bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of Implementation of Practice Standards for Electrocardiographic Monitoring With Nurses’ Knowledge, Quality of Care, and Patient Outcomes
Authors: Funk Marjorie , Fennie Kristopher P. , Stephens Kimberly E. , May Jeanine L. , Winkler Catherine G. , Drew Barbara J. , Borman Barbara , Calcasola Stephanie , Carey Mary , Currie Laura , Davis Leslie , Fitzpatrick Eleanor , Fleischman Rhonda , Hawkins Darice , Hazlewood Elise , Henry Rebecca , Honess Cindy , Kalowes Peggy , Ann Kearns Sharon , Leeper Bobbi , Liggett Joseph , Lusardi Paula , Lynn Carol , Man Manbo , McCauley Kathleen , Hing Mei , Pang Anita , Parkosewich Janet , Phillips JoAnne , Robinson Anne , Salazar Noraliza , Sandau Kristin , Piper Sandoval Cass , Sangkachand Prasama , Shaffer Rose , Sherrard Heather , Smith Maureen , Stamm Rebecca , Strang Vickie , Tee Nancy , Wells Krisna , White Paula 
Published: February 2017

Background—
Although continuous electrocardiographic (ECG) monitoring is ubiquitous in hospitals, monitoring practices are inconsistent. We evaluated implementation of American Heart Association practice standards for ECG monitoring on nurses’ knowledge, quality of care, and patient outcomes.

Methods and Results—
The PULSE (Practical Use of the Latest Standards of Electrocardiography) Trial was a 6-year multisite randomized clinical trial with crossover that took place in 65 cardiac units in 17 hospitals. We measured outcomes at baseline, time 2 after group 1 hospitals received the intervention, and time 3 after group 2 hospitals received the intervention. Measurement periods were 15 months apart. The 2-part intervention consisted of an online ECG monitoring education program and strategies to implement and sustain change in practice. Nurses’ knowledge (N=3013 nurses) was measured by a validated 20-item online test, quality of care related to ECG monitoring (N=4587 patients) by on-site observation, and patient outcomes (mortality, in-hospital myocardial infarction, and not surviving a cardiac arrest; N=95 884 hospital admissions) by review of administrative, laboratory, and medical record data. Nurses’ knowledge improved significantly immediately after the intervention in both groups but was not sustained 15 months later. For most measures of quality of care (accurate electrode placement, accurate rhythm interpretation, appropriate monitoring, and ST-segment monitoring when indicated), the intervention was associated with significant improvement, which was sustained 15 months later. Of the 3 patient outcomes, only in-hospital myocardial infarction declined significantly after the intervention and was sustained.

Conclusions—
Online ECG monitoring education and strategies to change practice can lead to improved nurses’ knowledge, quality of care, and patient outcomes.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT01269736.
Propagating Annular Modes: Empirical Orthogonal Functions, Principal Oscillation Patterns, and Time Scales
Authors: Sheshadri Aditi , Plumb R. Alan 
Published: February 2017

Abstract
The two leading empirical orthogonal functions (EOFs) of zonal-mean zonal wind describe north–south fluctuations, and intensification and narrowing, respectively, of the midlatitude jet. Under certain circumstances, these two leading EOFs cannot be regarded as independent but are in fact manifestations of a single, coupled, underlying mode of the dynamical system describing the evolution in time of zonal wind anomalies. The true modes are revealed by the principal oscillation patterns (POPs). The leading mode and its associated eigenvalue are complex, its structure involves at least two EOFs, and it describes poleward (or equatorward) propagation of zonal-mean zonal wind anomalies. In this propagating regime, the principal component (PC) time series associated with the two leading EOFs decay nonexponentially, and the response of the system to external forcing in a given EOF does not depend solely on the PC decorrelation time nor on the projection of the forcing onto that EOF. These considerations are illustrated using results from an idealized dynamical core model. Results from Southern Hemisphere ERA-Interim data are partly consistent with the behavior of the model’s propagating regime. Among other things, these results imply that the time scale that determines the sensitivity of a model to external forcing might be different from the decorrelation time of the leading PC and involves both the rate of decay of the dynamical mode and the period associated with propagation.
Atmospheric Energetics over the Tropical Pacific during the ENSO Cycle
Authors: Dong Di , Li Jianping , Huyan Lidou , Xue Jiaqing 
Published: February 2017

Abstract
The atmospheric perturbation potential energy (PPE) over the tropical Pacific is calculated and analyzed in a composite ENSO cycle. The PPE over the tropical Pacific troposphere increases during El Niño and decreases during La Niña, displaying two centers symmetrical about the equator and delaying the central–eastern Pacific SST anomaly by two months. Generated from atmospheric diabatic heating, the smaller part of PPE in the lower troposphere varies synchronously with the central–eastern Pacific SST through sensible heating, while the larger part of PPE lies in the mid- and upper troposphere and lags the central–eastern Pacific SST about one season because of latent heat release. As the tropical Pacific PPE peaks during the boreal late winter in an El Niño event, two anticyclones form in the upper troposphere as a result of the Gill model response. More PPE is converted to atmospheric kinetic energy (KE) above the central–western Pacific, but less over the eastern Pacific, leading to intensified Hadley circulations over the central–western Pacific and weakened Hadley circulations over the eastern Pacific. The strengthened Hadley circulations cause surface easterly wind bursts through KE convergence in the western equatorial Pacific, which may trigger a La Niña event. The reverse situation occurs during La Niña. Thus, the response of the Hadley circulations in the central–western Pacific provides a negative feedback during the ENSO cycle.
Fractal Analysis of Deep Ocean Current Speed Time Series
Authors: Cabrera-Brito Laura , Rodriguez German , García-Weil Luis , Pacheco Mercedes , Perez Esther , Waniek Joanna J. 
Published: February 2017

AbstractFractal properties of deep ocean current speed time series, measured at a single-point mooring on the Madeira Abyssal Plain at 1000- and 3000-m depth, are explored over the range between one week and 5 years, by using the detrended fluctuation analysis and multifractal detrended fluctuation analysis methodologies. The detrended fluctuation analysis reveals the existence of two subranges with different scaling behaviors. Long-range temporal correlations following a power law are found in the time-scale range between approximately 50 days and 5 years, while a Brownian motion–type behavior is observed for shorter time scales. The multifractal analysis approach underlines a multifractal structure whose intensity decreases with depth. The analysis of the shuffled and surrogate versions of the original time series shows that multifractality is mainly due to long-range correlations, although there is a weak nonlinear contribution at 1000-m depth, which is confirmed by the detrended fluctuation analysis of volatility time series.
Nutritional adequacy of meals from an independent catering facility versus chain restaurants for young adults
Authors: Nikolaou Charoula Konstantia , Hankey Catherine Ruth , Lean Michael Ernest John 
Published: February 2017

Background: Eating out of home has been associated with the increasing prevalence of obesity. While some chain restaurants provide nutritional information for their products, smaller independent catering facilities may not provide such information. The aim of this study was to assess the nutritional adequacy of meals provided to young adults at an independent catering facility and compare them with meals provided by chain restaurants. Methods: Meals were analysed in 2014 in the UK in relation of nutrient provision to targets for macro- and micro-nutrients. One-way ANOVA was performed to compare menus between the restaurants included in the analyses. Results: 2056 meal combinations were analysed, 210 from the student accommodation and 1,846 from five largest national chain restaurants. Mean (SD) nutritional content was: student accommodation: 1193(269)kcal, fat 52.0(22)g, saturated fat 24.5(14.5)g, protein 42.4(28.5)g, carbohydrate 117.0(30)g; chain restaurants: 922(160)kcal, fat 40.0(9.7)g, saturated fat 14.5(5.8)g, protein 31.2(6.5)g, carbohydrate 104.2(16.6)g. Meals from the student accommodation presented significantly more calories than the meals in all five chain restaurants ( p = 0.0015). Conclusions: Meal provision in the student accommodation was in excess of energy requirements and higher than the meals offered in chain restaurants. Regulating or setting nutritional standards for all places that provide food is essential as current food provision may favour unwanted weight gain and diet-related diseases.
The Protection of Privacy between a Rights-Based and a Freedom-Based Approach: What the Swiss Example Can Teach us
Authors: Lemmens Koen 
Published: February 2017

There has been a fierce debate amongst scholars about the way privacy ought to be protected in civil law countries. The key issue at stake is the question whether this protection should be implemented via so-called ‘personality rights’ (i.e. a special category of subjective rights) or whether it would be more appropriate to conceive privacy in terms of fundamental freedoms. It goes without saying that this choice entails important practical and theoretical consequences. In this article, I will first try to summary the different viewpoints, indicating each time the pros and contras. Then, I will deal with the Swiss way of privacy protection, for I believe that it shows clearly that the sketched ‘doctrinal’ opposition should not be overestimated and that it should be possible to conciliate the two approaches to privacy.
Locus Standi of Private Applicants under the Article 230 EC Action for Annulment: Any Lessons to Be Learnt from France?
Authors: De Parfouru Anatole Abaquesne 
Published: February 2017

This article examines the rules on locus standi of private applicants under the Article 230 action for annulment of the EC Treaty. It adopts a comparative approach to the question of standing of private parties to challenge a piece of secondary EC legislation under the action for annulment, by contrasting the standing rules in Article 230(4) EC, as interpreted by the ECJ and the CFI, with those, elaborated by the Conseil d'Etat, on locus standi of private applicants to challenge French administrative acts in a Recours pour Excès de Pouvoir (REP). Four major aspects will be considered: the types of acts amenable to review by non-privileged applicants, the two requirements of direct and individual concern and their equivalent in French administrative law (in particular the differences between the notions of ‘cercle d'intérêt’ and of'closed class'), as well as the locus standi of associations. The premise of this paper lies in the suggestion that ‘a revision of the Treaty which would borrow from the Member States' systems of judicial review should be considered’. Due consideration will be taken of the limits of comparing a supranational legal order to a national one. This comparison should be considered as a pretext to analyse the standing rules for private applicants under the action for annulment, and suggest possible improvements to these conditions in the light of the constitutional reflection on the role of citizens and of the civil society underlying the liberal standing requirements in French administrative law. The objective of this paper is therefore to demonstrate the inappropriateness of the strict locus standi rules for private applicants under Article 230(4) EC, and the refusal to abandon the ‘closed class test’ and the Plaumann formula, even where the applicants constitute a ‘small and easily identifiable group’, as the ECJ made clear in UPA and Jégo-Quéré. The need for reform of standing rules for non-privileged applicants is particularly pressing in light of the inadequacy of alternative mechanisms of judicial review and of the principle of effective judicial protection. In this respect, the modifications of the unratified 2004 Constitutional Treaty were clearly insufficient, and the 2007 Treaty of Lisbon, signed in December, reiterates this mistake by adopting an identical formulation of the standing rules for private applicants to that in the 2004 Constitutional Treaty.
A Law and Economics Perspective on Injunctive Relief
Authors: Ogus Anthony , Visscher Louis 
Published: February 2017

The Law and Economics perspective on injunctive relief has been developed primarily from the Calabresi and Melamed (1972) distinction between property rules and liability rules, two different judicial means of enforcing legal rights. Their analysis is predicated on the assumption that, if the prevention of the unlawful activity by an injunction does not reach an efficient solution between the relevant parties, then the latter can modify the terms of the injunction by means of bilateral negotiation, drawing on Coase's basic analysis. The approach is particularly important once it is appreciated that legal entitlements are imperfectly formulated and that, in appropriate circumstances, legal wrongdoing can increase social welfare. For example, in areas where intellectual property rights are particularly difficult to formulate because of the high technology involved, too rigid an enforcement of those imperfectly targeted rights generates welfare losses. The task for economic analysis is then to determine whether injunctive relief or damages is preferable in the particular circumstances governing the parties' activities. This largely involves comparing on the one hand the welfare losses which arise from imperfect damages awards which arise predominantly where the court has high information costs in assessing the plaintiff's losses (particularly where those losses are subjective and therefore cannot be determined by reference to market evaluation) or include irrecoverable third-party losses with, on the other hand, the transaction costs of negotiating a compromise solution or the welfare losses arising from a holdout (both conditions are likely where more than two parties are involved). One branch of the literature has added a new dimension to this analysis. It is concerned to explore how the choice of remedy ex post affects behaviour ex ante, in particular the propensity to invest. In addition, literature on optimal enforcement provides insights regarding the optimal timing of sanctions, which is relevant for the choice between injunctions (the first possible stage of legal intervention) and damages (the last possible stage).
Enforcing the Right to Property Properly
Authors: Lindenbergh Siewert D. 
Published: February 2017

Of all patrimonial rights, the right to property is considered by far the most powerful. The owner is entitled to the exclusive use of the object, the word ‘use’ is understood in a very wide meaning and the owner has a strong position as far as enforcement of his right is concerned. He can reclaim the object from anyone (revindicatio), he is usually entitled to both positive injunctions (removal of objects from his premises) and prohibitory injunctions (in case of trespass). And finally, when the owner has to put up with infringements, he is entitled to damages. There seems, however, to be quite a gap between the position of the owner who is entitled to an injunction and that of the owner who has to bear infringements and is only entitled to damages. In the first situation (injunction), the owner can vindicate his right according to a property rule which allows him to set the price for infringements. In the second case (damages), the owner is left to compensatory standards. In this paper, the consequences of the substantial shift in protection from an injunction to (different levels of) compensation will be illustrated with examples from the modern civil code of The Netherlands. Dutch law offers examples of different regimes of protection of the owner: a rather strong position (injunctive power) in the area of neighbour law, a relatively strong position in case of expropriation (a generous level of compensation), a typical liability rule (compensation according to objective standards) when a pressing societal interest prohibits injunctive relief, and a weak level of protection in case of a limited restraint of the owners capacity in case of a public development plan (only ‘fair’ compensation). These examples, which show a sliding scale of levels of protection, raise the question whether the right to property is vindicated properly when injunctive power is left for some form of compensation in money. They also raise the question according to which standards of compensation the right to property can and should be adequately protected.
Is Online Mediation the Way to Fit the Forum to the Fuss?
Authors: Lombardi Ettore Maria 
Published: February 2017

Traditional mediation is conducted in person with all affected parties at a physical ‘table’ with a session is orchestrated by the mediator with the parties and their representatives, often utilizing both joint and caucus sessions. Techniques as subtle as non-verbal cues, and techniques as overt as removing one party from the mediation room can be used. Online dispute resolution (ODR) takes place in ‘cyberspace’, described by the US Supreme Court as the virtual world ‘located in no particular geographic location but available to anyone, anywhere in the world, with access to the Internet’ (Reno v. Aclu, 521 U.S. 844, 849 (1997). ODR differs from traditional mediation in at least three ways relating to the formation and resolution of disputes. It represents a virtual community which deconstructs time, space, and the physical. Because it eliminates and changes boundaries it is important to rethink the traditional paradigms for resolving conflict and create opportunities for design of an interest-based dispute resolution model for the internet. This article discusses the differences between traditional mediation and ODR and with an online mediation conducted like traditional mediation, in which a neutral human third party facilitates discussions between the parties and helps them reach a voluntary settlement.
The New Approach to the New Approach: The Juridification of Harmonized Standards in EU Law
Authors: Schapel Harm 
Published: February 2017

In July 2012, the Court of Justice rendered the judgment in Fra.bo, a case about the liability of a German private standards body under the free movement of goods. In October 2012, the European Parliament and Council adopted Regulation 1025/2012 on European Standardization, the long awaited formal legal framework for the cooperation between the Commission and the European Standards Organizations. It is very unlikely that either the Court or the Union legislators were planning in these instances to affect a radical overhaul of the New Approach to technical harmonization. And yet, that is exactly what they did. The result of Fra.bo and the new Regulation is to subject European harmonized standards to judicial challenge by any disgruntled manufacturer of products excluded or adversely affected by the contents of such a standard. To have each and every manufacturer or importer complain in each and every court of the Union about each and every harmonized standard that adversely affects its position on the market, however, is much more likely to lead to wholesale paralysis than it is to increase the procedural integrity of European standardization.
The Employee Shareholder
Authors: de Gioia-Carabellese Pierre 
Published: February 2017

The aim of this paper is to discuss and analyse the impact of the new category of the employee shareholder within the context of the traditional theory of the contract of service and contract for services. A commentary on the provisions of the Growth and Infrastructure Act 2013 which heralded the introduction of the employee shareholder category will be provided in addition to a focus on the implied duties traditionally applied to personal employment contracts. One of the themes of the analysis is to assess whether and how these duties will apply to the future hybrid (and obscure) statutory construct of the ‘employee shareholder’. To provide a comparative analysis, this contribution will also briefly examine whether any potential counterpart of the new British concept exists in Italian law. Finally, the paper will discuss possible flaws in the British legislation concerning employee shareholders, by taking an approach that is disarticulated from the traditional theory of employment law. One such issue concerns the systematic offer of shares and acceptance of the loss of employee status, which may render the EU law requirements of publication of a prospectus and communication of a redundancy plan to the trade unions redundant.
Noninvasive tongue stimulation combined with intensive cognitive and physical rehabilitation induces neuroplastic changes in patients with multiple sclerosis: A multimodal neuroimaging study
Authors: Leonard Gabriel , Lapierre Yves , Chen Jen-Kai , Wardini Rima , Crane Joelle , Ptito Alain 
Published: February 2017

Background Multiple sclerosis (MS) patients have central nervous system (CNS) lesions that may impede cognitive and sensorimotor function. Few rehabilitative therapies are available. Objectives The objective of this paper is to study effects of noninvasive tongue stimulation using the Portable Neuromodulation Stimulator (PoNS™) combined with intensive cognitive and physical rehabilitation on working memory, gait, balance and concomitant changes in the brain. Methods Fourteen MS patients, seven each in an active and a sham stimulation group, participated. Participants received intensive physical therapy and working memory training for 14 weeks. Functional magnetic resonance imaging (fMRI) using motor imagery and working-memory tasks were completed prior to and following therapy, as were sensory organization tests (SOT), motor performance measures, and neuropsychological assessment. Results On the SOT, the active group showed significant improvement from baseline. fMRI revealed significant blood oxygen level-dependent signal changes in the left primary motor cortex for the Active Group, while the sham group had increased activity in bilateral premotor cortices. All individuals improved on working-memory tasks, but only the active group showed increased dorsolateral prefrontal cortex activity. Conclusions In this cohort of MS patients, the results suggest that PoNS stimulation can enhance motor performance and working memory while also driving neuroplasticity. Further studies are warranted to explore these findings.