bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patient‐focused nursing documentation expressed by nurses
Authors: Laitinen Heleena , Kaunonen Marja , Åstedt‐Kurki Päivi 
Published: January 2010

Aim.  The aim of the study was to investigate what expressions nurses use when documenting patient‐focused nursing care in electronic patient records.Background.  Much effort has been made in the development of nursing documentation. Many studies have found inadequate reporting, focused more on tasks and treatment than on the patient’s voice. Electronic patient record‐systems have been introduced, bringing new challenges because of unfamiliarity with computers. Electronic patient records have caused dissatisfaction and frustration, however, some studies show improvement in documentation given enough time and effort. Electronic patient record documentation is an integral part of patient‐focused care and thus needs to be investigated.Design.  The study is based on the grounded theory approach, as developed by Strauss and Corbin.Methods.  Forty electronic patient records were analysed, considering whether nurses’ written expressions reflected a patient‐focused approach. An inductive qualitative method was used, involving constant comparative analysis, up to axial coding.Results.  Three categories emerged from the data: Patient’s voice: the patient has expressed his/her thoughts, which are written by the nurse, Nurse’s view: the nurse recounts the patient’s own thoughts, state or situation and mutual view in patient–nurse relationship: the documentation describes the patient–nurse relationship.Conclusions.  This study found that the nursing documentation was patient‐focused, to some extent. This is significant because nursing documentation represents much more than simply a record of the continuity of care. Many topics for further studies were presented, e.g., the timing of documentation and the differences between the mode of nursing and the documentation.Relevance to clinical practice.  The presented findings may be helpful in the development of nursing documentation in electronic patient records and in nursing practice generally. Highlighting the patient’s voice could become an effective tool in nursing and its documentation, saving time and getting clear information for improving the patient’s care.
The next 25 years?: future scenarios and future directions for education and technology
Authors: Facer K. , Sandford R. 
Published: January 2010

AbstractThe educational technology research field has been at the heart of debates about the future of education for the last quarter century. This paper explores the socio‐technical developments that the next 25 years might bring and the implications of such developments for educators and for educational technology research. The paper begins by outlining the diverse approaches to educational futures that are currently visible in the field, and suggests four principles to underpin future thinking in educational technology. It then describes the methods used to inquire into long‐term socio‐technical futures in the 2‐year Beyond Current Horizons Programme. These included a foresight and scenario development process bringing together evidence reviews and insights from over 100 researchers from disciplines as diverse as computer science, demography and sociology of childhood, as well as consultation with over 130 organizations and individuals from industry, practice and educational beneficiary groups. The outcomes of this programme are then presented, including a set of future scenarios for education and a set of socio‐technical developments that might underpin such scenarios. The scenarios emerge from three future worlds (‘Trust Yourself’, ‘Loyalty Points’ and ‘Only Connect’), and from projections including: changing demography, new human–machine relations and a weakening of institutional boundaries. The paper then argues that the next 25 years will challenge our current organization of education around the unit of the individual child, the school and the discourses of the knowledge economy; and will require the development of new approaches to curriculum, cross‐institutional relationships, workforce development and decision‐making in education. Finally, the paper argues that these developments challenge educational technology research to move beyond pedagogy to curriculum; beyond the school to the community, home and workplace; and beyond social sciences to collaborations with medical and bio‐ethics fields.
Use of electronic sales data to tailor nutrition education resources for an ethnically diverse population
Authors: Eyles H. , Rodgers A. , Ni Mhurchu C. 
Published: January 2010

AbstractBackground:  Nutrition education may be most effective when personally tailored. Individualised electronic supermarket sales data offer opportunities to tailor nutrition education using shopper’s usual food purchases. The present study aimed to use individualised electronic supermarket sales data to tailor nutrition resources for an ethnically diverse population in a large supermarket intervention trial in New Zealand.Methods:  Culturally appropriate nutrition education resources (i.e. messages and shopping lists) were developed with the target population (through two sets of focus groups) and ethnic researchers. A nutrient database of supermarket products was developed using retrospective sales data and linked to participant sales to allow tailoring by usual food purchases. Modified Heart Foundation Tick criteria were used to identify ‘healthier’ products in the database suitable for promotion in the resources. Rules were developed to create a monthly report listing the tailored and culturally targeted messages to be sent to each participant, and to produce automated, tailored shopping lists.Results:  Culturally targeted nutrition messages (n = 864) and shopping lists (n = 3 formats) were developed. The food and nutrient database (n = 3000 top‐selling products) was created using 12 months of retrospective sales data, and comprised 60%‘healthier’ products. Three months of baseline sales data were used to determine usual food purchases. Tailored resources were successfully mailed to 123 Māori, 52 Pacific and 346 non‐Māori non‐Pacific participants over the 6‐month trial intervention period.Conclusions:  Electronic supermarket sales data can be used to tailor nutrition education resources for a large number of ethnically diverse supermarket shoppers.
Patient satisfaction with nursing care and its relationship with patient characteristics
Authors: Findik Ummu Yildiz , Unsar Serap , Sut Necdet 
Published: January 2010

AbstractThe aim of this study was to assess patient satisfaction with nursing care and the relationship between patient satisfaction and patient characteristics. This cross‐sectional study was conducted at a 1100‐bed tertiary care teaching hospital in Turkey. Data were collected using the Newcastle Satisfaction with Nursing Care Scales and a patient information form. Overall, data indicated a high level of patient satisfaction. Hospitalization affected the Experience of Nursing Care Scale independently, while the type of ward, sex, income, and education independently affected the Satisfaction with Nursing Care Scale. Patients who underwent surgical procedures, male patients, the 40–59‐year‐old age group, those who had low levels of education or income, and patients who were hospitalized for long periods were most satisfied. Patients' sex, age, income, duration of hospitalization, and ward type were important factors that affected their satisfaction with nursing care. The characteristics of patients who have a low level of satisfaction with nursing care should be assessed and taken into consideration by nurses.
Influence of bulk damage on crack initiation in low‐cycle fatigue of 316 stainless steel
Authors: KAMAYA M. 
Published: January 2010

ABSTRACTTo investigate the effect of bulk damage on fatigue crack initiation, crack initiations due to low‐cycle fatigue of Type 316 stainless steel were observed by electron backscatter diffraction (EBSD) and scanning electron microscopy. The EBSD observations showed that local misorientation developed inhomogeneously due to the cyclic strain, and many cracks were initiated from the slip steps and grain boundaries where the local misorientation was relatively large. The crack initiations could be categorized into two types: enhancement of the driving force by geometrical discontinuity (slip steps and notches), and reduction of material resistance against crack initiation caused by accumulated bulk damage at grain boundaries. In particular, more than half of the cracks were initiated from grain boundaries. However, in spite of the significant bulk damage, the fatigue life was extended by removing the surface cracks under strain of 1 and 2% amplitude. The stress state at the microstructural level was changed by the surface removal, and the damaged portion did not suffer further damage. It was concluded that although bulk damage surely exists, the fatigue life can be restored to that of the untested specimen by removing the surface cracks.
Sensitivity of different taxonomic levels of soil Gamasina to land use and anthropogenic disturbances
Authors: Bedano José Camilo , Ruf Andrea 
Published: January 2010

The effect of taxonomic level on the sensitivity of bioindicators has been widely investigated in aquatic ecosystems and, to a lesser extent, in terrestrial ecosystems. However, no studies have been conducted on the sensitivity of the different taxonomic levels of soil mites, especially Gamasina, to human activities.
The present study aimed to assess the sensitivity of different taxonomic levels of soil Gamasina mites to anthropogenic disturbances in Europe and Argentina. We arranged the data from previous projects in a hierarchical system and conducted a study to identify the critical taxonomical levels that had the highest discriminative potential between sites (Europe and Argentina) or management types (forests, grasslands, fallows, succession, recultivation and agricultural sites).
For the Gamasina community, geographical location was by far more important than the influence of any land use type. The analysis including only the European sites demonstrated that communities belonging to sites subjected to different land uses were also significantly different.
The species data set provided a clearer separation of sites according to both the geographical and the land‐use gradients than the genus and family data sets. The genus and, to a lesser extent, the family approach may be sufficient to elucidate the influence of great geographical differences and also of certain land uses (e.g. grasslands from the forests and arable sites).
Species presence/absence data provided valuable information in our analyses, although the use of quantitative data yielded a clearer separation of sites.
Hand‐assisted laparoscopic colectomy: the learning curve is for operative speed, not for quality
Authors: Ozturk E. , da Luz Moreira A. , Vogel J. D. 
Published: January 2010

AbstractAim  We aimed to define the learning curve for hand‐assisted laparoscopic colectomy (HALC).Method  A retrospective analysis of prospectively recorded data was performed. Consecutive segmental and total HALC performed by a single surgeon with no prior HALC experience was included. Operative time and quality‐related outcomes, including conversions, operative and postoperative complications, length of stay, reoperations and readmissions were compared for consecutive cohorts of 25 HALC. A subgroup analysis of right, left, total and proctocolectomy performed in each cohort of 25 HALC was also performed.Results  From December 2005 to February 2009, 200 HALC were performed. When evaluated in cohorts of 25 consecutive cases, operative times (155–206 min), operative complications (4–12%), postoperative complications (8–36%), length of stay (4–5 days), reoperations (0–8%) and readmissions (0–16%) were similar. In the subgroup analysis, there were no changes in the quality‐related measures for any colectomy type or the operative time for right and proctocolectomy as experience was gained. Operative time decreased for left (183–127 min) and total HALC (259–218 min) after experience with 50 cases (P < 0.05).Conclusion  HALC operative times decreased with surgeon experience. For quality‐related outcomes, there was no learning curve for HALC.
Prostate‐specific antigen relapse‐free survival and side‐effects in 734 patients with up to 10 years of follow‐up with localized prostate cancer treated by permanent125iodine implants
Authors: Prada Pedro J. , Juan Germán , González‐Suárez Herminio , Fernández José , Jimenez Isabel , Amón José , Cepeda Marcos 
Published: January 2010

Study Type – Therapy (case series) Level of Evidence 4OBJECTIVETo report our analysis of the oncological outcome, side‐effects and complications after125I‐brachytherapy, based on 10 years of experience, as low dose‐rate (LDR) prostate brachytherapy is an accepted, effective and safe therapy for localized prostate cancer.PATIENTS AND METHODSBetween April 1999 and December 2006, 734 consecutive patients were treated with clinically localized prostate cancer with a follow‐up of ≥30 months. No patients received external beam radiotherapy and 43% received hormonal therapy before brachytherapy; this therapy was given for 3–4 months. All patients had LDR prostate brachytherapy administered by one radiation oncologist. Biochemical failure was defined according to the ‘Phoenix consensus’.RESULTSThe median follow‐up for the 734 patients was 55 months; 26 had a clinical relapse and 11 died from prostate cancer; 20 patients died from other illnesses. The 10‐year actuarial biochemical control was 92%, 84% and 65%, respectively (P < 0.001) for the low‐, intermediate‐ and high‐risk groups. Multivariate Cox regression analyses identified Gleason score and prostate‐specific antigen (PSA) level as independent prognostic factors for biochemical failure. The actuarial biochemical control with Gleason score was 88%, 76% and 67% for patients with a Gleason score of ≤6, 7 and >7, respectively (P < 0.001). The biochemical control was 90%, 80% and 42% for patients with a PSA level of ≤10, 10.1–20 and >20 ng/mL, respectively (P < 0.001). No patients reported incontinence after treatment. There was acute urinary retention in 22 (2.9%) patients. Logistic regression showed that the most significant factors correlating with the probability of catheterization were the pretreatment prostate volume and hormonal therapy.CONCLUSIONSThe excellent long‐term results and low morbidity, and the many advantages of prostate brachytherapy over other treatments, show that brachytherapy is an effective treatment for clinically organ‐confined prostate cancer.
Impact of a novel, extended approach of perineal radical prostatectomy on surgical margins in localized prostate cancer
Authors: Inoue Shogo , Shiina Hiroaki , Sumura Masahiro , Urakami Shinji , Matsubara Akio , Igawa Mikio 
Published: January 2010

Study Type – Therapy (case series) Level of Evidence 4OBJECTIVETo validate the rationale of extended perineal radical prostatectomy (ePRP) for treating localized prostate cancer.PATIENTS AND METHODSBetween December 2000 and May 2007, 196 patients with localized prostate cancer underwent PRP, among which 91 and 105 patients were treated with conventional PRP (cPRP) and ePRP, respectively. The apex, middle, base, and anterior regions of the prostate were separately analysed, and the focus of analysis was on the distribution, size, Gleason score, and positive surgical margins (PSMs) of prostate cancer foci.RESULTSThe operation time was significantly shorter in ePRP compared with cPRP (161 min vs 188 min; P= 0.001), while there was no significant difference in estimated blood loss between cPRP and ePRP (550 mL vs 500 mL). At the apex and base, there was no significant difference in the PSM rate between cPRP and ePRP. In the middle, there was a lower incidence of PSMs in ePRP (2.4%) than in cPRP (10.9%; P= 0.009). On the anterior side, PSMs were more frequent in cPRP (21.6%) than in ePRP (7.1%; P= 0.029). Logistic regression analysis adjusted by PSA level showed that PSM rate was the most significantly affected by the surgical approach.CONCLUSIONWe think that ePRP provides an effective treatment strategy for localized prostate cancer in light of excellent cancer control and minimum potential of surgical invasiveness.
THE STRUCTURE OF THE FINANCIAL SERVICES INDUSTRY
Authors: LAUB P. MICHAEL , HOFFMAN CHARLES F. 
Published: January 2010

Since most studies of the financial services industry have viewed the structure of the industry as fixed, there has been little discussion of its determinants. Events of the past few years make it clear that the structure of the financial services industry is changing much more rapidly than it did between the end of World War II and the mid 1960's. This paper categorizes and discusses the major factors affecting the structure of the financial services industry. The concept of supply and demand provides a useful framework for categorizing these factors. Demand is best analyzed in terms of the demand for various characteristics or attributes of financial services. These include: 1) yield; 2) liquidity; 3) safety; 4) convenience of access to the services, 5) financial advice or information. The demand for these various characteristics or attributes depends importantly on demographic and economic factorsThe supply of financial services is determined by the cost curves associated with those services which are in turn determined by the cost of the factors of production and the underlying production function. Three aspects of these cost curves have an important effect on the supply of financial services and the structure of the industry — economies of scale, economies of joint production and distribution, and the management of risk. The nature of the cost and production functions underlying the supply of financial services and the structure of the industry is affected by several exogenous factors. Foremost among them are the economy, technology, regulation, and the role of the Federal government in financial service marketsBased on the discussion of how the various exogenous factors affect the structure of the financial services industry, an attempt is made to predict how structure will change as deregulation occurs.
TALL TREES, PEOPLE, AND POLITICS: THE OPPORTUNITY COSTS OF THE REDWOOD NATIONAL PARK
Authors: WALKER JOHN L. 
Published: January 2010

Because individuals in the marketplace directly face opportunity costs, they must balance marginal costs against marginal benefits. In contrast, in politics, the opportunity costs facing decision makers are diluted. Estimates of the social costs of various public programs are generally understated, while the estimates of social benefits are exaggeratedThis paper places the establishment and expansion of the Redwood National Park within this framework and analyzes it as a public investment decision. It is shown that in the initial creation of the Redwood National Park in 1968, the costs of land acquisition and employment loss were underestimated, while the projections for gains in tourism were excessive. Despite the opposition of local landowners and residents, the Park was further expanded 10 years later in 1978. There was again a misstatement of costs and benefits and also the creation of an expensive new entitlement program to defuse the opposition of laborThe experience with the redwood National Park illustrates the results of the political process, which allows decision makers to internalize benefits and externalize costs. Emotion and rhetoric tend to displace a careful weighing of marginal costs and benefits
RESTORING PREDICTABILITY TO MERGER GUIDELINE ANALYSIS
Authors: JORDE THOMAS M. 
Published: January 2010

Two recent developments reduce predictability and accountability in merger analysis. First, the 1984 Merger Guidelines adopt a multifactor method of analysis that focuses upon market structure, other market factors, financial trends, and efficiencies. Little guidance is given concerning the relative importance of these factors or how they will be measured and balanced. Second, current enforcement agencies appear to take a “regulatory” approach to merger enforcement. They issue “no‐action” decisions in 90–95 percent of the mergers reviewed and reach “fix‐it‐first” consent settlements before complaints are filed in most remaining cases.These developments provide mixed blessings. Enforcement agencies gain flexibility and discretion. However, the business community suffers a reduction in predictability in merger analysis, which makes planning more difficult. Congress loses ability to carry out its oversight responsibilities, and the public's understanding of the government's policies is impaired.Systematic, regular reports of information used by the government analyzing significant “second‐request” mergers should replace the present system of providing either no information or, at best, only selected information through ad hoc press releases and official speeches. Reporting on these transactions would not be burdensome, because their number is relatively small and the information already has been produced by the investigating enforcement agency. This information could easily be incorporated into the annual Hart‐Scott‐Rodino Act reports.For each of these mergers, the information reported should include the government's views concerning the relevant market and the degree of concentration in that market. It also should specify the type and magnitude of other market factors, efficiencies, and/or defenses that might have played a role in reaching a decision not to prosecute the merger or a fix‐it‐first settlement. This information could be provided without infringing on confidentiality.
THE IMPACT OF ANTITRUST GUIDELINES ON BUSINESS
Authors: LANGENFELD JAMES 
Published: January 2010

The dual antitrust goals of predictable law enforcement and accurate decisions in individual cases have been in conflict for decades. There are three dimensions to this conflict. First, there may be insufficient information on how the courts and enforcement agencies interpret the antitrust statutes. Second, the enforcement agencies may not use consistent standards to evaluate actual and potential antitrust cases. Third, antitrust guidelines may differ significantly from case law.Unfortunately, attempts to improve one dimension of antitrust policy generally create conflicts elsewhere. Thus, the search for better antitrust decision making in individual cases has made antitrust counseling more complex and expensive. Over time, standards have evolved at different rates at the Department of Justice (DOJ), the Federal Trade Commission (FTC), and the courts, and inconsistencies among these three decision‐making bodies have further complicated the task of antitrust counseling. In this environment, improved and updated information on antitrust standards can potentially be very valuable to the business community.