bluuebunny/crossref_metadata_2025_split huggingface dataset:
Contractual audit and mental health rehabilitation: a study of formulating effectiveness in a Finnish supported housing unit
Authors: Saario Sirpa , Raitakari Suvi 
Published: April 2010

Saario S, Raitakari S. Contractual audit and mental health rehabilitation: a study of formulating effectiveness in a Finnish supported housing unitInt J Soc Welfare 2010: 19: 321–329 © 2010 The Author(s), Journal compilation © 2010 Blackwell Publishing Ltd and International Journal of Social Welfare.Mental health NGOs in Western Europe are increasingly managed by contractual audit procedures. This article concerns how contractual audit and its emphasis on effectiveness of care impact on the practices of long‐term mental health rehabilitation. To demonstrate this, a case study of a Finnish NGO that provides supported housing is presented. The study looks at how service purchasing practices, as stated in the contract between the municipality and the NGO, are reflected in the meetings among practitioners. Documentary and meeting data were utilised together with Mitchell Dean's notion of technologies of agency. It was found that practitioners actively sought to show the effectiveness of their everyday work in terms of contractual audit by demonstrating both the economic and progressive aspects of care. Thus, professional competency in mental health rehabilitation appears to entail both the skills of care interventions and the ability to perform these interventions as efficient and financially accountable activities.
Synthesis of pattern and process in biodiversity conservation assessment: a flexible whole‐landscape modelling framework
Authors: Ferrier Simon , Drielsma Michael 
Published: April 2010

AbstractAim To describe a general modelling framework for integrating multiple pattern‐ and process‐related factors into biodiversity conservation assessments across whole landscapes.Location New South Wales (Australia), and world‐wide.Methods The framework allows for a rich array of alternatives to the target‐based model traditionally underpinning systematic conservation planning and consists of three broad modelling components. The first component models the future state (condition) of habitat across a landscape as a function of present state, current and projected pressures acting on this state, and any proposed, or implemented, management interventions. The second component uses this spatially explicit prediction of future habitat state to model the level of persistence expected for each of a set of surrogate biodiversity entities. The third component then integrates these individual expectations to estimate the overall level of persistence expected for biodiversity as a whole.Results Options are explored for tailoring implementation of the framework to suit planning processes varying markedly in purpose, and in availability of data, time, funding and expertise. The framework allows considerable flexibility in the nature of employed biodiversity surrogates (species‐level, discrete or continuous community‐level) and spatial data structures (polygonal planning units, or fine‐scaled raster), the level of sophistication with which each of the three modelling components is implemented (from simple target‐based assessment to complex process‐based modelling approaches), and the forms of higher‐level analysis supported (e.g. optimal plan development, priority mapping, interactive scenario evaluation).Main conclusions The described framework provides a logical, and highly flexible, foundation for integrating disparate pattern‐ and process‐related factors into conservation assessments in dynamic, multiple‐use landscapes.
Effect of Diabetes Mellitus on Protein–Energy Wasting and Protein Wasting in End‐Stage Renal Disease
Authors: Noori Nazanin , Kopple Joel D. 
Published: April 2010

AbstractProtein wasting (PW) or protein–energy wasting (PEW) occurs commonly in patients with diabetes mellitus who have end‐stage renal disease (ESRD) and are undergoing maintenance dialysis (MD) therapy. Some but not all studies indicate that PW or PEW is more prevalent in diabetic when compared with nondiabetic MD patients and that diabetic patients commencing maintenance hemodialysis (MHD) are more likely to lose fat‐free, edema‐free weight than are incident nondiabetic MHD patients. The causes of PW and PEW in diabetic MD patients are probably largely similar to those of nondiabetic MD patients. These causes include anorexia, reduced food intake, concurrent illnesses particularly when associated with inflammatory processes, physical or mental debility, removal of nutrients by dialysis procedure, acidemia, possibly physical deconditioning, and oxidant and carbonyl stress. However, diabetic MD patients are also at greater risk for PW or PEW from comorbidities related to diabetes per se. These disorders include ischemic vascular disease, hypertension, gastrointestinal dysfunction, and neuropathy. Metabolic disorders such as insulin deficiency or resistance to the actions of insulin, and elevated levels of counterregulatory hormones may also contribute to PW or PEW in diabetic MD patients. Mechanisms by which these metabolic disorders in diabetic ESRD patients may cause PW or PEW are discussed.
Long‐Term Performance of the Hemodialysis Reliable Outflow (HeRO) Device: The 56‐Month Follow‐Up of the First Clinical Trial Patient
Authors: Nassar George M. 
Published: April 2010

AbstractThe Hemodialysis Reliable Outflow (HeRO®) Vascular Access Device is a novel long‐term subcutaneous dialysis graft, ideally suited for catheter‐dependent patients and patients dialyzing with failing fistulas or grafts due to venous outflow stenosis. This case presentation depicts the clinical course of the first patient to enter a Food and Drug Administration approved clinical trial and receive the HeRO device. The course of this patient over 56 months of follow‐up provides the longest experience with the HeRO device to‐date. In this patient, the HeRO device provided long‐term dialysis access patency in conjunction with adequate dialysis and a low intervention rate.
Pulse Conductance and Flow‐induced Hemolysis During Pulsatile Cardiopulmonary Bypass
Authors: Simons Antoine P. , Wortel Pieter , Van Kan Rob A.T. , Van Der Veen Frederik H. , Weerwind Patrick W. , Maessen Jos G. 
Published: April 2010

AbstractIn this study, the hypothesis was tested that a low‐resistant, high‐compliant oxygenator provides better pulse conductance and less hemolysis than a high‐resistant, low‐compliant oxygenator during pulsatile cardiopulmonary bypass. Forty adults undergoing coronary artery bypass surgery were randomly divided into two groups using either an oxygenator with a relatively low hydraulic resistance (Quadrox BE‐HMO 2000, Maquet Cardiopulmonary AG, Hirrlingen, Germany) or with a relatively high hydraulic resistance (Capiox SX18, Terumo Cardiovascular Systems, Tokyo, Japan). The phase shift between the flow signals measured at the inlet and outlet of the oxygenator was used to assess compliance. Pulse conductance in terms of pressure attenuation was calculated by dividing the outlet pulse pressure of the oxygenator by the inlet pulse pressure. A normalized index was used to assess hemolysis. The phase shifts in time of the flow pulses were 36 ± 6 ms in the low‐resistant (high‐compliant) oxygenator, and 14 ± 2 ms in the high‐resistant (low‐compliant) oxygenator group (P < 0.001). The low‐resistant, high‐compliant oxygenator provided 27% better pulse conductance compared with the high‐resistant, low‐compliant oxygenator (0.84 ± 0.02 and 0.66 ± 0.01, respectively, P < 0.001). Inlet pulse pressures were significantly higher (29%) in the high‐resistant, low‐compliant (Capiox) group than in the low‐resistant, high‐compliant (Quadrox) group (838 ± 38 mm Hg and 648 ± 25 mm Hg respectively, P < 0.001), but no significant difference in hemolysis was found. A low‐resistant, high‐compliant oxygenator provides better pulse conduction than a high‐resistant, low‐compliant oxygenator. However, the study data could not confirm the association of high pressures with increased hemolysis.
Ceramic‐On‐Metal for Total Hip Replacement: Mixing and Matching Can Lead to High Wear
Authors: Affatato Saverio , Spinelli Michele , Zavalloni Mara , Traina Francesco , Carmignato Simone , Toni Aldo 
Published: April 2010

AbstractCeramic‐on‐ceramic and metal‐on‐metal bearing surfaces are often employed for total hip replacement because of their resistance to wear. However, they have some limits: brittleness is a major concern for ceramic, and ion release is a drawback for metal. To reduce the effect of these limitations, a hybrid coupling of ceramic‐on‐metal has been proposed. The theoretical advantage of this new coupling might lead orthopedic surgeons to use it indiscriminately. We asked whether the wear rate of this innovative solution was comparable with that of ceramic‐on‐ceramic, which is considered to be the gold standard for wear resistance. In a hip simulator study, we tested the wear pattern of a hybrid ceramic‐on‐metal coupling supplied by the same distributor; in particular, three different configurations were tested for 5 million cycles: 36‐mm ceramic‐on‐ceramic, 32‐mm and 36‐mm ceramic‐on‐metal. These combinations were gravimetrically and geometrically evaluated. After 5 million cycles, the volumetric loss for the metal acetabular cups (Φ 36‐mm) was 20‐fold greater than that of the ceramic cups of the same size (Φ 36‐mm); a volumetric loss of 4.35 mm3 and 0.26 mm3 was observed, respectively, for ceramic‐on‐metal and ceramic‐on‐ceramic combinations. Significant statistical differences were observed between all 36‐mm different combinations (P <  0.0001). The increased diameter of the 36‐mm ceramic‐on‐metal configuration resulted in a lower volumetric loss compared with that of the 32‐mm ceramic‐on‐metal configuration. Our findings showed an increase in wear for the proposed hybrid specimens with respect to that of the ceramic‐on‐ceramic ones. This confirms that even in the case of ceramic‐on‐metal bearings, mixing and matching could not prove effective wear behavior, not even comparable with that of the ceramic‐on‐ceramic gold standard.
Effect of Photocrosslinkable Chitosan Hydrogel and Its Sponges to Stop Bleeding in a Rat Liver Injury Model
Authors: Horio Takuya , Ishihara Masayuki , Fujita Masanori , Kishimoto Satoko , Kanatani Yasuhiro , Ishizuka Takamitsu , Nogami Yashiro , Nakamura Shingo , Tanaka Yoshihiro , Morimoto Yuji , Maehara Tadaaki 
Published: April 2010

AbstractThis study examined the hemostatic efficacy of photocrosslinkable chitosan hydrogel‐mixed photocrosslinked chitosan sponges (PCM‐S) after hepatic injury in rats. The left lobe of the liver was penetrated with a dermal punch to produce a penetrating wound in heparinized and nonheparinized rats. Treated rats either had PCM‐S applied into the wound and then were immediately ultraviolet irradiated, or they had TachoComb (TC) inserted into the wound. Blood loss, hemostasis, and survival were quantified after the hepatic injury. Measurements on serum alanine aminotransferase in nonheparinized rats and hemoglobin concentrations and histologic examinations in heparinized rats were performed to assess hepatic function. Although the hemostatic effect in the PCM‐S‐treated nonheparinized rats was identical to that of the TC‐treated group, PCM‐S‐treatment has higher hemostatic effect in heparinized rats. No adverse events related to the use of PCM‐S were detected in blood and histologic examinations.
Comparison of Sustained Hemodiafiltration With Continuous Venovenous Hemodiafiltration for the Treatment of Critically Ill Patients With Acute Kidney Injury
Authors: Abe Masanori , Okada Kazuyoshi , Suzuki Midori , Nagura Chinami , Ishihara Yuko , Fujii Yuki , Ikeda Kazuya , Kaizu Kazo , Matsumoto Koichi 
Published: April 2010

AbstractDespite improvements in medical care, the mortality of critically ill patients with acute kidney injury (AKI) who require renal replacement therapy (RRT) remains high. We describe a new approach, sustained hemodiafiltration, to treat patients who suffered from acute kidney injury and were admitted to intensive care units (ICUs). In our study, 60 critically ill patients with AKI who required RRT were treated with either continuous venovenous hemodiafiltration (CVVHDF) or sustained hemodiafiltration (S‐HDF). The former was performed by administering a postfilter replacement fluid at an effluent rate of 35 mL/kg/h, and the latter was performed by administering a postfilter replacement fluid at a dialysate‐flow rate of 300–500 mL/min. The S‐HDF was delivered on a daily basis. The baseline characteristics of the patients in the two treatment groups were similar. The primary study outcome—survival until discharge from the ICU or survival for 30 days, whichever was earlier—did not significantly differ between the two groups: 70% after CVVHDF and 87% after S‐HDF. The hospital‐survival rate after CVVHDF was 63% and that after S‐HDF was 83% (P < 0.05). The number of patients who showed renal recovery at the time of discharge from the ICU and the hospital and the duration of the ICU stay significantly differed between the two treatments (P < 0.05). Although there was no significant difference between the mean number of treatments performed per patient, the mean duration of daily treatment in the S‐HDF group was 6.5 ± 1.0 h, which was significantly shorter. Although the total convective volumes—the sum of the replacement‐fluid and fluid‐removal volumes—did not differ significantly, the dialysate‐flow rate was higher in the S‐HDF group. Our results suggest that in comparison with conventional continuous RRT, including high‐dose CVVHDF, more intensive renal support in the form of postdilution S‐HDF will decrease the mortality and accelerate renal recovery in critically ill patients with AKI.
Configuration‐Based Processing of Phosphene Pattern Recognition for Simulated Prosthetic Vision
Authors: Guo Hong , Qin Ruogu , Qiu Yihong , Zhu Yisheng , Tong Shanbao 
Published: April 2010

AbstractVisual prosthesis can elicit phosphenes by stimulating the retina, optic nerve, or visual cortex along the visual pathway. Psychophysical studies have demonstrated that visual function can be partly recovered with phosphene‐based prosthetic vision. This study investigated the cognitive process of prosthetic vision through a face recognition task. Both behavioral response and the face‐specific N170 component of event‐related potential were analyzed in the presence of face and non‐face stimuli with natural and simulated prosthetic vision. Our results showed that: (i) the accuracy of phosphene face recognition was comparable with that of the normal one when phosphene grid increased to 25 × 21 or more; (ii) shorter response time was needed for phosphene face recognition; and (iii) the N170 component was delayed and enhanced under phosphene stimuli. It was suggested that recognition of phosphene patterns employ a configuration‐based holistic processing mechanism with a distinct substage unspecific to faces.
Brain Protection During Pediatric Cardiopulmonary Bypass
Authors: Su Xiaowei W. , Ündar Akif 
Published: April 2010

AbstractImprovements in peri‐ and postoperative surgical techniques have greatly improved outcomes for pediatric patients undergoing cardiopulmonary bypass (CPB) in the treatment of congenital heart defects (CHDs). With decreased mortality rates, the incidence of adverse neurological outcomes, comprising cognitive and speech impairments, motor deficits, and behavioral abnormalities, has increased in those patients surviving bypass. A number of mechanisms, including ischemia, reperfusion injury, hypothermia, inflammation, and hemodilution, contribute to brain insult, which is further confounded by unique challenges presented in the pediatric population. However, a number of brain monitoring and preventative techniques have been developed or are being currently evaluated in the practice of pediatric CPB. Monitoring techniques include electroencephalography, near‐infrared as well as visible light spectroscopy, transcranial Doppler ultrasound, and emboli detection and classification quantitation. Preventative measures include hypothermic perfusion techniques such as deep hypothermic circulatory arrest, low‐flow CPB, blood gas management, and pharmacologic prophylaxes, among others. The present review summarizes the principles of brain insult, neurodevelopmental abnormalities, monitoring techniques, methods of prevention, as well as preexisting morbidities and risk factors in pediatric CPB, with a focus on brain protection. Clinical and translational research is presented with the aim of determining methods that may optimize neurological outcomes post CPB and guiding further study.
Comparison of Perfusion Quality in Hollow‐Fiber Membrane Oxygenators for Neonatal Extracorporeal Life Support
Authors: Talor Jonathan , Yee Stella , Rider Alan , Kunselman Allen R. , Guan Yulong , Ündar Akif 
Published: April 2010

AbstractPerfusion quality is an important issue in extracorporeal life support (ECLS); without adequate perfusion of the brain and other vital organs, multiorgan dysfunction and other deficits can result. The authors tested three different pediatric oxygenators (Medos Hilite 800 LT, Medtronic Minimax Plus, and Capiox Baby RX) to determine which gives the highest quality of perfusion at flow rates of 400, 600, and 800 mL/min using human blood (36°C, 40% hematocrit) under both nonpulsatile and pulsatile flow conditions. Clinically identical equipment and a pseudo‐patient were used to mimic operating conditions during neonatal ECLS. Traditionally, the postoxygenator surplus hemodynamic energy value (SHEpost, extra energy obtained through pulsatile flow) is the one relied upon to give a qualitative determination of the amount of perfusion in the patient; the authors also examined SHE retention through the membrane, as well as the contribution of SHEpost to the postoxygenator total hemodynamic energy (THEpost). At each experimental condition, pulsatile flow outperformed nonpulsatile flow for all factors contributing to perfusion quality: the SHEpost values for pulsatile flow were 4.6–7.6 times greater than for nonpulsatile flow, while the THEpost remained nearly constant for pulsatile versus nonpulsatile flow. For both pulsatile and nonpulsatile flow, the Capiox Baby RX oxygenator was found to deliver the highest quality of perfusion, while the Minimax Plus oxygenator delivered the least perfusion. It is the authors' recommendation that the Baby RX oxygenator running under pulsatile flow conditions be used for pediatric ECLS, but further studies need to be done in order to establish its effectiveness beyond the FDA‐approved time span.
Injuries Related to Snow Blowers in the United States: 2002 Through 2008
Authors: Hammig Bart , Jones Ches 
Published: April 2010

AbstractObjectives:  The objective was to examine injuries related to the use of a snow blower among patients treated in an emergency department (ED).Methods:  Data were obtained from the National Electronic Injury Surveillance System (NEISS) for the years 2002–2008. National estimates of ED visits for injuries associated with the use of a snow blower were obtained, and descriptive epidemiologic characteristics assessed.Results:  From 2002 through 2008, there were an estimated 32,307 ED visits for injuries related to the use of a snow blower in the United States. Older adults had a higher proportion of ED visits for such injuries than younger age groups. The majority of injuries involved injuries to the hand, with 42% of cases diagnosed with fractures and 20% resulting in amputations.Conclusions:  Findings indicate that injuries from snow blowers remain a public health problem. Efforts to reduce injury incidence are discussed in accordance with inherent challenges of prevention of injuries associated with these products.ACADEMIC EMERGENCY MEDICINE 2010; 17:566–569 © 2010 by the Society for Academic Emergency Medicine
Attitude and tendency of cheating behaviours amongst undergraduate students in a Dental Institution of India
Authors: Monica M. , Ankola A. V. , Ashokkumar B. R. , Hebbal I. 
Published: April 2010

AbstractHonesty and integrity are key characteristics expected of a doctor, although academic misconduct amongst medical students is not new. Academic integrity provides the foundation upon, which a flourishing academic life rests. The aim of this study was to investigate the attitude of undergraduate dental students about the seriousness of cheating behaviours and to determine the rate of malpractice amongst these students. A self designed closed ended questionnaire was distributed to 300 undergraduate students in a Dental Institution in India, to rate the seriousness of six cheating behaviours and to assess the rate of malpractice. The response rate was 100%. Two of the six cheating behaviours were considered by at least 61% of the students as very serious cheating behaviours. Almost 70% of the students agreed that they have involved in malpractice in examinations at least once. The majority also felt that cheating in examinations will not have any significant effect on their future. This study has revealed that cheating is an important issue, which needs to be addressed for the benefit of the society at large.
Oral health students’ perceptions of clinical reflective learning – relevance to their development as evolving professionals
Authors: Tsang A. K. L. , Walsh L. J. 
Published: April 2010

AbstractContext:  A clinical professional should be a reflective practitioner, however reflective learning and deliberate clinical reflections have not traditionally featured in dentistry or dental hygiene programs. To the authors’ knowledge, there are no studies exploring the perceptions of oral health students to reflective learning and clinical reflective practices.Aim:  This study determined student perceptions of clinical reflective learning and its relevance to their clinical and professional development.Methods:  Reflective learning was embedded as a topic in the curriculum of the University of Queensland Bachelor of Oral Health program, within the discipline of dental hygiene practice. Reflective practices were integrated with clinical practice, and were linked with assessment requirements. Students’ perceptions of clinical reflective learning were obtained via quantitative and qualitative analyses of sequenced questionnaires. Computer‐assisted thematic analyses of the students’ reflective journals, reflective essays and summary notes from in‐class group discussions validated students’ perceptions.Results:  Students (n = 17) perceived clinical reflective learning as relevant, and useful for consolidating their clinical learning and accelerating their professional development. In particular, students gained insights about their strengths and weaknesses, thought more deeply about what they were doing in the clinic, and unpacked difficult concepts.Conclusion: Students views of clinical reflective learning in this program were positive. They believed that the deliberate reflective process assisted their clinical learning and professional development.