bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preparation of Three‐Dimensional Chitosan–Graphene Oxide Aerogel for Residue Oil Removal
Authors: Guo Xiaoqing , Qu Lijun , Zhu Shifeng , Tian Mingwei , Zhang Xiansheng , Sun Kaikai , Tang Xiaoning 
Published: July 2016

ABSTRACT: Graphene oxide has been used as an adsorbent in wastewater treatment. However, the hydrophily and dispersibility in aqueous solution limit its practical application in environmental protection. In this paper, a novel, environmentally friendly adsorbent, chitosan and chitosan–graphene oxide aerogels with a diverse shape, large specific surface area, and unique porous structure were prepared by a freeze‐drying method. The structure of the adsorbents was investigated using scanning electron microscopy, Fourier transform‐infrared spectroscopy, and X‐ray diffraction (XRD); the specific surface area and swelling capability were also characterized. In addition, removal of diesel oil from seawater by chitosan aerogel (CSAG) and chitosan–graphene oxide aerogel (AGGO‐1 and AGGO‐2) was studied and batch adsorption experiments were carried out as a function of different adsorbent dosages (0–6 g), contact time (0–120 minutes), pH (3–9), and initial concentrations of oil residue (3–30 g/L) to determine the optimum condition for the adsorption of residue oil from seawater. The results showed that the chitosan–graphene oxide aerogels were more effective to remove diesel oil from seawater compared with pure chitosan aerogel. A removal efficiency ≥ 95% of the chitosan–graphene oxide aerogels could be achieved easily at the initial concentrations of 20 g/L, which indicated that the chitosan–graphene oxide aerogels can be used to treat the industrial oil leakage or effluent in the natural water.
Az Európai Unió liberalizált energiapiaca
Authors: Sztankó Éva 
Published: July 2016

Az egységes európai energiapiac – az elmúlt években tapasztalható előrelépések ellenére – még nem valósult meg. Az energiahálózatok teljes körű integrációja és a nemzeti piacok teljes megnyitása érdekében további alapvető változtatásokra van szükség, hogy az energiaellátás biztonságos, alacsony költségű és fenntartható lehessen. Ehhez a meglévő hálózatok korszerűsítése mellett ki kell építeni a keresleti és a kínálat oldal rugalmasságát is biztosító integrált infrastruktúrát; ez alapvető feltétele annak, hogy új technológiák, új szereplők és komplementer szolgáltatók jelenjenek meg a piacon. A következő elemzés áttekinti a piaci integráció eredményeit, a liberalizációt még hátráltató korlátokat és a lehetséges kezelési módokat. A változásokat kiváltó okok ismertetése mellett kísérletet tesz az európai energiaszektorban végbemenő jelentős átalakulások és a legfontosabb feladatok bemutatására is.
Journal of Economic Literature (JEL) kódok: Q40, Q41, Q49
Huszonegy közgazdasági érv a feltétel nélküli alapjövedelemmel szemben
Authors: Csillag István , Mihályi Péter 
Published: July 2016

Összeurópai szinten és Magyarországon is élénk társadalmi vita folyt 2013/2014 fordulóján a feltétel nélküli alapjövedelem (FNA) intézményének megvalósíthatóságáról. Ennek a diskurzusnak fontos állomása volt egy, a magyar viszonyokra adaptált 100 oldalas koncepció megjelenése. A Bánfalvi István nevével fémjelzett tanulmány alapgondolata, hogy 2015-től alanyi jogon minden gyermek 25 ezer, minden felnőtt 50 ezer, illetve minden várandós nő 75 ezer forintot kapjon. A jelen tanulmány egyfelől konkrét bírálatát adja ennek a 25–50–75 javaslatnak, másfelől igyekszik szélesebb statisztikai keretek között vizsgálni a jövedelmi szegénység magyarországi adatait. A tanulmány végkövetkeztetése az, hogy a szegénység csökkentése szempontjából a kistelepülésekre bezsúfolódott roma népesség újramobilizálása a jövő kulcskérdése.
Journal of Economic Literature (JEL) kódok: H21, I38, J15
A tudásintenzív üzleti szolgáltatások innovációs jellemzői
Authors: Nagy Sándor 
Published: July 2016

A cikk a szolgáltatások innovációs megközelítéséből kiindulva lehatárolja a tudásintenzív üzleti szolgáltatásokat, összefoglalja azok innovációs jellemzőit. Megállapítja, hogy az egyes szolgáltatási tevékenységeknél más szektorokhoz viszonyítva hiányoznak az ösztönzéshez szükséges intézményi és egyéb formális támogató rendszerek, amelyek nemcsak tudásközpontokként szolgálhatnának a vállalkozások számára, hanem hozzájárulhatnának az innovációk védelméhez és terjedéséhez is. A szellemi tulajdonnak a szolgáltatások körében hiányzó hatékony védelme (a termelő szektorral ellentétben) nagy kockázatot jelent, ami gátolja az optimális tudástranszfert, és pazarló, duplikált innovációs erőfeszítéseket okoz.
Journal of Economic Literature (JEL) kódok: O31, O32, L84
Az állami újraelosztás és a gazdasági növekedés hosszú távú összefüggései
Authors: Nádasi Levente 
Published: July 2016

Jelen tanulmány célja, hogy intézményi, történeti, modellszerű és statisztikai megközelítésben tanulmányozza az állami újraelosztás mértékének változását, és azt, egyes országokban az újraelosztás változásamilyen hatással van a hosszú távú gazdasági növekedésre. Általánosan kijelenthető, hogy Európában az 1870-es évek óta napjainkig folyamatosan (trendjét tekintve) nő a kormányzati kiadások GDP-hezviszonyított aránya. Megvizsgálom, milyen csatornákon keresztül hat az állam mérete a gazdasági növekedésre, illetve milyen egyéb tényezők befolyásolják a két változó hosszú távú kapcsolatának természetét. Hipotézisem szerint a fejlett államokban a magas állami újraelosztás hosszú távon már gátolja a gazdasági növekedést. Ezt igyekszem belátni 30 európai ország statisztikai elemzéséből is.
Journal of Economic Literature (JEL) kódok: E66, H62, C10
Dispatches from the front: emergency medicine teachers' perceptions of competency-based education
Authors: Bandiera Glen , Lendrum David 
Published: July 2016

ABSTRACTObjectives:Controversy exists regarding the applicability of competency-based education during clinical rotations in emergencymedicine (EM). Little has been written about the perceptions of front-line teachers regarding one such competencybased education paradigm, the CanMEDS framework. We undertook to determine 1) what perceptions exist among frontline teachers at two academic health science emergency departments (EDs) regarding the use of the CanMEDS roles to frame what residents should learn on ED rotations and 2) how those same teachers envision practically incorporating the CanMEDS roles into feedback provided to residents.Methods:Teachers at two sites volunteered for a semistructured focus group study. Focus groups were moderated by an experienced qualitative researcher, and verbatim transcriptions were coded by two independent reviewers. The codes were merged into final themes. The final focus group was used to further explore issues raised and test assumptions made in the preceding groups.Results:In five focus groups involving 21 participants, the Medical Expert and Professional roles were seen as most relevant to an EM rotation, whereas the Health Advocate, Manager, Scholar, and Collaborator roles were least relevant. On further exploration, however, faculty identified highly relevant components of each role that they could envision teaching in an ED. Participants also felt that the framework helped highlight the breadth of physician competencies and provided structure for teaching and feedback.Conclusions:EM faculty find the CanMEDS framework helpful for structuring teaching and learning and that many elements of the roles, when defined, are feasible to integrate into a clinical rotation.
An unusual case of pediatric abdominal pain
Authors: Bjoernsen Lars P. , Lindsay M. Bruce 
Published: July 2016

ABSTRACTChronic and recurrent abdominal pains are common complaints in children and adolescents, but the evaluation in the emergency department (ED) can be challenging. We present a rare yet serious case of a 17-year-old white female who presented to the ED with a 2-day history of diffuse abdominal pain, nausea, and intractable vomiting. Abdominal examination and imaging, including computed tomography (CT), were negative during an episode 6 weeks previously. This was her fifth similar episode in a 2-month period, and she had been seen at three different hospitals and admitted on each occasion. Three days prior to presentation to our ED, she was seen at a gastroenterology clinic and diagnosed with irritable bowel syndrome and an ovarian cyst. Symptomatic therapy during the current presentation, with intravenous fluids, antiemetics, and parenteral narcotics, failed to alleviate her abdominal pain and vomiting. Emergent CT evaluation revealed a high-grade colonic obstruction with focal circumferential narrowing in the transverse colon and a lower gastrointestinal follow-through radiograph with Gastrografin enema showed a classic “apple-core” lesion. Colonic adenocarcinoma with positive regional lymph nodes was found during emergent exploratory laparotomy. Pediatric patients with recurrent, episodic abdominal pain should undergo systematic evaluation and symptomatic treatment. A previous negative workup should not dissuade emergency physicians from proceeding with a systematic and thorough evaluation of the pediatric patient presenting with abdominal pain and vomiting.
Examination of staphylococcal stethoscope contamination in the emergency department (pilot) study (EXSSCITED pilot study)
Authors: Tang Patrick H.P. , Worster Andrew , Srigley Jocelyn A. , Main Cheryl L. 
Published: July 2016

ABSTRACT

Introduction:
The objective of this study was to determine the prevalence of Staphylococcus-contaminated stethoscopes belonging to emergency department (ED) staff and to identify the proportion of these that were Staphylococcus aureus or methicillin-resistant Staphylococcus aureus (MRSA).

Methods:
We conducted a prospective observational cohort study of bacterial cultures from 100 ED staff members' stethoscopes at three EDs. Study participants were asked to complete a questionnaire.

Results:
Fifty-four specimens grew coagulase-negative staphylococci and one grew methicillin-susceptible S. aureus. No MRSA was cultured. Only 8% of participants, all of whom were nurses, reported cleaning their stethoscope before or after each patient assessment. Alcohol-based wipes were most commonly used to clean stethoscopes. A lack of time, being too busy, and forgetfulness were the most frequently reported reasons for not cleaning the stethoscope in the ED.

Conclusions:
This study indicates that although stethoscope contamination rates in these EDs are high, the prevalence of S. aureus or MRSA on stethoscopes is low.
Impact of a teaching attending physician on medical student, resident, and faculty perceptions and satisfaction
Authors: Cassidy-Smith Tara N. , Kilgannon J. Hope , Nyce Andrew L. , Chansky Michael E. , Baumann Brigitte M. 
Published: July 2016

ABSTRACT:Objectives:To determine if a dedicated teaching attending for medical student education improves medical student, attending physician, and resident perceptions and satisfaction.Methods:Two dedicated teaching attending physician shifts were added to the clinical schedule each week. A before-after trial compared medical student evaluations from 2000 to 2004 (preteaching attending physician) to medical student evaluations from 2005 to 2006 (teaching attending physician). Attending physician and resident perceptions and satisfaction with the teaching attending physician shifts using a 5-point Likert-type scale (1 = poor to 5 = excellent) were also assessed.Results:Eighty-nine (100%) medical students participated, with 63 preteaching attending physician and 26 teaching attending physician rotation evaluations. The addition of teaching attending physician shifts improved mean medical student satisfaction with bedside teaching (4.1 to 4.5), lecture satisfaction (4.2 to 4.8), preceptor scores (4.3 to 4.8), and perceived usefulness of the rotation (4.5 to 5.0) (allp&lt; 0.05). Thirteen attending physicians (93%) participated in the crosssectional questionnaire. The addition of teaching attending physician shifts improved faculty ratings of their medical student interactions by ≥ 1.5 points for all items (p≤ 0.001). Faculty perceptions of their resident interactions improved for quality of bedside teaching (3.1 to 4.0), their availability to hear resident presentations (3.4 to 4.2), and their supervision of residents (3.4 to 4.1) (p≤ 0.01). Residents (n= 35) noted minor improvements with the timeliness of patient dispositions, faculty bedside teaching, and attending physician availability.Conclusions:The addition of select teaching attending physician shifts had the greatest effect on medical student and faculty perceptions and satisfaction, with some improvements for residents.
Iatrogenic bacterial meningitis: an unmasked threat
Authors: Barnwell Robert , Ball Vincent 
Published: July 2016

ABSTRACT
Iatrogenic bacterial meningitis (IBM) is a rare but serious complication of neuraxial procedures, such as spinal and epidural anesthesia or lumbar puncture. We report a case of a 46-year-old female who presented to the emergency department with bacterial meningitis after spinal anesthesia. We reviewthe existing literature outlining the pathogenesis, vector hypothesis, diagnosis, treatment, and prevention as they relate to IBM. We highlight the role of the emergency physician in the rapid diagnosis of this disease, and underscore the need for sterile technique when performing lumbar punctures.
Residents-as-teachers: a survey of Canadian specialty programs
Authors: Patocka Catherine , Meyers Christine , Delaney J. Scott 
Published: July 2016

ABSTRACTIntroduction:The ability to teach is a critical component of residency and future practice. This is recognized by the Royal College of Physicians and Surgeons of Canada, which incorporates teaching functions into the CanMEDS competencies. The aim of our study was to identify how emergency medicine specialty programs across Canada prepare their residents for roles as teachers and to compare these results to those of other Royal College specialty programs.Methods:A 40-item English questionnaire was developed and translated into French. It was e-mailed to the program directors of all Royal College Emergency Medicine (EM), Anesthesia, Diagnostic Radiology, General Surgery, Internal Medicine, Obstetrics and Gynecology, Pediatrics, and Psychiatry residency programs. The survey asked what modalities were in use to teach residents how to teach and allowed respondents to comment on recent changes.Results:Twelve of 13 (92%) EM programs and 78 of 113 (69%) other specialty programs responded. All responding programs incorporated some kind ofmandatory teaching responsibilities. Four of 12 (33%) EM programs reserved formal teaching functions for postgraduate year 3 and above, whereas only 7 of 78 (9%) other specialty programsdid so. The remaining 71 of 78 (91%) non-EM specialty programs incorporated formal teaching functions in all years of residency. Six of 12 (50%) EM programs offered rotations in clinical medical education compared to only 11 of 78 (14%) other specialty programs.Conclusions:Canadian EM programs appear to differ from other specialty programs in the way that they develop residents-as-teachers. Half of EM programs offer rotations in clinical medical education, and many introduce formal teaching functions later in residency.
International Federation for Emergency Medicine model curriculum for emergency medicine specialists
Authors:   The Core Curriculum and Education Committee for the International Federation for Emergency Medicine
Published: July 2016

ABSTRACT
To meet a critical and growing need for emergency physicians and emergency medicine resources worldwide, physicians must be trained to deliver time-sensitive interventions and lifesaving emergency care. Currently, there is no globally recognized, standard curriculum that defines the basic minimum standards for specialist trainees in emergency medicine. To address this deficit, the International Federation for Emergency Medicine (IFEM) convened a committee of international physicians, health professionals, and other experts in emergency medicine and international emergency medicine development to outline a curriculum for training of specialists in emergency medicine. This curriculum document represents the consensus of recommendations by this committee. The curriculum is designed to provide a framework for educational programs in emergency medicine. The focus is on the basic minimum emergency medicine educational content that any emergency medicine physician specialist should be prepared to deliver on completion of a training program. It is designed not to be prescriptive but to assist educators and emergency medicine leadership to advance physician education in basic emergency medicine no matter the training venue. The content of this curriculum is relevant not just for communities with mature emergency medicine systems but in particular for developing nations or for nations seeking to expand emergency medicine within the current educational structure. We anticipate that there will be wide variability in how this curriculum is implemented and taught. This variability will reflect the existing educational milieu, the resources available, and the goals of the institutions' educational leadership with regard to the training of emergency medicine specialists.
How do I find a point-of-care answer to my clinical question?
Authors: Worster Andrew , Haynes R. Brian 
Published: July 2016

ABSTRACT
Emergency physicians often need point-of-care access to current, valid information to guide patient management. Most emergency physicians do not work in a hospital with a computerized decision support system that prompts and provides them with information to answer their clinical questions. Searching for answers to clinical questions online, especially those related to diagnosis and treatment, can be challenging, in part because determining the validity and clinical applicability of the results of individual studies is beyond the time constraints of most emergency physicians. This article describes currently available point-of-care sources of evidence-based information to answer clinical questions and provides the access information for each.
Survey of emergency physicians’ requirements for a clinical decision rule for acute respiratory illnesses in three countries
Authors: Perry Jeffrey J. , Goindi Reena , Symington Cheryl , Brehaut Jamie , Taljaard Monica , Schneider Sandra , Stiell Ian G. 
Published: July 2016

ABSTRACT

Objective:
There are currently no widely used guidelines to determine which older patients with acute respiratory conditions require hospital admission. This study assessed the need for clinical decision rules to help determine whether hospital admission is required for patients over 50 years for three common respiratory conditions: chronic obstructive pulmonary disease (COPD), heart failure (HF), and community-acquired pneumonia (CAP).

Design:
Postal survey.

Setting:
Emergency physicians (EPs) from the United States, Canada, and Australasia.

Participants:
A random sample of EPs from the United States, Canada, and Australasia.

Interventions:
A modified Dillman technique with a prenotification letter and up to three postal surveys.

Main Outcomes:
EP opinions regarding the need for and willingness to use clinical decision rules for emergency department (ED) patients over 50 years with COPD, HF, or CAP to predict hospital admission. We assessed the required sensitivity of each rule for return ED visit or death within 14 days.

Results:
A total of 801 responses from 1,493 surveys were received, with response rates of 55%, 60%, and 46% for Australasia, Canada, and the United States, respectively. Over 90% of EPs reported that they would consider using clinical decision rules for HF, CAP, and COPD. The median required sensitivity for death within 14 days was 97 to 98% for all conditions.

Conclusions:
EPs are likely to adopt highly sensitive clinical decision rules to predict the need for hospital admission for patients over 50 years with COPD, HF, or CAP.
Patients' satisfaction and wait times at Guelph General Hospital Emergency Department before and after implementation of a process improvement project
Authors: Preyde Michèle , Crawford Kim , Mullins Laura 
Published: July 2016

ABSTRACTObjective:A process improvement program (PIP) was implemented in the emergency department (ED) at Guelph General Hospital in July 2009. The purpose of this study was to examine patients' satisfaction and wait times by level of Canadian Triage and Acuity Scale (CTAS) score before and 6 months after implementation of this program.Methods:Two samples were recruited: one was recruited before implementation of the PIP, January to June 2009 (T1), and one was recruited 6 months after implementation, January to June 2010 (T2). Patients were contacted by telephone to administer a survey including patient satisfaction with quality of care. Time to physician initial assessment, numbers left without being seen, and length of stay (LOS) were obtained from hospital records to compare wait times before and 6 months after implementation of the PIP.Results:Patients (n = 301) reported shorter wait times after implementation (e.g., 12% reported seeing a physician right away at T1 compared to 29% at T2). Time to physician initial assessment improved for patients with CTAS scores of III, IV, and V (average decrease from 2.1 to 1.7 hours), fewer patients (n = 425) left without being seen after implementation, and the mean and 90th percentile of LOS decreased for all patients except the mean LOS for discharged patients with a CTAS score of I. Total time spent in the ED for admitted patients decreased from 11.11 hours in the 2009 period to 9.95 in the 2010 period, and for nonadmitted patients, the total time decreased from 3.94 to 3.29 hours. The overall satisfaction score improved from a mean of 3.17 to 3.4 (of 4; p &lt; 0.001).Conclusion:Implementation of the ED PIP corresponded with decreased wait times, increased patient satisfaction, and improved patient flow for patients with CTAS scores of III, IV, and V.
Are patients willing to remove, and capable of removing, their own nonabsorbable sutures?
Authors: Macdonald Peter , Primiani Nadia , Lund Adam 
Published: July 2016

ABSTRACTObjectives:Providing patients with instructions and equipment regarding self-removal of nonabsorbable sutures could represent a new efficiency in emergency department (ED) practice. The primary outcome was to compare the proportion of patients successfully removing their own sutures when provided with suture removal instructions and equipment versus the standard advice and follow-up care. Secondary outcomes included complication rates, number of physician visits, and patient comfort level.Methods:This prospective, controlled, single-blinded, pseudorandomized trial enrolled consecutive ED patients who met the eligibility criteria (age &gt; 19 years, simple lacerations, nonabsorbable sutures, immunocompetent). The study group was provided with wound care instructions, a suture removal kit, and instructions regarding suture self-removal. The control group received wound care instructions alone. Outcomes were assessed by telephone contact at least 14 days after suturing using a standardized questionnaire.Results:Overall, 183 patients were enrolled (93 in the intervention group; 90 in the control group). Significantly more patients performed suture self-removal in the intervention group (91.5%; 95% CI 85.4–97.5) compared to the control group (62.8%; 95% CI 52.1–73.6) (p&lt; 0.001). Patients visited their physician less often in the intervention group (9.8%; 95% CI 3.3–16.2) compared to the control group (34.6%; 95% CI 24.1–45.2%) (p&lt; 0.001). Complication rates were similar in both groups.Conclusion:Most patients are willing to remove, and capable of removing, their own sutures. Providing appropriate suture removal instructions and equipment to patients with simple lacerations in the ED appears to be both safe and acceptable.