bluuebunny/crossref_metadata_2025_split huggingface dataset:
Parsing apart the persisters: Etiological mechanisms and criminal offense patterns of moderate- and high-level persistent offenders
Authors: Amemiya Jamie , Vanderhei Susan , Monahan Kathryn C. 
Published: July 2016

AbstractLongitudinal investigations that have applied Moffitt's dual taxonomic framework to criminal offending have provided support for the existence of adolescent-limited and life-course persistent antisocial individuals, but have also identified additional trajectories. For instance, rather than a single persistent trajectory, studies have found both high-levelandmoderate-level persistent offenders. To inform theory and progress our understanding of chronic antisocial behavior, the present study used a sample of serious adolescent offenders (N=1,088) followed from middle adolescence to early adulthood (14–25 years), and examined how moderate-level persistent offenders differed from low-rate, desisting, and high-level persistent offenders. Results indicated that moderate-level persisters' etiology and criminal offense patterns were most similar to high-level persisters, but there were notable differences. Specifically, increasing levels of contextual adversity characterized both moderate-level and high-level persisting trajectories, but moderate-level persisters reported consistently lower levels of environmental risk. While both high- and moderate-level persisters committed more drug-related offenses in early adulthood compared to adolescence, moderate-level persisters engaged in lower levels of antisocial behavior across all types of criminal offenses. Taken cumulatively, the findings of this study suggest that sociocontextual interventions may be powerful in reducing both moderate- and high-level persistence in crime.
How does restricted and repetitive behavior relate to language and cognition in typical development?
Authors: Larkin Fionnuala , Meins Elizabeth , Centifanti Luna C. M. , Fernyhough Charles , Leekam Susan R. 
Published: July 2016

AbstractRelations between restricted and repetitive behavior at age 26 months and children's concurrent (N = 203) and later (n = 161) social cognition and language development were investigated. Restricted and repetitive behavior was assessed using two scales: sensory and motor repetitive behaviors and rigidity/routines/restricted interests. Language was assessed at ages 26 and 51 months; social cognition was assessed at ages 26 (symbolic play) and 51 and 61 months (theory of mind). Sensory and motor repetitive behavior was negatively related to children's (a) language performance at 26 and 51 months, (b) instructed symbolic play at 26 months, and (c) theory of mind performance at 51 and 61 months. Path analyses showed that children's sensory and motor repetitive behavior at age 26 months was related to lower receptive verbal ability and theory of mind at 51 months, which led to lower theory of mind at 61 months. Rigidity/routines/restricted interests at 26 months were unrelated to concurrent and later social cognition and language. These results are discussed in terms of the pathways via which sensory and motor repetitive behavior might impact negatively on development.
A cascade from disregard for rules of conduct at preschool age to parental power assertion at early school age to antisocial behavior in early preadolescence: Interplay with the child's skin conductance level
Authors: Kochanska Grazyna , Brock Rebecca L. , Boldt Lea J. 
Published: July 2016

AbstractYoung children's disregard for conduct rules (failing to experience discomfort following transgressions and violating adults' prohibitions) often foreshadows future antisocial trajectories, perhaps in part because it elicits more power-assertive parental discipline, which in turn promotes children's antisocial behavior. This process may be particularly likely for children with low skin conductance level (SCL). In 102 two-parent community families, we tested a model in which children's SCL, assessed at 8 years, was posed as a moderator of the cascade from children's disregard for conduct rules at 4.5 years to parents' power assertion at 5.5 and 6.5 years to antisocial behavior at 10 and 12 years. Children's disregard for conduct rules was observed in scripted laboratory paradigms, parents' power assertion was observed in discipline contexts, and children's antisocial behavior was rated by parents. Conditional process analyses revealed that the developmental cascade from early disregard for rules to future parental power assertion to antisocial outcomes occurred only for the children with low SCL (below median), but not their high-SCL (above median) peers. By elucidating the specific interplay among children's disregard for rules, the parenting they receive, and their psychophysiology, this study represents a developmentally informed, multilevel approach to early etiology of antisocial behavior.
Time-varying effects of families and peers on adolescent marijuana use: Person–environment interactions across development
Authors: Epstein Marina , Hill Karl G. , Roe Stephanie S. , Bailey Jennifer A. , Iacono William G. , McGue Matt , Kristman-Valente Allison , Catalano Richard F. , Haggerty Kevin P. 
Published: July 2016

AbstractStudies have demonstrated that the effects of two well-known predictors of adolescent substance use, family monitoring and antisocial peers, are not static but change over the course of adolescence. Moreover, these effects may differ for different groups of youth. The current study uses time-varying effect modeling to examine the changes in the association between family monitoring and antisocial peers and marijuana use from ages 11 to 19, and to compare these associations by gender and levels of behavioral disinhibition. Data are drawn from the Raising Healthy Children study, a longitudinal panel of 1,040 youth. The strength of association between family monitoring and antisocial peers and marijuana use was mostly steady over adolescence, and was greater for girls than for boys. Differences in the strength of the association were also evident by levels of behavioral disinhibition: youth with lower levels of disinhibition were more susceptible to the influence of parents and peers. Stronger influence of family monitoring on girls and less disinhibited youth was most evident in middle adolescence, whereas the stronger effect of antisocial peers was significant during middle and late adolescence. Implications for the timing and targeting of marijuana preventive interventions are discussed.
Skeleton composition versus stable process systems in Eden
Authors: DIETERLE M. , HORSTMEYER T. , LOOGEN R. , BERTHOLD J. 
Published: July 2016

AbstractWe compare two inherently different approaches to implement complex process systems in Eden:stable process systemsand acompositionalapproach. Astable process systemis characterised by handling several computation stages in each of the participating processes. Often, processes communicate using streams of data, change behaviour with the different computation phases, and more often than not, exactly one process is allocated to each processor element. In contrast, a complex process system can also be achieved byskeleton compositionof a number of elementary skeletons, such as parallel transformation, reduction, or special communication patterns. In a compositional implementation, each computation phase leads to a new set of interacting processes. When implementing complex parallel algorithms, skeleton composition is usually easier and more flexible, but has a larger overhead from additional process creation and communication. We present case studies of different parallel application kernels implemented as stable systems and using composition in Eden, including a comprehensive description of Eden's features. Our results show that the compositional performance loss can be alleviated by co-locating processes which directly communicate, and by using Eden's remote data concept to enable such direct communication. Moreover, Eden's parallel runtime system handles communication between co-located processes in an optimised way. EdenTV visualisations of execution traces are invaluable to analyse program characteristics and for targeted optimisations towards better process placement and communication avoidance.
The Tie That Binds: Exploring Community College Curriculum Design
Authors: Gentry Bobbi , Lawrence Christopher , Richards Erin 
Published: July 2016

ABSTRACTMore students are beginning their college careers at community colleges before completing degrees at four-year institutions. As enrollments swell at these two-year institutions, issues surrounding transfer and articulation agreements are increasingly important, and two- and four-year institutions must work together on the recruitment, retention, and transition of political science majors. Central to this collaboration is the curriculum. Building on conclusions from the 2011 Leadership Collaborative Core Curriculum and General Education track regarding a common curriculum in the discipline, this article examines the political science curriculum using data from 47 two-year colleges with separate political science departments. We examined similarities and differences among these programs and found sufficient commonality in curriculum to allow students to transfer credits to four-year institutions. The article also offers community colleges an indication of common curricular features and informs the wider profession about community college curriculum design.
Characteristics associated with the application of an ecological approach to preventing childhood obesity
Authors: Stark Christina M , Devine Carol M , Dollahite Jamie S 
Published: July 2016

AbstractObjectiveApplying an ecological approach to childhood obesity prevention requires a new way of thinking and working for many community-based practitioners who are used to focusing on individual behaviour change. The present study investigated individual and organizational characteristics associated with the application of an ecological approach by practitioners 6 months post-training.DesignIndividual and organizational characteristics and outcomes of a 6-week online training course were assessed at pre-course, post-course and 6-month follow-up. The application of an ecological approach was measured by three outcomes (application of course content, implementation of an action plan and trying a different approach) and analysed using a generalized estimating equation model with a binomial distribution and logit link and linear mixed models.SettingAn online course for participants in the USA and abroad.SubjectsPublic health nutrition and youth development educators and their community partners, and other community practitioners, who completed the course and all three surveys (n 240).ResultsOne individual characteristic (networking utility) and three organizational characteristics (ecological approach within job scope, funding, course content applied to work) were positively and significantly associated with the application of an ecological approach (P<0·05). Individual characteristics that were negatively and significantly associated with the application of an ecological approach were being a registered dietitian and having ≥16 years of work experience (P<0·05).ConclusionsTraining of community practitioners and the scope and funding of their positions should explicitly emphasize the usefulness or utility of networking and the use of an ecological approach for preventing childhood obesity.
Education scholarship in emergency medicine part 1: innovating and improving teaching and learning
Authors: Sherbino Jonathan , van Melle Elaine , Bandiera Glen , McEwen Jill , LeBlanc Constance , Bhanji Farhan , Frank Jason R. , Regehr Glenn , Snell Linda 
Published: July 2016

ABSTRACTAs emergency medicine (EM) education evolves, a more advanced understanding of education scholarship is required. This article is the first in a series of three articles that reports the recommendations of the 2013 education scholarship consensus conference of the Academic Section of the Canadian Association of Emergency Physicians. Adopting the Canadian Association for Medical Education's definition, education scholarship (including both research and innovation) is defined. A rationale for why education scholarship should be a priority for EM is discussed.
Education scholarship in emergency medicine part 2: supporting and developing scholars
Authors: Bandiera Glen , LeBlanc Constance , Regehr Glenn , Snell Linda , Frank Jason R. , Sherbino Jonathan 
Published: July 2016

ABSTRACTEmergency medicine (EM) is defined, in part, by clinical excellence across an immense breadth of content and the provision of exemplary bedside teaching to a wide variety of learners. The specialty is also well-suited to a number of emerging areas of education scholarship, particularly in relation to team-based learning, clinical reasoning, acute care response, and simulation-based teaching. The success of EM education scholarship will be predicated on systematic, collective attention to providing the infrastructure for this to occur. Specifically, as a new generation of emergency physicians prepares for education careers, academic organizations need to develop means not only to identify potential scholars but also to mentor, support, and encourage theircareers. This paper summarizes the supporting literature and presents related recommendations from a 2013 consensus conference on EM education scholarship led by the Academic Section of the Canadian Association of Emergency Physicians.
Medical role of first responders in an urban prehospital setting
Authors: Berringer Ross , Christenson Jim , Blitz Maurice , Spinelli John , Freeman Jeff , Maddess Glenn , Rae Sandra 
Published: July 2016

ABSTRACT:

Background:
Almost all North American cities have first responder programs. To date there is no published documentation of the roles first responders play, nor of the frequency and type of interventions they perform. Many urban stakeholders question the utility and safety of routinely dispatching large vehicles emergently to calls that may not require their services. Real world data on first responder interventions will help emergency medical services (EMS) directors and planners determine manpower requirements, assess training needs, and optimize dispatch protocols to reduce the rate of inappropriate “code 3” (lights and siren) responses.

Objective:
Our objectives were to determine how often first responders arrive first on scene, to estimate the time interval between first response and EMS response, and to examine the frequency and type of interventions performed by first responders.

Methods:
In a prospective observational study, trained observers were assigned to fire department first responder (FDFR) units. These observers recorded on-scene times for FDFR and EMS units, and documented the performance of first responder interventions.

Results:
FDFRs arrived first on scene in 49% of code 3 calls. They performed critical interventions in 18% of calls attended and 36% of calls where they arrived first. Oxygen administration was the most frequent critical intervention, yet occult hypoxemia was common and compliance with oxygen administration protocols was poor.

Conclusions:
First responders perform critical interventions during a minority of code 3 calls, even when “critical” is defined generously. Many “lights and siren” dispatches are unnecessary. Future research should attempt to identify dispatch criteria that more accurately predict the need for first responder intervention. First responder training and continuous quality improvement (CQI) should focus on interventions that are performed with some regularity, particularly oxygen administration.
Manpower crisis in emergency medicine: Can residency programs make an impact?
Authors: Steiner Ivan P. , Yoon Philip W. , Holroyd Brian R. 
Published: July 2016

RÉSUMÉ :
Une étude sur la main-d’œuvre canadienne menée en 1994 avait prédit une pénurie à l’échelle nationale de 562 médecins d’urgence qualifiés avant 2001. Plusieurs facteurs ont changé depuis la publication de ces données; cependant, aucun n’a changé l’ordre de grandeur de cette pénurie. À la lumière de ces renseignements, on a étudié la situation de la Edmonton Capital Health Region (CHR) et évalué l’impact des programmes de résidence en MU de l’Université de l’Alberta (CRMC [Collège Royal des médecins et chirurgiens du Canada] et CMFC [Collège des médecins de famille du Canada], créés en 1992) sur les besoins locaux en main-d’œuvre.
Le nombre de médecins d’urgence certifiés dans la CHR est passé de 9 du CRMC-MU et 2 du CMFC-MU en 1990 à 14 du CRMC-MU et 16 du CMFC-MU en 1999, soit une augmentation de 27 %. Le gain le plus important provenait du recrutement de 14 diplômés en médecine d’urgence de la région; cependant, malgré ce succès, et même avec un recrutement de 100 % des diplômés de l’Université de l’Alberta, on constate encore une pénurie importante de médecins d’urgence dans la CHR.
Cette situation n’est pas unique. Elle est le résultat d’un nombre insuffisant de postes de formations en médecine d’urgence au Canada. La seule solution possible à long terme serait d’augmenter considérablement le nombre de postes de résidence du CRMC tout en maintenant, et dans certaines juridictions en augmentant, le nombre de diplômés du CMFC.
Is early discharge safe after naloxone reversal of presumed opioid overdose?
Authors: Etherington Jeremy , Christenson James , Innes Grant , Grafstein Eric , Pennington Sarah , Spinelli John J. , Gao Min , Lahiffe Brian , Wanger Karen , Fernandes Christopher 
Published: July 2016

ABSTRACT

Introduction:
Patients with suspected opioid overdose frequently require naloxone treatment. Despite recommendations to observe such patients for 4 to 24 hours after naloxone, earlier discharge is becoming more common. This prospective, observational study of patients with presumed opioid overdose examines the safety of early disposition decisions and the accuracy of outcome prediction by physicians 1 hour after the administration of naloxone.

Methods:
The study was carried out at St. Paul’s Hospital, an inner city teaching centre that cares for most of the injection drug users in Vancouver, BC. Patients were formally assessed 1 hour after receiving naloxone for presumed opioid overdose. Demographics, medical history and physical examination were documented on specific data forms, and physicians recorded their comfort with early discharge. Patients were followed up, and those who required a critical intervention or suffered a pre-defined adverse event (AE) within 24 hours of their 1-hour assessment were identified.

Results:
Of 573 patients, 48% were discharged in less than 2 hours, 23% in 2–4 hours and 29% in &gt;4 hours. 94 patients who were held in the emergency department (ED) or admitted required a critical intervention, including supplemental oxygen for hypoxia (74), repeat naloxone (52), antibiotics administered intravenously (IV) (14), assisted ventilations (13), fluid bolus for hypotension (12), charcoal for associated life-threatening overdose (6), IV inotropic agents (2), antiarrhythmics for sustained tachycardia &gt;130 beats/min (1), and administration of bicarbonate for arterial [HCO3] &lt;5 or venous CO2 &lt;5 (1). Physicians predicted adverse events with 94% sensitivity and 59% specificity. No discharged patients suffered a serious AE within 24 hours of ED discharge.

Conclusions:
Emergency physicians can clinically identify patients at risk of deterioration after naloxone reversal of suspected opioid overdose. Prolonged observation or hospital admission is not usually required. Selective early discharge of patients with presumed opioid overdose is feasible and appears safe. A clinical prediction rule may be useful in identifying patients eligible for early discharge.
Resource contribution by Canadian faculties of medicine to the discipline of emergency medicine
Authors: Steiner Ivan P. , Yoon Philip W. , Goldsand George , Rowe Brian H. 
Published: July 2016

ABSTRACTObjective:Undergraduate and postgraduate emergency medicine (EM) education has developed rapidly over the last 20 years. Our objective was to establish a national educational inventory, cataloguing the human and financial resources provided to EM programs by Canadian faculties of medicine.Methods:A 17-question survey was distributed to all 27 Canadian EM program directors, representing 11 Royal College of Physicians and Surgeons of Canada (RCPSC) programs and 16 College of Family Physicians of Canada (CFPC-EM) programs. The questionnaire addressed teaching responsibilities, teaching support and academic support in each program.Results:All 27 program directors returned valid questionnaires. Annually, an estimated 3,049 students and residents participate in EM learning. This includes 1,369 undergraduates (45%), 1,621 postgraduates (53%) and 59 others (2%). Of the postgraduates, 173 are EM residents — 92 (53%) in RCPSC programs and 81 (47%) in CFPC-EM programs. Overall, 587 EM faculty teach residents and students, but only 36 (6%) of these hold academic geographical full time positions. At the university level, all 16 CFPC-EM programs are administered by departments of family medicine. Of 11 RCPSC programs, 1 has full departmental status, 2 are free-standing divisions, 3 are administered through family medicine, 3 through medicine, 1 through surgery and 1 by other arrangements. Currently 8 programs (30%) have associate faculty, 14 (52%) have designated research directors and 10 (37%) describe other human resources. Sixteen (59%) programs receive direct financial and administrative support and 17 (63%) receive financial support for resident initiatives. Only 8 program directors (30%) perceive that they are receiving adequate support.Conclusions:Despite major teaching and clinical responsibilities within the faculties of medicine, Canadian EM programs are poorly supported. Further investment of human and financial and human resources is required.
Prehospital vs. emergency department pronouncement of death: a cost analysis
Authors: Cheung Mathew , Morrison Laurie , Richard Verbeek P. 
Published: July 2016

ABSTRACT

Objective:
National survival rates for out-of-hospital cardiac arrests are less than 5%, and substantial resources are associated with transporting cardiac arrest victims to hospital for emergency department (ED) resuscitation. The low overall survival rate and the identification of predictors of unsuccessful resuscitation have opened debate on the “futility” of transporting such patients to the ED. This study compares the costs of prehospital pronouncement of death to the costs of transporting patients to a hospital ED for physician pronouncement.

Methods:
The study was a retrospective chart review on a matched cohort of out-of-hospital cardiac arrest patients. Patients were included if documentation was adequate and ambulance response time was less than 8 minutes. A cohort of 20 patients pronounced dead in the field were matched to 20 patients pronounced dead in an ED. Cases were matched on 6 evidence-based predictors of unsuccessful resuscitation. Direct medical costs and mean physician and prehospital provider times were compared.

Results:
The total cost of pronouncement of death in the ED was $45.35 higher than the cost of field pronouncement (p &lt; 0.001). Paramedics spent more time delivering care when death was pronounced in the field (83.3 vs. 55.9 min; p &lt; 0.001). Base hospital physicians spent more time when patients were transported to hospital for ED pronouncement (16.3 vs. 4.3 min; p &lt; 0.001). Total provider time for field pronouncement was 15.5 min longer (p = 0.004), but field pronouncement consumed 12.0 min less physician time.

Conclusions:
Paramedic pronouncement of death in the field is less costly than transporting patients to hospital for physician pronouncement. Pronouncement in the field requires more paramedic time but less physician time.