bluuebunny/crossref_metadata_2025_split huggingface dataset:
NICE CG83 – rehabilitation after critical illness: implementation across a network
Authors: Cotton Karen 
Published: September 2012

Background: The National Institute for Health and Clinical Excellence (NICE) Clinical Guideline (CG) 83: Rehabilitation after Critical Illness was published to focus attention on a group of patients who can potentially endure a multitude of physical and non‐physical complications following a serious illness. Historically the sequelae of critical illness have not been adequately assessed or managed despite growing knowledge in this area of health care.Aim: To share the lessons learned during the ongoing implementation of NICE CG83 across five hospitals within one critical care network in a single county.Design: The critical care network director appointed a passionate and experienced champion to examine the current position within each hospital, make recommendations and provide expert knowledge and practical assistance to improve the rehabilitation of patients in accordance with the NICE guideline. The ‘Quick wins' were successfully addressed to encourage the implementation process whilst allowing time for new services and processes to be developed.Results: Success was achieved by addressing the patient, relative and inter‐professional communication issues as a network. All hospitals introduced discharge booklets and improved their discharge information and then chose different strategies to address the recommendations of the guideline in the most effective way possible. Strategies such as early intervention physiotherapy, the assessment and management of delirium, follow‐up clinics and outpatient rehabilitation classes were among those implemented.Conclusion: This paper outlines the processes developed, the difficulties encountered and showcases the valuable work that has been achieved.Relevance to clinical practice: Increasingly, hospitals have an obligation to comply with NICE guidelines for the benefit of patients. Rehabilitation following critical illness is important for patients to regain their former or best possible quality of life in a timely manner.
Altered risk‐aversion and risk‐taking behaviour in patients with Alzheimer's disease
Authors: HA Juwon , KIM Eun‐Jin , LIM Sewon , SHIN Dong‐Won , KANG Yeo‐Jin , BAE Seung‐Min , YOON Hyung‐Kun , OH Kang‐Seob 
Published: September 2012

AbstractAim:  Normal individuals are risk averse for decisions framed as gains but risk taking for decisions framed as losses. This framing effect is supposed to be attenuated in Alzheimer's disease (AD) patients. We investigated the effects of highlighting rewards versus highlighting punishments on the risky decision‐making of AD patients.Method:  Fourteen mild to moderate AD patients (Mini‐Mental Status Examination score, 11–23; Clinical Dementia Rating, 1–2) and 16 healthy volunteers were recruited for the study. Subjects completed a computerized task on risky decision‐making in which mathematically equivalent dilemmas were presented in terms of opportunities to gain monetary rewards (‘positive frame’) or avoid suffering losses (‘negative frame’).Results:  As expected, AD patients chose more risky options under the positive frame than the negative frame, contrary to the control group (Z =−2.671, P= 0.007). The normal difference in the distribution of risky choices between positively and negatively framed dilemmas was significantly reduced in the AD group after we adjusted for years of education, mean age and depression (F= 5.321, P= 0.030). Deliberation time did not differ significantly between the two groups.Conclusion:  These results suggest that AD patients making high‐risk choices is associated with attenuated sensitivity to the emotional frames that highlight rewards or punishments, possibly reflecting altered evaluations of prospective gains and losses.
Efficacy of a high dosage of donepezil for Alzheimer's disease as examined by single‐photon emission computed tomography imaging
Authors: KANAYA Kiyoshi 
Published: September 2012

AbstractBackground:  The efficacy of donepezil 10 mg/day against Alzheimer's disease (AD) was examined, with a primary focus on changes in cerebral blood flow (CBF) as determined by single‐photon emission computed tomography imaging.Methods:  The subjects were 24 outpatients who had been diagnosed with probable AD, which had progressed to advanced AD. Mini‐Mental State Examination and Alzheimer's Disease Assessment Scale (ADAS) scores were determined before and after the donepezil dosage increase. 99mTc‐ethylcysteinate dimer single‐photon emission computed tomography was performed to evaluate changes in CBF. Then, a comparative study evaluated changes after the donepezil dosage increased.Results:  After the donepezil dosage increase, adverse effects associated with gastrointestinal symptoms were observed in one patient, and irritability was observed in three. The average Mini‐Mental State Examination score changed from15.25 ± 6.24 to 14.67 ± 6.07; significant changes were not observed. Seventeen subjects were evaluated with the Alzheimer's Disease Assessment Scale‐cognitive subscale. After the dosage increase, the average subscale score decreased from 24.52 ± 13.39 to 21.56 ± 9.14, and significant improvement was observed (P= 0.021). With respect to changes in the CBF, the values of all three indicators decreased after the higher dosage increased CBF. However, no significant differences were observed in CBF. Analysis performed after the donepezil dosage increase revealed significant increases in CBF in the right occipital and temporal lobes, left temporal lobe, right parietal lobe, and both parts of the posterior cerebellum.Conclusion:  Increasing the donepezil dosage from 5 mg/day to 10 mg/day is effective for the treatment of AD.
Job Stress and Dyadic Synchrony in Police Marriages: A Preliminary Investigation
Authors: Roberts Nicole A. , Leonard Rachel C. , Butler Emily A. , Levenson Robert W. , Kanter Jonathan W. 
Published: September 2012

Despite reports documenting adverse effects of stress on police marriages, few empirical studies focus on actual emotional behaviors of officers and spouses. In this preliminary investigation, 17 male police officers and their nonpolice wives completed daily stress diaries for 1 week and then participated in a laboratory‐based discussion about their respective days. Conversations were video‐recorded and coded for specific emotional behaviors reflectinghostilityandaffection,which are strong predictors of marital outcomes. We examined associations between officers' job stress (per diaries and the Police Stress Survey) and couples' emotional behavior (mean levels and behavioral synchrony) using a dyadic repeated measures design capitalizing on the large number of observations available for each couple (1020 observations). When officers reported more job stress, they showed less hostility, less synchrony with their wives' hostility, and more synchrony with their wives' affection; their wives showed greater synchrony with officers' hostility and less synchrony with officers' affection. Therefore, for officers, greater job stress was associated with less behavioral negativity, potentially less attunement to wives' negativity, but potentiallygreaterattunement to wives' affection—perhaps a compensatory strategy or attempt to buffer their marriage from stress. These attempts may be less effective, however, if, as our synchrony findings may suggest, wives are focusing on officers' hostility rather than affection. Although it will be important to replicate these results given the small sample, our findings reveal that patterns of behavioral synchrony may be a key means to better understand how job stress exacts a toll on police marriages.
The Development of Family Alliance From Pregnancy to Toddlerhood and Child Outcomes at 5 Years
Authors: Favez Nicolas , Lopes Francesco , Bernard Mathieu , Frascarolo France , Lavanchy Scaiola Chloe , Corboz‐Warnery Antoinette , Fivaz‐Depeursinge Elisabeth 
Published: September 2012

This article presents a longitudinal study of the development of “family alliance” from pregnancy to toddlerhood in a community sample, as well as its links with the emotional and cognitive development of the child at age 5 years. Family alliance is defined as the quality of the interactive coordination between family members. We consider that the alliance constitutes a context for the child to learn emotion regulation and to develop an understanding of inner states. Family interactions (N = 38) were observed at the 5th month of pregnancy and at 3, 9, and 18 months after birth in a standardized situation of observation (Lausanne Trilogue Play). Marital satisfaction and child temperament were assessed through self‐reported questionnaires. Several outcomes of the child at age 5 years were measured: theory of mind performances, predominant emotional themes in pretend play, internalized and externalized symptoms. Results show that (a) three patterns of evolution of family alliance occur: “high stable” (n = 19), “high to low” (n = 10), and “low stable” (n = 9); (b) a high stable alliance is predictive of better outcomes in children at age 5 years, especially regarding theory of mind; (c) the temperament of the child is predictive of child outcomes; and (d) an interaction effect occurs between family alliance and temperament. These results highlight the importance of both family‐level and individual‐level variables for understanding individual differences in the social and cognitive development of children.
Global Emergency Medicine: A Review of the Literature From 2011
Authors: Schroeder Erika D. , Jacquet Gabrielle , Becker Torben Kim , Foran Mark , Goldberg Elizabeth , Aschkenasy Miriam , Bertsch Karina , Levine Adam C. ,   on behalf of the Global Emergency Medicine Literature Review (GEMLR) Group
Published: September 2012

ACADEMIC EMERGENCY MEDICINE 2012; 19:1196–1203 © 2012 by the Society for Academic Emergency MedicineAbstractObjectives:  The Global Emergency Medicine Literature Review (GEMLR) conducts an annual search of published and unpublished articles relevant to global emergency medicine (EM) to identify, review, and disseminate the most important research in this field to a wide audience of academics and practitioners.Methods:  This year, 7,924 articles written in seven languages were identified by our search. These articles were divided up among 20 reviewers for initial screening based on their relevance to the field of global EM. An additional two reviewers searched the grey literature. A total of 206 articles were deemed appropriate by at least one reviewer and approved by their editor for formal scoring of their overall quality and importance.Results:  Of the 206 articles that met our predetermined inclusion criteria, 24 articles received scores of 17 or higher and were selected for formal summary and critique. Interrater reliability for our scoring system was good with an interclass correlation coefficient of 0.628 (95% confidence interval = 0.51 to 0.72).Conclusions:  Compared to previous reviews, there was a significant increase in the number of articles that were devoted to emergency care in resource‐limited settings, with fewer articles related to disaster and humanitarian response. The majority of articles that met our selection criteria were reviews that examined the efficacy of particular treatment regimens for diseases that are primarily seen in low‐ and middle‐income countries.
The Changing Landscape of America’s Health Care System and the Value of Emergency Medicine
Authors: Sasson Comilla , Wiler Jennifer L. , Haukoos Jason S. , Sklar David , Kellermann Arthur L. , Beck Dennis , Urbina Chris , Heilpern Kathryn , Magid David J. 
Published: September 2012

ACADEMIC EMERGENCY MEDICINE 2012; 19:1204–1211 © 2012 by the Society for Academic Emergency MedicineAbstractThe Patient Protection and Affordable Care Act (ACA), passed in 2010, has important implications for emergency physicians (EPs). In addition to dramatically reducing the number of uninsured in the United States, this comprehensive health care reform legislation seeks to curb the escalating costs of health care delivery, optimize resource utilization, eliminate waste, and improve the quality of service delivered by the health care system. At the annual Association of American Medical Colleges (AAMC) meeting on November 5, 2011, an expert panel from public health, emergency medicine, and health services research was convened by the Association of Academic Chairs of Emergency Medicine (AACEM) and the Society for Academic Emergency Medicine (SAEM) to discuss possible future models for the emergency care system and academic emergency medicine in the era of the ACA.
Renal cell carcinoma with inferior vena caval tumour thrombus: Surgical management and clinical outcomes at a low‐volume centre
Authors: Cheung Man‐Hung , Ho Kwan‐Lun , Chan See‐Ching , Ho Ka‐Lai , Tam Po‐Chor , Yiu Ming‐Kwong , Au Timmy W.K. 
Published: September 2012

AimIn the present study, we discuss the surgical management, complications and clinical outcomes of patients with renal cell carcinoma (RCC) extending into the inferior vena cava (IVC), who were treated with surgical resection at a teaching hospital from 1997 to 2011.Patients and MethodsTwelve patients diagnosed with RCC and IVC tumour thrombus underwent radical nephrectomy and IVC tumour thrombectomy during the study period.ResultsOf the 12 patients (male : female: 1:1), the mean age was 65 years (range: 48–82 years). All had good premorbid performance status and no distant metastasis at the time of operation. Employing the Mayo Clinic classification, the tumour thrombus extension was level I in four cases (33 per cent), level II in four cases (33 per cent), level III in two cases (17 per cent) and level IV in two cases (17 per cent). In one patient, the renal tumour extended into the right atrium and had a solitary right pulmonary artery tumour embolus, which subsequently underwent a simultaneous right pulmonary artery tumour embolectomy. In our series, the mean blood loss in levels I–IV tumour thrombus were 1050 mL, 2075 mL, 4152 mL and 11 500 mL, respectively. Complications occurred in three cases (25 per cent), and one (8.3 per cent) required re‐laparotomy for haemostasis. There was no hospital mortality. The median follow up was 45.5 months (range: 6–125 months). Median disease‐free and overall survivals were 29 and 76 months, respectively. Five‐year disease‐free and overall survivals were 35.5 per cent and 62.5 per cent, respectively.ConclusionRadical nephrectomy and IVC tumour thrombectomy remain a challenging procedure. With detailed perioperative planning and multidisciplinary efforts, surgical resection is the definitive treatment of choice for patients with RCC and IVC tumour thrombus. The perioperative and survival outcomes of the present series were comparable to contemporary series.
Surgeon‐performed intraoperative ultrasonography‐guided excision of nonpalpable breast masses with adequate surgical margins under local anaesthesia
Authors: Karadeniz Cakmak Guldeniz , Emre Ali U. , Tascilar Oge 
Published: September 2012

AimWith the improvement of expertise in technique and skills of ultrasonography (US), many surgeons now perform image‐guided procedures for breast masses themselves. To minimize operative time, and to achieve adequate surgical margins with an acceptable cosmetic outcome, we designed a safe and simple hybrid technique to excise suspicious nonpalpable masses, which is described herein for the first time.Patients and MethodsIntraoperatively‐marked incision is performed, and a needle is advanced at a 0.5‐cm distance to the lesion according to real‐time ultrasound measurements. Four deep sutures are passed to fix and hang the predicted specimen adjacent to the needle in four directions. En bloc excision with aimed surgical margins of approximately 0.5 cm is achieved by means of retracting sutures, and confirmed by specimen and tumour bed US.ResultsIn the present study, there were 25 women (17 with malignant and 8 with benign lesions), with a mean age of 50.88 years (range: 30–69) and mean tumour diameter of 10.6 mm (range: 6–15). All lesions were correctly identified and localized by intraoperative US, and free margins of excision were obtained in all malignant lesions by means of the presented technique. The combined operative technical approach with surgeon‐performed intraoperative US‐guided needle placement and retracting sutures were feasible, simple and beneficial. We achieved complete tumour removal in all dimensions with no reexcision. The procedure was performed under local anaesthesia in an outpatient fashion with no complications.ConclusionOur report of the operative technique demonstrates that a combination of surgeon‐performed image‐guided localizations, together with a suture‐oriented fashion to assure negative surgical margins in all dimensions, improves margin clearance rate at the time of first surgical intervention. This method can be performed with operative and cost efficiency, and might become a valuable tool to minimize operative time and yield minimal sacrifice of normal breast tissue with maximal cosmetic outcome.
Photoluminescence Investigations of the Near White Light Emitting Perovskite Ceramic SrZrO3:Dy3+ Prepared Via Gel‐Combustion Route
Authors: Gupta Santosh K. , Mohapatra Manoj , Natarajan Venkataraman , Godbole Shrikant V. 
Published: September 2012

Trivalent dysprosium‐doped strontium zirconate perovskite (SrZrO3) phosphors were prepared by gel‐combustion synthesis using citric acid as fuel and ammonium nitrate as oxidizer. X‐ray diffraction patterns confirmed the formation of orthorhombic phase of SrZrO3 with minor impurity, which completely disappears at high temperature. The morphological investigation was carried out using scanning electron microscopy (SEM). Photoluminescence studies showed that no emission from the host is observed, indicating the efficient energy transfer from the ZrO32− group to Dy3+ ions. The emission line is purely because of f–f transitions of Dy3+. Moreover, these phosphors predominantly exhibit near white light emission, when excited by 229 nm UV light due to strong 4F9/2→6H13/2 transition at 577 nm (yellow), strong 4F9/2→6H15/2 transition at 482 nm (blue), and weak 4F9/2→6H9/2 transition at 677 nm (red). Enhancement in emission intensity was observed with increase in the annealing temperature of the phosphor. The CIE chromaticity coordinates of the SrZrO3:Dy3+ phosphors were observed to fall in the white light domain of the chromaticity diagram, which indicate that such fine tuning might be possible after varying the temperature of annealing.
Experimentalist governance: An introduction
Authors: Eckert Sandra , Börzel Tanja A. 
Published: September 2012

AbstractThis symposium critically engages with the volume Experimentalist Governance in the European Union: Towards a New Architecture (2010), edited by Charles F. Sabel and Jonathan Zeitlin. “Experimentalist Governance” (EG) opens up an original theoretical perspective on the emergent governance architecture of the EU and sheds new light on developments in key policy sectors. This symposium brings together a transatlantic group of distinguished political scientists and legal scholars to discuss the added value of EG as a concept for analysis, its theoretical underpinnings, empirical relevance, and normative implications, in terms of legitimacy. Contributors discuss EG from different disciplinary and theoretical perspectives, referring to a variety of empirical examples in the EU context and beyond. The symposium closes with a response from the authors to their critics. This collection of essays sheds new light on debates around the nature of the EU and democratic governance beyond the nation state.
Enseignements de la réduction des retraites du deuxième pilier en Hongrie et en Pologne
Authors: Fultz Elaine 
Published: September 2012

RésuméEn 1997, la Hongrie et la Pologne ont été les premiers pays d'Europe centrale à privatiser partiellement leur système de retraite national en réorientant une partie des cotisations au régime de retraite public vers des comptes d'épargne‐retraite individuels gérés par le secteur privé. Puis, dans le sillage de la crise économique mondiale, elles ont l'une et l'autre réduit l'importance de ce deuxième pilier, la Hongrie en cessant de financer les comptes et en récupérant la majeure partie des sommes qui avaient été accumulées (en décembre 2010) et la Pologne en réduisant (en avril 2011) la part des cotisations affectée au deuxième pilier. Les raisons qui ont conduit à ce recul du deuxième pilier doivent être recherchées dans la manière dont il a été conçu en 1997, des aspects importants, liés au financement des comptes, aux caractéristiques des prestations privées et à l'encadrement des frais de gestion, n'ayant à l'époque pas été prévus. Dans les deux pays, les pouvoirs publics ont tenté de combler ces lacunes, mais avec un succès limité. La crise économique mondiale, en réduisant les rendements des investissements du deuxième pilier et en renchérissant le coût du crédit, a aggravé la situation. Comme le montre la conclusion, certaines questions restent ouvertes et la réponse qui leur sera apportée déterminera les incidences à long terme du recul du deuxième pilier.
Revenu de solidarité active (RSA) et incitations au retour à l'emploi en France
Authors: Anne Denis , L'Horty Yannick 
Published: September 2012

RésuméDans le présent article, nous utilisons un inventaire des transferts locaux et/ou extralégaux (ou droits connexes) dans 13 villes et agglomérations françaises pour mesurer, dans un premier temps, les gains du retour à l'emploi pour les bénéficiaires de prestations légales soumises à condition de ressources (Revenu minimum d'insertion — RMI — et Allocation de parent isolé — API) pour différents types de ménages avant 2009. Les réformes des prestations nationales et légales engagées durant les années 2000, en particulier les mesures relatives à la Prime pour l'emploi (PPE), un crédit d'impôt sur le revenu d'activité, n'ont pas permis de garantir qu'il soit toujours financièrement intéressant de retravailler pour les bénéficiaires de prestations soumises à condition de ressources. Dans la majorité des communes et pour la plupart des types de ménages, accepter un emploi à temps partiel en contrepartie du salaire minimum entraînait une diminution de revenu par rapport au fait de continuer de vivre de prestations sociales, et accepter un emploi à plein temps n'était pas toujours intéressant. Les effets des réformes ont été contrebalancés par l'impact d'autres mesures, comme l'octroi d'aides aux transports par de nombreux conseils régionaux, l'instauration de tarifs sociaux pour le téléphone et l'électricité et l'exonération de la redevance audiovisuelle. Dans un second temps, nous simulons les conséquences de l'introduction du Revenu de solidarité active (RSA), qui a remplacé le RMI en 2009, en tenant compte de l'incidence de la hausse des transferts nationaux et légaux sur les transferts locaux et/ou extralégaux. Nous observons que le RSA élimine, pour la quasi‐totalité des communes et des types de ménages, les facteurs qui avaient un effet financièrement dissuasif sur le retour à l'emploi. Nous montrons aussi que le taux marginal de prélèvement de 38 pour cent retenu par le gouvernement est très proche du taux maximal compatible avec un objectif d'incitation au retour à l'emploi.