bluuebunny/crossref_metadata_2025_split huggingface dataset:
The impact of maternal negative affectivity on dietary patterns of 18‐month‐old children in the Norwegian Mother and Child Cohort Study
Authors: Ystrom Eivind , Niegel Susan , Vollrath Margarete E. 
Published: June 2009

AbstractEarly dietary habits are formative for dietary habits later in life. Maternal personality might be an important factor in unhealthy feeding of children. The current study aims to assess the degree to which the personality trait of negative affectivity in mothers predicts their child's diet at age 18 months. This study is a part of the Norwegian Mother and Child Cohort Study conducted at the Norwegian Institute of Public Health. A total of 27 763 mothers completed 3 repeated assessments of negative affectivity before and after childbirth and of the child's diet when the child was 18 months old. Exploratory factor analysis was used to identify the dietary patterns, and structural equation modeling was used to investigate the relationship with negative affectivity adjusted for socio‐demographical variables. Exploratory factor analysis of a foods frequency questionnaire revealed two dietary patterns in the child, labeled unhealthy diet and wholesome diet. The unhealthy diet comprised foods rich in sugar and fat; the wholesome diet comprised foods rich in fibre, vitamins and minerals. Mothers high in negative affectivity were more inclined to feed their child an unhealthy diet. The results were adjusted for maternal age, years of education, relative income, marital status, number of children, having the child in daycare, maternal smoking, maternal body mass index, and child gender. This study shows that a maternal personality trait, negative affectivity, is related to feeding the child an unhealthy diet after controlling for key socio‐demographic variables.
Dietary behaviour, food and nutrient intake of pregnant women in a rural community in Burkina Faso
Authors: Huybregts Lieven Fernand , Roberfroid Dominique Albert , Kolsteren Patrick Wilfried , Van Camp John Hendrik 
Published: June 2009

AbstractThe aim of this study was to assess potential changes in dietary habits during pregnancy in a rural community in Houndé district, Burkina Faso. In‐depth interviews were performed on a random sample of 37 pregnant women in order to analyse specific perceptions and attitudes regarding food consumption during pregnancy. In addition to this, an interactive 24‐h recall survey was used to compare the food intake of 218 pregnant and 176 non‐pregnant women. The majority of interviewees reported dietary restrictions during pregnancy but no consistent pattern of avoided food types was found. Most of the mentioned ‘forbidden’ foods were in related to physical discomfort during gestation. Interviewees also admitted to ignoring culturally determined food prohibitions/prescriptions. No differences were observed in food intake, food choice and nutrient intake between the group of pregnant and non‐pregnant women. During the third trimester of gestation women did not show any major differences in food and nutrient intake compared with women from the first/second trimester. The mean nutrient intakes were found to be insufficient compared with the recommended daily allowances, especially for pregnant women. In conclusion, pregnant women in this rural area of Burkina Faso do not seem to restrict their diet significantly during pregnancy. The additional nutritional requirements of pregnancy are not accounted for in their dietary practises.
Evaluation of emergency medicine trainees' ability to use transport equipment
Authors: Samuel Manoj , Stella Julian 
Published: June 2009

AbstractObjective:  To assess the skills of advanced emergency medicine trainees in the use of commonly used transport equipment and to determine what teaching has been undertaken and what level of confidence trainees have in their ability to use the equipment tested.Methods:  This is a prospective multicentre observational study examining equipment use. Three pieces of equipment were examined: the infusion pump, defibrillator‐monitor and transport ventilator. A questionnaire and a series of practical tasks were used. Advanced trainees from Victorian ED were enrolled as participants. Outcomes included proportion of participants able to perform all tasks successfully, subjective registrar confidence with use of equipment and departmental training practices. Eleven ED were represented, covering metropolitan tertiary, metropolitan peripheral and regional hospitals.Results:  There were 47 participants enrolled in the study. The range of advanced training years of participants was 1–5+. Of the 47 participants, 39 (83%; 95% CI 72.2–93.7%) had been involved as medical escorts. Eighteen participants (38.3%; 95% CI 24.4–52.2%) described some form of teaching for equipment use. The median level of confidence of participants (on a 5‐point scale) was 4 (25–75% interquartile range 3–4), which correlates with a moderate degree of confidence. Of 47 participants, 7 (14.9%; 95% CI 4.7–25.1%) rated themselves as not confident or somewhat under‐confident (i.e. 1 or 2 on the scale). Of 47, 12 passed overall (25.5%; 95% CI 13.1–38%) and 8 completely failed (17.0%; 95% CI 6.3–27.8%) the skill testing.Conclusion:  When tested in isolation, there appears to be deficits in the equipment skills of advanced ED trainees who are expected to be proficient in transport medicine.
Education initiative improves the evidence‐based use of metoclopramide following morphine administration in the emergency department
Authors: Yeoh Bernard SK , McD Taylor David , Taylor Simone E 
Published: June 2009

AbstractObjective:  We aimed to evaluate a multifaceted education initiative designed to reduce the prophylactic use of metoclopramide.Methods:  This was a pre‐ and post‐intervention trial undertaken in a single ED. All ED doctors and nurses were targeted. The intervention comprised a specifically designed, 19‐slide ‘e‐learning module’, accessible via the ED intranet, supplemented by in‐service training and a range of reminder techniques (posters, emails and drug room flyers). The primary end‐point was the proportion of patients administered metoclopramide prophylactically with their initial morphine dose. Data were collected on random samples of patients who received morphine, using explicit medical chart review.Results:  Both pre‐ and post‐intervention periods were of 3 month duration. The charts of 146 cases were reviewed in each period. In the post‐intervention period:• The proportion of patients administered metoclopramide prophylactically decreased from 22.6% to 4.1% (difference 18.5% [95% CI 10.3–26.7], P < 0.001)• The proportion of patients administered metoclopramide appropriately (for known morphine sensitivity, established nausea and rescue anti‐emesis) rose marginally from 28.8% to 32.9% (difference 4.1% [95% CI −7.2–15.4], P = 0.53)• There was a 12.7% decrease in the number of ampoules of metoclopramide issued to the ED without a concurrent rise in the issue of other anti‐emetic drugsConclusion:  The education initiative resulted in a significant improvement in the evidence‐based use of metoclopramide.
Frequent attenders with mental disorders at a general hospital emergency department
Authors: Wooden Michael DG , Air Tracy M , Schrader Geoffrey D , Wieland Barbara , Goldney Robert D 
Published: June 2009

AbstractObjectives:  To define the clinical and demographic characteristics of frequent attenders with mental disorders at a general hospital ED; to determine whether those persons had additional attendances at other ED in the same city; and to assess the documented care of those frequent attenders.Method:  A retrospective descriptive study of those who attended the Queen Elizabeth Hospital, Woodville South, Australia ED on average at least once per month between 1 July 2006 and 15 March 2007.Results:  Of 11594 attenders, 54 (0.47%) at the ED were frequent attenders with mental disorders. Their 735 attendances represented 4.5% of the total of 16 345 attendances. Of those frequent attenders, 34 (63%) also visited other Adelaide hospital ED on an additional 410 occasions. Presentations peaked on the weekends and between 18.00 h and midnight. Although 43% of frequent attenders had specific mental health‐care plans, only two‐thirds of those had been assigned to a mental health team.Conclusions:  The documented management of frequent attenders with mental disorders at a general hospital ED appeared to be less than optimal. Furthermore, the majority of those frequent attenders also attended other general hospital ED in the same city, and this did not appear to be recognized.
Structured team approach to the agitated patient in the emergency department
Authors: Downes Michael A , Healy Paul , Page Colin B , Bryant Jennifer L , Isbister Geoffrey K 
Published: June 2009

AbstractObjective:  Behavioural disturbance and aggression in the ED is an increasing problem. The present study describes the characteristics of patients with acute behavioural disturbance and their emergent treatment in an ED with a structured team approach.Methods:  This was a retrospective review of acute behavioural emergencies that required response from the Code Black (CB) Team (duress response team) in the ED during 2006. The hospital security log and hospital incident‐reporting system identified all documented CB, and the patients' medical records were reviewed. Information extracted included patient demographics and presenting complaint, details of the CB, the use of pharmacological sedation, physical restraint and patient disposition. Injuries to hospital staff were also extracted.Results:  There were 122 patients, median age 32 years (interquartile range: 24–43 years, range: 14–81 with 71 male patients (58%) who accounted for 143 CB activations. The primary problems were deliberate self‐poisoning or self‐harm (38%), alcohol and illicit drug intoxication (33%) and psychiatric, organic illness and drug withdrawal (29%). One hundred and eight (89%) patients had a past history of alcohol/illicit drug abuse or psychiatric illness. Indications for CB activation were threatening harm to others or behaving violently in 67% of cases. Combined pharmacological sedation and physical restraint were required on 66 (46%) occasions, pharmacological sedation alone on 20 (14%), physical restraint alone on 14 (10%) and neither on 43 (30%) occasions. Benzodiazepines were most commonly used for initial sedation, including i.m. (29%), i.v. midazolam (20%), diazepam (42%) and antipsychotics (9%), most commonly droperidol. More diazepam and droperidol were used for subsequent pharmacological sedation. A staff member was injured on only one occasion (0.7%).Conclusions:  Acute behavioural disturbance was common in the present study, and underlying causes were predominantly organic in nature. A team approach appears to be valuable in managing these incidents.
Nebulized fentanyl versus intravenous morphine in children with suspected limb fractures in the emergency department: A randomized controlled trial
Authors: Furyk Jeremy S , Grabowski Walter J , Black Lisa H 
Published: June 2009

AbstractObjective:  To compare the efficacy of nebulized fentanyl (NF) with i.v. morphine (IVM) in paediatric patients presenting to the ED with clinically suspected limb fractures.Methods:  A convenience sample of patients aged 4–13 years, presenting with clinically suspected limb fractures, were randomized to receive either NF at 4 µg/kg or IVM at 0.1 mg/kg. Pain scores were assessed at 0, 15 and 30 min using the Wong and Baker faces pain scale (0–10). Vital signs and adverse effects were also recorded.Results:  Of the 77 patients enrolled in the study, data were available for analysis on 73 patients. Of those, 36 received NF and 37 received IVM. The two groups were similar in terms of demographics and initial pain scores. Mean pain score at 15 min was decreased by 3.06 (NF) and by 1.97 (IVM) (difference 1.09; 95% CI 2.32 to −0.32). At 30 min the decreases were 3.6 (NF) and 3.0 (IVM), respectively (difference 0.6; 95% CI 1.89 to −0.65). Decreases in pain scores for both NF and IVM were statistically significant (P < 0.0001), but the difference in the effect of NF and IVM did not reach statistical significance. There was no significant change in any vital signs or serious adverse events in either group.Conclusion:  NF in a dose of 4 µg/kg given via a standard nebulizer provided clinically significant improvements in pain scores, comparable to IVM. NF should be considered as a treatment option for use in children presenting in acute pain.
Pain management practices in paediatric emergency departments in Australia and New Zealand: A clinical and organizational audit by National Health and Medical Research Council's National Institute of Clinical Studies and Paediatric Research in Emergency Departments International Collaborative
Authors: Herd David W , Babl Franz E , Gilhotra Yuri , Huckson Sue ,   PREDICT group
Published: June 2009

AbstractObjective:  To audit pain management practices and organization in paediatric ED across Australia and New Zealand.Methods:  Retrospective audit of pain management practices in Paediatric Research in Emergency Departments International Collaborative ED in 20 cases each of migraine, abdominal pain and femoral shaft fracture. Review of organizational status of pain management at Paediatric Research in Emergency Departments International Collaborative sites.Results:  Of 14 ED, 10 participated in the clinical audit. A total of 196 migraine, 197 abdominal pain and 177 femur fracture cases were reviewed. Less than half had degree of pain measured or had pain score documented on triage. Migraine received analgesia in 62% of cases (opioids in 11%). Abdominal pain received analgesia in 62% of cases (opioids in 14%). Fractured femurs received analgesia in 78% of cases (opioids 49%, femoral nerve blocks 40%). Median minutes to enteral medication were 100, 85 and 75, and for parenteral medication (mainly opiates) 103, 137 and 26, for migraine, abdominal pain and femur fracture, respectively. Thirteen hospitals participated in the organizational audit. Of all ED, 92% had pain management policies or guidelines, 92% taught pain management topics in education programmes and 62% used mandatory pain competencies. Only 15% had quality improvement programmes for pain reduction.Conclusion:  We found a notable lack of pain assessment documentation and delays to analgesia. There is a need to improve pain assessment and management, although a majority of paediatric ED surveyed had important organizational and educational structures in place. Issues to explore include use of opioids in migraine and the underuse of femoral nerve blocks.
White‐eyed blowout fracture: Another look
Authors: Mehanna Patrick , Mehanna Daniel , Cronin Andrew 
Published: June 2009

AbstractOrbital floor fractures have the potential to cause significant morbidity both in the short and long terms and commonly present to the ED for initial assessment. Although treatment of the majority of these injuries involves clinic review and possible later surgery, there is a specific subset that present to emergency clinically suggestive of a head injury. This subset, ‘white‐eyed blowout’, usually occurring under 18 years of age, with a history of trauma and little sign of soft tissue injury, describes a trap door orbital floor fracture with herniation and acute entrapment of orbital muscle and is regarded as a maxillofacial emergency. The injury presents with marked nausea, vomiting, headache and irritability suggestive of a head injury that commonly distracts from the true aetiology. It requires prompt diagnosis and treatment to avoid permanent morbidity. We present three cases and discuss their management.
Successful retrograde tracheal intubation using a central venous catheterization set: two cases
Authors: Oh Je Hyeok , Kim Sung Eun , Lee Sang Jin 
Published: June 2009

AbstractRetrograde tracheal intubation (RTI) is an airway management technique requiring relatively simple skills that can be learned easily and retained. However, proper RTI equipment is not generally available in many ED. RTI requires through‐the‐needle catheters and flexible‐tip guidewires, which are included in the more generally available central venous catheterization set. We performed RTI using the central venous catheterization set in two patients with obstructed airways where specific RTI equipment was unavailable and demonstrated successful intubation in both cases. Our method might be a useful alternative for RTI in situations where the purpose‐specific equipment is unavailable.
The GermanGemeinwirtschaftslehre: Implications for modern nonprofit economics
Authors: Valentinov Vladislav 
Published: June 2009

AbstractThis article examines the way modern nonprofit economics can be informed by theGemeinwirtschaftslehre, a strand of public and nonprofit economics that was popular in German‐speaking countries until the 1980s. Despite its present decline, theGemeinwirtschaftslehreyields a valuable implication that nonprofit firms address market failure by supplanting the pecuniary entrepreneurial motivation with a nonpecuniary one. In this article, this implication is used to reconsider two central and controversial issues in modern nonprofit economics: the rationale behind the nondistribution constraint in nonprofit firms, and the integration between the market failure and supply‐side theories of the nonprofit sector. The article concludes by discussing the emerging prospects for empirical research.
The devaluation of life
Authors: Viscusi W. Kip 
Published: June 2009

AbstractThe US Environmental Protection Agency (EPA) has been the target of two recent controversies involving the devaluation of life: the 2003 use of a senior discount for the value of statistical life for people over age 65, and the 2008 downward reassessment of the value of statistical life by the EPA Air Office. Even though these new values of statistical life were still among the highest used in the Federal government, there was a strong negative public reaction to each. The public outcry over the EPA policies appears to have stemmed from an irrational response to decreases in the value of statistical life. Proposed Congressional legislation that purportedly seeks to reform the valuations would politicize benefit assessments. A sounder approach is to establish a peer‐reviewed scientific advisory panel to advise agencies on the value of statistical life.
Viscoelastic properties of Staphylococcus aureus and Staphylococcus epidermidis mono‐microbial biofilms
Authors: Di Stefano Antonio , D'Aurizio Eleonora , Trubiani Oriana , Grande Rossella , Di Campli Emanuela , Di Giulio Mara , Di Bartolomeo Soraya , Sozio Piera , Iannitelli Antonio , Nostro Antonia , Cellini Luigina 
Published: June 2009

SummaryThe viscoelastic properties of mono‐microbial biofilms produced by ocular and reference staphylococcal strains were investigated. The microorganisms were characterized for their haemolytic activity and agr typing and the biofilms, grown on stainless steel surface under static conditions, were analysed by Confocal Laser Scanning Microscopy. Static and dynamic rheometric tests were carried out to determine the steady‐flow viscosity and the elastic and viscous moduli. The analysed biofilms showed the typical time‐dependent behaviour of viscoelastic materials with considerable elasticity and mechanical stability except for Staphylococcus aureus ATCC 29213 biofilm which showed a very fragile structure. In particular, S. aureus 6ME biofilm was more compact than other staphylococcal biofilms studied with a yield stress ranging between 2 and 3 Pa. The data obtained in this work could represent a starting point for developing new therapeutic strategies against biofilm‐associated infections, such as improving the drug effect by associating an antimicrobial agent with a biofilm viscoelasticity modifier.
The roles of outer membrane cytochromes of Shewanella and Geobacter in extracellular electron transfer
Authors: Shi Liang , Richardson David J. , Wang Zheming , Kerisit Sebastien N. , Rosso Kevin M. , Zachara John M. , Fredrickson James K. 
Published: June 2009

SummaryAs key components of the electron transfer (ET) pathways used for dissimilatory reduction of solid iron [Fe(III)] (hydr)oxides, outer membrane multihaem c‐type cytochromes MtrC and OmcA of Shewanella oneidensis MR‐1 and OmcE and OmcS of Geobacter sulfurreducens mediate ET reactions extracellularly. Both MtrC and OmcA are at least partially exposed to the extracellular side of the outer membrane and their translocation across the outer membrane is mediated by bacterial type II secretion system. Purified MtrC and OmcA can bind Fe(III) oxides, such as haematite (α‐Fe2O3), and directly transfer electrons to the haematite surface. Bindings of MtrC and OmcA to haematite are probably facilitated by their putative haematite‐binding motifs whose conserved sequence is Thr–Pro–Ser/Thr. Purified MtrC and OmcA also exhibit broad operating potential ranges that make it thermodynamically feasible to transfer electrons directly not only to Fe(III) oxides but also to other extracellular substrates with different redox potentials. OmcE and OmcS are proposed to be located on the Geobacter cell surface where they are believed to function as intermediates to relay electrons to type IV pili, which are hypothesized to transfer electrons directly to the metal oxides. Cell surface‐localized cytochromes thus are key components mediating extracellular ET reactions in both Shewanella and Geobacter for extracellular reduction of Fe(III) oxides.
Food restriction promotes downregulation of myocardial L-type Ca2+ channels
Authors: De Tomasi Loreta Casquel , Bruno Alessandro , Sugizaki Mário Mateus , Lima-Leopoldo Ana Paula , Nascimento André Ferreira , Júnior Silvio Assis de Oliveira , Pinotti Matheus Fécchio , Padovani Carlos Roberto , Leopoldo André Soares , Cicogna Antonio Carlos 
Published: June 2009

Food restriction (FR) has been shown to impair myocardial performance. However, the mechanisms behind these changes in myocardial function due to FR remain unknown. Since myocardial L-type Ca2+ channels may contribute to the cardiac dysfunction, we examined the influence of FR on L-type Ca2+ channels. Male 60-day-old Wistar rats were fed a control or a restricted diet (daily intake reduced to 50% of the amount of food consumed by the control group) for 90 days. Myocardial performance was evaluated in isolated left ventricular papillary muscles. The function of myocardial L-type Ca2+ channels was determined by using a pharmacological Ca2+ channel blocker, and changes in the number of channels were evaluated by mRNA and protein expression. FR decreased final body weights, as well as weights of the left and right ventricles. The Ca2+ channel blocker diltiazem promoted a higher blockade on developed tension in FR groups than in controls. The protein content of L-type Ca2+ channels was significantly diminished in FR rats, whereas the mRNA expression was similar between groups. These results suggest that the myocardial dysfunction observed in previous studies with FR animals could be caused by downregulation of L-type Ca2+ channels.