bluuebunny/crossref_metadata_2025_split huggingface dataset:
High-resolution Anorectal Manometry in Parkinson Disease With Defecation Disorder
Authors: Yu Ting , Wang Yun , Wu Gaojue , Xu Qinrong , Tang Yurong , Lin Lin 
Published: January 2016

Goal:
To investigate the characteristics of high-resolution anorectal manometry (HR-ARM) in Parkinson disease (PD) patients with defecation disorder (DD) compared with patients with functional defecation disorder (FDD).

Background:
DD is a common gastrointestinal symptom in PD. HR-ARM is a relatively new and reliable method for detecting DD.

Study:
A cohort of PD patients with DD was matched with FDD patients. Defecatory symptoms were investigated by questionnaire. Anorectal motility and sensation were evaluated by HR-ARM. Differences in defecatory symptoms, sensorimotor parameters, and DD type were analyzed. Defecatory symptoms and manometric variables obtained in early-stage PD were compared with advanced stage, and relationships between manometric parameters and evacuatory symptoms explored.

Results:
Straining and sensation of blockage was experienced significantly more in PD than FDD, and stool consistency more severely affected. Maximum squeeze and intrarectal pressure during defecation in PD was lower than in FDD. Anal resting and residual pressures, duration of sustained squeeze, threshold volumes for first sensation, urgency, and maximum discomfort were similar between groups. PD patients presented predominantly with inadequate propulsive forces, whereas FDD patients showed dyssynergic defecation. Defecatory symptoms and manometric parameters did not differ between stages of PD.

Conclusions:
PD patients with DD experienced more straining and sensation of blockage than FDD patients, possibly related to inadequate anorectal motility and paradoxical anal contraction of pelvic floor. Impaired squeeze response and inadequate propulsive forces are specific to anorectal function of PD patients with DD, compared with FDD, with abnormalities unchanged between early and advanced PD.
Systemic Prophylactic Antibiotics for the Modified Introducer Method for Percutaneous Endoscopic Gastrostomy
Authors: Adachi Yasushi , Akino Kimishige , Mita Hiroaki , Kikuchi Takefumi , Yamashita Kentaro , Sasaki Yasushi , Arimura Yoshiaki , Endo Takao 
Published: January 2016

Background:
Percutaneous endoscopic gastrostomy (PEG) is the most common method of enteral nutrition in patients who require long-term tube feeding. According to meta-analyses, administration of systemic prophylactic antibiotics for PEG reduces peristomal infection. However, with several recent developments in the procedure and instruments, the risk of infection might have been reduced. The aim of this study was to evaluate the use of systemic antibiotic prophylaxis for a modified introducer method of PEG.

Methods:
This prospective, randomized, double-blind trial assessed 278 patients undergoing PEG for inclusion. Ninety-one patients with an indication for PEG who gave informed consent to participate were randomized. Forty-six patients received prophylactic ampicillin and 45 patients received a placebo. A modified introducer method of PEG using a Seldinger PEG kit was performed. The primary outcome was the occurrence of clinically evident wound infection within 3 days after PEG.

Results:
Wound infection within 3 days was observed in none in the prophylaxis group and in 1 patient in the control group (P=0.4945). There was no significant difference between 2 groups in the other parameters, including peristomal infection within 7 days, overall infection, white blood cell counts, C-reactive protein level, and successive rate of finishing antibiotics.

Conclusions:
For wound infection within 3 days, noninferiority of the placebo group to the antibiotics group was preliminarily suggested with our criteria, but not for peristomal infection within 7 days. More strict criteria for noninferiority should be examined in a further large sample study.
Characteristics of Rib Fractures in Child Abuse—The Role of Low-Dose Chest Computed Tomography
Authors: Sanchez Thomas R. , Grasparil Angelo D. , Chaudhari Ruchir , Coulter Kevin P. , Wootton-Gorges Sandra L. 
Published: January 2016

Objectives
Our aim is to describe the radiologic characteristics of rib fractures in clinically diagnosed cases of child abuse and suggest a complementary imaging for radiographically occult injuries in highly suspicious cases of child abuse.

Methods
Retrospective analysis of initial and follow-up skeletal surveys and computed tomography (CT) scans of 16 patients younger than 12 months were reviewed after obtaining approval from our institutional review board. The number, location, displacement, and age of the rib fractures were recorded.

Results
Out of a total 105 rib fractures, 84% (87/105) were detected on the initial skeletal survey. Seventeen percent (18/105) were seen only after follow-up imaging, more than half of which (11/18) were detected on a subsequent CT. Majority of the fractures were posterior (43%) and anterior (30%) in location. An overwhelming majority (96%) of the fractures are nondisplaced.

Conclusions
Seventeen percent of rib fractures analyzed in the study were not documented on the initial skeletal survey. Majority of fractures are nondisplaced and located posteriorly or anteriorly, areas that are often difficult to assess especially in the acute stage. The CT scan is more sensitive in evaluating these types of fractures. Low-dose chest CT can be an important imaging modality for suspicious cases of child abuse when initial radiographic findings are inconclusive.
Applying to Integrated Plastic Surgery Residency Programs: Trends in the Past 5 Years of the Match
Authors: Tadisina Kashyap Komarraju , Orra Susan , Bassiri Gharb Bahar , Kwiecien Grzegorz , Bernard Steven , Zins James E. 
Published: January 2016

Background:
The average integrated plastic surgery applicant spends over $6000 for interviews. The average program director reviews over 200 applications per cycle. It is important to make the application process efficient and cost effective for both applicants and programs. The authors analyzed recent trends and the literature in an attempt to increase the likelihood that applicants match, suggest means of reducing applicants’ costs, and improve the process.

Methods:
A cross-sectional study of the National Residency Matching Program Charting Outcomes and results and data for the years 2009 to 2014 was performed. Applicant profile elements were examined for differences between matched/unmatched U.S. senior medical students. In addition, a literature review was performed.

Results:
The number of integrated plastic surgery positions rose from 69 in 2010 to 130 in 2014. Both matched and unmatched U.S. senior medical students have higher Step 2 scores, research and volunteer experiences, than 5 years ago. The likelihood of matching into an integrated plastic surgery residency has increased (2009, 52 percent; 2011, 44 percent; and 2014, 71 percent). Successful match rates were associated with Alpha Omega Alpha status and graduating from a top-40 ranked medical school (p < 0.05). Applicants with a lower number of ranked programs had increased match rates in 2014 than in previous years. Literature review revealed that program directors also value strong recommendation letters, publications, persistent work ethic (“grit”), away rotations, and an accurate curriculum vitae.

Conclusions:
Within the setting of increased applicant competitiveness, the authors recommend maximizing subjective qualities in order to differentiate themselves from a highly eligible applicant pool. In addition, applicants should diversify the types of programs at which they interview to maximize their chances of matching.
The Potential of Twitter as a Data Source for Patient Safety
Authors: Nakhasi Atul , Bell Sarah G. , Passarella Ralph J. , Paul Michael J. , Dredze Mark , Pronovost Peter J. 
Published: January 2016

Background
Error-reporting systems are widely regarded as critical components to improving patient safety, yet current systems do not effectively engage patients. We sought to assess Twitter as a source to gather patient perspective on errors in this feasibility study.

Methods
We included publicly accessible tweets in English from any geography. To collect patient safety tweets, we consulted a patient safety expert and constructed a set of highly relevant phrases, such as “doctor screwed up.” We used Twitter’s search application program interface from January to August 2012 to identify tweets that matched the set of phrases. Two researchers used criteria to independently review tweets and choose those relevant to patient safety; a third reviewer resolved discrepancies. Variables included source and sex of tweeter, source and type of error, emotional response, and mention of litigation.

Results
Of 1006 tweets analyzed, 839 (83%) identified the type of error: 26% of which were procedural errors, 23% were medication errors, 23% were diagnostic errors, and 14% were surgical errors. A total of 850 (84%) identified a tweet source, 90% of which were by the patient and 9% by a family member. A total of 519 (52%) identified an emotional response, 47% of which expressed anger or frustration, 21% expressed humor or sarcasm, and 14% expressed sadness or grief. Of the tweets, 6.3% mentioned an intent to pursue malpractice litigation.

Conclusions
Twitter is a relevant data source to obtain the patient perspective on medical errors. Twitter may provide an opportunity for health systems and providers to identify and communicate with patients who have experienced a medical error. Further research is needed to assess the reliability of the data.
Does Physician's Training Induce Overconfidence That Hampers Disclosing Errors?
Authors: Brezis Mayer , Orkin-Bedolach Yael , Fink Daniel , Kiderman Alexander 
Published: January 2016

Purpose
Although transparency is critical for reducing medical errors, physicians feel discomfort with disclosure. We explored whether overconfidence relates to physician's reluctance to admit that an error may have occurred.

Method
At 3 university medical centers, a survey presented a clinical vignette of a girl with urinary infection and penicillin allergy to medical students and physicians, asking them to rate their level of confidence for each step of the diagnosis and management. After anaphylaxis develops after cephalosporin administration, respondents were asked about their willingness to admit that an error might have occurred and to rate their level of discomfort in doing so. We analyzed levels of confidence, accuracy, willingness to admit mistake, and discomfort.

Results
Respondents reported high levels of confidence for their answers to the questions of diagnosis and management, even when wrong—indicating miscalibration of confidence and accuracy. Compared with students, physicians had significantly higher levels of confidence, lower accuracy, and lower willingness to admit mistake. Although most respondents agreed in principle that errors should be disclosed, in the presented case, significantly less agreed to admit that a mistake might have occurred or to say so explicitly to the family. An association was found between overconfidence and discomfort with disclosure.

Conclusions
Our study shows overconfidence associated with clinician's training and with reluctance to admit mistake, suggesting a contributing role to the difficulty in leveraging safety events into quality improvement. Training physicians to have both knowledge and adequate self-doubt is an educational challenge.
A Systems Approach to Analyzing and Preventing Hospital Adverse Events
Authors: Leveson Nancy , Samost Aubrey , Dekker Sidney , Finkelstein Stan , Raman Jai 
Published: January 2016

Objective
This study aimed to demonstrate the use of a systems theory-based accident analysis technique in health care applications as a more powerful alternative to the chain-of-event accident models currently underpinning root cause analysis methods.

Method
A new accident analysis technique, CAST [Causal Analysis based on Systems Theory], is described and illustrated on a set of adverse cardiovascular surgery events at a large medical center. The lessons that can be learned from the analysis are compared with those that can be derived from the typical root cause analysis techniques used today.

Results
The analysis of the 30 cardiovascular surgery adverse events using CAST revealed the reasons behind unsafe individual behavior, which were related to the design of the system involved and not negligence or incompetence on the part of individuals. With the use of the system-theoretic analysis results, recommendations can be generated to change the context in which decisions are made and thus improve decision making and reduce the risk of an accident.

Conclusions
The use of a systems-theoretic accident analysis technique can assist in identifying causal factors at all levels of the system without simply assigning blame to either the frontline clinicians or technicians involved. Identification of these causal factors in accidents will help health care systems learn from mistakes and design system-level changes to prevent them in the future.
Career barriers influencing career success
Authors: Santos Gina Gaio 
Published: January 2016

Purpose– Few research has addressed the factors that undermine people’s subjective perceptions of career success. Hence, the purpose of this paper is to further illuminate the issue of career barriers in perceptions of career success for a specific group of professionals: academics.Design/methodology/approach– This study adopts an interpretative-social constructionist methodology. Complementarily, it was employed a phenomenological method in data gathering and analysis – with the use of in-depth interviews and a theme analysis. The research was undertaken with a group of 87 Portuguese academics of both sexes and in different stages of their academic careers.Findings– The findings pinpoint the existence of multi-level barriers encountered by the academics when trying to succeed in their careers. The interviewees mentioned particularly the organizational-professional career barriers pertaining to three general themes: poor collegiality and workplace relationships; the lack of organizational support and employment precariousness; and the career progression standards and expectations. At the individual life cycle level the interviewees referred to the theme of finding balance; at the same time, the gender structure was also a theme mentioned as an important career barrier in career success, particularly by the women interviewed.Research limitations/implications– One of the limitations of this research is related to the impossibility of generalizability of its findings for the general population. Nevertheless, the researcher provides enough detail that grants the reader with the ability to judge of its similarity to other research contexts.Practical implications– This research highlights the role played by distinct career barriers for a specific professional group: academics. This has implications for higher education policy-makers and for human resources managers in higher education institutions.Originality/value– The current study extends the literature on career success by offering detailed anecdotal evidence on how negative work experiences might hinder career success. This research shows that to understand career barriers to success it is useful to consider multi-level factors: organizational-level factors (e.g. poor collegiality and workplace relationships); individual-level factors (e.g. life-cycle factors such as age/career stage); and structural-level factors (e.g. gender).
Burnout and the work-family interface
Authors: Robinson Laura D. , Magee Christopher , Caputi Peter 
Published: January 2016

Purpose
– The purpose of this paper is to examine whether work-to-family conflict (WFC) and work-to-family enrichment (WFE) predicted burnout in working mothers using conservation of resources theory. The authors also examined whether these relationships varied between sole and partnered working mothers.

Design/methodology/approach
– In total, 516 partnered and 107 sole mothers in paid employment completed an online survey twice, six months apart.

Findings
– WFC was significantly positively related to burnout, and WFE significantly negatively related to burnout. Marital status moderated the inverse relationship between WFE and personal burnout, and this relationship was significant for partnered mothers only.

Research limitations/implications
– Limitations include self-report data, and the sample being highly educated thereby limiting generalizability.

Practical implications
– Providing an enriching and supportive work environment may be an important strategy for minimizing burnout in mothers, particularly for sole mothers.

Social implications
– Employed sole mother’s risks of burnout may be higher than for other mothers even when experiencing WFE, which can have implications for their functioning and for family well-being.

Originality/value
– This two-wave study is the first to highlight that sole mothers, who are at risk of greater socio-economic disadvantages, do not benefit from WFE to the same degree as partnered mothers. Future work-family and burnout research should further examine differences based family structure.
Mid-career as a process of discovery
Authors: Maddox-Daines Kay 
Published: January 2016

Purpose– The purpose of this paper is to explore the mid-career experience of female managers within a small higher education institution in the UK. It considers how managers manage “self” within this phase of career.Design/methodology/approach– This study takes an ethnographic approach to the exploration of experiences in mid-career. Using a relational approach it was possible to draw together new insights deriving from the data. A narrative approach provided the framework from which deeper insights were captured through detailed participant stories toldin situ.Findings– This study offers a deep analysis of the constructs of management experience as these are negotiated within mid-career. The priority of female managers in this study is directed towards the balance of home and work. There is less evidence of a desire for upward progression, instead the focus now shifts to the achievement of authenticity and balance.Research limitations/implications– This study was conducted in the higher education sector in the UK which is noted for its increasing commercialisation agenda and low staff turnover. Undertaking comparable research in other sectors will provide further insights into the generalisability of findings. Managers in this study were wholly white, middle class and most are still working in the region in which they were born. A more diverse cohort may be studied to ascertain the importance attributable to balance of work and life across different groups.Practical implications– This study presents some important areas of consideration for those involved in the support and advancement of female managers. Indeed, for those engaged in cognitive and developmental work this study provides rich and in-depth qualitative data that may prove helpful when formulating policy. It is of significance to senior managers within organisations and encourages attention towards executive development and organisational culture, both of which support the retention of talent within the organisation.Social implications– This paper provides insights into middle and senior management practice that may be of use by policy makers in the wider higher education sector context, as well as in general management good practice discussions more widely. This study may also be of interest to aspiring female managers and those relatively new to their roles as they seek to position themselves to achieve a sense of authenticity within their organisations.Originality/value– This study provides an empirical contribution to the study of female managers working within a small higher education institution in the UK. It provides deep insights into management practice at mid-career within the workplace and the way in which this is conceivedin situ.
A balance model of theoretical sustainability – framework and propositions
Authors: Eriksson David , Svensson Göran 
Published: January 2016

PurposeThis paper aims to describe and discuss a balance model of theoretical business sustainability, to leverage the inferior side, so as to enhance performance.Design/methodology/approachA conceptual description and discussion are provided, along with an empirical depiction.FindingsThe empirical illustration presents one organization that embodies the goals of theoretical business sustainability in the marketplace and society.Research limitations/implicationsFurther research is needed to enhance our understanding of the phenomenon and performance of business sustainability in supply chains.Practical implicationsFindings highlight that there is no justification for practitioners to strive consistently for anything other than theoretical business sustainability, and stakeholders need to push organizations in that direction.Originality/valueThe paper contributes to our understanding of what should be done and why business sustainability performance should be improved in supply chains.
CSR governance and departmental organization: a typology of best practices
Authors: Lock Irina , Seele Peter 
Published: January 2016

Purpose
This paper aims to study the state of the art of corporate social responsibility (CSR) governance and operational structure within the most sustainable companies to arrive at a typology of CSR organization. Whether companies consider corporate social responsibility (CSR) a strategic management task is mirrored in the department and governance structure of CSR.

Design/methodology/approach
By conducting a web content analysis, the authors apply a “best practice” approach to examine the vertical and horizontal organization of CSR within the “most sustainable companies worldwide” (Robeco SAM, 2013).

Findings
The results show that most corporations have in place governance structures for CSR that organize it horizontally in stand-alone departments. Three types of CSR organization best practice emerged: the single-headed, two-headed and infused types.

Practical implications
The paper indicates three different ways that companies can organize CSR internally. The authors discuss the feasibility of such organization for large and small companies and their day-to-day business.

Originality/value
The paper addresses the under-researched area of vertical and horizontal CSR organization at the micro level. The authors analyze the state of the art of organizational and governance structures of CSR in the most sustainable companies and deduce three types of CSR governance and operational architecture.