bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mortality and its predominant causes in a large cohort of patients with biopsy‐determined inflammatory myositis
Authors: Limaye V. , Hakendorf P. , Woodman R J. , Blumbergs P. , Roberts‐Thomson P. 
Published: December 2010

AbstractBackground:  There is a paucity of literature on the patterns and predictors of mortality in idiopathic inflammatory myopathies (IIM).Aims:  To determine the patterns and predictors of mortality in a South Australian cohort of patients with biopsy‐proven IIM.Methods:  The living/deceased status (and for deceased patients the causes of death) of patients with histologically determined IIM was determined from the Births, Deaths and Marriages Registry. Standardised mortality ratios (SMR) were generated compared with the age/gender matched South Australian population. The effect of presence/absence of the components of the Bohan and Peter criteria on risk ratios (RR) for mortality was determined. The effect of comorbidities and autoantibodies on mortality was investigated.Results:  The SMR for mortality in IIM was 1.75 and was significantly increased in all disease subgroups, being highest in patients with dermatomyositis (2.40). Dominant causes of death were cardiovascular disease (31%), infections (22%) and malignancy (11%). Risk factors for death were age at time of biopsy (hazard ratio 1.05), ischaemic heart disease (RR 2.97, P < 0.0001), proximal weakness at diagnosis (RR 1.8, P= 0.03), definite diagnosis of IIM per the Bohan and Peter criteria (RR 2.14, P < 0.0001), and the absence of autoantibodies (RR 1.9, P < 0.001).Conclusions:  Patients with IIM are at 75% increased risk for mortality, and cardiovascular diseases account for the commonest causes of death. This study suggests a thorough cardiovascular evaluation of these patients is indicated, and raises the possibility that targeted interventions such as the use of aspirin or statins may improve outcomes in IIM.
Treatment and monitoring of coagulation abnormalities in children undergoing heart surgery
Authors: Arnold Philip 
Published: December 2010

SummaryBleeding is a considerable clinical problem during and after pediatric heart surgery. While the primary cause of bleeding is surgical trauma, its treatment is often complicated by the presence of coagulopathy. The principle causes of coagulopathy are discussed to provide a context for treatment. The role of laboratory and point of care tests, which aim to identify the cause of bleeding in the individual patient, is also discussed. An attempt is made to examine the current evidence for available therapies, including use of blood products and, more recently proposed, approaches based on human or recombinant factor concentrates.
Lived experiences of internationally educated nurses in hospitals in the United States of America
Authors: Jose M. M. 
Published: December 2010

JOSE M. M. (2011) Lived experiences of internationally educated nurses in hospitals in the United States of America. International Nursing Review58, 123–129Aim:  The overall goal of this study was to elicit and describe the lived experiences of internationally educated nurses (IENs) who work in a multi‐hospital medical centre in the urban USA.Background:  Since World War Two, US health care agencies have addressed the nursing shortage by hiring IENs. While other countries have produced substantial research findings about their IENs, much less research has been done about IENs in the USA. Findings from the limited US studies suggest that more research is needed and first‐hand reports of lived experiences must be added.Methods:  Using a phenomenology of practice study design and Giorgi's principles of data analysis, narratives from the guided interviews with 20 new immigrant IENs who had migrated from the countries of the Philippines, Nigeria and India to the USA, were collected and studied for themes.Findings and discussion:  Six themes that emerged from the stories of IENs together describe a trajectory of lived experiences that the IENs encountered during their adjustments to living and working in the USA. The emergent themes weredreams of a better life, a difficult journey, a shocking reality, rising above the challenges, feeling and doing better and ready to help others. Study findings are similar to studies done in other countries and highlight the needs of IENs.Conclusion:  The study findings provide important first‐hand insights from the subjective perspectives of the IENs in US hospitals and will guide recruitment and retention of a diverse nursing workforce. Findings will enrich orientation and transition programs for IENs as well as strengthen the cohesiveness of a diverse nursing workforce in the USA.
Nurses' and nursing students' attitudes towards late abortions
Authors: Ben Natan M. , Melitz O. 
Published: December 2010

BEN NATAN M. & MELITZ O. (2011) Nurses' and nursing students' attitudes towards late abortions. International Nursing Review58, 68–73Aim:  The aim of the present study is to compare the attitudes of nursing students and nurses working in maternity wards towards late abortions performed after the 16th week of pregnancy and to identify the factors influencing their attitudes.Methods:  A quantitative design was employed in this descriptive study, using two convenience samples: 100 nurses working in the maternity ward of a large hospital and 100 nursing students from a nursing school in Israel. The self‐report questionnaire was specially designed for purposes of this study.Findings:  Results showed that the nurses had less prejudicial attitudes towards late abortions than the nursing students. Overall, the participants had a more positive attitude towards late abortions in the following cases: (1) risk of malformation or developmental disability, (2) pregnancy as a result of rape, and (3) danger to the life of the mother. There was a weak negative connection between the participants' number of children and their attitudes towards late abortions. In addition, there was a significant relationship found between the level of religious observance and attitudes towards late abortions, as negative attitudes increased with higher religious observance. Indeed, the level of religious observance was found to be the most significant predictor of the participants' attitudes towards late abortions.Conclusion:  Differences in attitudes were found between nursing students and nurses providing care to patients undergoing late abortions. Their personal religious beliefs, as well as the reason for the abortion, were found to be influential in determining their attitudes.
HAVING KNOW‐HOW: INTELLECT, ACTION, AND RECENT WORK ON RYLE'S DISTINCTION BETWEEN KNOWLEDGE‐HOW AND KNOWLEDGE‐THAT
Authors: SAX GREG 
Published: December 2010

AbstractStanley and Williamson reject Ryle's knowing‐how/knowing‐that distinction charging that it obstructs our understanding of human action. Incorrectly interpreting the distinction to imply that knowledge‐how is non‐propositional, they object that Ryle's argument for it is unsound and linguistic theory contradicts it. I show that they (and their interlocutors) misconstrue the distinction and Ryle's argument. Consequently, their objections fail. On my reading, Ryle's distinction pertains to, not knowledge, but an explanatory gap between explicit and implicit content, and his argument for it is sound. I defend the distinction's necessity in explaining human action and show that it propels a fruitful explanatory program.
ST. THOMAS AQUINAS ON DEATH AND THE SEPARATED SOUL
Authors: TONER PATRICK 
Published: December 2010

AbstractSince St. Thomas Aquinas holds that death is a substantial change, a popular current interpretation of his anthropology must be mistaken. According to that interpretation – the ‘survivalist’ view – St. Thomas holds that we human beings survive our deaths, constituted solely by our souls in the interim between death and resurrection. This paper argues that St. Thomas must have held the ‘corruptionist’ view: the view that human beings cease to exist at their deaths. Certain objections to the corruptionist view are also met.
A Corporate Geography of Canada: Insights into a Multi‐Jurisdictional Model of Corporate Governance
Authors: GRAY TAYLOR R. 
Published: December 2010

ABSTRACTComparative corporate governance has long focused on national models of corporate governance with particular attention paid to the balance of influence between divergent path dependence and convergent global market forces. Within this debate, the Canadian model of corporate governance has received little attention and has long been assumed to be an extension of the U.S. model. An analysis of the corporate geography of Canada demonstrates that the path‐dependent forces of Canada's resource‐dependent economic development remain a principal determinant in contemporary corporate Canada. Continued resource dependence in combination with a system of asymmetric federalism has led to a distinctively multi‐jurisdictional model of corporate governance. As corporate interests are provincially distinct because of the heterogeneous distribution of natural resources and markets across Canada, this model may lead to provincial lock‐in and an associated degree of managerial entrenchment.
Intra‐ and Interobsever Reliability of Sonographic Assessment of the Optic Nerve Sheath Diameter in Healthy Adults
Authors: Bäuerle Jochen , Lochner Piergiorgio , Kaps Manfred , Nedelmann Max 
Published: December 2010

ABSTRACTBACKGROUNDThe use of an ultrasound‐based evaluation of the optic nerve sheath diameter (ONSD) has previously been demonstrated for detecting raised intracranial pressure. In order to be feasible in clinical workup, the test qualities of transorbital ultrasonography need to be determined. The aim of this study was therefore to establish normal values and to assess the intra‐ and interobserver reliability of this method.METHODSUsing a 9‐3 MHz linear array transducer, the ONSD of 40 healthy subjects was independently measured by 2 investigators.RESULTSDepicting the optic nerve and its sheath was possible in all individuals. The mean ONSD was 5.4 ± .6 mm with a range of 4.3‐7.6 mm. The intraobserver reliability analyzed with Cronbach's Alpha was found to be high with values between .92 and .97. Pearson's correlation coefficient between the 2 investigators was .81 on the right side and .84 on the left. There was no correlation between ONSD and age, body mass index, or gender.CONCLUSIONSTransorbital B‐mode sonography is a feasible method to assess the ONSD with a high intra‐ and interobsever reliability. Normal values on ONSD are presented in this study that will be useful in future studies on pathological conditions.
Intracranial Hypotension Caused by Dural‐Pleural Fistula
Authors: Chaudhry Mohammed Suhail 
Published: December 2010

ABSTRACTThis report describes a rare complication in a woman who underwent thoracic spinal surgery. One month postoperatively, her rehabilitation was interrupted by the development of a severe headache, nausea, vomiting, and a right‐side occulomotor nerve palsy. Imaging of her brain revealed changes typical of intracranial hypotension, and subsequent imaging of the spine revealed a cerebrospinal fluid (CSF) leak at the site of surgery. The CSF was seen to track into the right pleural space via a dural‐pleural fistula. Surgical repair of the fistula led to a definitive resolution in symptoms, thus highlighting the importance of early recognition of this highly unusual complication. J Neuroimaging 2012;22:208‐209.
Stroke Fast Track Reduces Time Delay to Neuroimaging and Increases Use of Thrombolysis in an Academic Medical Center in Thailand
Authors: Ratanakorn Disya , Keandoungchun Jesada , Sittichanbuncha Yuwares , Laothamatas Jiraporn , Tegeler Charles H. 
Published: December 2010

ABSTARCTDelays between hospital arrival and neuroimaging prevented patients from receiving thrombolysis. We report impact of Stroke Fast Track (SFT) on time to imaging, and rates of recombinant tissue plasminogen activator (rt‐PA) in eligible patients. Characteristics, time intervals, and rates of rt‐PA were evaluated in 464 patients with suspected acute stroke within 7 days (2005–2006). Complete time intervals were available on 380. Median times between emergency room arrival, brain computerized tomography (CT), and CT results were 25 and 45 minutes, respectively, for patients arriving <3 hours from onset, 40, and 65 minutes for those arriving >3 hours, and 35 and 60 minutes for all patients, which is significantly shorter than 2.5 hours to CT in 2004, prior to SFT (P < .0001). Although not different in time to first physician, patients arriving >3 hours had longer times to CT and CT results (P < .001). Overall, 5.5% of ischemic stroke patients received intravenous rt‐PA, including 27.1% of those arriving within 3 hours, which represented 100% of all eligible patients, compared with 0% in 2004. SFT reduced time delay in neuroimaging and increased use of rt‐PA in Thailand. Continuous quality improvement is needed to achieve best results in each setting, and to insure optimal care for acute stroke patients.
Diffusion Tensor Imaging of Corpus Callosum Integrity in Multiple Sclerosis: Correlation with Disease Variables
Authors: Sigal Tal , Shmuel Miron , Mark Dolev , Gil Harari , Anat Achiron 
Published: December 2010

ABSTRACTBACKGROUND AND PURPOSECorpus callosum (CC) is frequently involved in multiple sclerosis (MS). We aimed to investigate the relations between CC microstructure integrity as measured by diffusion tensor imaging (DTI) in relapsing‐remitting MS patients with low neurological disability in comparison with age‐matched healthy subjects and further to identify correlations between DTI‐CC parameters and clinical variables of MS disease activity.METHODSCC volume was measured on 3.0T brain MRI by MS Analyze software. DTI metrics acquired along 31 independent directions were obtained and fractional anisotropy (FA), apparent diffusion coefficient (ADC), longitudinal (λ1) and transverse (λ 2, λ 3) diffusivities were measured in MS patients and healthy subjects. Disease activity was assessed by relapse rate and neurolgical disability by the Extended Disability Status Scale (EDSS).RESULTSThirty relapsing‐remitting MS patients and 30 age‐ and sex‐matched healthy subjects were studied. CC volume and DTI metrics differed significantly between MS patients and healthy subjects. In MS patients, all DTI parameters correlated with neurological disability. ADC, longitudinal and transverse diffusivity correlated with disease duration. ADC and the transverse diffusivity correlated with relapse rate.CONCLUSIONSCC DTI parameters, especially ADC and transverse diffusivity correlated with disease variables especially with those associated with clinical activity.
Distribution of Emergency Departments According to Annual Visit Volume and Urban–Rural Status: Implications for Access and Staffing
Authors: Muelleman Robert L. , Sullivan Ashley F. , Espinola Janice A. , Ginde Adit A. , Wadman Michael C. , Camargo Jr. Carlos A. 
Published: December 2010

AbstractObjectives:  Ongoing efforts to improve access to emergency care and emergency department (ED) staffing would benefit from a better understanding of the distribution of EDs in the United States by size and location. This article describes the distribution of U.S. ED visit volumes according to ED urban versus rural status.Methods:  The authors used the 2007 National Emergency Department Inventories (NEDI)‐USA database to identify all nonfederal U.S. hospitals with EDs and their annual ED visit volumes. One of twelve 2003 Urban Influence Codes was applied to each ED location based on its county. These categories were collapsed into urban counties and three types of rural counties: adjacent to urban, large nonadjacent, and small nonadjacent. The number of emergency physicians (EPs) needed to staff the higher‐volume rural EDs was estimated.Results:  Of the 4,874 U.S. EDs in 2007, 58% were in urban counties and 42% in rural counties. Among the 2,038 rural EDs, 56% were adjacent to urban, 15% were large nonadjacent, and 29% were small nonadjacent. Of the 1,503 lower‐volume (< 10,000 visit) EDs, 21% were in urban counties. Of the 3,371 higher‐volume (≥ 10,000 visit) EDs, 25% were in rural counties. Of the 857 higher‐volume rural EDs, 66% were adjacent to urban, 22% were large nonadjacent, and 12% were small nonadjacent. The authors estimate that approximately 5,600 EPs are needed to staff these higher‐volume rural EDs.Conclusions:  There are many lower‐volume EDs in urban areas and higher‐volume EDs in rural areas. Most higher‐volume rural EDs are in rural areas adjacent to urban counties. These data challenge popular assumptions regarding ED visit volumes, locations, and staffing needs.ACADEMIC EMERGENCY MEDICINE 2010; 17:1390–1397 © 2010 by the Society for Academic Emergency Medicine
A Link to Improve Stroke Patient Care: A Successful Linkage Between a Statewide Emergency Medical Services Data System and a Stroke Registry
Authors: Mears Greg D. , Rosamond Wayne D. , Lohmeier Chad , Murphy Carol , O’Brien Emily , Asimos Andrew W. , Brice Jane H. 
Published: December 2010

AbstractObjectives:  Regionalization of stroke care, including diversion to stroke centers, requires that emergency medical services (EMS) systems accurately identify acute stroke patients. A barrier to evaluating and improving EMS stroke patient identification is the inability to link EMS data with hospital data for individual patients. We sought to create and validate a linkage of the North Carolina EMS Data System (NC‐EMS‐DS) with data contained in the North Carolina Stroke Care Collaborative (NCSCC) Registry.Methods:  All NCSCC Registry patients arriving to one of three hospitals by EMS in a 6‐month period were matched against NC‐EMS‐DS. Records were deterministically matched on receiving hospital, hospital arrival date/time, age, and sex. We performed linkage validation by providing each site investigator with a stroke patient list derived from North Carolina Stroke Care Collaborative Registry (NC‐EMS‐DS), matched by individual patient to deidentified data in the NCSCCR. Each site investigator determined the set of true matches by comparing the matched list to a NCSCCR patient identifier key maintained at each site. Incorrect matches were reviewed by the research team to identify methods for future improvement in the matching logic.Results:  For the three validation hospitals, 753 NCSCC Registry patients arrived by EMS. For these patients, 473 (63%) matches to local EMS records were identified, and 421 (89%) of the matches were verified using full patient identifiers. Most match verification failures were due to incorrect date/time stamp and inability to find a corresponding EMS record.Conclusions:  Linking EMS records electronically to a stroke registry is feasible and leads to a large number of valid matches. This small validation is limited by EMS data quality. Matching may improve with better EMS documentation and standardized facility documentation.ACADEMIC EMERGENCY MEDICINE 2010; 17:1398–1404 © 2010 by the Society for Academic Emergency Medicine
Inter‐hospital Communications and Transport: Turning One‐way Funnels Into Two‐way Networks
Authors: Rokos Ivan C. , Sanddal Nels D. , Pancioli Arthur M. , Wolff Catherine , Gaieski David F. 
Published: December 2010

AbstractThe Inter‐hospital Communications and Transport workgroup was charged with exploring the current status, barriers, and data necessary to optimize the initial destination and subsequent transfer of patients between and among acute care settings. The subtitle, “Turning Funnels Into Two‐way Networks,” is descriptive of the approach that the workgroup took by exploring how and when smaller facilities in suburban, rural, and frontier areas can contribute to the daily business of caring for emergency patients across the lower‐acuity spectrum—in some instances with consultant support from academic medical centers. It also focused on the need to identify high‐acuity patients and expedite triage and transfer of those patients to facilities with specialty resources. Draft research recommendations were developed through an iterative writing process and presented to a breakout session of Academic Emergency Medicine’s 2010 consensus conference, “Beyond Regionalization: Integrated Networks of Emergency Care.” Priority research areas were determined by informal consensus of the breakout group. A subsequent iterative writing process was undertaken to complete this article. A number of broad research questions are presented.ACADEMIC EMERGENCY MEDICINE 2010; 17:1279–1285 © 2010 by the Society for Academic Emergency Medicine
Categorization, Designation, and Regionalization of Emergency Care: Definitions, a Conceptual Framework, and Future Challenges
Authors: Kocher Keith E. , Sklar David P. , Mehrotra Abhishek , Tayal Vivek S. , Gausche‐Hill Marianne , Myles Riner R. 
Published: December 2010

AbstractThis article reflects the proceedings of a breakout session, “Beyond ED Categorization—Matching Networks to Patient Needs,” at the 2010 Academic Emergency Medicine consensus conference, “Beyond Regionalization: Integrated Networks of Emergency Care.” It is based on concepts and areas of priority identified and developed by the authors and participants at the conference. The paper first describes definitions fundamental to understanding the categorization, designation, and regionalization of emergency care and then considers a conceptual framework for this process. It also provides a justification for a categorization system being integrated into a regionalized emergency care system. Finally, it discusses potential challenges and barriers to the adoption of a categorization and designation system for emergency care and the opportunities for researchers to study the many issues associated with the implementation of such a system.ACADEMIC EMERGENCY MEDICINE 2010; 17:1306–1311 © 2010 by the Society for Academic Emergency Medicine
Administrative Challenges to Regionalization
Authors: Pilgrim Randy , Martinez Ricardo , Jouriles Nicholas , Hufstetler Greg , Wise Pat , Wise Robert , Acker Joe , Soremekun Olan A. , Carrier Emily 
Published: December 2010

AbstractThe ideal emergency care system delivers the right care to the right patient at the right time and yields appropriate patient outcomes at a sustainable overall cost. Transforming the current system of emergency care into the Institute of Medicine’s vision of a coordinated, regionalized, and accountable emergency care system requires careful consideration of administrative challenges and barriers. Left unaddressed, certain processes, systems, and structures may prevent integration efforts or threaten long‐term viability.ACADEMIC EMERGENCY MEDICINE 2010; 17:1359–1363 © 2010 by the Society for Academic Emergency Medicine
Regionalization and Emergency Care: The Institute of Medicine Reports and a Federal Government Update
Authors: Carr Brendan G. , Asplin Brent R. 
Published: December 2010

AbstractThe 2010 Academic Emergency Medicine consensus conference on regionalization in emergency care began with an update on the Institute of Medicine (IOM) reports on the Future of Emergency Care. This was followed by two presentations from federal officials, focusing on regionalization from the perspective of the White House National Security Staff and the Emergency Care Coordination Center. This article summarizes the content of these presentations. It should be noted that this summary is the perspective of the authors and does not represent the official policy of the U.S. government.Academic Emergency Medicine 2010; 17: 1351–1353 © 2010 by the Society for Academic Emergency Medicine