bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Phenomenological Inquiry into the Embodied Nature of Occupation at End of Life
Authors: Lala Anna Park , Kinsella Elizabeth Anne 
Published: October 2011

Background. Occupational therapists propose that occupation is a basic human need across the lifespan. However, there is limited understanding of how occupation contributes to the end-of-life experience. Purpose. The purpose of this study was to examine the embodied nature of occupation at end of life from the perspectives of Canadians 60 years of age or older who are diagnosed with a terminal illness. Methods. The study adopted a phenomenological methodological approach to conduct semi-structured interviews with eight participants. Findings. Six themes were identified. Participants described orientations toward occupations that involved: living with death, reworking everyday life, being guided by the will of the body, giving priority to relationships, attending to the small things, and engaging existential orientations. Implications. This study contributes to knowledge about occupation at end of life and offers a starting point to guide practice that is attentive to the lived dimensions of occupation at end of life.
Introducing the Leadership in Enabling Occupation (LEO) Model
Authors: Townsend Elizabeth A. , Polatajko Helene J. , Craik Janet M. , von Zweck Claudia M. 
Published: October 2011

Background. Occupational therapy is a broad profession yet access to services remains restricted and uneven across Canada. Access to the potential breadth of occupational therapy is severely restrained by complex supply, retention, and funding challenges. To improve access to occupational therapy, widespread leadership is needed by all practitioners. Purpose. This brief report introduces the Leadership in Enabling Occupation (LEO) Model, which displays the inter-relationship of four elements of everyday leadership as described in “Positioning Occupational Therapy for Leadership,” Section IV, of Enabling Occupation II: Advancing a Vision of Health, Well-being and Justice through Occupation (Townsend & Polatajko, 2007). Key Issues. All occupational therapists have the power to develop leadership capacity within and beyond designated leadership positions. Implications. LEO is a leadership tool to extend all occupational therapists' strategic use of scholarship, new accountability approaches, existing and new funding, and workforce planning to improve access to occupational therapy.
Evidence-based Practice: Improving Outcomes for Patients with a Central Venous Access Device
Authors: Mathers Dorothy 
Published: October 2011

AbstractPurpose: To apply evidence-based practice when flushing central venous access devices (CVADs).Background/Introduction: There is a lack of standardized flushing protocols for CVADs among health care institutions. Identifying best practice and assuring skillful implementation of evidence-based practice protocols is essential to maintaining catheter patency.Review of Relevant Literature: Evidence supports the use of nonheparinized saline flush, positive-pressure valve caps, and proper flushing technique to maintain CVAD patency (Bowers, Speroni, Jones, & Atherton, 2008; Hadaway, 2006; & Jasinsky & Wurster, 2009). Reinforcement of proper flushing techniques has demonstrated improved patency rates of CVADs (Feehery, Allen, & Bey, 2003).Methods: Corporate and individual in-services were conducted to improve nurses' skill and knowledge of evidence-based practice related to flushing CVADs. Outcomes were measured by comparing baseline data with data collected in the same manner post-education. Data was obtained by means of a questionnaire and direct observation of nurses' flushing technique.Outcomes: The evidence-based practice project demonstrated a significant improvement (p &lt;0.05) in both the nurses' knowledge and skill in flushing CVADs.Conclusion: Continuing education and reinforcement of proper flushing technique is an appropriate strategy to increase knowledge of and compliance with evidence-based practice protocols.Implications for practice: Providing continuing education and periodic reinforcement of nursing skills can lead to improved patient outcomes. These strategies, along with changing flushing protocols to non-heparinized saline, can also reduce health care costs. Future studies are needed to determine the appropriate frequency of in-service education.
The Ideal Use of the Power Injectable Peripherally Inserted Central Catheter in the Pediatric Population
Authors: Klee Stephanie Juanita 
Published: October 2011

Abstract
Introduction: The peripherally inserted central catheter (PICC) is being used more frequently in pediatric populations in both hospital and home care settings in order to provide secure vascular access. In 2007, the Power PICC was introduced to pediatric populations. In contrast to traditional PICCs, the power injectable PICC withstands higher flow rates and can deliver contrast injections. Although effectiveness studies of power injectable PICCs have been performed in adults, only limited published research is available regarding pediatric populations.
Purpose: This study aimed to develop criteria for identifying the ideal pediatric candidate for the power injectable PICC. A secondary aim was to identify contraindications and barriers to power injectable catheter use in pediatric populations.
Methods: Retrospective and prospective chart reviews were used to analyze complication rates for 97 power injectable PICCs placed in patients aged 4 months to 17 years.
Results: A low incidence of catheter complications was identified during and post- insertion. Our documented infection rate of 1.30 per 1000 catheter days was similar to the infection rate of 1.27 per 1000 catheter days found in the Abedin & Kapoor (2008) study.
Discussion: The introduction into a pediatric hospital of power injectable PICCs for power injection scans for contrast injection was safe and effective in patients with many disease processes.
Conclusion: In properly selected pediatric patients, the power injectable PICC is not associated with an increased risk to thrombosis or infection and can improve patient outcome.
Clinical Evaluation of the Sorbaview SHIELD Securement Device Used on Peripheral Intravenous Catheters in the Acute Care Setting
Authors: Flippo Polly L. , Lee Jayne 
Published: October 2011

Abstract
Peripheral intravenous therapy (PIV) is probably the most common acute care invasive procedure, estimated at 90 percent for all inpatients. Current standards of practice recommend the use of a manufactured catheter stabilization device to secure PIVs. At FirstHealth Moore Regional Hospital (MRH), the PIV policy requires the use of a stabilization device to achieve a 96 hour dwell time for the PIV. The hospital does not utilize an intravenous therapy team; all nurses can insert PIVs and apply the dressing. In 2009, as a cost reduction measure, MRH changed securement devices from a two piece dressing and securement device to the Sorbaview SHIELD (SHIELD). A clinical evaluation of the SHIELD was conducted in January 2010, with 109 medical-surgical patients with PIVs, to demonstrate the expected cost savings associated with the SHIELD by maintaining the PIV for 96 hours and meeting patient and staff expectations. In 91.5% of the patients, the PIV stayed in for their length of stay (if less than 96 hours) or for 96 hours, only eight patients had unscheduled restarts. Eighty-six percent of nurses surveyed rated the device as excellent to good. Ninety-one percent of patients reported no discomfort of their PIV site. Changing to this device in 2009 has resulted in an average annual cost savings of $120,000 over the two piece device and has improved compliance by nursing.
Managing Peripherally Inserted Central Catheter Thrombosis Risk: A Guide for Clinical Best Practice
Authors: Meyer Britt M. 
Published: October 2011

AbstractPurpose: The purpose of this study was to evaluate the effectiveness of clinical practice changes in an effort to reduce peripherally inserted central catheter thrombosis risk.Patients and Method: A retrospective analysis of adult patients in the acute care setting.Results: A total number of 1307 charts of patients who received PICCs were reviewed encompassing the months of January 2008, October 2008 and August 2010. During the period from January 2008 to October 2008, clinical practice changes were made to include the use of ultrasound guidance. Ensuring catheter tip termination in the superior vena cava with the addition of ultrasound technology as an insertion practice combined to decrease symptomatic PICC related deep vein thrombosis rates from 4.8 % to 2.9%. During the period from October 2008 to August 2010, an additional practice was introduced that involved measurement and documentation of vein diameters(without the use of a tourniquet) prior to all PICC insertion procedures. Deep vein thrombosis (DVT) rates dropped further from 2.9 % to 1.4 % during this period.Conclusion: Obtaining central tip location and using ultrasound guidance for PICC placement are effective in reducing PICC related DVT. Additionally, routine measurement of vein diameters in their native state and use of that information to ensure that the vessel diameter is at least twice the outer diameter of the catheter is an effective practice to reduce DVT rates and reduce thrombosis risk.
Lower Volume Peripheral Blood Sample Collection: Key Considerations for Nurses - Roundtable Discussion
Authors: Bowe-Geddes Leigh Ann 
Published: October 2011

Abstract
A group of seven nurses from a range of laboratory and hospital settings across the United States were invited to present opinions and clinical case study examples that reflect the key considerations in peripheral blood sample collection involving lower volume samples and patients affected by difficult venous access (DVA). Panelists were asked to review and compare prevailing standard operating procedures (SOPs) in sample collection and challenges in efforts to expand the use of lower volume sample collection and processing. The discussion identified achievable goals to improve standard of care in lower volume blood sample collection and the treatment of DVA patients.
Medical Care Costs Associated With Progression of Diabetic Nephropathy
Authors: Nichols Gregory A. , Vupputuri Suma , Lau Helen 
Published: October 2011

OBJECTIVE
To estimate the direct medical costs of hypertensive patients with type 2 diabetes by the level of proteinuria and to evaluate the differences between patients whose nephropathy did and did not progress.

RESEARCH DESIGN AND METHODS
We identified 7,758 patients with diabetes and hypertension who had a urine albumin-to-creatinine ratio (UACR) during 2001–2003 and at least one follow-up UACR 3–5 years later. Patients were followed for up to 8 years for progression of nephropathy, which was defined by increasing levels of proteinuria: normoalbuminuria (UACR &lt;30 mg/g), microalbuminuria (30–299 mg/g), macroalbuminuria (≥300 mg/g), and end-stage renal disease (dialysis or transplant). We calculated annualized inpatient, outpatient, pharmaceutical, and total medical costs incurred by patients after the baseline measure through 2008, comparing patients who did and did not progress to a higher nephropathy stage. We also compared pre- and postprogression costs among those whose nephropathy progressed.

RESULTS
Patients with normoalbuminuria who progressed to microalbuminuria experienced an annualized change in baseline costs that was $396 higher (P &lt; 0.001) than those who maintained normal albuminuria ($902 vs. $506). Among those with microalbuminuria, progression was significantly associated with a $747 difference (P &lt; 0.001) in annualized change in outpatient costs compared with no progression ($1,056 vs. $309). Among patients who progressed, costs were 37% higher following progression from normoalbuminuria to microalbuminuria ($10,188 vs. $7,424; P &lt; 0.001), and 41% higher following progression from microalbuminuria to macroalbuminuria ($12,371 vs. $8,753; P &lt; 0.001).

CONCLUSIONS
Progression of nephropathy was strongly associated with higher subsequent medical care costs in hypertensive patients with diabetes. Greater prevention efforts may reduce the substantial economic burden of diabetic nephropathy.
Effect of flunixin meglumine on the amelioration of lameness in dairy steers with amphotericin B-induced transient synovitis-arthritis
Authors: Schulz Kara L. , Anderson David E. , Coetzee Johann F. , White Brad J. , Miesner Matt D. 
Published: October 2011

Abstract
Objective—To characterize amphotericin B–induced lameness in cattle and to ascertain the analgesic effects of flunixin meglumine by use of multimodal assessment.
Animals—10 healthy Holstein steers free from musculoskeletal disease.
Procedures—Steers were randomly allocated to a treatment or negative control group. Amphotericin B was injected into the distal interphalangeal joint of the lateral claw of the left hind limb of all steers. Treatment steers received flunixin meglumine at the time of synovitis-arthritis induction and at 12 hours after induction. Control steers received no medication. Multimodal analysis included vital parameters, visual lameness score, behavioral monitoring with accelerometers, pressure mat analysis, and plasma cortisol determination before and after induction. Data were analyzed by use of linear mixed models with treatment and time designated as fixed effects, accounting for repeated measures on individual calves.
Results—Amphotericin B injection induced moderate, transient lameness. Control steers were more than twice as likely to be lame as treatment steers (mean ± SD lameness score, 92.2 ± 8.1 % vs 40.7 ± 2.5%). Treatment steers placed significantly greater force and contact area on the affected foot and greater force, impulse, and contact area on the paired claw, compared with control steers. Furthermore, treatment steers spent considerably less time in recumbency than controls.
Conclusions and Clinical Relevance—Amphotericin B successfully induced synovitis-arthritis in dairy steers that was transient in nature. Flunixin meglumine was efficacious in providing analgesia for these steers.
Evaluation of the risk of paratuberculosis in adult cows fed Mycobacterium avium subsp paratuberculosis DNA-positive or -negative colostrum as calves
Authors: Pithua Patrick , Godden Sandra M. , Wells Scott J. , Stabel Judith R. 
Published: October 2011

Abstract
Objective—To estimate the risk of subclinical Mycobacterium avium subsp paratuberculosis (MAP) infection in cows that ingested MAP DNA–positive raw colostrum as calves, compared with risk in cows that ingested MAP DNA–negative raw colostrum as calves.
Animals—205 calves born in 12 commercial dairy herds.
Procedures—Each calf was separated from its dam within 30 to 60 minutes after birth and fed raw colostrum. For each calf, samples of the colostrum fed were collected and tested for the presence of MAP DNA by use of a nested PCR assay for the target gene ISMAP02. Calves fed colostrum positive or negative for MAP DNA were classified into exposed (n = 69) and unexposed (136) groups, respectively. Each calf was tested for MAP infection at 30, 42, and 54 months of age by use of a serum ELISA and bacterial culture of feces. Weibull hazard regression models were used to evaluate the association between exposure to MAP DNA–positive colostrum and time to testing positive for MAP infection.
Results—Hazard of MAP infection was not different between groups (exposed vs unexposed) when serum ELISA, bacterial culture of feces, or both diagnostic tests (parallel interpretation) were positive.
Conclusions and Clinical Relevance—Heifer calves fed MAP DNA–positive colostrum were at no greater risk of MAP infection, compared with heifer calves fed MAP DNA–negative colostrum. This result contradicts findings from other studies and should be interpreted with caution.
Effects of opsonization of Rhodococcus equi on bacterial viability and phagocyte activation
Authors: Dawson Dominic R. , Nydam Daryl V. , Price Christopher T. , Graham James E. , Cynamon Michael H. , Divers Thomas J. , Felippe Maria Julia B. 
Published: October 2011

Abstract
Objective—To investigate the effect of opsonization of Rhodococcus equi with R equi-specific antibodies in plasma on bacterial viability and phagocyte activation in a cell culture model of infection.
Sample—Neutrophils and monocyte-derived macrophages from 6 healthy 1-week-old foals and 1 adult horse.
Procedures—Foal and adult horse phagocytes were incubated with either opsonized or nonopsonized bacteria. Opsonization was achieved by use of plasma containing high or low concentrations of R equi-specific antibodies. Phagocyte oxidative burst activity was measured by use of flow cytometry, and macrophage tumor necrosis factor (TNF)-α production was measured via an ELISA. Extracellular and intracellular bacterial viability was measured with a novel R equi-luciferase construct that used a luminometer.
Results—Opsonized bacteria increased oxidative burst activity in adult horse phagocytes, and neutrophil activity was dependent on the concentration of specific antibody. Secretion of TNF-α was higher in macrophages infected with opsonized bacteria. Opsonization had no significant effect on bacterial viability in macrophages; however, extracellular bacterial viability was decreased in broth containing plasma with R equi-specific antibodies, compared with viability in broth alone.
Conclusions and Clinical Relevance—The use of plasma enriched with specific antibodies for the opsonization of R equi increased the activation of phagocytes and decreased bacterial viability in the extracellular space. Although opsonized R equi increased TNF-α secretion and oxidative burst in macrophages, additional factors may be necessary for effective intracellular bacterial killing. These data have suggested a possible role of plasma antibody in protection of foals from R equi pneumonia.
Evaluation of biomechanical effects of four stimulation devices placed on the hind feet of trotting horses
Authors: Clayton Hilary M. , Lavagnino Michael , Kaiser LeeAnn J. , Stubbs Narelle C. 
Published: October 2011

Abstract
Objective—To compare effects of 4 types of stimulation devices attached to the hind feet on hoof flight, joint angles, and net joint powers of trotting horses.
Animals—8 clinically normal horses.
Procedures—Horses were evaluated under 5 conditions in random order: no stimulators, loose straps (10 g), lightweight tactile stimulators (55 g), limb weights (700 g), and limb weights with tactile stimulators (700 g). Reflective markers on the hind limbs were tracked during the swing phase of 6 trotting trials performed at consistent speed to determine peak hoof heights and flexion angles of the hip, stifle, tarsal, and metatarsophalangeal joints. Inverse dynamic analysis was used to calculate net joint energies. Comparisons among stimulators were made.
Results—Peak hoof height was lowest for no stimulators (mean ± SD, 5.42 ± 1.38 cm) and loose straps (6.72 ± 2.19 cm), intermediate for tactile stimulators (14.13 ± 7.33 cm) and limb weights (16.86 ± 15.93 cm), and highest for limb weights plus tactile stimulators (24.35 ± 13.06 cm). Compared with no stimulators, net tarsal energy generation increased for tactile stimulators, limb weights, and limb weights plus tactile stimulators, but only the weighted conditions increased net energy generation across the hip joint.
Conclusions and Clinical Relevance—The type and weight of foot stimulators affected the magnitude of the kinematic and kinetic responses and the joints affected. These findings suggest that different types of foot stimulators are appropriate for rehabilitation of specific hind limb gait deficits, such as toe dragging and a short stride.
Magnetic resonance imaging vertebral canal and body ratios in Doberman Pinschers with and without disk-associated cervical spondylomyelopathy and clinically normal English Foxhounds
Authors: De Decker Steven , Gielen Ingrid M.V. L. , Duchateau Luc , Saunders Jimmy H. H. , van Bree Henri J. J. , Polis Ingeborgh , Van Ham Luc M. L. 
Published: October 2011

Abstract
Objective—To determine magnetic resonance imaging (MRI) vertebral ratio values representing vertebral canal height, vertebral canal shape, and vertebral body shape in Doberman Pinschers with and without disk-associated cervical spondylomyelopathy (DACSM) and clinically normal English Foxhounds.
Animals—Doberman Pinschers with (n = 18) and without (20) DACSM and clinically normal English Foxhounds (18).
Procedures—All dogs underwent low-field MRI of the cervical vertebral column. From 5 specific measurements made at C3 through C7, 4 linear vertebral ratios were calculated and assessed for correlation: vertebral canal height-to-body height ratio (CBHR), vertebral canal height-to-body length ratio (CBLR), caudal canal height-to-cranial canal height ratio (CCHR), and vertebral body length-to-height ratio (BLHR). The CBHR and CBLR described vertebral canal height, CCHR described vertebral canal shape, and BLHR described vertebral body shape. A midvertebral canal-occupying ratio (mVCOR) for the spinal cord was calculated at C5.
Results—Compared with both groups of unaffected dogs, CBHR, CBLR, and BLHR for Doberman Pinschers with DACSM were significantly smaller. The C7 CCHR was significantly larger in DACSM-affected Doberman Pinschers, compared with clinically normal English Foxhounds. Ratios did not differ significantly between unaffected Doberman Pinschers and clinically normal English Foxhounds. Correlation coefficients between CBHR, CBLR, and mVCOR were low and not significant.
Conclusions and Clinical Relevance—Doberman Pinschers with DACSM had significantly smaller vertebral canal heights and more square-shaped vertebral bodies, compared with unaffected Doberman Pinschers, combined with a funnel-shaped vertebral canal at C7. Breed-specific differences were not evident. Linear MRI vertebral canal-to-body ratios do not appear to predict relative vertebral canal stenosis.
Comparison of plasma and peritoneal indices of fibrinolysis between foals and adult horses with and without colic
Authors: Watts Ashlee E. , Fubini Susan L. , Todhunter Rory J. , Brooks Marjory B. 
Published: October 2011

Abstract
Objective—To identify hemostatic imbalances indicative of an increased risk of intra-abdominal adhesion formation in foals versus adult horses.
Animals—Horses with colic undergoing exploratory laparotomy or abdominocentesis as part of a clinical examination (n = 16 foals ≤ 6 months of age and 19 adults ≥ 5 years of age) and horses without colic undergoing herniorrhaphy (15 foals) or euthanasia for noninflammatory and nongastrointestinal disease (10 foals and 20 adults).
Procedures—Paired abdominal fluid and blood samples were collected from each horse into buffered sodium citrate and centrifuged immediately after collection. Supernatants were stored at −80°C, then thawed for measurement of fibrinogen concentration, plasminogen activity, antiplasmin activity, and D-dimer concentration. Supernatant analyte concentrations or activities were compared within age group (foals with and without colic vs adults with and without colic) and within disease status (foals and adults without colic vs foals and adults with colic).
Results—All analyte concentrations or activities in abdominal fluid samples were significantly lower in the noncolic groups than in the colic groups, and none differed between foal and adult groups. Several plasma analyte values differed by disease status and age.
Conclusions and Clinical Relevance—The risk of intra-abdominal adhesion formation in the foals in this study did not appear to be attributable to differences in intra-abdominal hemostasis between adult horses and foals. Strategies for initial medical and surgical management of colic in adult horses may be applicable to foals with similar disorders.