bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effect of sleepiness on performance monitoring: I know what I am doing, but do I care?
Authors: MURPHY TIMOTHY I. , RICHARD MARY , MASAKI HIROAKI , SEGALOWITZ SIDNEY J. 
Published: February 2006

SummaryThe behavioral, cognitive, and psychophysiological effects of extended wakefulness are well known. As time awake increases, errors become more common and are often attributed to lapses in attention. Such lapses can be reflected in the error‐related negativity (Ne/ERN), a negative electroencephalogram deflection occurring after errors and is thought to be related to error detection or response conflict. Following the Ne/ERN, a positive deflection (error positivity, Pe) is also observed and is thought to reflect further evaluation of the error. To elicit Ne/ERNs, the Eriksen Flanker Task was administered to 17 women (aged 19–45 years) at two levels of alertness (4 and 20 h awake). After extended wakefulness, participants reported being subjectively sleepier and performing worse, but showed no significant difference in subjective effort. Across alertness conditions, they reported a similar number of subjective errors which closely matched an objective analysis of the errors. The Ne/ERN was not significantly reduced by sleepiness in contrast to the Pe which was reduced. Behavioral slowing after errors was larger in the alert than in the sleepy condition. These results show that after 20 h of wakefulness, individuals are reacting to their errors. However, further evaluation of the error, and remediation of these errors may be impaired despite continued effort.
Subjective sleepiness, simulated driving performance and blink duration: examining individual differences
Authors: INGRE MICHAEL , ÅKERSTEDT TORBJÖRN , PETERS BJÖRN , ANUND ANNA , KECKLUND GÖRAN 
Published: February 2006

SummaryThe present study aimed to provide subject‐specific estimates of the relation between subjective sleepiness measured with the Karolinska Sleepiness Scale (KSS) and blink duration (BLINKD) and lane drifting calculated as the standard deviation of the lateral position (SDLAT) in a high‐fidelity moving base driving simulator. Five male and five female shift workers were recruited to participate in a 2‐h drive (08:00–10:00 hours) after a normal night sleep and after working a night shift. Subjective sleepiness was rated on the KSS in 5‐min intervals during the drive, electro‐occulogram (EOG) was measured continuously to calculate BLINKD, and SDLAT was collected from the simulator. A mixed model anova showed a significant (P < 0.001) effect of the KSS for both dependent variables. A test for a quadratic trend suggests a curvilinear effect with a steeper increase at high KSS levels for both SDLAT (P < 0.001) and BLINKD (P = 0.003). Large individual differences were observed for the intercept (P < 0.001), suggesting that subjects differed in their overall driving performance and blink duration independent of sleepiness levels. The results have implications for any application that needs prediction at the subject level (e.g. driver fatigue warning systems) as well as for research design and the interpretation of group average data.
A conceptual framework based on Activity Theory for mobile CSCL
Authors: Zurita Gustavo , Nussbaum Miguel 
Published: February 2006

AbstractThere is a need for collaborative group activities that promote student social interaction in the classroom. Handheld computers interconnected by a wireless network allow people who work on a common task to interact face to face while maintaining the mediation afforded by a technology‐based system. Wirelessly interconnected handhelds open up new opportunities for introducing collaboration and thereby changing classroom pedagogical practices. We present a conceptual framework and a method for the design of a mobile computer‐supported collaborative learning system based on Activity Theory. An instance of the framework for teaching basic mathematics skills was evaluated with 24 6‐ and 7‐year‐old children in a month‐long study. Positive effects were observed on student social interaction, motivation and learning.
A METAETHICAL OPTION FOR THEISTS
Authors: Swan Kyle 
Published: February 2006

ABSTRACTJohn Hare has proposed “prescriptive realism” in an attempt to stake out a middle‐ground position in the twentieth century Anglo‐American debates concerning metaethics between substantive moral realists and antirealist‐expressivists. The account is supposed to preserve both the normativity and objectivity of moral judgments. Hare defends a version of divine command theory. The proposal succeeds in establishing the middle‐ground position Hare intended. However, I argue that prescriptive realism can be strengthened in an interesting way.
ETHICS AND EPISTEMOLOGY  Ecclesial Existence in a Postmodern Era
Authors: O'Neil Michael 
Published: February 2006

ABSTRACTThis essay endeavors to show that application of a universalist epistemic method in theological ethics results in a construal of God, which is, from a biblical perspective, reductionist, and is a form of ethics in which universality is achieved at the expense of plurality. It argues for the formal possibility of an ecclesial ethics grounded in a tradition‐centered rationality. It further argues that such an ethic need not result in a narrow and defensive sectarianism, a rigid and static orthodoxy, or an authoritarian dogmatism. The posture of an ecclesial ethic based on the kind of critical realism advocated here may retain an apologetic and dialogical relation with the broader society, as it seeks to embody the incarnational narrative in its particular context.
MAIMONIDES ON KINGSHIP  The Ethics of Imperial Humility
Authors: Diamond James A. 
Published: February 2006

ABSTRACTIn his adoption of the Maimonidean guidelines for extreme humility, the king acts as the supreme existential model for imitatio dei. Imperial governance, when filtered through the prism of Maimonidean humility, results in a regime that most closely resembles a divine one. Using those who occupy the very bottom of the social and political hierarchy (slaves and orphans) as models, the king projects his own sense of “lowliness” to the people. The king thereby promotes their sense of autonomy, and inhibits any anthropocentrism that would be fostered if he were to be viewed as an autocrat. His administration of the royal office is limited by the ethical and philosophical dictates of humility, thereby offering a window into the distinction between its common (anivut) and extreme (shefal ruah) manifestations. Maimonides does in fact define the parameters of this extraordinary humility, but he chooses to do so within the context of a distinct and concrete personality—that of the king.
ON MEDICINE, CULTURE, AND CHILDREN'S BASIC INTERESTS: A REPLY TO THREE CRITICS
Authors: Miller Richard B. 
Published: February 2006

ABSTRACTMargaret Mohrmann, Paul Lauritzen, and Sumner Twiss raise questions about my account of basic interests, liberal theory, and the challenges of multiculturalism as developed in Children, Ethics, and Modern Medicine. Their questions point to foundational issues regarding the justification and limitation of parental authority to make decisions on behalf of children in medical and other contexts. One of the central questions in that regard is whether adults' decisions deserve to be respected, especially when they seem contrary to a child's or adolescent's basic interests. Questions about respect, in turn, focus attention on others' decisions about what seems good for families and children, decisions that may be paternalistic or utilitarian. Such decisions are further complicated by a child's or adolescent's budding autonomy and need for respect and recognition. Pediatric bioethics grounded in an account of a child's basic interests produces a theory of negative and positive rights for assessing adults' actions in relation to children, especially (but not only) when adults demand respect in their expressions of care.
RESPONSE TO RICHARD B. MILLER'S CHILDREN, ETHICS, AND MODERN MEDICINE
Authors: Lauritzen Paul 
Published: February 2006

ABSTRACTIn this essay, Paul Lauritzen examines Richard B. Miller's liberal account of pediatric ethics by asking if the duty to promote a child's basic interests is substantial enough to secure the well‐being of children. This question is raised in light of two case studies: daytime TV talk shows that broadcast interviews with sexually active children, and a medical study conducted to test the effect of growth hormone treatment on adult height in peripubertal children. In both cases, Lauritzen argues, children are subjected to potential harms that are not easily explained, and therefore not easily prevented, by appeals to basic interests.
ON CROSS‐CULTURAL CONFLICT AND PEDIATRIC INTERVENTION
Authors: Twiss Sumner B. 
Published: February 2006

ABSTRACTA critical examination of Richard Miller's position in his recent Children, Ethics, and Modern Medicine on how to handle pediatric interventions in cases of cross‐cultural conflict between parents and doctors with respect to treating young children. Particular emphasis is placed on Miller's interpretation of and arguments about a Hmong case extensively researched by Anne Fadiman in her The Spirit Catches You and You Fall Down. The conclusion drawn is that Miller's position requires further nuance and development, and some recommendations are made toward that end.
Attitudes of women with chronic pelvic pain to the gynaecological consultation: a qualitative study
Authors: Price J , Farmer G , Harris J , Hope T , Kennedy S , Mayou R 
Published: February 2006

Objective  To describe the attitudes that women with chronic pelvic pain (CPP) attending gynaecology clinics have to their consultations and to determine the ways in which their health care can be improved.Design  Qualitative study using semistructured individual interviews.Setting  UK gynaecology outpatient clinics in district general and teaching hospitals.Sample  Twenty‐six women with CPP.Methods  Semistructured individual interviews were conducted. Data gathering and analysis followed a grounded theory approach.Main outcome measures  Women's wishes regarding their care and their actual experiences of care.Results  Four main themes emerged. The women wanted (a) personal care, which they often did not receive; (b) to feel understood and to be taken seriously, although they often felt dismissed, which applied both to women with and without an explanation for their pain; (c) explanation as much as cure, but an adequate explanation was often not provided; and (d) to be reassured, which often they were not. Effective reassurance was complex as it included general reassurance and specific reassurance about cause and treatment.Conclusions  Improvements are needed in the outpatient care of women presenting with CPP. Changes should focus on providing more personal care, so that presenting problems are seen to be taken seriously, findings and management are appropriately explained, and women are more effectively reassured. Interventions need to be developed that meet these needs and tested to determine if they are feasible, acceptable, and improve outcomes.
Mode of delivery is associated with maternal and fetal endocrine stress response
Authors: Vogl SE , Worda C , Egarter C , Bieglmayer C , Szekeres T , Huber J , Husslein P 
Published: February 2006

Objective  To determine whether mode of delivery is associated with the endocrine stress response in mother and child.Design  Prospective observational study.Setting  Tertiary care centre, University hospital.Population  A total of 103 nulliparous women with uncomplicated singleton pregnancies at term undergoing either spontaneous labour for vaginal delivery or delivering by caesarean section without labour. Thirty women delivered vaginally without any pain relief, 21 women delivered vaginally with epidural anaesthesia, 23 women had ventouse extraction and 29 women underwent caesarean section with epidural analgesia.Methods  After delivery, maternal and umbilical cord blood was collected for determination of different stress‐associated hormones.Main outcome measures  Concentrations of epinephrine (EP), norepinephrine (NOR), adrenocorticotropic hormone (ACTH), cortisol (CORT), prolactin (PRL), corticotropin‐releasing factor and beta‐endorphin (BE).Results  Caesarean section was associated with significantly lower maternal concentrations of EP, NOR, ACTH, CORT, PRL and BE and lower newborn levels of EP, NOR and CORT compared with all other modes of delivery. Concentrations of EP, ACTH and BE differed significantly in newborns delivered by normal vaginal delivery, vaginal delivery with epidural anaesthesia and ventouse extraction.Conclusions  The mode of delivery and analgesia used during birth are associated with maternal and fetal endocrine stress responses.
End‐of‐life in a Swedish population: demographics, social conditions and characteristics of places of death
Authors: Jakobsson Eva , Johnsson Tommy , Persson Lars‐Olof , Gaston‐Johansson Fannie 
Published: February 2006

The objectives of this study were to identify and describe the demographics and social conditions as well as characteristics of the places of death in a randomly selected sample that died in a county in Sweden during 2001. The present study reports part of the findings from a larger study undertaken during 2003 using a survey design of retrospective reviews of death certificates, medical records, and nursing records. Among several noteworthy findings are: first, an examination of these individuals' living arrangements reveal not only a large and vulnerable group that lives alone at the end‐of‐life but also a group living separated from their partners near end‐of‐life; second, individuals differ with respect to residence prior to death, that is private homes versus residential care facilities, imparting highly different contexts of care at the end‐of‐life; and third, a high prevalence of institutionalized deaths demonstrates that places of death other than hospitals and residential care facilities are uncommon, if not rare. It is concluded that increased attention to the social circumstances of the time period surrounding individuals' at the end‐of‐life is essential.There is need to develop more integrated models of care for dying people. Contemporary services available are not designed to meet a wide range of peoples' needs at the end‐of‐life. Home‐based care, residential care and hospital care must be adapted to the changing patterns of dying. The services available should be organized to the benefit of the users rather than around the providers. This is the first study of its kind of a Swedish sample and while the data are limited to one county in Sweden its findings may contribute to a deeper understanding of demographic and social patterns at the end‐of‐life in general.
Mothers’ experiences of having their newborn child in a neonatal intensive care unit
Authors: Wigert Helena , Johansson Renée , Berg Marie , Hellström Anna Lena 
Published: February 2006

Background:  From birth the child has an ability to respond to the environment, which influences the interaction between mother and child. If this attachment is interrupted, the child's emotional development is negatively influenced. When the child needs care in a neonatal intensive care unit (NICU) it is difficult to establish contacts between mother and child. Separation from the child is found to be the most difficult aspect for mothers when their newborn child is hospitalized in a NICU.Aim:  The aim of this study was to describe mothers’ experiences when their full‐term newborn child was cared for in a NICU during the postpartum maternity care period.Method:  A phenomenological hermeneutic interview study was performed. Ten mothers were interviewed once, 6 months to 6 years after the experience.Results:  The essence of the experience is understood as an alternation between two opposite concepts, exclusion and participation, with emphasis on exclusion. A feeling of exclusion dominates when the new mother feels a lack of interaction and a sense of not belonging to either the maternity care unit or the NICU. This has a negative effect on her maternal feelings. On the contrary, when a feeling of participation dominates, a continuous dialogue exists and the mother is cared for as a unique person with unique needs. This supports her maternal feelings in a positive direction. The implication of the result for nurses is that it is important to decrease mothers’ experience of exclusion and to increase their feeling of participation when their child is cared for in a NICU. A return visit to the responsible nurse to go through the treatment and experiences should be offered to all parents whose child has been cared for in a NICU.
Hyperarousal, depression and quality of life – validity and reliability of the Swedish version of the Hyperarousal Scale
Authors: Edéll‐Gustafsson Ulla , Carstensen John , Regestein Quentin , Swahn Eva , Svanborg Eva 
Published: February 2006

Aim:  Research focusing on hyperarousability in association with general sensitivity to stress has increased. This study aimed to: (i) describe values for self‐reported hyperarousal behaviour traits, depression, sleeplessness behaviour and health‐related quality of life [The Short Form 36 Health Survey Questionnaire (SF‐36)] in a gender‐stratified random sample from the Swedish population; and (ii) test the validity and reliability of the Swedish version of the Hyperarousal Behavioural Trait Scale (H‐scale).Methods:  In this study, 402 women and 391 men from Sweden were included. A test–retest study was performed on 297 subjects.Results:  The total mean score on the H‐scale was 29.5 (SD 10.0, 95% CI 28.8–30.2). Compared to men, women scored higher on the H‐scale (total score, sub‐scales and many items), whereas no evidence of an age trend was seen. The H‐scale has proven to be a valid and reliable scale. Pearson's correlation coefficient showed similar magnitude and direction between the H‐scale and the Zung's Self‐rating Depression Scale, as between the H‐scale and the Vicious Cycle of Sleeplessness Behaviour Scale, Vitality, Mental Health and the Mental Component Summary index on the SF‐36 respectively. The Cronbach's alpha for the H‐scale was 0.84 and estimated stability test–retest point of time varies between 0.73 and 0.80.Conclusions:  This study indicates gender differences in response style in association with altered health‐related quality of life. The H‐scale is a valid and reliable self‐reported scale for measuring hyperarousal behavioural trait research outcome in clinical practice.
‘They were talking about me’– elderly women's experiences of taking part in a discharge planning conference
Authors: Efraimsson Eva , Sandman Per‐Olof , Rasmussen Birgit H. 
Published: February 2006

Introduction:  Discharge planning procedures needs improving to make transition to care settings in the community smooth, safe and secure. Research about discharge planning that involves a patient perspective is limited. The intention of this study was to focus on the patients’ (elderly women) experiences of taking part in discharge planning conferences (DPCs) to deepen our understanding of the meaning of facing ‘the world of the institution’ from a life‐world perspective.Aim:  This study aims at describing elderly women's experience of taking part in a DPC as they are about to be discharged from hospital.Methodological design:  To illuminate the phenomenon from a life‐world perspective, an interview study was chosen. Eight follow‐up interviews with seven elderly women were carried out. The interviews were analysed using a qualitative content analysis methodology.Findings:  The interpretation of data was that the women's future was as in suspense as they got ill or were hit by accidents. The analysis revealed four themes that reflected the women's experiences of taking part in the DPCs: Being affiliated; Being in focus, Standing outside; and finally Being unprepared.Study limitations and conclusion:  The limitations of the study are related to: selection of participants; participation in the interview was connected to a video recording study; gap in time between participation in the DPC and the interview. The findings are still seen as trustworthy as the experiences expressed by the participating women in data are to be seen as a contribution to an emerging understanding of the meaning of the phenomenon from a life world perspective. The findings make clear that the institutional world easily and without much resistance from the patients transgresses the boarder of their life worlds. This awakes a need to reconsider how a caring perspective can be established in practice.
Homocysteine Level and Cognitive Function in Patients with Arterial Disease: The Second Manifestations of ARTerial Disease Study
Authors: Raamt Fleur van A. , Kalmijn Sandra , Mali Willem P. Th. M. , Van Zandvoort Martine J. E. , Van Der Graaf Yolanda ,   for the SMART Study Group
Published: February 2006

OBJECTIVES: To assess the relationship between total plasma homocysteine (tHcy) level and cognitive function in patients with manifest arterial disease.DESIGN: Cross‐sectional.SETTING: Patients with symptomatic cerebrovascular disease, cardiovascular disease, peripheral arterial disease, or abdominal aortic aneurysm included in the Second Manifestations of ARTerial disease study, a single‐center, longitudinal study with an extensive screening program at baseline.PARTICIPANTS: Three hundred forty‐five consecutively included patients, mean age 59.MEASUREMENTS: The patients underwent an extensive neuropsychological test. The cognitive domains assessed were memory, executive function, attention, and visuoperception and construction. Each raw score was transformed into standardized z‐scores, and a sum score for global cognitive function was determined. Risk factors and vascular damage were measured in detail.RESULTS: Linear regression showed that elevated levels of tHcy were related to lower global cognitive function (β=−0.065, 95% confidence interval (CI)=−0.116 to −0.013) and, more specifically, lower performance on memory (β=−0.078, 95% CI=−0.155 to −0.002), attention (β=−0.079, 95% CI=−0.163 to −0.005), and visuoperception and construction (β=−0.125, 95% CI=−0.236 to −0.014) per standard deviation increase in tHcy (SD=6.4 mol/L), after adjustment for age, sex, educational level, extent of atherosclerosis, and location of vascular disease. Silent cerebral infarcts did not influence this relationship.CONCLUSION: A relationship was found between tHcy levels and cognitive function that was independent of extent and location of arterial disease. The results suggest that vascular mechanisms are not responsible for the relationship between tHcy and cognitive function.