bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nurses’ Attitudes Towards People with Dementia: the semantic differential technique
Authors: Norbergh Karl-Gustaf , Helin Yvonne , Dahl Annika , Hellzén Ove , Asplund Kenneth 
Published: March 2006

One important aspect of the nurse-patient relationship is nurses’ attitudes towards their patients. Nurses’ attitudes towards people with dementia have been studied from a wide range of approaches, but few authors have focused on the structure of these attitudes. This study aimed to identify a structure in licensed practical nurses’ attitudes towards people with dementia. Twenty-one group dwelling units for people with dementia at 11 nursing homes participated in the study. A total of 1 577 assessments of 178 patients were sent out to 181 respondents and 1 237 answers were returned. The semantic differential technique was used. The scale had 57 bipolar pairs of adjectives that estimate an unknown number of dimensions of nurses’ attitudes towards an identified patient. The assessments were analysed using entropy-based measures of association combined with structural plots. The analysis revealed four dimensions, which related to licensed practical nurses’ opinions of the patients: an ethical and aesthetic dimension; an ability to understand; an ability to experience; and an ability for social interaction. The results of the study indicated that, on the positive to negative attitude continuum, the nurses’ attitudes fell at the positive to neutral end. This is an important finding owing to the personhood perspective, from which it is reasonable to assume that, with a more positive attitude to people with dementia, the prerequisites for person-centred care will improve.
The Society for Academic Emergency Medicine's 2004–2005 Emergency Medicine Faculty Salary and Benefit Survey
Authors: Kristal Steven Lee , Randall‐Kristal Karen A. , Thompson Bruce M. 
Published: March 2006

Abstract
Objectives:
To report on the sixth survey of the Society for Academic Emergency Medicine (SAEM) of emergency medicine faculty salaries, benefits, work hours, and department demographics for all programs accredited by the Residency Review Committee for Emergency Medicine (RRC‐EM).
Methods:
Data represent compensation paid for the 2004–2005 academic year. Responses were collected by SAEM, and blinded program and individual faculty data were entered into a customized version of a relational database program with a built‐in statistical package. Salary data were sorted by criteria such as program region, faculty title, American Board of Emergency Medicine certification, academic rank, years since completing residency, program size, and whether data were reported to the American Association of Medical Colleges (AAMC). Demographic data were analyzed with regard to numerous criteria including department staffing levels, emergency department (ED) volumes, ED length of stay, department income sources, salary incentive components, research funding, and specific type and value of fringe benefits offered. Data were compared with previous SAEM studies.
Results:
Sixty‐one of 132 (46%) accredited programs responded, yielding data on 1,213 full‐time faculty from all four AAMC regions. Mean salaries were reported as follows: all faculty, $189,848; first‐year faculty, $153,855; programs reporting data to AAMC, $183,605; programs not reporting data to AAMC, $204,383; core faculty, $197,259; and noncore faculty, $164,215. Mean salaries as reported by AAMC region were as follows: Northeast, $192,864; South, $182,768; Midwest, $192,224; and West, $195,732. Full‐time emergency medicine residency program faculty are reported to be working an average of 1,032 total clinical hours per year. Workweeks average 22 clinical hours per week and 22 nonclinical hours per week, with 5.1 weeks of time off per year.
Conclusions:
Reported salaries for full‐time emergency medicine residency faculty continue to rise overall but fell for the first time in one region (the Midwest). Academic rank continues to correlate directly with salary. Fellowship training continues to show a negative correlation with salary. Significant regional differences in salaries have been present in all six SAEM surveys.
Testing Positive for Methadone and Either a Tricyclic Antidepressant or a Benzodiazepine Is Associated with an Accidental Overdose Death: Analysis of Medical Examiner Data
Authors: Chan Gar Ming , Stajic Marina , Marker Elizabeth K. , Hoffman Robert S. , Nelson Lewis S. 
Published: March 2006

Abstract
Objectives:
Patients in emergency departments who use methadone frequently use tricyclic antidepressants (TCAs) and/or benzodiazepines (BZDs). This is a potentially dangerous drug combination. The authors hypothesized that the presence of methadone and a TCA, a BZD, or both is associated with an “accidental” overdose (AOD) death more often than a death from any other cause.
Methods:
A retrospective chart review of New York City Office of Chief Medical Examiner data for 2003 was performed. Decedents who tested positive for methadone that were classified as an AOD death, as determined by the medical examiner, were compared with deaths from all other causes for the presence of a TCA, a BZD, or both. A logistical regression was performed to develop a multivariate model identifying additional variables associated with a methadone‐positive AOD death. A p‐value of <0.05 was considered significant, and 95% confidence intervals (CIs) were calculated.
Results:
In 2003, there were 5,817 medical examiner cases, of which 500 (8.6%) were methadone positive. Of the methadone‐positive cases, 493 were available for analysis; 95 (19.3%) were TCA positive and 158 (32.0%) were BZD positive. The odds of having an AOD death in methadone‐positive decedents testing TCA positive, BZD positive, or both were 2.11 (95% CI = 1.32 to 3.37; p < 0.01) for TCAs, 1.66 (95% CI = 1.12 to 2.45; p < 0.02) for BZDs, and 4.34 (95% CI = 1.97 to 9.56; p < 0.001) for both. The multivariate logistic regression of analytes revealed the following covariates associated with an AOD death as well: amitriptyline, cocaine, morphine, or opiates.
Conclusions:
Among the methadone‐positive cases, testing positive for a TCA, a BZD, or both was associated with an AOD death.
Age Effect on Efficacy and Side Effects of Two Sedation and Analgesia Protocols on Patients Going through Cardioversion: A Randomized Clinical Trial
Authors: Parlak Mine , Parlak Ismet , Erdur Bulent , Ergin Ahmet , Sagiroglu Emel 
Published: March 2006

Abstract
Background:
Cardioversion (CV), a painful procedure, requires sedation and analgesia. Although several sedation agents currently are in use for CV, data on age‐specific efficacy and side effects of midazolam and propofol have been limited.
Objectives:
To compare the efficacy and side effects of midazolam and propofol in patients of two different age groups, younger than 65 years and 65 years and over, who were going through CV.
Methods:
Seventy consented patients with CV indications caused by atrial fibrillation were included in this clinical trial. The participants were placed into four groups by using a stratified randomization method: patients aged younger than 65 years who were receiving midazolam (n= 12) or propofol (n= 11) and patients 65 years and over who were receiving midazolam (n= 25) or propofol (n= 22). Medications were administered by slow intermittent bolus injections. During CV, time to reach Ramsay Sedation Scale level 5 (RSS‐5; induction time); time to reach RSS‐2 (recovery time); and side effects including desaturation, apnea, and changes in hemodynamic parameters were recorded by a person blinded to the patient treatment allocation.
Results:
Mean induction time was similar in all four groups. Mean recovery time (min ± SD) was shorter in both propofol groups when compared with both midazolam groups: 18.8 (± 4.06) and 40.33 (± 20.8) in the group younger than 65 years and 18.2 (± 5.12) and 54.2 (± 20.85) in the group 65 years or older, respectively (p < 0.001). Older participants in each medication group needed less medication than younger patients. There were no hemodynamic differences between the groups. Desaturation was higher in both midazolam groups as compared with individuals in the age‐matched propofol groups (both p < 0.05). Patient reactions were less in propofol groups with similar joules during CV procedures than were those in the midazolam groups.
Conclusions:
Propofol appears to be a better choice for CV sedation in elders because of its short recovery time, fewer side effects, and its more comfortable sedative effect.
Resident‐As‐Teacher: A Suggested Curriculum for Emergency Medicine
Authors: Farrell Susan E. , Pacella Charissa , Egan Daniel , Hogan Victoria , Wang Ernest , Bhatia Kriti , Hobgood Cherri D. 
Published: March 2006

AbstractResident teaching is a competency that must be recognized, developed, and assessed. The ACGME core competencies include the role of physician as educator to “educate patients and families” and to “facilitate the learning of students and other health care professionals.” Residents spend a significant proportion of their time in teaching activities, and students report achieving much of their clinical learning from their interactions with residents. Although many residents enjoy their critical role as teacher, many do not feel well prepared to teach. This article summarizes a preliminary curriculum of modules for a resident teacher‐training program for emergency medicine residents. The goal of these modules is to provide learning objectives and an initial structure through which residents could improve basic teaching skills. Many of these skills are adaptable to residents' interactions with each other and with students, other healthcare professionals, and patients. Each module and corresponding teaching exercises can be found at http:www.saem.org
Childhood Soccer Injuries Treated in U.S. Emergency Departments
Authors: Adams Annette L. , Schiff Melissa A. 
Published: March 2006

Abstract
Objectives:
Soccer, an increasingly popular sport among children in the United States, is a common precipitant to injury‐related emergency department (ED) visits. The authors estimated the number of children treated in EDs for soccer‐related injuries and described the nature of these injuries.
Methods:
Data from the 2000 National Electronic Injury Surveillance System All Injury Program were used to estimate the overall number and rate of soccer injuries in children, calculate injury rates per 1,000 children, and describe the body regions affected and types of injuries. Results were stratified by five‐year age groups (5–9 years, 10–14 years, and 15–19 years).
Results:
Approximately 144,600 children sustained soccer‐related injuries in 2000 for a rate of 2.36 injuries per 1,000 children. Injury rates increased with age (0.8, 5–9 year olds; 3.1, 10–14 year olds; 3.2, 15–19 year olds). Common types of injuries were strains/sprains (36.7%), fractures (23.0%), and contusions (20.9%). Fractures decreased with age; sprains/strains increased with age. Commonly injured body regions varied by age. Wrist and finger injuries were most common (12.7% and 12.4%, respectively) in the youngest group; in the 10–14‐year‐old group, ankle and wrist injuries were most common (15.7% and 13.6%, respectively). In the oldest age group, ankle injuries were most common (21.9%), followed by knee injuries (17.6%).
Conclusions:
Substantial numbers of children were treated in EDs for soccer‐related injuries. Injury types and affected body regions varied by age. Injury prevention efforts to reduce soccer‐related injuries may need to be age specific.
Ten‐year Experience with an Emergency Medicine Resident Research Project Requirement
Authors: Holmes James F. , Sokolove Peter E. , Panacek Edward A. 
Published: March 2006

Abstract
Background:
Controversy exists regarding the value and quality of required emergency medicine (EM) resident scholarly projects.
Objectives:
To describe the research designs and presentation rate at national scientific meetings and the publication rate of EM resident scholarly projects at a university‐based residency program.
Methods:
The authors reviewed the initial ten years (1993–2002) of resident scholarly projects from an EM residency program. Since the inception of the program, a formal research study has been required of all residents for residency graduation. Scholarly projects were reviewed and categorized by study design. Abstracts from the American Academy of Emergency Medicine (AAEM), American College of Emergency Physicians (ACEP), and Society for Academic Emergency Medicine (SAEM) annual meetings were searched to identify projects presented at any of these national meetings. A PubMed search for resident and faculty investigators was performed, and faculty and graduated residents were queried to identify all resident scholarly projects published in peer‐reviewed journals.
Results:
Eighty‐seven residents produced 90 scholarly projects. Study designs were prospective data collection, 42 (47%); retrospective chart review, 38 (42%); survey, 5 (6%); animal, 4 (4%); and computer program development, 1 (1%). Of the 80 projects collecting patient data, 72 were conducted at a single center; 6, at two centers; and 2, at five centers each. Of the 42 prospective clinical studies, 27 (64%) were observational and 15 (36%) were interventional. Forty‐six (51%) abstracts were presented at national meetings (SAEM, 20; ACEP, 19; AAEM, 3; and other, 4). Thirty‐six (40%) of the projects have been published in peer‐reviewed journals. Abstract presentation at national meetings (range, 13%–64% of projects per yr) and manuscript publication rates (range, 0–67% of projects per yr) were variable from year to year.
Conclusions:
Resident scholarly projects at one institution were equally likely to use a prospective or retrospective design, and most were conducted at a single center. More than half of the projects were presented at national research meetings, and more than a third were subsequently developed into manuscripts and published in peer‐reviewed journals. When an original research study is required for satisfying the scholarly requirement for EM residency graduation, resident projects can contribute to the EM literature.
Ventricular Fibrillation in Pediatric Cardiac Arrest
Authors: Smith Brian T. , Rea Tom D. , Eisenberg Mickey S. 
Published: March 2006

Abstract
Objectives:
After activating 9‐1‐1 for out‐of‐hospital cardiac arrest (CA), guidelines for children 1 year and older have evolved to include immediate automated external defibrillator (AED) use for witnessed arrest, and two minutes of cardiopulmonary resuscitation (CPR) followed by AED use for unwitnessed arrests. The best approach to resuscitation in a two‐tiered emergency medical services (EMS) system depends in part on how likely the patient is to present with ventricular fibrillation (VF). Therefore, the authors evaluated the frequency of VF with respect to age and other characteristics to further elucidate the role of the AED among pediatric CAs.
Methods:
The investigation was a retrospective cohort study of EMS‐treated, nontraumatic, out‐of‐hospital CA among persons aged 1–18 years in King County, Washington, between April 1, 1976, and December 31, 2003. The primary goal was to identify the proportion of patients presenting to EMS in VF, according to age. The association between other characteristics and the likelihood of VF was also evaluated. Finally, hospital survival according to cardiac rhythm at EMS arrival was evaluated.
Results:
Ventricular fibrillation was the presenting rhythm in 17.6% of cases (48/272). The proportion presenting with VF was 7.6% (10/131) among children aged 1–7 years and 27.0% (38/141) among children aged 8–18 years (p < 0.001). In multivariable models, VF was independently associated with age 8 years and older compared with 1–7 years (odds ratio, 3.19; 95% confidence interval [CI] = 1.46 to 6.97), witnessed arrest (odds ratio, 3.33; 95% CI = 1.63 to 6.82), and cardiac etiology (odds ratio, 2.89; 95% CI = 1.32 to 6.34). Survival was 31.3% (15/48) for VF and 10.7% (24/224) for nonshockable rhythm CAs.
Conclusions:
The proportion of children aged younger than 8 years presenting with VF is low compared with older children. The greatest increase in VF proportion occurs in children older than 12 years. Based on these results, the best approach for initial EMS resuscitation in a two‐tiered EMS system, CPR versus AED use, is uncertain among younger children. Inclusion of witness status into the decision process for younger children may more efficiently allocate AED use, a finding in accordance with 2005 guidelines.
Aldosterone Blockade Attenuates Urinary Monocyte Chemoattractant Protein-1 and Oxidative Stress in Patients with Type 2 Diabetes Complicated by Diabetic Nephropathy
Authors: Takebayashi Kohzo , Matsumoto Sachiko , Aso Yoshimasa , Inukai Toshihiko 
Published: March 2006

Abstract
Context: Aldosterone causes organic impairment by enhancement of oxidative stress and subsequent induction of proinflammatory cytokines and chemokines.
Objective: This study was designed to investigate the effect of spironolactone, an aldosterone blocker, on oxidative stress and the level of urinary monocyte chemoattractant protein (MCP)-1, a cysteine-cysteine chemokine that may contribute to progression of various nephropathies in type 2 diabetic patients with diabetic nephropathy.
Design, Setting, Patients and Other Participants, and Intervention: The patients were randomly assigned to two groups in which they received either spironolactone (50 mg/d; n = 23) or amlodipine (2.5 mg/d; n = 14).
Main Outcome Measures: Urinary 8-iso-prostaglandin (PG) F2α (a marker of oxidative stress), urinary MCP-1, and urinary albumin excretion (UAE) were measured at the start of administration (0 months) and after 3 months in each group. Baseline levels of these variables were also measured in 25 age-matched healthy subjects.
Results: There were significant positive correlations between log10-transformed (log) 8-iso-PGF2α and log MCP-1 levels in control and diabetic subjects and all subjects combined, but no correlations between log UAE and log 8-iso-PGF2α or log MCP-1 were found in any group. Significant decreases in 8-iso-PGF2α, MCP-1, and UAE were observed with spironolactone (P = 0.0001, P = 0.0041, and P = 0.0037, respectively), and systolic blood pressure significantly decreased after both spironolactone and amlodipine therapy (P = 0.00011 and P = 0.0051, respectively).
Conclusions: Our data suggest that urinary MCP-1 is correlated with oxidative stress as measured by urinary 8-iso-PGF2α and that spironolactone can decrease urinary MCP-1 and oxidative stress.
Inventory Policies in a Decentralized Assembly System
Authors: Bernstein Fernando , DeCroix Gregory A. 
Published: March 2006

We consider a system in which a single finished good is assembled from two components. Demand for the finished product is stochastic and stationary, and procurement and assembly lead times are constant. Unsatisfied demand is backordered. The inventory of each component or assembly is controlled by a separate firm using a base-stock policy. Each firm is charged holding costs on its own inventory, plus a share of the shortage cost due to backorders of the finished product. We investigate the equilibrium base-stock levels that arise in this system under both echelon and local base-stock policies. In both cases, the component firms’ base-stock levels are economic complements. We then examine the effect on system performance when one firm uses information about other firms’ pipeline inventory. We find that, under echelon base-stock policies, all firms benefit with the use of pipeline information. In contrast, under local policies, using pipeline information may actually increase costs for some firms (including the firm that makes direct use of the information). Also, we compare the behavior of the decentralized system with that of the assembly system under centralized control. Finally, we describe a payment scheme between the final assembler and the suppliers that allows the decentralized system to achieve the centralized solution.
An Optimal Lot-Sizing and Offline Inspection Policy in the Case of Nonrigid Demand
Authors: Anily Shoshana , Grosfeld-Nir Abraham 
Published: March 2006

A batch production process that is initially in the in-control state can fail with constant failure rate to the out-of-control state. The probability that a unit is conforming if produced while the process is in control is constant and higher than the respective constant conformance probability while the process is out of control. When production ends, the units are inspected in the order they have been produced. The objective is to design a production and inspection policy that guarantees a zero defective delivery in minimum expected total cost. The inspection problem is formulated as a partially observable Markov decision process (POMDP): Given the observations about the quality of the items that have already been inspected, the inspector should determine whether to inspect the next unit or stop inspection and possibly pay shortage costs. We show that the optimal policy is of the control limit threshold (CLT) type: The observations are used to update the probability that the production process was still in control while producing the candidate unit for inspection. The optimal policy is to continue inspection if and only if this probability exceeds a CLT value that may depend on the outstanding demand and the number of uninspected items. Structural properties satisfied by the various CLT values are presented.
Effect of Glucosamine on Glucose Control
Authors: Stumpf Janice L , Lin Shu-Wen 
Published: March 2006

Objective: To review the literature regarding the effect of glucosamine on glucose control. Data Sources: English-language articles on the effects of administration of exogenous glucosamine on glucose control were identified through a search of MEDLINE (1966–March 2006), EMBASE (1988–March 2006), and International Pharmaceutical Abstracts (1970–March 2006) databases using the search terms glucosamine, blood glucose, and diabetes mellitus. Abstracts of articles were then reviewed to determine relevance to the topic. Bibliographies of selected articles were screened for other pertinent references. Data Synthesis: Theoretically, glucosamine may alter glucose metabolism. Insulin resistance has been noted following intravenous administration of glucosamine in animal studies; however, these findings have not been confirmed in humans. Alterations in glucose control have not been documented in long-term efficacy studies using oral glucosamine for osteoarthritis or in trials of short duration conducted in healthy or diabetic subjects. The long-term effects of glucosamine in patients with diabetes have yet to be established in well-controlled trials. Conclusions: Small, short-term studies suggest that glucosamine may be used in selected patients without affecting glucose control; however, data in patients with diabetes mellitus are limited, and close monitoring for potential changes in glucose control is recommended.