bluuebunny/crossref_metadata_2025_split huggingface dataset:
“We're Almost Guests in Their Clinical Care”: Inpatient Provider Attitudes Toward Chronic Disease Management
Authors: Blecker Saul , Meisel Talia , Dickson Victoria Vaughan , Shelley Donna , Horwitz Leora I. 
Published: March 2017

BACKGROUNDMany hospitalized patients have at least 1 chronic disease that is not optimally controlled. The purpose of this study was to explore inpatient provider attitudes about chronic disease management and, in particular, barriers and facilitators of chronic disease management in the hospital.METHODSWe conducted a qualitative study of semi‐structured interviews of 31 inpatient providers from an academic medical center. We interviewed attending physicians, resident physicians, physician assistants, and nurse practitioners from various specialties about attitudes, experiences with, and barriers and facilitators towards chronic disease management in the hospital. Qualitative data were analyzed using constant comparative analysis.RESULTSProviders perceived that hospitalizations offer an opportunity to improve chronic disease management, as patients are evaluated by a new care team and observed in a controlled environment. Providers perceived clinical benefits to in‐hospital chronic care, including improvements in readmission and length of stay, but expressed concerns for risks related to adverse events and distraction from the acute problem. Barriers included provider lack of comfort with managing chronic diseases, poor communication between inpatient and outpatient providers, and hospital‐system focus on patient discharge. A strong relationship with the outpatient provider and involvement of specialists were facilitators of inpatient chronic disease management.CONCLUSIONSProviders perceived benefits to in‐hospital chronic disease management for both processes of care and clinical outcomes. Efforts to increase inpatient chronic disease management will need to overcome barriers in multiple domains.
The Unmet Need for Postacute Rehabilitation Among Medicare Observation Patients: A Single‐Center Study
Authors: Goldstein Jennifer N. , Schwartz J. Sanford , McGraw Patricia , Banks Tobias L. , Hicks LeRoi S. 
Published: March 2017

BACKGROUNDMedicare beneficiaries admitted under observation status must pay for postacute inpatient rehabilitation (PAIR) services, out of pocket, at potentially prohibitive costs.OBJECTIVETo determine if there is an unmet need for PAIR among Medicare observation patients and if this care is associated with longer hospital stay and increased rehospitalization.DESIGN/SETTINGObservational study using electronic medical record and administrative data from a regional health system.PATIENTS1323 community‐dwelling Medicare patients admitted under observation status.MEASUREMENTSSummary statistics were calculated for demographic and administrative variables. Physical therapy (PT) and case management recommendations for a representative sample of 386 medical records were reviewed regarding need for PAIR services. Linear regression was used to measure the association between PT recommendation and hospital length of stay, adjusting for ICD‐9 (International Classification of Diseases, Ninth Revision) diagnosis, age, sex, and provider. Chi‐square test was used to determine the association between PT recommendation and 30‐day hospital revisit.RESULTSOf the 1323 study patients, 11 (0.83%) were discharged to PAIR facilities. However, 17 (4.4%) of the 386 patients whose charts were reviewed received a recommendation for this care. Adjusted mean hospital stay was longer (P < 0.001) for patients recommended for rehabilitation (75.9 h) than for patients with no PT needs (46.8 h). In addition, the 30‐day hospital revisit rate was higher (P = 0.037) for the patients who had been recommended for rehabilitation (52.9%, 9/17) than for those who had not (25.4%, 30/118).CONCLUSIONSMedicare observation patients' potential need for PAIR services is 5‐ to 6‐fold higher than their use of these services. Observation patients recommended for this care may have worse outcomes.
Hospital Medicine Resident Training Tracks: Developing the Hospital Medicine Pipeline
Authors: Sweigart Joseph R. , Tad‐y Darlene , Kneeland Patrick , Williams Mark V. , Glasheen Jeffrey J. 
Published: March 2017

BACKGROUNDHospital medicine (HM) is rapidly evolving into new clinical and nonclinical roles. Traditional internal medicine (IM) residency training likely does not optimally prepare residents for success in HM. Hospital medicine residency training tracks may offer a preferred method for specialized HM education.METHODSInternet searches and professional networks were used to identify HM training tracks. Information was gathered from program websites and discussions with track directors.RESULTSThe 11 HM tracks at academic medical centers across the United States focus mostly on senior residents. Track structure and curricular content are determined largely by the structure and curricula of the IM residency programs in which they exist. Almost all tracks feature experiential quality improvement projects. Content on healthcare economics and value is common, and numerous track leaders report this content is expanding from HM tracks into entire residency programs. Tracks also provide opportunities for scholarship and professional development, such as workshops on abstract creation and job procurement skills. Almost all tracks include HM preceptorships as well as rotations within various disciplines of HM.CONCLUSIONSHM residency training tracks focus largely on quality improvement, health care economics, and professional development. The structures and curricula of these tracks are tightly linked to opportunities within IM residency programs. As HM continues to evolve, these tracks likely will expand to bridge clinical and extra‐clinical gaps between traditional IM training and contemporary HM practice.
Inhibitory effects of vancomycin and fosfomycin on methicillin-resistant Staphylococcus aureus from antibiotic-impregnated articulating cement spacers
Authors: Yuenyongviwat V. , Ingviya N. , Pathaburee P. , Tangtrakulwanich B. 
Published: March 2017

Objectives Vancomycin and fosfomycin are antibiotics commonly used to treat methicillin-resistant Staphylococcus aureus (MRSA) infection. This study compares the in vitro inhibitory effects against MRSA of articulating cement spacers impregnated with either vancomycin or fosfomycin. Methods Vancomycin-impregnated articulating cement spacers and fosfomycin-impregnated articulating cement spacers were immersed in sterile phosphate-buffered saline (PBS) solutions and then incubated. Samples were collected for bioactivity evaluation. The aliquots were tested for MRSA inhibition with the disc diffusion method, and the inhibition zone diameters were measured. The inhibition zone differences were evaluated using the Wilcoxon Rank Sum Test. Results The vancomycin group had significantly larger inhibition zones than the fosfomycin group from day three through to completion of the fourth week of incubation (p < 0.001). The vancomycin group exhibited a MRSA inhibition zone up to four weeks but the fosfomycin group showed an inhibition zone for only three days and after that did not show the the potential to inhibit MRSA. Conclusion This in vitro study found that the inhibitory effect of vancomycin-impregnated articulating cement spacers against MRSA outperformed fosfomycin-impregnated articulating cement spacers. Further comparing our results to other published reports suggests there might be a limitation of the disc diffusion bioassay to show a large inhibitory zone in a high concentration of a highly soluble antibiotic. Cite this article: V. Yuenyongviwat, N. Ingviya, P. Pathaburee, B. Tangtrakulwanich. Inhibitory effects of vancomycin and fosfomycin on methicillin-resistant Staphylococcus aureus from antibiotic-impregnated articulating cement spacers. Bone Joint Res 2017;6:132–136. DOI: 10.1302/2046-3758.63.2000639.
The effect of systemic administration of G-CSF on a full-thickness cartilage defect in a rabbit model MSC proliferation as presumed mechanism
Authors: Sasaki T. , Akagi R. , Akatsu Y. , Fukawa T. , Hoshi H. , Yamamoto Y. , Enomoto T. , Sato Y. , Nakagawa R. , Takahashi K. , Yamaguchi S. , Sasho T. 
Published: March 2017

Objectives The aim of this study was to investigate the effect of granulocyte-colony stimulating factor (G-CSF) on mesenchymal stem cell (MSC) proliferation in vitro and to determine whether pre-microfracture systemic administration of G-CSF (a bone marrow stimulant) could improve the quality of repaired tissue of a full-thickness cartilage defect in a rabbit model. Methods MSCs from rabbits were cultured in a control medium and medium with G-CSF (low-dose: 4 μg, high-dose: 40 μg). At one, three, and five days after culturing, cells were counted. Differential potential of cultured cells were examined by stimulating them with a osteogenic, adipogenic and chondrogenic medium. A total of 30 rabbits were divided into three groups. The low-dose group (n = 10) received 10 μg/kg of G-CSF daily, the high-dose group (n = 10) received 50 μg/kg daily by subcutaneous injection for three days prior to creating cartilage defects. The control group (n = 10) was administered saline for three days. At 48 hours after the first injection, a 5.2 mm diameter cylindrical osteochondral defect was created in the femoral trochlea. At four and 12 weeks post-operatively, repaired tissue was evaluated macroscopically and microscopically. Results The cell count in the low-dose G-CSF medium was significantly higher than that in the control medium. The differentiation potential of MSCs was preserved after culturing them with G-CSF. Macroscopically, defects were filled and surfaces were smoother in the G-CSF groups than in the control group at four weeks. At 12 weeks, the quality of repaired cartilage improved further, and defects were almost completely filled in all groups. Microscopically, at four weeks, defects were partially filled with hyaline-like cartilage in the G-CSF groups. At 12 weeks, defects were repaired with hyaline-like cartilage in all groups. Conclusions G-CSF promoted proliferation of MSCs in vitro. The systemic administration of G-CSF promoted the repair of damaged cartilage possibly through increasing the number of MSCs in a rabbit model. Cite this article: T. Sasaki, R. Akagi, Y. Akatsu, T. Fukawa, H. Hoshi, Y. Yamamoto, T. Enomoto, Y. Sato, R. Nakagawa, K. Takahashi, S. Yamaguchi, T. Sasho. The effect of systemic administration of G-CSF on a full-thickness cartilage defect in a rabbit model MSC proliferation as presumed mechanism: G-CSF for cartilage repair. Bone Joint Res 2017;6:123–131. DOI: 10.1302/2046-3758.63.BJR-2016-0083.
Augmented reality in bone tumour resection
Authors: Cho H. S. , Park Y. K. , Gupta S. , Yoon C. , Han I. , Kim H-S. , Choi H. , Hong J. 
Published: March 2017

Objectives We evaluated the accuracy of augmented reality (AR)-based navigation assistance through simulation of bone tumours in a pig femur model. Methods We developed an AR-based navigation system for bone tumour resection, which could be used on a tablet PC. To simulate a bone tumour in the pig femur, a cortical window was made in the diaphysis and bone cement was inserted. A total of 133 pig femurs were used and tumour resection was simulated with AR-assisted resection (164 resection in 82 femurs, half by an orthropaedic oncology expert and half by an orthopaedic resident) and resection with the conventional method (82 resection in 41 femurs). In the conventional group, resection was performed after measuring the distance from the edge of the condyle to the expected resection margin with a ruler as per routine clinical practice. Results The mean error of 164 resections in 82 femurs in the AR group was 1.71 mm (0 to 6). The mean error of 82 resections in 41 femurs in the conventional resection group was 2.64 mm (0 to 11) (p < 0.05, one-way analysis of variance). The probabilities of a surgeon obtaining a 10 mm surgical margin with a 3 mm tolerance were 90.2% in AR-assisted resections, and 70.7% in conventional resections. Conclusion We demonstrated that the accuracy of tumour resection was satisfactory with the help of the AR navigation system, with the tumour shown as a virtual template. In addition, this concept made the navigation system simple and available without additional cost or time. Cite this article: H. S. Cho, Y. K. Park, S. Gupta, C. Yoon, I. Han, H-S. Kim, H. Choi, J. Hong. Augmented reality in bone tumour resection: An experimental study. Bone Joint Res 2017;6:137–143.
Die neue Zeitenwende in den internationalen Beziehungen – Konsequenzen für deutsche und europäische Politik
Authors: Krause Joachim 
Published: March 2017

Kurzfassung:Die internationalen Beziehungen machen derzeit einen fundamentalen Wandel durch, der Ähnlichkeiten mit früheren wechselhaften Perioden der Geschichte aufweist. Oft gingen diese Perioden in Krieg und Instabilität über, wenn es nicht gelang, neue politische Ordnungsmuster zu verankern. Die derzeitige Phase ist gekennzeichnet durch den Zerfall einer unter Bedingungen westlicher Hegemonie gestalteten internationalen Ordnung, die droht in eine Phase der Anarchie überzugehen. Die Ursachen dafür dürften in Folgewirkungen der Globalisierung und anderer Elemente der liberalen Ordnung zu suchen sein, die bislang zu wenig Beachtung fanden.
Innenpolitische Determinanten der Putinschen Außenpolitik
Authors: Adomeit Hannes 
Published: March 2017

Kurzfassung:
Die konfrontative russische Außenpolitik wird oft als Reaktion auf angebliche Fehler des Westens gesehen. Tatsächlich sind es hauptsächlich innere Faktoren, die das russische Außenverhalten bestimmen. Im Wesentlichen wird das außenpolitische Verhalten Russlands aus der Krise des von Putin geschaffenen Regierungssystems (einer korrupten, anti-liberalen und undemokratischen Machtvertikale) erklärbar. Dieses System tendiert dazu, innere Stabilisierung durch das Schüren von äußeren Konflikten zu suchen und dabei die Lösung der zentralen wirtschaftlichen und gesellschaftlichen Probleme zu vernachlässigen. Zeitweilig wurde dieses Machtsystem auch innerhalb der russischen Machtelite als dysfunktional für die wirtschaftliche Modernisierung und damit als existenzgefährdend für das Land angesehen. Die von Präsident Dmitri Medwedew eingeleitete Modernisierungspartnerschaft mit dem Westen sollte diese Defizite abbauen, ist aber heute gescheitert.
Grundzüge einer neuen NATO-Strategie
Authors: Kamp Karl-Heinz 
Published: March 2017

Kurzfassung:
Angesichts der fundamentalen Veränderungen in den vergangenen Jahren kommt die NATO nicht umhin, ihre strategischen Grundlagen an die Realitäten einer Welt anzupassen, in der es darum geht sich auch auf reale Bedrohungen (Art. 5) einzustellen. Die Verständigung auf neue Kernaufgaben wird kein einfaches Unterfangen sein, weil die Mitgliedstaaten von unterschiedlichen Gefahren in unterschiedlicher Weise betroffen sind. Die Erfahrungen mit dem Strategischen Konzept von 2010 haben allerdings gezeigt, dass nicht nur der Diskussionsprozess einen Wert in sich darstellt, sondern auch trotz unterschiedlicher Positionen Konsens in substanziellen Fragen gefunden werden kann. Sich einer strategischen Debatte aus Furcht vor sichtbarem Dissens zu verweigern, ist keine Option für ein Bündnis, das sich gerade durch die Kontroverse um Mittel und Ziele immer wieder an neue Herausforderungen angepasst hat.
Strategic Foresight – Die Zukunft antizipieren
Authors: Klüfers Philipp , Masala Carlo , Tepel Tim , Tsetsos Konstantinos 
Published: March 2017

Zusammenfassung:
Strategische Vorausschau wird zunehmend in Politik und Wirtschaft nachgefragt. Der Beitrag liefert einen Überblick über die gängigsten Methoden dieser Form der Zukunftsanalyse. Die Autoren konzentrieren sich dabei auf methodische Anforderungen, die Kategorisierung unterschiedlicher methodischer Ansätze, die Bewertung von deren Stärken und Schwächen sowie die Identifikation relevanter Anwendungsfelder. Zudem widmen sie sich der Problematik der Ableitung von Handlungsempfehlungen und diskutieren die Sinnhaftigkeit strategischer Vorausschau zur Entscheidungsunterstützung.
Russia changes the game: Bilanz der russischen Militärintervention in Syrien
Authors: Bino Tomisha , Krause Joachim 
Published: March 2017

Kurzfassung:Die seit Herbst 2015 laufende russische Militärintervention in Syrien hat nicht nur die Lage vor Ort verändert, sondern auch die strategische Lage im Nahen und Mittleren Osten auf den Kopf gestellt. Russland hat demonstriert, dass es im östlichen Mittelmeerraum über militärische Handlungsfähigkeit verfügt. Mit ihrer zögerlichen Haltung hat die Regierung in Washington Russland einWindow of Opportunityeröffnet. Die Russen im Nachhinein zu einer Aufgabe ihres Einsatzes zu zwingen, ist für die USA kaum möglich, es sei denn sie sind zu einer massiven Eskalation bereit. Die Intervention hat das scheinbar unvermeidliche Ende des Assad-Regimes abwenden können und hat das Bündnis zwischen Russland und dem Iran gestärkt, was innerhalb der sunnitischen arabischen Welt zu großer Besorgnis beiträgt.
‘The Times They are a Changin' – Fundamental Structural Change in International Relations as a Challenge for Germany and Europe
Authors: Krause Joachim 
Published: March 2017

Abstract:The international system is going through a period of fundamental change, which has similarities with earlier periods in history. Such periods of change might usher into war and instability if it turned out to be impossible to arrive at a new international order. The current period of change is characterized by the collapse of a liberal international order, which was established under conditions of Western hegemony. The coming anarchy is the consequence of unforeseen structural changes wrought about by globalization and other developments associated with the global spread of the liberal order.
Invisible minimalism
Authors: Falcato Ana 
Published: March 2017

AbstractThis essay attempts a rapprochement between Kent Bach’s view on semantic minimalism and the most radical version of contextualism about language on offer: Charles Travis’s occasion-sensitivity. Despite common assumptions held by defenders of semantic literalism – which cast Bach’s proposal as a form of contextualism – Bach rejects all conceivable forms of contextualism. In this paper, I argue that in spite of his systematic rejection of contextualism, Bach’s position bears a striking resemblance to Travis’s occasion-sensitivity. Further, when analyzed in light of the conceptual framework developed by Travis, Bach’s strand of minimalism can be shown to contain a deep-rooted conceptual inconsistency to the extent that he aims to ascribe “pure semantic content” to a linguistic entity that is necessarily pragmatic.
Representing ordinary people: experiential interview fragments in CCTV News
Authors: Feng Debing 
Published: March 2017

AbstractThe television news interview has been widely studied in the field of Conversation Analysis. Few researchers, however, have paid attention to the interview fragments that often occur in news bulletin programs. This article applies Conversation Analysis and the notion of recontextualization to the analysis of experiential interview fragments deployed in CCTV News. It is shown that this type of fragments enjoys a relatively fixed sequence structure: introduction–fragment, where the fragment consists of (question+) answer turns. The introduction may be designed to raise a question, offer background information or summarize key points. The fragment itself, unlike a complete interview, is often selected and designed to achieve particular communicative purposes. In CCTV News, for example, the fragments tend to be employed to represent ordinary people’s experience, beneficiary identity and positive image, among others.
Patient participation in action: patients’ interactional initiatives during interdisciplinary goal-setting meetings in a rehabilitation clinic
Authors: Keel Sara , Schoeb Veronika 
Published: March 2017

AbstractClinical guidelines require the patient’s participation in the entire rehabilitation process, including discharge planning. However, very little is known about how this institutional requirement is actually dealt with in everyday clinical practice. Adopting a conversation analytic approach, our paper tackles the matter, looking at situations in which patients achieve interactional initiatives within interdisciplinary entry meetings (IEMs) at a rehabilitation clinic in German-speaking Switzerland. Based on audio-visual recordings of 11 IEMs, whose central aim is to formulate patients’ rehabilitation goals and to plan their discharge, the paper offers a detailed analysis of two conversational environments in which patients accomplish initiatives: incipient disagreement among the interdisciplinary team and difficulties faced by the professionals in moving towards the formulation of a goal. In both situations, the progress of the activity is at stake. Moreover, the analysis reveals the interactive and stepwise accomplishment of patients’ initiatives. Our paper argues that shedding light on how patients’ initiatives are interactively implemented makes it possible to discuss how issues of epistemic rights and entitlement to participate are locally negotiated. In the final discussion, the paper raises the question of how patients’ competence in intervening in the goal-formulation activity can be taken into account in clinical guidelines on patient participation.
A rose is more than a rose … the diatextual constitution of subjects and objects
Authors: Mininni Giuseppe , Manuti Amelia 
Published: March 2017

Abstract
This paper integrates contributions coming from psychology with a phenomenological and semiotic perspective and focuses on the relationship of reciprocal constitution between “Subject” and “Object.” This relationship is evoked through radically different concepts such as the notions of “experience,” “consciousness” and “embodiment,” focusing attention on “discourse” as a macro-procedure generating the mutual link between Subject and Object. Therefore, the relationship between subject and object is identifiable through the text, namely “diatext.” It will be further argued that human beings act as “diatexters” of their existence in the world. Accordingly, psycho-discursive practices have the performative power to constitute both objects and subjects because they offer a creative solution by interlacing the “Body-Mind-Problem” to the “Mind-Culture-Problem.” In detail, the discursive resource granted by metaphors may be recognized as a modelling matrix embodying thought, as the interweaving of conceptual fields and as reasoning processes.