bluuebunny/crossref_metadata_2025_split huggingface dataset:
Inconsistency Over Time in the Preferences of Older Persons with Advanced Illness for Life‐Sustaining Treatment
Authors: Fried Terri R. , O'Leary John , Van Ness Peter , Fraenkel Liana 
Published: June 2007

OBJECTIVES: To determine whether preferences for future attempts at life‐sustaining treatment change over time in a consistent and predictable manner.DESIGN: Observational cohort study.SETTING: Community.PARTICIPANTS: One hundred eighty‐nine community‐dwelling persons ages 60 and older with advanced cancer, heart failure, or chronic obstructive pulmonary disease.MEASUREMENTS: Participants were asked, if faced with an illness exacerbation that would be fatal if untreated, whether they would undergo high‐burden therapy for a chance to avoid death and risk an impaired health state to avoid death. Interviews occurred at least every 4 months for up to 2 years.RESULTS: When asked their willingness to undergo high‐burden therapy for a chance to avoid death, 35% had an inconsistent preference trajectory (e.g., becoming more and then less willing over time or vice versa). The proportion with inconsistent trajectories increased to 48% and 49% when asked their willingness to risk physical or cognitive disability, respectively, to avoid death. Participants with variable health states over time were more likely to have inconsistent trajectories, although inconsistent trajectories were also common in those with stable health states.CONCLUSION: A large proportion of older persons with advanced illness have inconsistent trajectories of willingness to undergo burdensome therapy or risk an impaired health state for a chance to avoid death. Variability in their health state over time explained this in part, although the frequency of inconsistent trajectories even in those with stable health states suggests that preferences are influenced by transient factors rather than representing stable core values.
Hedging, Financing and Investment Decisions: A Simultaneous Equations Framework
Authors: Lin Chen‐Miao , Smith Stephen D. 
Published: June 2007

AbstractWe empirically investigate the interactions among hedging, financing, and investment decisions. We argue that the way in which hedging affects a firm's financing and investing decisions differs for firms with different growth opportunities. We find that high growth firms increase their investment, but not leverage, by hedging. However, we also find that firms with few investment opportunities use derivatives to increase their leverage.
Convertible Securities, Employee Stock Options and the Cost of Equity
Authors: Daves Phillip R. , Ehrhardt Michael C. 
Published: June 2007

AbstractWe provide a method for calculating the cost of equity and the cost of capital in the presence of convertible securities and employee stock options. We demonstrate how this approach can be applied if a company already has issued convertible claims or if it is considering doing so for the first time. We provide several numerical examples illustrating the significance of errors in estimating the cost of capital that can result when (1) employee stock options are ignored or (2) the observable stock price is used as a proxy for the unobservable underlying asset.
Empire, Exile, and England's ‘British Problem’: Recent Approaches to Spenser's Shepheardes Calender as a Colonial and Postcolonial Text
Authors: Mottram Stewart 
Published: June 2007

AbstractThe ‘British Problem’, or new British history, began in the 1970s as a reaction to a sort of cultural myopia that reduced all British to purely English history. To identify a ‘British Problem’, then, was to encourage historians of England to view England in relation to its British neighbours, and to explore how far England's British relations have affected English political and cultural history. Recent years have seen the application of this new British history to the study of English literature, with early modernists approaching texts from a British perspective, arguing that England's colonial interests in Wales, Scotland and Ireland affected writing by Spenser and Shakespeare in particular. This article surveys recent critical interest in England's ‘British Problem’ as it applies to Tudor English literature, but it also asks that we do not forget England amid all this talk of England's burgeoning ‘British’ empire. Colonial interests apart, England also saw itself in the sixteenth century as ‘postcolonial’, as independent from Catholic Europe and the influence of Rome. The word ‘empire’ was used to describe England's postcolonial independence, even as it was used to encode England's colonial ambitions over Britain. The article, then, goes on to survey England's self‐image in the sixteenth century as an ‘empire’, or independent nation‐state, exploring how England came to be written at this time in relation to concepts of empire and exile associated with the Roman poet Virgil. It ends by focusing on recent critical interest in Spenser's Shepheardes Calender as both a colonial and postcolonial text, a text about England's relations to Britain as well as about England's relations to Rome.
Clinical Nurse Specialists' Use of Evidence in Practice: A Pilot Study
Authors: Profetto‐McGrath Joanne , Smith Karen Bulmer , Hugo Kylie , Taylor Michael , El‐Hajj Hannan 
Published: June 2007

ABSTRACT Background: The interest in finding ways to bridge the gap between nursing research and implementation of findings into practice has been increasing. Clinical nurse specialists (CNSs) may be a bridge between frontline nurses and current developments in practice. While several researchers have studied the use of evidence by nurses in general, no known studies have been focused specifically on the use of evidence by CNSs. Purpose: The purpose of this pilot study was to develop an understanding of the sources, nature, and application of evidence used by CNSs in practice and to investigate the feasibility of conducting a qualitative study focused on the CNS role in relation to evidence use in practice. Methods: This pilot study is a descriptive exploratory design in the qualitative paradigm. Seven CNSs from a large Western Canadian health region were interviewed. Interview transcripts were reviewed for recurrent themes about sources of evidence, evidence use, and barriers and facilitators to evidence use. Findings: CNSs access and use evidence from a variety of sources. All CNSs indicated that research literature was a primary source of evidence and research was used in decision‐making. Peers and experience were also important sources of evidence. CNSs used the Internet extensively to consult research databases, online sources of evidence, and to contact peers about current practice. CNSs also gathered evidence from frontline nurses, healthcare team members, and families before decision‐making. The choice of evidence often depended upon the type of question they were attempting to answer. Barriers cited by CNSs support previous research and included lack of time, resources, and receptivity at clinical and organizational levels. Facilitators included peers, organizational support, and advanced education. Discussion: CNSs in Canada have advanced education and clinical expertise and many are employed in roles that permeate organizational management and clinical nursing care. It is suggested that qualitative research in naturalized settings that investigates the role of CNSs in relation to the dissemination of evidence in nursing practice needs attention.
Postnatal Debriefing Interventions to Prevent Maternal Mental Health Problems After Birth: Exploring the Gap Between the Evidence and UK Policy and Practice
Authors: Rowan Cathy , Bick Debra , Bastos Maria Helena da Silva 
Published: June 2007

ABSTRACT Background: Postnatal mental health problems range from transient psychological problems to depression, anxiety, psychosis, and post‐traumatic stress disorder (PTSD). Debriefing is a structured psychological intervention to prevent postnatal psychological problems, particularly PTSD and depression. Many UK maternity service providers have established postnatal debriefing services, in some cases supported by policy, despite a lack of robust evidence. In this article, current evidence of the effectiveness of postnatal debriefing and the availability and current provision of debriefing offered in UK maternity services is described. Methods: A structured literature review was undertaken. Findings: Eight randomized controlled trials were conducted to evaluate debriefing or counseling interventions in childbirth settings, and seven studies were done to evaluate debriefing or counseling interventions provided within UK maternity services or describe the availability of such services. Results of six RCTs were that no differences in outcomes were found, one report indicated possible harm from debriefing, and two indicated a positive association related to a psychological intervention. Methodological issues might account for differing trial outcomes. No standard intervention was used in any RCTs or service interventions. Confusion apparently exists in use of the term “debriefing” in UK maternity service policy and practice. Although service evaluations showed that women valued opportunities to discuss their birth, evidence to support the content and timing of service provision and effectiveness of this was lacking. Discussion: It might be appropriate to consider offering women an opportunity to discuss their childbirth experience and to differentiate this discussion from the offer of a formal debriefing, which is unsupported by evidence. Implications for Practice/Conclusion: Midwives and other health care professionals who provide opportunities for women to talk about childbirth should be clear about terms used to describe the intervention, as well as the purpose and content of this. Differentiating between women who perceive their experience of childbirth as traumatic and those who develop symptoms of PTSD (for whom specific treatment may be required) is important. All health care professionals should be aware of the signs and symptoms of mental health problems after birth, which may include depression, anxiety, or psychosis in addition to PTSD.
Uptake and distribution of root‐applied or foliar‐applied 65Zn after flowering in aerobic rice
Authors: Jiang W. , Struik P.C. , Lingna J. , Van Keulen H. , Ming Z. , Stomph T.J. 
Published: June 2007

AbstractWe investigated the uptake and distribution of zinc (Zn) either applied to the roots or to the leaves in rice during grain development. Plants of two aerobic rice cultivars were grown in a nutrient solution with either sufficient Zn or surplus Zn. Root treatment with 1 week‘s supply of both 65Zn and unlabelled Zn was started at flowering or 15 days after flowering (DAF). Foliar treatment with 65Zn applied to the flag leaf or to senescent leaves was carried out at flowering. When 65Zn was applied to roots, plants continued to take up Zn after flowering, even beyond 15 DAF, irrespective of cultivar and Zn nutritional status of the plants. During the 1 week of supply of both 65Zn and unlabelled Zn, which either started at flowering or 15 DAF, the absorbed 65Zn was mainly distributed to roots, stem and grains. Little 65Zn was allocated to the leaves. Following a week of 65Zn supply directly after flowering, under sufficient Zn or surplus Zn, the proportions of total 65Zn uptake allocated to the grains continued to change during grain filling (9–33%). This Zn mainly came from the roots but under sufficient Zn supply also from the stem. With 65Zn applied to leaves (either the flag leaf or the lowest senescent leaf), both cultivars showed similar Zn distribution within the plants. About 45–50% of the 65Zn absorbed was transported out of the 65Zn‐treated leaf. From that Zn, more than 90% was translocated to other vegetative organs; little was partitioned to the panicle parts and even less to the grains. These results suggest that in rice plants grown under sufficient or surplus Zn supply, most of the Zn accumulated in the grains originates from uptake by roots after flowering and not from Zn remobilisation from leaves.
New Developments in Health Care Delivery
Authors: Norris John A. 
Published: June 2007

The letters HMO (short for Health Maintenance Organization) have very quickly become household words. In general, an HMO may be described as the organizational entity of a health care system which contracts with hospital and medical care providers on behalf of its enrolled members. More precisely, it is an organization, (usually a corporation) which accepts the responsibility to provide, directly or through contract, an agreed upon set of comprehensive health maintenance and treatment services for a volun. tariiy enrolled group of persons and is reimbursed through a premgotiated payment made by or on behalf of each person enrolled in the plan. (U. S. Department of H.E.W., Health Maintenance Organization [1971]).HMOs can be either for profit or not for profit, although for profit HMOs are rare since establishing a for profit HMO involves the navigation of uncharted waters, containing many obstacles which most HMO organizers would prefer to avoid.
Pulmonary Embolism and Sudden Death
Authors: Barkan Donald B. , Sagall Elliot L. 
Published: June 2007

Charcot testified 110 years ago to a fundamental truth in medicine:“Disease is very old, and nothing about it has changed. it is we who change as we learn what was formerly imperceptible.”In ancient Grecian yore, when Hermes, son of Zeus and bearer of the Caduceus, was the heavenly messenger to mediate between the gods and man, the “embolon” was recognized as a mortal peril. Such ram, undetected beneath the waterline of the prow of an ancient warship, could be driven with hydraulic force into an unwary enemy vessel often with catastrophic or fatal effect.Even today, the threat of sudden death from a pulmonary embolus - the clot which migrates from a source of origin on the inner wall of a vein to lodge in and thereby plug an artery within the lung - remains a major medical and surgical risk. Thrombosis and thrombophlebitis of the deep veins of the legs, often unpreventable and frequently undetectable clinically, are the nidus of a potentially fatal pulmonary embolism.
“Authoratative” Medical Texts
Authors: MacKaut Stephen H. 
Published: June 2007

Attorneys and physicians dealing with medicolegal issues frequently are confronted by the question of which medical textbooks a physician is likely to recognize as “authoritative” so that the text may be used in direct or cross-examination. Consequently, doctors and lawyers must have more than a passing familiarity with these texts for pretrial research and preparation for courtroom testimony.The following list has been prepared as a guide for this purpose. This list itemizes by medical subject the standard textbooks in each field. Where more than one book is listed under a given specialty, the books are listed in rough order of the author's preference.Those books preceded by the letter “A” are contained in “Recommended Textbooks and Journals for a “Core Medical Library” in 280 New England Journal of Medicine 475-8 (Feb. 27, 1969).
Psychiatry and the Law Reviewed at Symposium
Authors: Beyer Henry A. 
Published: June 2007

Over 250 psychiatrists, lawyers and health professionals heard seven distinguished speakers present and defend their views concerning the proper role of psychiatrists in the courtroom and of lawyers in the fieid of mental health at the 1974 Isaac Ray Symposium held at Butler Hospital, Providence, Rhode Island earlier this year.Dr. Jacques Quen of Cornell University Medical College reviewed the remarkable 19th century contributions of Isaac Ray. He concluded that Ray would have supported the Birnbaum and Wyatt v. Stickney expositions of the right to treatment, (although probably not Wyatt's explicit numerical requirements), but would have objected to the great power which judges possess to release involuntarily committed patients in habeas corpus actions.
The Nonprofit Hospital Amendment to the National Labor Relations Act
Authors: Katz Barbara F. 
Published: June 2007

Until the passage of a recent amendment by Congress, nonprofit hospitals were excluded from coverage by the National Labor Relations (Wagner) Act (NLRA), which had established as the national policy the right of workers in most industries affecting interstate commerce to organize themselves into unions. Such exclusion from NLRA jurisdiction primarily affected the unskilled nonprofit hospital employees. such as general aides, orderlies, porters. nursing aides, housekeeping and maintenance personnel as opposed to professional and technical hospital employees.When there were indications that the nonprofit hospital exemption was being reevaluated. numerous arguments in favor of its retention were advanced by its proponents.First, it has been contended that unions tend to break down discipline and that once unionized, employees may be less willing to give immediate obedience to orders.
Edelin Decision Sparks New Abortion Controversy
Authors: Holzer James F. 
Published: June 2007

Two years and 25 days following United States Supreme Court's controversial decision on abortion, a Massachusetts Superior Court jury of nine men and three women handed down an historic decision of their own against a Boston physician accused of manslaughter in connection with an abortion he performed on a 17 year old girl.And so on February 15, 1975, 36 year old Dr. Kenneth C. Edelin, Coordinator of Ambulatory Care in OB/GYN at Boston City Hospital, was found gullty as charged:“ … Kenneth Edelin, on the third day of October in the year of our Lord One Thousand Nine Hundred and Seventy Three did assault and beat a certain person, to wit, a male child described to said jurors as Baby Boy, and by such assault and beating, did kill the same person … ”
Occupational Safety and Health Act … And the Hospital
Authors: Atz Barbara 
Published: June 2007

The principles of occupational safety and health have long been applied to industry, but it is only in recent times that serious consideration has been given to their application in the hospital. This interest coincided with the passage, in 1970, of the Occupatinal Safety and Health Act (OSHA), the government's first venture into general occupational safety and health.The statute's purpose is “to provide for the general welfare, to assure so far as possible every working man and woman in the nation safe and healthful working conditions and to preserve our human resources.” In general, the Act permits the Secretary of Labor to promulgate occupational safety and health standards. The secretary or his authorized representative may, “with Out delay,” enter the premises of any employer who is covered by the Act, which includes virtually every private sector employer. The legislation applies to 5 million businesses and 57 million employees, who in a year suffer 14,000 deaths and 2 million disabling injuries or diseases related to their occupation.
Childbirth and the Courts: The Wrong Issue in the Wrong Forum
Authors: Annas George J. 
Published: June 2007

While most courtroom confrontations involving childbirth concern parents seeking damages for alleged physician and hospital negligence, a number of recent cases have involved parents seeking simply to have their babies with a minimum of medical intervention. Courts, however, have consistently deferred to “expert” medical opinion in this area.The extreme reluctance of courts to substitute their judgment for that of hospital boards is nowhere better illustrated than in the cases involving fathers in the delivery room. While most hospitals with maternity wards currently permit “husband-coached' (Lamaze or psychoprophylactic being the most common method) childbirth, in which the father is with the mother throughout labor and delivery, supplying physical and emotional support, lawsuits to compel a change in the policies of those institutions that do not, have been universally unsuccessful to date.
The Impact of P.L. 93-641 on the State Certificate of Need Process
Authors: Glantz Leonard 
Published: June 2007

One of the most significant aspects of P.L. 93-641, the National Health Planning and Resources Development Act of 1974 is the requirement that States adopt certificate of need laws as a method of health facilities regulation. This demonstrates a certain Congressional dissatisfaction with health planning alone and a desire to be more active in the actual distribution of health care facilities.Over the years Congress has made a number of attempts to institute federal programs that would insure an adequate supply of health services to all people In 1946 it passed the Hill-Burton Act which was designed to respond to Congress perception that an inadequate supply of hospital beds existed in the United Slates. In addition to providing funds for the actual building of hospital beds, Hill-Burton required states to conduct surveys of bedding patterns and to participate in some rudimentary planning.
Judicial Review of Malpractice Reform Legislation: The Story so Far
Authors: Gold Jay Alexander 
Published: June 2007

The malpractice Insurance crisis of 1975 saw many insurance companies which had provided medical malpractice coverage leave the field. Those that stayed increased their premium rates astronomically. One of the results has been a flood of legislation, a torrent unparalleled , , , in the history of medical law In this country. We may expect soon to be deluged again, this time with court decisions reviewing and interpreting the constitutionality of these laws. This brief article reviews the first trickle of such cases.The bulk of the issues litigated to date have centered around the use of screening panels. A number of states have set up such panels. in all of the cases so far litigated. the panels contained a judge who usually sat with a physician and a lawyer. Before a lawsuit is filed, the plaintiff is required to bring the case before Me panel, which makes a determination of liability and damages. Either party may there after bring the case to trial.
The Right to Refuse Treatment and Natural Death Legislation
Authors: Raible Jane A. 
Published: June 2007

A great deal of discussion and debate has centered around the right of a terminally ill patient to refuse life-sustaining treatment. The statement of policy found in Idaho's recent Natural Death Act summarizes many of these issues:The legislature finds that adult persons have a fundamental right to control decisions relating to the rendering of their medical care, including the decisions to have life sustaining procedures withheld or withdrawn in instances of a terminal condition.The legislature further finds that modern medical technology has made possible the artificial prolongation of human life beyond natural limits.The legislature further finds that patients suffering from terminal conditions are sometimes unable to express their desire to withhold or withdraw such artificial life prolongation procedures because of the progress of the disease process which renders the patient comatose or unable to communicate with the physician.