bluuebunny/crossref_metadata_2025_split huggingface dataset:
MORE THAN MEETS THE EYE: RELATIONAL AUTONOMY AND DECISION-MAKING BY ADULTS WITH DEVELOPMENTAL DISABILITIES
Authors: Salami Eniola , Lashewicz Bonnie 
Published: April 2017

In Canadian law, the concept of autonomy is individualistic in nature, manifest as the capacity, or legal ability of an individual to actively understand the purpose and consequences of their actions according to whether they have faculties to comprehend and weigh risks and benefits. Feminist scholars critique such conceptualizations of autonomy and, instead, argue the importance of “relational autonomy” which is predicated on the view that actions result from one’s own volition in combination with the influence of one’s social and relational connections. In this paper, we examine the dynamics and implications of relational autonomy in decision-making by adults with developmental disabilities by studying adults with developmental disabilities in interaction with their caregiving family members. Our purpose is to contribute understandings of how and in what ways family caregiving relational contexts both support and hinder decision-making by adults with developmental disabilities. We begin with an overview of conceptualizations and applications of autonomy, then illustrate relational autonomy dynamics through comparative analysis of data from two women with developmental disabilities who were interviewed together with their family caregivers about successes and struggles in giving and receiving care and making decisions. These two women, and their family caregivers (N=9) are selected from a larger sample of adults with developmental disabilities and their family caregivers (N = 26) because the contrasts, as well as the similarities, between their family care situations are striking, and taken together, illustrate a range of ways in which decision-making is supported and hindered. We conclude by upholding the importance of relational autonomy for legal understandings of decision-making, yet we caution that critical examination of relationship dynamics is vital.
STL’UL NUP: LEGAL LANDSCAPES OF THE HUL’QUMI’NUM MUSTIMUHW
Authors: Morales Sarah 
Published: April 2017

Landscape is a part of every individual’s sense of being. However, one cannot deny the special relationships that Indigenous peoples maintain with places they have inhabited since the beginning of creation. These places are deeply imbued with meaning, and are sites of personal and community identity. In addition, these places are legal in nature. They teach Indigenous people about their legal obligations – to each other, their ancestors and the natural world. This paper examines the connection between land and law for the Hul’qumi’num Mustimuhw, a group of Island Hul’qumi’num speaking First Nations, located on southeastern Vancouver Island. It discusses how lands within Indigenous territories can be transformed into legal landscapes, when considered in relation to place, time and experience. It also examines specific legal landscapes within the Hul’qumi’num territory and explores the laws and regulations that reside within and flow from them. Through this paper, one can gain insight into how these places inform the Hul’qumi’num lgal tradition and impart important teachings to the Hul’qumi’num Mustimuhw about the nature of their relationship and their obligations to particular places and inhabitants of those places.
BUILDING INTERNATIONAL APPROACHES TO CLIMATE CHANGE, DISASTERS, AND DISPLACEMENT
Authors: McAdam Jane 
Published: April 2017

On average, one person is displaced each second by a disaster-related hazard. Most people move within their own countries, but some are forced across international borders. This article outlines the scope of existing international legal frameworks to assist people displaced in the context of disasters and climate change, and suggests a variety of different tools that are required to address the phenomenon. Legal, policy, technical and scientific interventions, including disaster risk reduction, climate change adaptation and mitigation, development, and migration opportunities, will determine whether, and for how long, people can remain in their homes, and whether doing so enables them to lead dignified lives or exposes them to risks and increased vulnerability. Identifying the need for a broad, complementary set of policy strategies necessarily affects how international law should be progressively developed in this area.
Single dose Intraoperative Antibiotics versus Postoperative Antibiotics for Patient Undergoing Laparoscopic Cholecystectomy for Symptomatic Cholelithiasis
Authors: Thapa Sagun Bahadur , Kher Yeshwant Ramakrishna , Tambay Yashwant Gajanan 
Published: April 2017

Introduction: Surgical site infection is a common complication shown in literature following cholecystectomies. Smaller incision and use of trocars in laparoscopic cholecystectomy lessen the contamination resulting in less chances of surgical site infection. However, in fear of postoperative infection, many opt for the prolonged postoperative use of antibiotic and there is growing consensus against it. Antibiotics not only increases the cost and hospital stay duration but it aids in emergence of multidrug resistance. Because of the controversies, we conducted this clinical trial to see whether a single prophylactic dose of antibiotic at the time of induction of anesthesia for laparoscopic cholecystectomy was equally effective in controlling post-operative infection as multi-dose antibiotics during and post-operative period.
Methods: The study was conducted at the department of general surgery, Lumbini Medical College Teaching Hospital, from November 2015 to October 2016. All cases with symptomatic cholelithiasis subjected for laparoscopic cholecystectomy were enrolled. Patients were randomized into two groups; Group SD received single dose of an intravenous dose of amikacin 500 mg, at induction of anesthesia and Group MD received multiple intravenous dose of amikacin, during and postoperatively for two days. Complications, hospital stay, and treatment cost in two groups were compared and analyzed.
Results: There were a total of 240 patients in the study, 118 in Group SD and 122 in Group MD. Post-operative infection rate was 4.2% (n= 5, N=118) in Group SD and 3.3% (n=4, N=122) in Group MD; the difference was not significant (p=0.75). Hospital stay was prolonged and cost was higher significantly in Group MD.
Conclusion: Single dose of prophylactic antibiotic, administered at induction of anesthesia, is equally effective as multiple doses of post surgical antibiotics to prevent post-operative infection in patients undergoing elective laparoscopic cholecystectomy for uncomplicated cholelithiasis.
Creation of a Queryable Toxicology Database Available to Forensic Pathologists
Authors: Cain Matthew D. , Park Seung L. , Robinson C. Andrew , Davis Gregory G. 
Published: April 2017

Purpose Forensic pathologists typically depend upon case reports or published compilations of case reports when determining the role a drug may have played in death. Case reports may provide a helpful range, but the cases reported are typically few and often lack information on circumstances surrounding death and autopsy findings. A searchable database recording circumstances, autopsy findings, drug concentrations, and the cause and manner of death would allow forensic pathologists to compare a specific case to similar cases, facilitating evaluation and interpretation of toxicology results. Method This project uses data extracted by computer programs from over 18 000 computer files of autopsy and toxicology reports generated between 2004 and 2012. Using PHP Hypertext Preprocessor and MariaDB, a relational database, we developed a webpage that stores the data and allows for complex queries. Results Users can search for cases by specifying drugs and medical conditions, demographics, height, body mass, and manner of death. The number of cases with a given drug for this eight-year span from one office is comparable to the numbers reported in compilations of case reports. Conclusion Our webpage enables a pathologist evaluating a case to search the database for cases with similar circumstances and findings. New cases are easily added to the database as they are completed. The database allows other institutions to contribute data and records the data source, which increases the usefulness of the database even more. This database provides pathologists a powerful new tool for the evaluation of toxicology findings in their practice.
Trauma of the Pericardial Sac and Heart: An Autopsy Series
Authors: Zydowicz Sara , Adams Vernard I. 
Published: April 2017

From 145 consecutive autopsies on traffic fatalities and leaps from heights performed by one author were found 38 cases with laceration of the heart, laceration of the pericardial sac, or contusion of the heart. Twenty-eight subjects had pericardial laceration: 13 of the left side singly, eight of the right side singly, one of the anterior wall singly, and six with multiple lacerations. Five of the 13 had herniation of the heart into a pleural cavity. Twenty-one of the 38 had laceration of the heart; 12 multiple and nine singly. The lacerations were equally distributed between atria and ventricles but almost all the atrial lacerations involved the right atrium. Thirteen of the 38 subjects had contusion of the heart in the absence of a cardiac laceration. Two of them also had a sprain injury of the intrapericardial portion of the inferior vena cava. The contusions were in epicardial fat depots in the atrioventricular sulci and along the acute and obtuse margins of the heart. None of the contusions was confined to the myocardium. Eleven of the 38 had a sternal fracture and 30 had rib fractures. Major craniocervical trauma and lacerations of the liver, spleen, aorta, and lung were common. Only six of 38 ever had a pulse after the crash or leap. The longest survival was 3.75 hours. Pericardial lacerations most commonly occurred in the unbuttressed parts of the pericardium, namely, the left and right pleuropericardia. Pericardial laceration is essentially a traumatic rupture caused when the heart is compressed between the sternum and vertebral column and the sac gives way.
The Association between Laminectomy and Drug Overdose Deaths: A Matched Case-Control Study
Authors: Inusah Seidu , Griffin Russell L. , Gorman Emily F. , Davis Gregory G. , McGwin Gerald 
Published: April 2017

Objective To evaluate the association between death due to drug overdose and a history of laminectomy. Design A retrospective matched case-control study of 234 drug overdose decedents from the Jefferson County Coroner/Medical Examiner's Office in Birmingham, Alabama were matched 1:2 on age to a control group consisting of decedents with any manner of death (accident, natural, suicide, homicide, or undetermined). Laminectomy cases were identified by the presence of a linear surgical scar near the spine in an orientation and place typical for a laminectomy. Results Decedents whose cause of death was a drug overdose were 2.43 times (95% confidence interval [CI] 1.37-4.31) more likely to have a laminectomy scar compared to decedents in a control group consisting of all manners of death. This association held for males (odds ratio [OR] 2.34; 95% CI: 1.09-5.04) and whites (OR 2.35; 95% CI 1.06-5.18) after stratification. Conclusion In the absence of an obvious cause for death, the presence of a laminectomy scar suggests the possibility of a fatal overdose and is a factor to consider in favor of performing an autopsy and toxicological analysis for drugs of abuse.
Suicide in Jail: A Ten-Year Retrospective Study
Authors: Kucmanic Matthew J. , Gilson Thomas P. 
Published: April 2017

Suicide in jails, like all death in custody, may involve complicated investigation. Allegations of mistreatment and/or abuse may be raised and these possibilities need to be addressed. Apart from these investigative concerns, the occurrence of suicides in such a controlled environment raises additional questions about potential preventative measures. Between 2004 and 2014, there were ten deaths of incarcerated individuals in Cuyahoga County (metropolitan Cleveland) Ohio. Most (80%) were white and all were male. Similar to previous reviews, the majority of decedents hanged themselves (90%), with one case of asphyxiation by airway obstruction with a foreign body. Psychiatric disorders were noted in six of ten decedents while seven of ten had a history of substance abuse including alcoholism. Overall, nine of ten had at least one of these disorders. All suicide deaths occurred within one year of incarceration, which may reflect the absence of a long-term prison fatality in our county. It is noteworthy that 70% of deaths occurred within the first month of incarceration with four of ten events occurring in less than a day including two deaths in less than 30 minutes. Positive toxicology for abused substances was noted in 75% (three) of the four individuals who died in less than a day and only in one other suicide, which occurred on the second day of incarceration. Our data suggest that suicide in jail is predominantly a male phenomenon, with early incarceration being a particularly vulnerable period. The presence of another inmate in the same cell as the decedent was not seen to have an independent deterrent effect. Intoxication, particularly in individuals with a history of substance abuse and/or alcoholism, should raise concern for potential self-harm in recently jailed individuals. Possible interventions suggested by this study might include closer direct surveillance in the early incarceration period, earlier access to mental health services as well as design modifications in holding cells with possible dedicated short-term holding areas where self-harm risks are minimized and surveillance can be optimized.
Sudden Death Due to Spontaneous Small Bowel Perforation within an Incarcerated Umbilical Hernia
Authors: Maskovyak Amanda , Felo Joseph 
Published: April 2017

Umbilical hernias are estimated to occur in up to 20% of patients with long-standing cirrhosis and ascites. Complications such as strangulation and infarction of the bowel or rupture of the bowel loops and/or hernia sac are uncommon but potentially life-threatening consequences. Often these events happen in association with abdominal trauma or after procedures such as paracentesis. Spontaneous rupture is more likely in cases where strangulation and subsequent necrosis of the bowel has weakened and thinned the incarcerated intestinal wall. We report a case of a 63-year-old male with a history of alcohol abuse complicated by cirrhosis and ascites who was found dead in his home approximately 30 minutes after last being seen alive. He was found at rest in a seated position without evidence of recent trauma. At autopsy, an ulcerated umbilical hernia was present containing a loop of perforated, necrotic small bowel. There was evidence of peritonitis including one liter of yellow-red fluid accumulation in the peritoneal cavity, multifocal areas of fibrinopurulent debris adherent to the small bowel, and a dull gray discoloration to the peritoneal lining. The case was signed out as death due to peritonitis and spontaneous perforation of small intestine due to strangulated and infarcted small intestinal umbilical hernia and the manner, natural. Although spontaneous perforation of the bowel within a hernia sac is uncommon, it may contribute to sudden death in patients lacking a history of trauma or recent medical procedures and physicians certifying these deaths should be aware of the possibility.
PENERAPAN TEKNOLOGI PENGGUNAAN RUMPUT LAUT SEBAGAI BIOFILTER ALAMI AIR TAMBAK UNTUK MENGURANGI TINGKAT SERANGAN PENYAKIT PADA UDANG VANNAMEI (Litopenaeus vannamei)
Authors: Rahmaningsih Sri 
Published: April 2017

Pembudidaya tambak di Kabupaten Tuban terutama pembudidaya udang vannamei menghadapi kondisi lingkungan yang cukup berat bagi pertumbuhan udang, hal ini disebabkan karena banyaknya industri di Kabupaten Tuban misalnya pabrik PT. Semen Gresik Tuban, pabrik TPPI yang berlokasi di tepi pantai utara laut Tuban dimana limbahnya dapat mempengaruhi kualitas air tambak baik secara langsung maupun tidak. Termasuk pembudidaya udang yang ada di desa Kenanti, Kecamatan Tambakboyo dan hampir semua petambak yang ada di sepanjang pantai utara Tuban diprediksikan ikut merasakan pengaruh adanya cemaran yang berasal dari laut (belum terdapat penelitian yang memastikan hal ini), belum lagi yang berasal dari tambak itu sendiri (limbah internal) sehingga wajar apabila saat ini tingkat keberhasilan dalam budidaya udang terutama udang vannamei sangat rendah. Tingkat keberhasilan dalam budidaya udang vannamei terutama pada budidaya udang secara intensif sangat ditentukan oleh kualitas air yang digunakan dalam budidaya dan juga pada teknologi yang telah digunakan. Pemanfaatan rumput laut sebagai biofilter dalam budidaya udang vannamei merupakan teknologi sederhana yang mudah dilaksanakan. biofilter alami. Rumput laut sebagai tumbuhan air yang menyerap degradasi bahan organik untuk pertumbuhan, sehingga mengurangi resiko meningkatnya bahan organik air yang akan diperlukan untuk memelihara udang windu. Suhu dan kecerahan sangat mempengaruhi keberhasilan rumput Iaut sebagai biofilter karena kedua komponen ini akan laju fotosintesis rumput laut dan laju penyerapan bahan-bahan organik. Metode pendekatan yang dipakai pada pelaksanaan program ini adalah dengan melakukan sosialisasi penerapan teknologi penggunaan rumput laut sebagai biofilter alami ini pada kelompok petani yang ada di Kecamatan Tambakboyo melalui pelatihan, kemudian diadakan tambak percontohan sehingga petani tambak dalam mengadopsi teknologi ini dapat lebih mudah memahami.
INSTALASI PERMESINAN PADA KAPAL PSP 01
Authors: Wiyastra Anjaya Purwa , Baskoro Mulyono S. , Purwangka Fis 
Published: April 2017

Kapal PSP 01 merupakan kapal latih sekaligus kapal penangkap ikan yang dimiliki oleh Departemen Pemanfaatan Sumberdaya Perikanan (PSP), Fakultas Perikanan dan Ilmu Kelautan (FPIK), IPB. Kapal ini menggunakan tenaga penggerak inboard engine berjenis diesel empat langkah yang berasal dari truk Mitsubishi Canter dengan tipe 4D30-C. Penelitian ini bertujuan untuk mendeskripsikan modifikasi instalasi permesinan di Kapal PSP 01 dan mendeskripsikan kesesuaian instalasi permesinannya mengacu pada pedoman FAO tahun 2009 tentang Safety Guide for Small Fishing Boats. Pendekatan dilakukan dengan menggunakan metode studi kasus dimana dilakukan pengamatan dan pengumpulan data yang meliputi modifikasi pada instalasi permesinan Kapal PSP 01 serta kesesuaiannya terhadap pedoman FAO tentang safety guide for small fishing boats. Hasil penelitian didapat bahwa mesin kapal PSP 01 dimodifikasi pada bagian sistem penyalaan, sistem bahan bakar, sistem pelumasan, sistem transmisi, dan sistem pendingin mesin. Berdasarkan pedoman FAO tahun 2009 tentang Safety Guide for Small Fishing boats, instalasi permesinan Kapal PSP 01 dalam hal sistem pompa lambung terpenuhi 58,33%, sistem bahan bakar terpenuhi 52,63%, sistem pembuangan gas pembakaran terpenuhi 33.33%, ventilasi kamar mesin terpenuhi 0%, rangkaian instalasi kelistrikan terpenuhi 85,71%, instalasi baterai terpenuhi 100%, pemeriksaan harian sebelum menyalakan mesin terpenuhi 75%, pemeriksaan harian setelah menyalakan mesin terpenuhi 100%, pemeriksaan tiap empat belas hari terpenuhi sebesar 20%, dan pemeriksaan tiap 100-150 jam setelah mesin beroperasi terpenuhi sebesar 0%.
Accompagner la mort, organiser la fin de vie
Authors: Le Theule Marie-Astrid , Lambert Caroline , Morales Jérémy 
Published: April 2017

Cet article1 porte sur l’organisation de la mort dans le contexte hospitalier. Au-delà des questions éthiques, les auteurs étudient les enjeux techniques, professionnels et sociologiques de la gestion hospitalière de la fin de vie. Une étude ethnographique leurs a permis d’observer le travail quotidien de gériatres et leurs efforts pour organiser une « bonne » mort. Ils montrent que ce travail, largement invisible, permet d’organiser le passage vers une mort « naturelle » et « confortable », non seulement « apaisée » mais surtout accompagnée.
Impact of the Level of Urothelial Carcinoma Involvement of the Prostate on Survival after Radical Cystectomy
Authors: Moschini Marco , Soria Francesco , Susani Martin , Korn Stephan , Briganti Alberto , Roupret Morgan , Seitz Christian , Gust Killian , Haitel Andrea , Montorsi Francesco , Wirth Gregory , Robinson Brian D. , Karakiewicz Pierre I. , Özsoy Mehmet , Rink Michael , Shariat Shahrokh F. 
Published: April 2017

Objective: Urothelial prostatic involvement (UPI) at the time of radical cystoprostatectomy (RCP) was found associated with worse survival outcomes by several previous reports. Our aim is to evaluate the impact of different levels of UPI on survival outcomes using a large series of male patients treated with RCP. Methods: Whole step section specimens from 995 male BCa patients were assessed for UPI defined as: no involvement vs. prostatic urethral carcinoma in situ (CIS) vs. lamina propria involvement vs. ductal CIS vs. prostate stromal involvement. Primary end point of the study was predictors of prostatic involvement at RCP and its impact on overall survival after surgery. Results: Prostatic involvement was recorded in 307 (30.9%) patients: 28% with prostatic urethral CIS, 12% with lamina propria involvement, 13% with ductal CIS and 47% with stromal involvement. Median follow-up was 70 months. Patients with stromal involvement had a worse 5-year survival (12%) than those with prostatic urethra CIS (40%), lamina propria involvement (36%), and ductal CIS (35%). Considering predictors of prostatic involvement, multifocal tumor (Odds Ratio [OR]: 6.60, p < 0.001), lymphovascular invasion (OR: 2.61, p < 0.001), lymph node metastases (OR: 2.02, p < 0.001) and CIS (OR: 2.02, p < 0.001) were found associated. Similar predictors were found assessing stromal involvement. Conclusions Approximately one third of RCP patients harbor prostatic involvement of urothelial carcinoma. While all UPI are associated with worse overall survival, stromal involvement confers the worst outcome supporting its classification as T4 in the TNM staging.
The ‘One in a Million’ study: creating a database of UK primary care consultations
Authors: Jepson Marcus , Salisbury Chris , Ridd Matthew J , Metcalfe Chris , Garside Ludivine , Barnes Rebecca K 
Published: April 2017

BackgroundAround 1 million primary care consultations happen in England every day. Despite this, much of what happens in these visits remains a ‘black box’.AimTo create an archive of videotaped consultations and linked data based on a large sample of routine face-to-face doctor–patient consultations with consent for use in future research and training.Design and settingCross-sectional study in 12 general practices in the west of England, UK.MethodUp to two GPs from each practice took part in the study. Over 1 to 2 days, consecutive patients were approached until up to 20 eligible patients for each GP consented to be videotaped. Eligible patients were aged ≥18 years, consulting on their own behalf, fluent in English, and with capacity to consent. GP questionnaires were self-administered. Patient questionnaires were self-administered immediately pre-consultation and post-consultation, and GPs filled in a checklist after each recording. A follow-up questionnaire was sent to patients after 10 days, and data about subsequent related consultations were collected from medical records 3 months later.ResultsOf the 485 patients approached, 421 (86.8%) were eligible. Of the eligible patients, 334 (79.3%) consented to participate and 327 consultations with 23 GPs were successfully taped (307 video, 20 audio-only). Most patients (n = 300, 89.8%) consented to use by other researchers, subject to specific ethical approval.ConclusionMost patients were willing to allow their consultations to be videotaped, and, with very few exceptions, to allow recordings and linked data to be stored in a data repository for future use for research and training.