bluuebunny/crossref_metadata_2025_split huggingface dataset:
Surgeon and Hospital Volume as Quality Indicators for CABG in Taiwan: Examining Hazard to Mortality and Accounting for Unobserved Heterogeneity
Authors: Hockenberry Jason M. , Lien Hsien‐Ming , Chou Shin‐Yi 
Published: July 2010

Objective. To investigate whether provider volume has an impact on the hazard of mortality for coronary artery bypass grafting (CABG) patients in Taiwan.Data Sources/Study Setting. Multiple sources of linked data from the National Health Insurance Program in Taiwan.Study Design. The linked data were used to identify 27,463 patients who underwent CABG without concomitant angioplasty or valve procedures and the surgeon and hospital volumes. Generalized estimating equations and hazard models were estimated to assess the impact of volume on mortality. The hazard modeling technique used accounts for bias stemming from unobserved heterogeneity.Principal Findings. Both surgeon and hospital volume quartiles are inversely related to the hazard of mortality after CABG. Patients whose surgeon is in the three higher volume quartiles have lower 1‐, 3‐, 6‐, and 12‐month mortality after CABG, while only those having their procedure performed at the highest quartile of volume hospitals have lower mortality outcomes.Conclusions. Mortality outcomes are related to provider CABG volume in Taiwan. Unobserved heterogeneity is a concern in the volume–outcome relationship; after accounting for it, surgeon volume effects on short‐term mortality are large. Using models controlling for unobserved heterogeneity and examining longer term mortality may still differentiate provider quality by volume.
Mortality among Patients with Acute Myocardial Infarction: The Influences of Patient‐Centered Care and Evidence‐Based Medicine
Authors: Meterko Mark , Wright Steven , Lin Hai , Lowy Elliott , Cleary Paul D. 
Published: July 2010

Background. Recent studies have suggested that there is a positive impact of patient‐centered care (PCC) on both the patient–physician relationship and subsequent patient health‐related behaviors. One recent prospective study reported a significant relationship between the degree of PCC experienced by patients during their hospitalization for acute myocardial infarction (AMI) and their postdischarge cardiac symptoms. A limitation of this study, however, was a lack of information regarding the technical quality of the AMI care, which might have explained at least part of the differences in outcomes. The present study was undertaken to test the influence of both PCC and technical care quality on outcomes among AMI patients.Methods. We analyzed data from a national sample of 1,858 veterans hospitalized for an initial AMI in a Department of Veterans Affairs medical center during fiscal years 2003 and 2004 for whom data had been compiled on evidence‐based treatment and who had also completed a Picker questionnaire assessing perceptions of PCC. Cox proportional hazards models were used to estimate the relationship between PCC and survival 1‐year postdischarge, controlling for technical quality of care, patient clinical condition and history, admission process characteristics, and patient sociodemographic characteristics. We hypothesized that better PCC would be associated with a lower probability of death 1‐year postdischarge, even after controlling for patient characteristics and the technical quality of care.Results. Better PCC was associated with a significantly but modestly lower hazard of death over the 1‐year study period (hazard ratio 0.992, 95 percent confidence interval 0.986–0.999).Conclusions. Providing PCC may result in important clinical benefits, in addition to meeting patient needs and expectations.
Complications of laparoscopic myomectomy: A single surgeon’s series of 1001 cases
Authors: Paul G. P. , NAIK Sejal A. , Madhu K. N. , THOMAS Tony 
Published: July 2010

Objective:  The objective of this retrospective study was to evaluate the safety, intra‐operative and post‐operative morbidity of laparoscopic approach for myomectomy.Methods:  The total 1001 subjects who underwent endoscopic surgery over a 16‐year period were studied retrospectively. All the data were collected regarding clinical presentation, intra‐operative findings, intra‐operative and post‐operative complications, and hospital stay, and statistically analysed.Results:  The average age of subjects was 32.62 years and the most common indication for surgery was infertility (48.5%). A total of 2167 myomas were removed; 43.98% of subjects required removal of multiple myomas. The average blood loss was 248 mL, and the average hospital stay was 1.5 days. The overall major and minor complication rate is very low except one subject who required laparotomy for post‐operative bleeding, and there was one unexplained post‐operative death.Conclusions:  Laparoscopic myomectomy is comparable to laparotomy myomectomy in terms of duration of surgery, blood loss and complication rates. This large single surgeon series on laparoscopic myomectomy also shows a low complication rate suggesting that laparoscopic myomectomy is a safe and reliable procedure, even in the presence of multiple or large myomas.
Gender‐Related Influences of Parental Alcoholism on the Prevalence of Psychiatric Illnesses: Analysis of the National Epidemiologic Survey on Alcohol and Related Conditions
Authors: Morgan Peter T. , Desai Rani A. , Potenza Marc N. 
Published: July 2010

Background: Offspring of individuals with alcoholism are at increased risk for psychiatric illness, but the effects of gender on this risk are not well known. In this study, we tested the hypothesis that the gender of the parent with alcoholism and the gender of offspring affect the association between parental alcoholism and offspring psychiatric illness.Method: We analyzed the National Epidemiological Survey on Alcohol and Related Conditions (NESARC) data to examine the gender‐specific prevalence of axis I and axis II disorders in 23,006 male and 17,368 female respondents with and without a history of paternal or maternal alcoholism. Adjusted odds ratios were calculated for the disorders based on gender and presence of maternal or paternal alcoholism.Results: Maternal or paternal alcoholism was associated with a higher prevalence of every disorder examined, regardless of the gender of offspring. Gender‐related differences in prevalences were present in nearly all examined disorders, and the association between parental alcoholism and offspring psychiatric disorders was significantly different in men and women. These differences included stronger associations in female offspring of men with alcoholism (alcohol abuse without dependence); in female offspring of women with alcoholism (mania, nicotine dependence, alcohol abuse, and schizoid personality disorder); in male offspring of men with alcoholism (mania); and in male offspring of women with alcoholism (panic disorder).Conclusions: Interactions between gender and parental alcoholism were specific to certain disorders but varied in their effects, and in general female children of women with alcoholism appear at greatest risk for adult psychopathology.
Sociodemographic Predictors of Pattern and Volume of Alcohol Consumption Across Hispanics, Blacks, and Whites: 10‐Year Trend (1992–2002)
Authors: Caetano Raul , Baruah Jonali , Ramisetty‐Mikler Suhasini , Ebama Malembe S. 
Published: July 2010

Background:  There have been limited trend studies examining variations on the patterns of alcohol consumption among Whites, Blacks, and Hispanics in the United States. The current paper reports national trends in drinking patterns, volume of drinking (number of drinks per month), binge drinking, and drinking to intoxication among Blacks, Whites, and Hispanics over a period of 10 years and identifies sociodemographic predictors of these behaviors across the 3 ethnic groups.Methods:  Data are from the 1991 to 1992 National Longitudinal Alcohol Epidemiologic Survey (NLAES; n = 42,862) and the 2001 to 2002 National Epidemiologic Study on Alcohol and Related Conditions (NESARC; n = 43,093). Both surveys used multistage cluster sample procedures to select respondents 18 years of age and older from the U.S. household population.Results:  Trends varied across different dimensions of drinking and ethnic groups. There were no statistically significant differences in the mean number of drinks consumed per month among men and women in any of the 3 ethnic groups between 1992 and 2002, but there was a significant rise in the proportion of current drinkers in both genders and in all 3 ethnic groups. Multivariate analysis indicated that, compared to Whites in 1992, Blacks and Hispanics did not increase their volume of drinking, but Whites did. Drinking 5 or more drinks in day at all did not increase between 1992 and 2002, but drinking 5 or more drinks at least once a month was more likely for all groups in 2002 compared to Whites in 1992. Drinking to intoxication at all was more likely among Whites in 2002 than 1992, but drinking to intoxication at least once a month was more likely among Whites and Blacks in 2002 than 1992.Conclusion:  The only common trend between 1992 and 2002 across both genders and 3 ethnic groups was a rise in the proportion of drinkers. There was also a rise in drinking 5 or more drinks in a day (Whites, Blacks, and Hispanics) and drinking to intoxication (Whites and Blacks), but this was limited to those reporting such drinking at least once a month. The reasons for these changes are many and may involve complex sociodemographic changes in the population. It is important for the field to closely monitor these cross‐ethnic trends in alcohol consumption.
The Impact of Maternal Age on the Effects of Prenatal Alcohol Exposure on Attention
Authors: Chiodo Lisa M. , Da Costa David E. , Hannigan John H. , Covington Chandice Y. , Sokol Robert J. , Janisse James , Greenwald Mark , Ager Joel , Delaney‐Black Virginia 
Published: July 2010

Background:  Prenatal exposure to alcohol has a variety of morphologic and neurobehavioral consequences, yet more than 10% of women continue to drink during pregnancy, placing their offspring at risk for fetal alcohol spectrum disorders (FASD). Identification of at‐risk pregnancies has been difficult, in part, because the presence and severity of FASD are influenced by factors beyond the pattern of alcohol consumption. Establishing maternal characteristics, such as maternal age, that increase the risk of FASD is critical for targeted pregnancy intervention.Methods:  We examined the moderating effect of maternal age on measures of attention in 462 children from a longitudinal cohort born to women with known alcohol consumption levels (absolute ounces of alcohol per day at conception) who were recruited during pregnancy. Analyses examined the impact of binge drinking, as average ounces of absolute alcohol per drinking day. Smoking and use of cocaine, marijuana, and opiates were also assessed. At 7 years of age, the children completed the Continuous Performance Test, and their teachers completed the Achenbach Teacher Report Form.Results:  After controlling for covariates, stepwise multiple regression analyses revealed a negative relation between levels of prenatal binge drinking and several measures of attention. The interaction between alcohol consumption and maternal age was also significant, indicating that the impact of maternal binge drinking during pregnancy on attention was greater among children born to older drinking mothers.Conclusion:  These findings are consistent with previous findings that children born to older alcohol‐using women have more deleterious effects of prenatal alcohol exposure on other neurobehavioral outcomes.
Decomposition Analysis of Waste Generation From Stocks in a Dynamic System
Authors: Oguchi Masahiro , Tasaki Tomohiro , Moriguchi Yuichi 
Published: July 2010

SummaryWe conducted a decomposition analysis of material flows in a dynamic system, focusing on factors in the generation of waste consumer durables. A methodology for the analysis of consumer durables was developed and applied to three common consumer durables: cathode ray tube TVs, refrigerators, and passenger cars. The methodology decomposed changes in the numbers of waste products into three factors: changes in lifespan distribution, past trends in replacement sales, and past trends in sales for additional purchases. The decomposed equation clearly showed that the number of waste products would not necessarily be reduced by lifespan extension alone. This is because the number of waste products generated is affected not only by current lifespan distribution but also by past trends in sales for replacement and in additional purchases. The results show that changes in past replacement sales influence the current generation of waste, even if current replacement sales are declining. To reduce the generation of waste products on a short‐term basis, lifespan must be extended until the waste‐reducing effect of lifespan extension exceeds the waste‐increasing effect of the other two factors. From a long‐term perspective, controlling current replacement and additional purchases can be used to prevent future waste product generation.
Obama, Reagan and Zero Nukes
Authors: SHULTZ GEORGE 
Published: July 2010

Is President Barack Obama's proposal for zero nuclear weapons realistic? Will it make the world more secure, or more prone to wars since they are no longer unthinkable?To evaluate this bold strategic initiative, we have invited comments from two former US secretaries of state, a former director of the CIA and the former head of the International Atomic Energy Agency who led the hunt for Saddam's non‐existent weapons of mass destruction on the eve of the Iraq war.
The BRICs Come of Global Age
Authors: LULA DA SILVA LUIZ INÁCIO 
Published: July 2010

The world is rapidly evolving on many fronts. Brazil, Turkey and other emerging powers are taking their own initiatives and building their own global links outside the old frameworks of the G‐8, the United Nations Security Council and NATO. The “third way” politics of Tony Blair that embraced globalization from the left of center in Britain has given way to the Tory party once again. Just as recovery from the financial crash seemed on the horizon, Europe's sovereign debt crisis has erupted. The historically unprecedented pace and scale of urbanization in China is transforming the politics of the Communist Party.President Lula of Brazil, former US treasury secretary Henry Paulson, Singapore's foreign minister George Yeo and others take stock of these manifold developments.
Turkey's Emergence as a “Center Power” Is a Game Changer
Authors: OZEL SOLI 
Published: July 2010

The world is rapidly evolving on many fronts. Brazil, Turkey and other emerging powers are taking their own initiatives and building their own global links outside the old frameworks of the G‐8, the United Nations Security Council and NATO. The “third way” politics of Tony Blair that embraced globalization from the left of center in Britain has given way to the Tory party once again. Just as recovery from the financial crash seemed on the horizon, Europe's sovereign debt crisis has erupted. The historically unprecedented pace and scale of urbanization in China is transforming the politics of the Communist Party.President Lula of Brazil, former US treasury secretary Henry Paulson, Singapore's foreign minister George Yeo and others take stock of these manifold developments.
Protectionism Against China Is No Answer to America's Woes
Authors: FUKUYAMA FRANCIS , PAULSON HENRY 
Published: July 2010

The world is rapidly evolving on many fronts. Brazil, Turkey and other emerging powers are taking their own initiatives and building their own global links outside the old frameworks of the G‐8, the United Nations Security Council and NATO. The “third way” politics of Tony Blair that embraced globalization from the left of center in Britain has given way to the Tory party once again. Just as recovery from the financial crash seemed on the horizon, Europe's sovereign debt crisis has erupted. The historically unprecedented pace and scale of urbanization in China is transforming the politics of the Communist Party.President Lula of Brazil, former US treasury secretary Henry Paulson, Singapore's foreign minister George Yeo and others take stock of these manifold developments.
Greece Is Tip of Sovereign Debt Iceberg
Authors: ROUBINI NOURIEL 
Published: July 2010

The world is rapidly evolving on many fronts. Brazil, Turkey and other emerging powers are taking their own initiatives and building their own global links outside the old frameworks of the G‐8, the United Nations Security Council and NATO. The “third way” politics of Tony Blair that embraced globalization from the left of center in Britain has given way to the Tory party once again. Just as recovery from the financial crash seemed on the horizon, Europe's sovereign debt crisis has erupted. The historically unprecedented pace and scale of urbanization in China is transforming the politics of the Communist Party.President Lula of Brazil, former US treasury secretary Henry Paulson, Singapore's foreign minister George Yeo and others take stock of these manifold developments.
China's Megacity Mandarinate
Authors: YEO GEORGE 
Published: July 2010

The world is rapidly evolving on many fronts. Brazil, Turkey and other emerging powers are taking their own initiatives and building their own global links outside the old frameworks of the G‐8, the United Nations Security Council and NATO. The “third way” politics of Tony Blair that embraced globalization from the left of center in Britain has given way to the Tory party once again. Just as recovery from the financial crash seemed on the horizon, Europe's sovereign debt crisis has erupted. The historically unprecedented pace and scale of urbanization in China is transforming the politics of the Communist Party.President Lula of Brazil, former US treasury secretary Henry Paulson, Singapore's foreign minister George Yeo and others take stock of these manifold developments.
Traditional Chinese medicine and oral diseases: today and tomorrow
Authors: Zheng LW , Hua H , Cheung LK 
Published: July 2010

Oral Diseases (2010) 17, 7–12With a history of over 2000 years, traditional Chinese medicine (TCM) evolves into a unique system of diagnosing and treating illnesses. It is a challenge to convey the fundamentals of this traditional medicine to our Western colleagues because of the differences in language, philosophy and concept of diagnosis and treatment. This review attempts to tackle these barriers by introducing several widely used Chinese medicines for treating oral diseases. China Journals Full‐text Database and Pubmed were used as the searching engines. Although many studies have demonstrated that the Chinese medicines are effective in treating oral diseases including recurrent aphthous stomatitis, oral lichen planus, leukoplakia, and Sjögren’s syndrome, most of them lacked standard criteria of post‐treatment assessment and laboratory evidence. Randomized controlled clinical trials with specific assessment criteria are required to close the gap between TCM and evidenced‐based medicine.
Deficient Knowledge Nursing Diagnosis: Identifying the Learning Needs of Patients With Cardiac Disease
Authors: Galdeano Luzia Elaine , Rossi Lídia Aparecida , Spadoti Dantas Rosana Aparecida 
Published: July 2010

OBJECTIVES.  To identify the learning needs of patients with cardiac disease and the aspects of the disease and anesthetic and surgical procedures about which Brazilian patients have the greatest gaps in knowledge.METHODS.  Eighty preoperative patients answered a General Evaluation Questionnaire, a Questionnaire to Evaluate Patient Knowledge, and the Mini‐Mental State Exam.FINDINGS.  Fifty‐nine patients had learning needs. More than 50% of the patients were mistaken or unable to answer questions about the disease, and the goals of and type of surgery to be performed and anesthesia to be used.CONCLUSIONS.  Most patients had poor performance on the questionnaire that assessed their knowledge about coronary artery disease and its treatment.PRACTICE IMPLICATIONS.  This study can contribute to health professionals' assessment of patients' knowledge.OBJETIVOS.  Identificar as necessidades de aprendizagem de pacientes com doença cardíaca e os aspectos da doença arterial coronariana e da revascularização do miocárdio do nos quais os pacientes brasileiros apresentam conhecimento deficiente.MÉTODO.  Oitenta pacientes responderam o Questionário para avaliação geral, o Questionário para avaliar o conhecimento e o Mini‐Exame do Estado Mental.RESULTADOS.  Cinqüenta e nove pacientes apresentaram necessidade de aprendizagem. Mais de 50% dos pacientes erraram ou não souberam responder as questões referentes ao nome da doença, aos sinais e sintomas de complicação da doença, aos objetivos e tipo de cirurgia e anestesia.CONCLUSÃO.  Muitos pacientes não apresentaram bom desempenho no questionário para medir conhecimento em relação à Doença Arterial Coronária e seu tratamento.IMPLICAÇÕES PRÁTICAS.  Este estudo poderá contribuir para a avaliação do conhecimento dos pacientes por profissionais da saúde.
Invited Paper: Teaching Nursing Diagnosis to Increase Utilization After Graduation
Authors: Carpenito‐Moyet Lynda Juall 
Published: July 2010

BACKGROUND.  The majority of nursing programs identify the nursing process and diagnosis as critical elements in their curricula, yet it is often absent in classroom and clinical discussions. The failure of faculty to integrate the nursing process and diagnoses into learning experiences creates students spending endless hours creating a care plan document that requires little critical thinking, a document that does not improve the student's likelihood of utilizing nursing diagnosis after graduation.PURPOSE.  This paper would outline the educational barriers for integration of these concepts into practice.DISCUSSION.  Classroom and clinical strategies that guide the student to focused learning on nursing diagnoses and utilize standardized predicted care plans can produce desired curriculum outcomes, and ultimately, practice utilization will be presented.
Case Study: Child With Global Developmental Delay
Authors: Okumakpeyi Pearline , Lunney Margaret 
Published: July 2010

PURPOSE.  This case study focused on the care of a child with global developmental delay.DATA SOURCES.  Data were obtained through the author's clinical practice in long‐term care pediatric rehabilitation and literature sources.DATA SYNTHESIS.  NANDA‐International Classifications, the Nursing Interventions Classification (NIC), and Nursing Outcomes Classification (NOC) were used to identify the appropriate nursing diagnosis, nursing interventions, and patient outcomes.CONCLUSIONS.  This case study provides the pertinent nursing diagnoses, interventions, and outcomes for a child with global developmental delay. The interdisciplinary team approach and family involvement is addressed.IMPLICATIONS FOR NURSING.  Use of NANDA, NIC, and NOC outcomes constructs for enhancing the care of a child with global developmental delay.
Let's Not Forget the Biodiversity of the Cities
Authors: Lugo Ariel E. 
Published: July 2010

ABSTRACTCities contain over half of the world's population and are the source of many anthropogenic effects on the world's biota. Close examination of San Juan, Puerto Rico, a tropical city, reveals a significant green infrastructure. The city contains natural and human‐constructed forests, urban aquatic systems with native and introduced species, and a thriving and diverse biota adapted to urban conditions. It behooves tropical ecologists to pay attention to the biodiversity of urban environments to learn lessons about ecological persistence and adaptation to novel anthropogenic environments.