bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Effects of Information Technology on Perioperative Nursing
Authors: Sweeney Paula 
Published: October 2010

AbstractNumerous advances in technology during the past decade require that nurses not only be knowledgeable in nursing science but that they also become educated in information technology (IT). Perioperative IT has the potential to improve the quality of health care, reduce costs, decrease medication administration errors, reduce time spent on paperwork, increase management efficacy, and allow affordable access to health care. Nursing knowledge is needed for designing, implementing, and updating software, including an electronic health record (EHR). With the support of EHR data, nurses will be able to develop best practices for patient care and support research for evidence‐based practice. When a standardized terminology, such as the Perioperative Nursing Data Set, is incorporated into an EHR, consistent documentation can be shared among systems. With advances in technology, perioperative nursing roles are expanding in relation to IT requirements and nurses are pursuing additional education. In addition to traditional methods, e‐learning is an effective way to provide ongoing technological education.
Going Live: Implementing a Telesurgery Program
Authors: McCarthy Patricia M. 
Published: October 2010

AbstractTelesurgery is the real‐time transmission of surgery to an audience in a location separate from the OR suite. Staff members at Faulkner Hospital, Jamaica Plain, Massachusetts, established an annual telesurgery event as a method of teaching health care providers about specific orthopedic and gynecology procedures. In October 2009, staff members at Faulkner Hospital successfully completed five separate live transmissions during a four‐day period. Extensive planning, attention to detail, and cooperation among team members and hospital service line members are essential to conducting a safe and successful telesurgery event.
Reducing the Risk of Unplanned Perioperative Hypothermia
Authors: Lynch Susan , Dixon Jacqueline , Leary Donna 
Published: October 2010

AbstractMaintaining normothermia is important for patient safety, positive surgical outcomes, and increased patient satisfaction. Causes of unplanned hypothermia in the OR include cold room temperatures, the effects of anesthesia, cold IV and irrigation fluids, skin and wound exposure, and patient risk factors. Nurses at Riddle Memorial Hospital in Media, Pennsylvania, performed a quality improvement project to evaluate the effectiveness of using warm blankets, warm irrigation fluids, or forced‐air warming on perioperative patients to maintain their core temperature during the perioperative experience. Results of the project showed that 75% of patients who received forced‐air warming perioperatively had temperatures that reached or were maintained at 36° C (96.8° F) or higher within 15 minutes after leaving the OR.
Prevention of Transmissible Infections in the Perioperative Setting
Authors: Cicconi Linda , Claypool Margie , Stevens William 
Published: October 2010

AbstractRisk of infection from bloodborne pathogens makes it imperative for surgical team members to detect surgical glove punctures before skin contact with pathogens occurs. The use of a second, colored pair of gloves worn by scrubbed team members during surgical procedures provides an early indicator of an outer glove puncture while the primary glove or underglove remains intact. This practice reduces the risk of occupational exposures for health care workers and the risk of surgical site infections for patients. We conducted a quality improvement project during which we randomly observed staff members for compliance with double gloving in the OR at the Veterans Affairs Medical Center, Pittsburgh, Pennsylvania, during a 12‐month period, and we conducted a review of sharps injuries for a 45‐month period after intensive education about sharps injuries and use of a hands‐free neutral zone technique. We found that when staff members were compliant with double‐gloving techniques, there was a decrease in skin contact breaches, and the use of a hands‐free neutral zone technique decreased the rate of sharps injuries.
Clinical Issues—November 2010
Authors: Petersen Carol , Blanchard Joan 
Published: October 2010

This MonthResponsibility for obtaining the surgical informed consentKey words: surgical consent, consent for surgery, informed consent.Requirement for a history and physical examination before minor surgeryKey words: patient history, physical examination, H&P, minor surgical procedures.Marking instruments with color‐coded tapeKey words: instrument tape, color‐coded tape, sterilization.Wearing perfume in the perioperative settingKey words: perfume, fragrance‐free health care environments, sensory hyperreactivity.
Der Eltern-Ordner ,,Gesund groß werden‘‘ - modellhafte Evaluation der Funktion und Wirksamkeit von Elternmaterialien
Authors: Pawils Silke , Schwinn Anke , Busche Wiebke , Koch Uwe , Knesebeck Monika von dem , Fillinger Sabine 
Published: October 2010

Einleitung
Die BZgA hat das Konzept des Eltern-Ordners im Auftrag des BMG in Abstimmung mit den pädiatrischen Fachgesellschaften, dem Berufsverband der Kinder- und Jugendärzte und dem Zentralinstitut für die kassenärztliche Versorgung entwickelt und dem Bundesausschuss der Ärzte und Krankenkassen vorgestellt. Die Inhalte wurden mit fachlicher Unterstützung einer Expertengruppe der Pädiatrie und Entwicklungspsychologie erarbeitet. Ziele des Eltern-Ordners und Prüfungsinhalt der Evaluation sind es, allen Eltern den Zugang zu relevantem Gesundheitswissen zu eröffnen, die Elternkompetenz zu stärken, das Arzt-Eltern-Gespräch im Rahmen der U-Untersuchungen besser vorzubereiten. An einer Nettostichprobe von N = 1.634 Familien wurden die Effekte des Eltern-Ordners in einer randomisierten Studie mit Kontrollgruppendesign in den Bundesländern Rheinland-Pfalz und Sachsen untersucht.
Cross-over evaluation of electrically induced pain and hyperalgesia
Authors: Dusch M. , Namer B. , Strupf M. , Schley M. , Rukwied R. , Hägglöf B. , Schmelz M. , Koppert W. 
Published: October 2010

Abstract

Background
Anewexperimental protocol of electrically induced pain and hyperalgesia was established to examine orally administered drugs. In a randomized, double-blind, placebo-controlled cross-over study this experimental protocol was used to assess the effects of paracetamol.

Methods
Twenty-four subjects were enrolled in this study. The magnitude of pain, axon reflex flare, and areas of pin-prick hyperalgesia and touch-evoked allodynia were assessed in two consecutive sessions; prior to, and 2 h after drug administration. This protocol was repeated after 1 week. Subjects were randomized to receive either paracetamol (2 g) or a placebo.

Results
In comparison to the placebo arm there were no significant effects of paracetamol on pain, hyperalgesia, allodynia, or axon reflex flare. Pain and flare responses were highly reproducible on the same day (r = 0.77 and r = 0.79, respectively), and after 1 week (r = 0.6 and r = 0.71, respectively). The correlation between areas of hyperalgesia and allodynia was, however, significantly improved when the protocol was repeated on the same day (r = 0.8 and r = 0.75), as opposed to after a week (r = 0.54 and r = 0.53).

Discussion
The electrical pain model is a well established method for the assessment of intravenously applied analgesics. In order to assess effects of orally applied drugs the model had to be modified: for the assessment of hyperalgesia and allodynia a protocol repeating the model within 1 day proved to have advantages over repetition after 1 week.
The attenuation of pain behaviour and serum interleukin-6 concentration by nimesulide in a rat model of neuropathic pain
Authors: Zanjani Taraneh Moini , Sabetkasaei Masoumeh , Karimian Behnaz , Labibi Farzaneh , Farokhi Babak , Mossafa Nariman 
Published: October 2010

Abstract

Background
Evidence for a role of immune system in hyperalgesic pain states is increasing. Recent work in neuroimmunology suggests that the immune system does more than simply perform its well known functions of recognizing and removing invading pathogens and tumors. Interest in neuroinflammation and neuroimmune activation has grown rapidly in recent years with the recognition of the role of central nervous system inflammatiom and immune responses in the aetiology of pain states. Among various theories, the role of inflammatory responses of the injured nerve has recently received attention. Cytokines are heterogenous group of polypeptides that activate the immune system and mediate inflammatory responses, acting on a variety of tissue, including the peripheral and central nervous system. Interleukin-6 (IL-6) a pro-inflammatory cytokine, is potentially important in pain aetiology, have pronociceptive actions. Neuropathic pain may be due to a primary insult to the peripheral or central nervous system. Substances released during inflammation from immune cells play an important role in the development and maintenance of chronic pain. Nimesulide, a highly selective cox-2 inhibitor, effectively reduces hyperalgesia due to peripherally administration of inflammatory agents like formalin. The safety of nimesulide was reported for some conditions in which other NSAIDs are contraindicated. Here we have determined the effect of nimesulide on pain behaviour and serum IL-6 level in chronic constriction injury (CCI) model of neuropathic pain.

Methods
Experiments were carried out on male Wistar rats, (weight 150–200 g, n = 8). Rats were divided into 3 different groups: 1-CCI + saline 0.9% 2Sham + saline 0.9% (control) 3CCI + drug. Nimesulide (1.25, 2.5, 5 mg/kg, i.p.) was injected 1h before surgery and continued daily to day 14 post-ligation. 42 °C water for thermal hyperalgesia, von Frey filaments for mechanical allodynia, acetone test for cool allodynia and 10 °C water for cold hyperalgesia were respectively used as pain behavioural tests. Behavioural tests were recorded before surgery and on postoperative days 1, 3, 5, 7, 10, 14 and the serum concentration of IL-6 was determined at the day 14.

Results
The results of this study showed a decrease in hyperalgesia and allodynia following nimesulide administration.

Conclusions
It appears that nimesulide was able to reduce pain behaviour due to nerve inflammation and a parallel decrease in the serum IL-6 concentration was observed.

Implications
The immune system is an important mediator in the cascade of events that ultimately results in hyperalgesia. Cytokines contribute to the patheogenesis of neuropathic pain, therefore drugs that inhibit cytokine release from immune cells may reduce inflammatory pain states.
Difficult diagnosis of facial pain: A case report and mini-review
Authors: Jääskeläinen Satu K. , Forssell Heli , Tenovuo Olli , Parkkola Riitta 
Published: October 2010

Abstract
This case report elucidates pitfalls of clinical and radiologic investigations of neuropathic pain due to trigeminal pathology, and utility of neurophysiologic examination when diagnosing facial pain. Our patient was a 63-year-old woman who developed acute, severe facial pain, first located behind the left eye. Neuralgic exacerbations, paresthesia within lower face on the left and restricted mouth opening occurred during the course of the disease with gradual progression. Brain MRI and CT scans were interpreted as normal at 4 and 10 months after symptom onset. At 9 months, detailed neurophysiologic examination showed severe chronic mandibular neuropathy at the left oval foramen with more prominent disturbance of the thick myelinated nerve fibers than the small fibers suggesting compressive etiology. Guided by the neurophysiologic findings, 11 months after the onset of the symptoms, a new brain MRI with contrast enhancement revealed metastatic adenocarcinoma of the left temporal bone along the mandibular nerve, exactly matching the site indicated by the neurophysiologic examination. Neurophysiologic tests offer cost-effective, sensitive tools for screening and accurate level diagnostics of neuropathy and neuropathic pain, which can be utilized also in the diagnosis of facial pain. In addition, whenever there are progressing neurologic deficits or neurophysiologic signs indicating expansive lesion, despite initially normal findings in the brain imaging studies, repeated MRI examinations are warranted, preferably focusing to the ‘neurophysiologic region of interest’ to avoid radiologic sampling errors. As no isolated technique achieves 100% diagnostic accuracy, only rational combinations of different methods will result in correct diagnosis of facial pain without unnecessary delays. Treatment of neuropathic pain is often delayed because of difficulties in reaching the correct diagnosis. During the work-up, many differential diagnostic alternatives have to be considered, also in patients with chronic orofacial pain. Table 1 shows the most important differential diagnoses of orofacial pain.
Early maladaptive schemas in Finnish adult chronic male and female pain patients
Authors: Saariaho Tom H.J. , Saariaho Anita S.I. , Karila Irma A. , Joukamaa Matti I. 
Published: October 2010

Abstract

Background and aims of the study
The connection between chronic pain and traumatic experiences in childhood has been established in several studies. The association of emotional maltreatment with chronic pain has been studied, but to a lesser degree. Schema therapy [24] is an extension of cognitive therapy and presents the early maladaptive schema (EMS) concept. EMSs reflect early, mainly emotional maltreatment. The aim of the present study was to examine the existence of EMSs, the association between EMSs and pain variables and EMS driven patterns.

Patients and measures
The study consisted of 271 first visit pain patients. Their socio-demographic data, pain variables and pain disability were assessed. The presence of EMSs was measured using the Young Schema Questionnaire Short Form Extended. One hundred and three successive participants were also interviewed according to the cognitive case conceptualization.

Results
More than half (58.3%) of the chronic pain patients scored EMSs as meaningful. The patients with meaningful EMSs had significantly higher pain intensity, duration of pain and pain disability. The two most frequently occurring EMSs in male pain patients were Unrelenting Standards/Hypercriticalness (US) (36.2%) and Self-Sacrifice (SS) (23.6%) and in female pain patients SS (40.3%) and US (27.1%). The speech contents of five of the highest scoring US and SS male and female patients (n = 20) were analyzed. The analyses showed schema driven behavior which exacerbated the pain situation. US and SS schemas had a stronger motivational effect on their behavior than the pain itself. Regression analyses showed that Self-Sacrifice schema in women and Emotional Deprivation schema in the total sample predicted pain disability as did pain intensity and the number of pain locations.

Conclusions
This study suggested that a remarkable amount of chronic pain patients may suffer from early maladaptive schemas which have an effect on their current pain situation and may reflect underlying early emotional maltreatment.
Patients referred from a multidisciplinary pain clinic to the social worker, their general health, pain condition, treatment and outcome
Authors: Aho Heli , Kauppila Timo , Haanpää Maija 
Published: October 2010

Abstract

Background and aims
As far as we know, the range of issues particular to social work, when working with clients at a pain clinic has not been previously researched.

Methods
A retrospective study of referrals at the multidisciplinary Pain Clinic of Helsinki University Central Hospital was conducted based on medical records, focusing on pain conditions, treatments and patient flow. Variables used were age, gender, pain conditions, treatment interventions, pain duration and intensity, disruption in everyday life due to pain, psychiatric co-morbidities, referrals, outside care providers, post-treatment care and health habits. Referrals were made mainly by other HUCH units or municipal health centers.

Results
The median age of patients (n = 55) was 44 years. The majority of patients were referred to the pain clinic by municipal health centers. Almost similar number of patients was referred by other HUCH clinics. The largest disease group was musculoskeletal diseases, afflicting 25 patients. Almost the same number of patients (22) suffered from neurological and sensory nervous system diseases. Three patients suffered from persistent somatoform pain disorder and five patients did not fall into any of these categories. Pharmacotherapy was the most prevalent treatment method at the pain clinic, and it was prescribed to all patients. The post-treatment care of the patients was mainly provided by primary health care services. Duration of pain was more than 3 years in more than 60% of the patients. There was a considerable lack of information about pain intensity in the patient files. For the majority of patients, pain caused difficulty in movement, housework, recreation, and sleeping. Patients referred to the pain clinic's social worker had not benefited greatly from previous interventions. More than half of the patients had received psychiatric consultation either at the pain clinic or in some other setting. Most often the patients had been diagnosed to suffer from depression by a psychiatrist. Over a third of the patients had reported suicidal intents to the hospital staff.

Conclusions
The pain situation of patients was severe, in terms of intensity and disability. Treatment was primarily based on drug therapy, and patients generally continued treatment in outpatient services. Depression and substance abuse were common; a third had experienced suicidal intent.
By searching for symptoms, the social worker pays attention to signs of depression at the clinic. Co-operation with social workers in outpatient services is also critical for social after-care. This requires that the social worker of a pain center has an excellent and practical knowledge of the social welfare and service systems.
Use of CART analysis to differentiate pollen of red pine (Pinus resinosa) and jack pine (P. banksiana) in New England
Authors: Barton Andrew M. , Nurse Andrea M. , Michaud Katelyn , Hardy Sarah W. 
Published: October 2010

AbstractThe identification of fossil pollen at the generic rather than species level is hampering progress in understanding the biogeography and dynamics of paleo-vegetation. We used CART analysis to facilitate the differentiation of fossil pollen of Pinus banksiana and Pinusresinosa, which are morphologically similar and nearly always combined in paleoecological studies. The CART model, using four of the ten morphological traits measured, exhibited a high level of correct identification for pollen of each of the species and shows promise as a tool for increasing the detail of paleoecological records and inferences.
Planktonic ciliate communities in a semi-enclosed bay of Yellow Sea, northern China: annual cycle
Authors: Jiang Yong , Xu Henglong , Al-Rasheid Khaled A.S. , Warren Alan , Hu Xiaozhong , Song Weibo 
Published: November 2010

To reveal the annual patterns of planktonic ciliate communities, planktonic ciliate species composition, abundance and biomass, and responses to environmental conditions, were investigated during an annual cycle in Jiaozhou Bay, Qingdao, northern China. A total of 64 species belonging to five orders (Oligotrichida, Haptorida, Cyrtophorida, Hypotrichida and Tintinnida) were identified, 9 of which were dominant. Ciliate communities presented a clear seasonal pattern in terms of both abundance and biomass. A single peak of ciliate abundance and biomass occurred in late August, mainly due to the oligotrichids, tintinnids and haptorids. The 9 dominant species showed a distinct temporal distribution with seasonal successions of ciliate communities. Multivariate analyses revealed that ciliate abundance was significantly correlated with water temperature, dissolved oxygen and nutrients, especially nitrate nitrogen and soluble reactive phosphate (P < 0.05). These findings provided basic data on annual cycle of planktonic ciliate communities in a semi-enclosed bay of Yellow Sea, northern China.
Devolution of environment and resources governance: trends and future
Authors: BERKES FIKRET 
Published: November 2010

SUMMARYHow can the governance of environment and resources be devolved in a way that incorporates effective user participation and feedback learning? Approaches that use the idea of adaptive management or learning-by-doing, combined with co-management, are particularly promising. Using an interdisciplinary literature covering many types of resources, and a conceptual model with three phases (communicative action, self-organization and collective action), the paper identifies some of the major processes leading to adaptive co-management. These include deliberation, visioning, building social capital, trust and institutions, capacity-building through networks and partnerships, and action-reflection-action loops for social learning. Such adaptive co-management is not simply a theoretical possibility but something that has been documented in a number of forestry, fisheries, wildlife, protected area, and wetland cases from both developed and developing countries. However, the experience with the decentralization reforms of the 1990s is largely negative for a number of reasons. Effective devolution takes time, requiring a shift in focus from a static concept of management to a dynamic concept of governance shaped by interactions, feedback learning and adaptation over time. Sharing of governance responsibilities and an ability to learn from experience are among the emerging trends in environmental management.
THE INTERNATIONAL CRIMINAL COURT – SOME REFLECTIONS
Authors: Moreno-Ocampo Luis 
Published: November 2010

AbstractI took office seven years ago as the Prosecutor of the International Criminal Court. Over those years, I have seen remarkable developments, the creation of a global judicial institution from scratch, the development of our operations in all regions of the world, mainly in conflict areas, the setting up of key jurisprudence on modes of liability, complementarity, criminal procedure as well as on victims' participation before the Court. Today I would like to focus on how the work of this Court can contribute to the prevention of massive crimes. Crimes we thought, over and over, would never happen again, only to see them occur, again and again, before our eyes: genocide, crimes against humanity and war crimes. How can we maximize the preventive impact of our work? How can we ensure that the crimes committed in Georgia during the summer of 2008, in Guinea in the fall of 2009 are not repeated? How can we stop current crimes in Darfur? How can we prevent a new cycle of violence during the next elections in Kenya scheduled for 2012? How can we support Colombia's efforts to end half a century of violence?
THE CIVILIAN IN MODERN WAR
Authors: Roberts A. 
Published: November 2010

AbstractThere is a widespread view that civilians are worse off in today' wars than ever before. Civilians are often deliberately targeted by belligerents or are victims of ‘collateral damage’. They form the majority of victims of landmines. They are used as human shields. They are displaced from their homes, even from their country. They are affected, often more than soldiers, by the pestilence, famine and displacement that wars bring in their wake. They are often particularly vulnerable in the types of war that are most prevalent in the world today – including civil wars and asymmetric conflicts. Children are forced to become soldiers. How can it be that the lot of civilians in war remains so dire, when so much attention has been paid to the protection of civilians in war – not just in international treaties, but in the work of international organizations and also that of numerous humanitarian bodies?