A weekly multidisciplinary clinic or resident teaching clinic with joint dermatologist-psychiatrist consultation is the most commonly reported model. Specifically, a stepped level of care approach is often used, where patients in increasing level of distress are stratified to the appropriate team of trained professionals. A corresponding curriculum to supplement practitioners’ knowledge is recommended. Conclusions: Various clinic models have been described to provide specialised psychodermatology care in specific settings. Research is needed to assess the impact of these multidisciplinary models of care on patient outcomes and health care costs.
The processing of the object marker a by heritage Spanish speakers
Authors: Jegerski Jill 
Published: December 2017

Objectives: Previous research has found that object marking with the Spanish particle a is variable among heritage Spanish speakers, based on data from offline experimental measures. The online self-paced reading method used for the present study has the advantage of being less metalinguistic, which may be important with heritage speakers. This incremental measure of sentence processing can also examine whether the single letter form a is simply skipped over during reading. Methodology: Thirty-two heritage Spanish speakers and 16 later Spanish-English bilinguals participated. Critical stimuli were 20 items testing a marking with direct objects and 20 items testing a marking of indirect objects in ditransitive constructions. Data and analysis: The data set included reading times from self-paced reading, accuracy for post-stimulus comprehension questions, and secondary data from an offline acceptability judgment, all of which were analyzed via ANOVAs by subject and by item. Findings: Both groups exhibited robust sensitivity to a marking of indirect objects, sensitivity to a marking with inanimate direct objects, and no sensitivity to a marking with animate direct objects. Originality: This is the first study to examine the real-time processing of object marking among heritage Spanish speakers. It is the second study to include a comparison group of late Spanish-English bilinguals in the US, as opposed to monolinguals residing abroad. Significance: Incremental data from online processing indicate that the visual nonsalience of the marker a is not the sole or primary cause of variability in the marking of animate direct objects, because it was noticed in other written sentential contexts. In addition, the similarity between the two participant groups shows that variability with differential object marking is not limited to heritage speakers, but can also occur among US Spanish users educated abroad, where incomplete acquisition is not a question.