bluuebunny/crossref_metadata_2025_split huggingface dataset:
Paradigms and Nursing Management, Analysis of the Current Organizational Structure in a Large Hospital
Authors: Wilson Donna 
Published: July 2010

Hospitals developed over the period of time when positivism become a predominant world view. Positivism was founded by four Western trends: preponderance of hierarchy and autocracy, popularization of bureaucracy, extensive application of a machine orientation to work and predominance of “scientific” inquiry. Organizational theory developed largely from quantitative research findings arising from a positivistic world view. A case study, analyzing a current nursing organizational structure at one large hospital, is presented. Nursing management was found to be based upon the positivistic paradigm. The predominance of a machine orientation, and an autocratic and bureaucratic structure are evidence of this. A change to shared governance had been attempted, indicating a shift to a more modern organizational structure based on a different paradigm. The article concludes by emphasizing that managers are largely responsible for facilitating change; change that will meet internal human resource needs and the cost-effectiveness crises of hospitals today through more effective use of human resources.
Planning for Strategic Change? A Participative Planning Approach for Community Hospitals
Authors: MacDonald Susan K. , Beange J. Edna , Blackford Peter C. H. 
Published: July 2010

Strategic planning is becoming to hospitals what business case analysis is to private corporations. In fact, this type of planning is becoming essential for the professional management of Ontario hospitals. The participative strategic planning process at Toronto East General Hospital (TEGH) is an example of how a professionally structured and implemented strategic planning process can be successfully developed and implemented in a community hospital. In this article, the environmental factors driving planning are reviewed and the critical success factors for the development and implementation of a strategic plan are examined in the context of TEGH's experience.
Travailler ensemble: La collaboration administrative et clinique fait noître un programme de soins gériatriques pour l'hôpital
Authors: Wells Donna L. , Saltmarche Anita , Adolphus Patricia , Marshall Kerry 
Published: July 2010

À Toronto, le Centre hospitalier Sunnybrook a conçu et rédigé un programme de soins pluridisciplinaires à l'intention des malades âgés en traitement actif. Le programme prévoit des activités particulières d'extension dans la collectivité, en conjonction avec les programmes hospitaliers, qui répondent aux besoins nouveaux d'une population vieillissante. Certains de ces objectifs sont de réussir à mesurer l'évolution de la durée de séjour, de réduire le nombre de patients en attente de transfert à un établissement de soins prolongés (d'où l' expression péjorative «problème de placement») et d'accroître la satisfaction des malades, des familles et du personnel. Une méthode d'évaluation du programme est en cours d'élaboration. Le programme fait appel à une triple démarche de soins: (1) le malade âgé bien portant, (2) le malade âgé dont le cas est plus complexe et (3) les soins aux patients qui sont en convalescence d'une maladie grave mais qui doivent être hospitalisés dans un établissement de soins prolongés.
Economic and Ethical Considerations in the Intensive Care Unit
Authors: Noseworthy Thomas W. , Jacobs Phil 
Published: July 2010

Intensive care units (ICUs) sustain life but, in certain cases, this resource becomes a means to prolong dying, with great physical, emotional and financial impact. The cost to care for patients in the ICU is at least three times more than general ward care; thus, ICUs have become one of the largest cost centres in the hospital. Economic pressures require us to be mindful of whom the ICU treats and for how long. Health professionals working in the ICU must critically appraise the ethical basis for their behaviour and actions. In so doing, many are likely to appeal to the patient's right to self-determination and the physician's reliance on the principles of beneficence and non-maleficence as the underpinnings of morality in medicine. One approach is to examine the issues and rights pertinent to an individual case using a circular model. Decisions are based on medical facts and prognosis, a patient's right to self-determination, a patient's best interests and external factors. Health personnel would be compelled to consider all of these issues. Within this framework, prevention or resolution of moral dilemma can take place within the clinical rather than the legal forum.
Case Mix Management Education in a Canadian Hospital
Authors: Moffat Malcolm , Prociw Michael 
Published: July 2010

The Sunnybrook Health Science Centre's matrix organization model includes a traditional departmental structure, a strategic program-based structure and a case management-based structure — the Clinical Unit structure. The Clinical Unit structure allows the centre to give responsibility for the management of case mix and volume to decentralized Clinical Unit teams, each of which manages its own budget. To train physicians and nurses in their respective roles of Medical Unit directors and Nursing Unit directors, Sunnybrook designed unique short courses on financial management and budgeting, and case-costing and case mix management. This paper discusses how these courses were organized, details their contents and explains how they fit into Sunnybrook's program of decentralized management.
Multidisciplinary Teams in Health Care: Lessons from Oncology and Renal Teams
Authors: Fried Bruce J. , Leatt Peggy , Deber Raisa , Wilson Elaine 
Published: July 2010

An indepth study conducted on units treating renal disease and cancer clinics determined that multidisciplinary teams are relatively commonplace in these areas. Developing four team organizational structures — sequential, primary, nucleus and dynamic — the authors hypothesize that each varies on a continuum in terms of how highly structured they are. The framework suggests that the ideology of equal participation on the team is the most difficult to sustain, and that difficulties typically arise as organization requirements become more complex. More research seems to be indicated to develop a comprehensive organizational framework, and the probable effect of organizational form on team performance. One of the key issues addressed is team leadership.
Designing for Psychogeriatric Care
Authors: Rapelje Douglas H. 
Published: July 2010

After two years of design research, the near-term goal of the Senior Citizens Department, Regional Niagara, was to build innovative homes to address the issues and programs the studies revealed. The long-term objective was to build homes that would start to change the public perception of long-term care facilities. Featuringa “Town Square”, the home comprises five houses of 20 beds, each providing a different level of care. Corridors are a unique design, and each house has its own dining room facilities and activity room. A central Day Care lounge features dining room facilities for family and friends. The Department hopes the overall design will help to break down the stereotype image of long-term care design, an d provide a suitable environment for the mentally and physically frail, as well as ambulatory residents.
Agronomic performance and nutritive value of forage legumes in binary mixtures with perennial ryegrass under different defoliation systems
Authors: KLEEN J. , TAUBE F. , GIERUS M. 
Published: July 2010

SUMMARYProtein in forage legumes is often poorly utilized by ruminants and high nitrogen (N) losses are expected. The objective of the present study was to investigate the effects of forage legumes (white clover, WC; red clover, RC; lucerne, LG; and birdsfoot trefoil, BT) in binary mixtures with perennial ryegrass (G) under different defoliation systems (silage, simulated grazing and grazing) on agronomic performance and forage quality. A high proportion of legumes may favour dry matter (DM) yield and the defoliation system may reduce the persistence of certain forage legumes, with a negative influence on the energy and N yield. Annual DM yield under grazing was highest for WC mixtures (WC+G, 1059·2 g DM/m²) compared to all other mixtures, confirming its adaptation to grazing. Mixtures with RC (RC+G) and LG (LG+G) performed similarly to WC+G, whereas BT mixtures (BT+G) were less competitive under more intensively used systems. Analyses of crude protein, cell wall characterization and protein fractionation showed a three-way interaction between year, mixture and defoliation system. RC and BT resulted in a positive protein quality of the mixtures, probably due to their content of secondary plant compounds. In conclusion, different forage legumes did not perform equally in the cutting and grazing systems, and both legume species and defoliation systems interacted in the production of forage of high protein quality for ruminant nutrition.
Containing the Kantian revolutions: a theoretical analysis of the neo-conservative critique of global liberal governance
Authors: DROLET JEAN-FRANÇOIS 
Published: July 2010

AbstractThis article examines the neo-conservative critique of global liberal governance. It provides a theoretically oriented assessment of the neo-conservative case against international law and human rights regimes, and draws out the main political and ethical implications for American democracy and American foreign policy. It is argued that the neo-conservative critique of global governance rests upon an interpretation of the normative order that weaves together democracy, individual rights and national autonomy through a volatile identity politics which is fundamentally at odds with both the pluralist character of ‘Westphalian diplomacy’ and the universal order of rights envisaged by advocates of global governance. More than just the policy autonomy of the US, what is really at stakes in those debates for neo-conservatives is the whole structure of cultural and socio-economic interests that is tied to the substantive interpretation of democracy upon which their domestic commitments to neo-liberal capitalism and liberal freedoms are predicated.
Comparative theory, China, and the future of East Asian regionalism(s)
Authors: BRESLIN SHAUN 
Published: July 2010

AbstractDespite the development of an increasingly sophisticated literature on comparative regional integration drawing from a variety of cases, the European experience remains the most often used benchmark against which other integrative processes are judged; there is still an often implicit expectation that ‘successful’ processes of regionalism will end up looking something like the European Union. While it is correct to move away from such a ‘Euro-dominance’, the theoretical lessons learned continue to have salience when applied to emerging and competing forms of integrative processes in East Asia. In particular, when economic considerations dominate regional relations – at times of economic crises – then integrative logics and strategies come to the fore. In more ‘normal’ times when geo-strategic considerations reassert themselves, then the consensus over region building and the very nature of the region itself is weakened and cooperation is replaced by competing visions and the over-supply of region.
Autoethnographic International Relations: exploring the self as a source of knowledge
Authors: BRIGG MORGAN , BLEIKER ROLAND 
Published: July 2010

AbstractResearch is all about a person's engagement with an issue. But most approaches to International Relations actively discourage personal involvement by the researcher. We question the adequacy of this norm and the related scholarly conventions. Instead, we explore how the personal experience of the researcher can be used as a legitimate and potentially important source of insight into politics. But we also note that simply telling the story of the researcher is inadequate. We engage the ensuing dilemmas by discussing how to both appreciate and evaluate autoethnographic insights. Rather than relying on pre-determined criteria, we argue that methodological uses of the self should be judged within knowledge communities and according to their ability to open up new perspectives on political dilemmas. We then advance two related suggestions: one advocates conceptualising research around puzzles; the other explores the methodological implications of recognising that producing knowledge is an inherently relational activity.
The role of input frequency and semantic transparency in the acquisition of verb meaning: evidence from placement verbs in Tamil and Dutch
Authors: NARASIMHAN BHUVANA , GULLBERG MARIANNE 
Published: July 2010

ABSTRACTWe investigate how Tamil- and Dutch-speaking adults and four- to five-year-old children use caused posture verbs (‘lay/stand a bottle on a table’) to label placement events in which objects are oriented vertically or horizontally. Tamil caused posture verbs consist of morphemes that individually label the causal and result subevents (nikka veyyii ‘make stand’; paDka veyyii ‘make lie’), occurring in situational and discourse contexts where object orientation is at issue. Dutch caused posture verbs are less semantically transparent: they are monomorphemic (zetten ‘set/stand’; leggen ‘lay’), often occurring in contexts where factors other than object orientation determine use. Caused posture verbs occur rarely in Tamil input corpora; in Dutch input, they are used frequently. Elicited production data reveal that Tamil four-year-olds use infrequent placement verbs appropriately whereas Dutch children use high-frequency placement verbs inappropriately even at age five. Semantic transparency exerts a stronger influence than input frequency in constraining children's verb meaning acquisition.
Use and variation of French diacritics on an Internet dating site
Authors: VAN COMPERNOLLE RÉMI A. 
Published: July 2010

ABSTRACTThis article explores sociolinguistic variation in the use of French accents and diacritics—where they would be expected in the formal written language—in electronic personals posted on an Internet dating site. Results of a series of VARBRUL analyses show both age (i.e., 18–25 years vs. 36–45 years) and gender to be significant social variables in accent/diacritic variation. Three potential explanations of the variation are addressed: (i) the eventual loss of accents and diacritics in computer-mediated French, (ii) stable variation with differences between ‘digital natives’ and ‘digital immigrants’, and (iii) a change in progress whereby accents and diacritics are becoming ‘prestige variants’ in computer-mediated contexts.
Multiple histone site epigenetic modifications in nuclear transfer andin vitrofertilized bovine embryos
Authors: Wu Xia , Li Yan , Xue Lian , Wang Lingling , Yue Yongli , Li Kehan , Bou Shorgan , Li Guang-Peng , Yu Haiquan 
Published: July 2010

SummaryDuring mammalian embryonic development, DNA methylation and histone modifications are important in gene expression regulation and epigenetic reprogramming. In cloned embryos, high levels of DNA methylation and abnormal demethylation were widely observed during the preimplantation period. Little is known whether there is a difference in histone modifications betweenin vitrofertilization (IVF) and cloned embryos during preimplantation development. In the present study, the distributions and intensity patterns of acetylations in H3 lysine 9, 18 and H4 lysine 8, 5 and tri-methyl lysine 4 and dimethyl-lysine 9 in histone H3 were compared in cloned and IVF bovine preimplantation embryos by using indirect immunofluorescence and scanning confocal microscopy. The results showed that the acetylation and methylation levels of H3K9ac, H3K18ac, H4K5ac, H4K8ac, H3K4me3 and H3K9me2 were abnormally high in the cloned embryos from the pronuclear to the 8-cell stage. H4K8ac and H4K5ac in the cloned embryos were particularly abnormal when compared with the IVF controls. At the blastocyst stage differences dissipated between cloned and IVF embryos and the distribution and intensity patterns of all histone modifications showed no obvious difference. These results suggest that somatic cells in recipient oocytes produced aberrant histone modifications at multiple sites before the donor cell genome is activated. After zygotic genome activation, distributions and intensity patterns of histone modifications were comparable with both cloned and IVF embryos.
Cognitive test performance predicts change in functional status at the population level: The MYHAT Project
Authors: GANGULI MARY , BILT JONI VANDER , LEE CHING-WEN , SNITZ BETH E. , CHANG CHUNG-CHOU H. , LOEWENSTEIN DAVID A. , SAXTON JUDITH A. 
Published: July 2010

AbstractIn the community at large, many older adults with minimal cognitive and functional impairment remain stable or improve over time, unlike patients in clinical research settings, who typically progress to dementia. Within a prospective population-based study, we identified neuropsychological tests predicting improvement or worsening over 1 year in cognitively driven everyday functioning as measured by Clinical Dementia Rating (CDR). Participants were 1682 adults aged 65+ and dementia-free at baseline. CDR change was modeled as a function of baseline test scores, adjusting for demographics. Among those with baseline CDR = 0.5, 29.8% improved to CDR = 0; they had significantly better baseline scores on most tests. In a stepwise multiple logistic regression model, tests which remained independently associated with subsequent CDR improvement were Category Fluency, a modified Token Test, and the sum of learning trials on Object Memory Evaluation. In contrast, only 7.1% with baseline CDR = 0 worsened to CDR = 0.5. They had significantly lower baseline scores on most tests. In multiple regression analyses, only the Mini-Mental State Examination, delayed memory for visual reproduction, and recall susceptible to proactive interference, were independently associated with CDR worsening. At the population level, changes in both directions are observable in functional status, with different neuropsychological measures predicting the direction of change. (JINS, 2010, 16, 761–770.)
Production of atypical category exemplars in patients with schizophrenia
Authors: BRÉBION GILDAS , BRESSAN RODRIGO A. , OHLSEN RUTH I. , PILOWSKY LYN S. , DAVID ANTHONY S. 
Published: July 2010

AbstractPrevious studies have revealed semantic memory impairments in patients with schizophrenia, and suggested that certain of these impairments were related to thought disorganization. One explanation offered for this is a broadening of the boundaries of semantic categories in schizophrenia. We selected 16 semantic categories, and required a sample of 41 schizophrenia patients and 43 healthy control subjects to produce one exemplar from each category. The typicality of the subjects’ responses was rated. The exemplars produced by the patients were on average less typical than those produced by the healthy controls. No significant association between typicality of the response and thought disorganization was revealed in the patient sample. Affective flattening, alogia, and anhedonia were significantly and inversely associated with the typicality score, that is, higher ratings of these symptoms were associated with more typical responses. Our results suggest that a broadening of semantic category boundaries is observed in patients with schizophrenia, but is unrelated to thought disorganization. This semantic abnormality is not a feature of the patients with high ratings of certain negative symptoms. (JINS, 2010, 16, 822–828.)
Changing human–ecological relationships and drivers using the Quesungual agroforestry system in western Honduras
Authors: Ayarza Miguel , Huber-Sannwald Elisabeth , Herrick Jeffrey E. , Reynolds James F. , García-Barrios Luis , Welchez Luis A. , Lentes Peter , Pavón Jellin , Morales Jairo , Alvarado Anabel , Pinedo Mario , Baquera Noemí , Zelaya Sergio , Pineda Rolando , Amézquita Edgar , Trejo Marco 
Published: July 2010

AbstractDevelopment of sustainable agricultural production systems in the tropics is challenging in part because the local and external conditions that affect sustainability are constantly in flux. The Quesungual agroforestry system (QSMAS) was developed in response to these changing conditions. The history and potential future of the QSMAS provide an opportunity to consider the factors affecting small-scale agricultural production systems on marginal lands throughout the world. We evaluated the QSMAS in Honduras in the context of the five principles of the Drylands Development Paradigm (DDP) during three periods: pre-QSMAS, QSMAS adoption and the future. The first two periods provided lessons that could be relevant to other regions. The QSMAS system in Honduras must continue to evolve, if long-term benefits are to be realized. We conclude that while the DDP was a useful framework for systematically identifying the critical drivers and processes determining the sustainability of QSMAS in Honduras, it is ultimately no more able to predict the future than the collective knowledge of those who choose to apply it. The DDP, however, can facilitate the integration and application of knowledge.
Ecogenomics and genome landscapes of marine Pseudoalteromonas phage H105/1
Authors: Duhaime Melissa Beth , Wichels Antje , Waldmann Jost , Teeling Hanno , Glöckner Frank Oliver 
Published: July 2010

Abstract
Marine phages have an astounding global abundance and ecological impact. However, little knowledge is derived from phage genomes, as most of the open reading frames in their small genomes are unknown, novel proteins. To infer potential functional and ecological relevance of sequenced marine Pseudoalteromonas phage H105/1, two strategies were used. First, similarity searches were extended to include six viral and bacterial metagenomes paired with their respective environmental contextual data. This approach revealed ‘ecogenomic’ patterns of Pseudoalteromonas phage H105/1, such as its estuarine origin. Second, intrinsic genome signatures (phylogenetic, codon adaptation and tetranucleotide (tetra) frequencies) were evaluated on a resolved intra-genomic level to shed light on the evolution of phage functional modules. On the basis of differential codon adaptation of Phage H105/1 proteins to the sequenced Pseudoalteromonas spp., regions of the phage genome with the most ‘host’-adapted proteins also have the strongest bacterial tetra signature, whereas the least ‘host’-adapted proteins have the strongest phage tetra signature. Such a pattern may reflect the evolutionary history of the respective phage proteins and functional modules. Finally, analysis of the structural proteome identified seven proteins that make up the mature virion, four of which were previously unknown. This integrated approach combines both novel and classical strategies and serves as a model to elucidate ecological inferences and evolutionary relationships from phage genomes that typically abound with unknown gene content.