bluuebunny/crossref_metadata_2025_split huggingface dataset:
Working in long‐term care settings for older people with dementia: nurses’ aides
Authors: Sung Huei‐chuan , Chang Shu‐min , Tsai Chuan‐shoiu 
Published: April 2005

Aim.  This paper reports a study exploring the reasons for continuing to work among nurse aides who cared for older people with dementia in long‐term care settings in Taiwan.Background.  High nurse aide turnover has been a major problem for many managers of long‐tem care facilities in Taiwan. Most studies on nurse aide turnover have focused on the factors on why they left, but little is known about their reasons for continuing to work in long‐term care settings in Taiwan.Methods.  A qualitative research design was used. Sixteen nurse aides were interviewed individually using a semi‐structured interview guide and content analysis was used to identify the major themes in the data.Results.  Five major themes emerged from interview data: monetary needs, relationships with residents, working environment, training opportunities and gratification (listed in order of frequency of occurrence).Conclusion.  Nurse aides face challenges in caring for the increased number of older people with cognitive impairment and it is important to assess their perspectives towards their work in the changing environment. The findings suggest that it is essential for nursing managers to assess nurse aides’ needs to increase job retention and to improve the quality of resident care in long‐term care settings.Relevance to clinical practice.  Careful appraisal of prospective nurse aides’ attitudes, regular training programmes in dementia care, adequate staffing and equipment, performance‐based pay rises and subsidized training are practical retention strategies for these nurse aides.
Effect of khat chewing on 14 selected periodontal bacteria in sub‐ and supragingival plaque of a young male population
Authors: Al‐Hebshi N. N. , Skaug N. 
Published: April 2005

Background/aims:  The habit of chewing khat (Catha edulis) for its amphetamine‐like effects is highly prevalent in Yemen and east Africa, and has expanded to Western countries. The purpose of this study was to estimate and compare the prevalence and levels of 14 periodontal bacteria in gingival plaque of khat chewers and khat nonchewers, as well as of khat chewing sides and khat nonchewing sides.Methods:  A total of 408 sub‐ and supragingival plaque samples were collected from 51 young males (29 khat chewers and 22 khat nonchewers; age range 19–28 years) and analyzed using whole genomic DNA probes and checkerboard DNA–DNA hybridization. Clinical parameters were recorded for all teeth at six sites per tooth.Results:  Streptococcus intermedius and Veillonella parvula were significantly more prevalent in the subgingival plaque of chewers, which also showed significantly higher levels of V. parvula and Eikenella corrodens. Similar results were found for the subgingival plaque of the chewing sides compared to the nonchewing sides. However, there was a significantly higher prevalence and higher levels of Tannerella forsythia in the subgingival plaque of the nonchewing sides. No significant differences were observed for the supragingival plaque between the two study groups. There was a significantly lower prevalence of Capnocytophaga gingivalis and Fusobacterium nucleatum in the khat chewing sides, and higher levels of V. parvula and Actinomyces israelii.Conclusion:  The data suggest that khat chewing induces a microbial profile that is not incompatible with gingival health.
SEVERE TRAUMA CAUSED BY STABBING AND FIREARMS IN METROPOLITAN SYDNEY, NEW SOUTH WALES, AUSTRALIA
Authors: Wong Kenneth , Petchell Jeffrey 
Published: April 2005

Background:  Stabbing and firearm trauma causing severe injuries (injury severity score (ISS) >15) and death is uncommon in Australia. The present study describes the experience with stabbings and firearm trauma causing severe injuries at a major Australian urban trauma centre.Methods:  Data from a prospectively generated trauma registry regarding all patients presenting to Royal Prince Alfred Hospital (RPAH), Sydney, Australia with penetrating trauma causing severe injuries from July 1991 to June 2001 was retrospectively analysed.Results:  Of all patients presenting to RPAH with stabbing and firearms wounds over the 11 year study period, 28% received an ISS >15. One hundred and forty patients were identified. 94% were male. The mean age was 34 years (15−82 years). The number of cases/year has not shown an increasing trend. Thirty per cent of patients sustained firearm related injuries, with the remainder mainly caused by knives or machetes. Fifteen per cent of injuries were self inflicted. The most common location of injury was on a public street. Fifty‐two per cent of patients were injured in more than one anatomical region, with the abdomen being the most common site of injury (53%). On hundred and seventy‐four operations were performed − laparotomies (43%), thoracotomies (26%), craniotomies (5%) and orthopaedic, vascular, wound explorations and other procedures (26%). Twenty‐eight per cent of patients suffered at least one complication during their admission, with coagulopathy being the most common complication (20%). Mean length of stay was 10.4 days (1−107 days). The total mortality rate for the severely injured patients was 21%, with gun‐related injuries having a higher mortality rate than stabbing injury (36%vs 15%). Sixty per cent of deaths were related to exsanguination.Conclusions:  Stabbings and firearm trauma are associated with significant morbidity, mortality and utilization of hospital resources in metropolitan Sydney. Overall mortality rates are similar to institutions with higher volumes of penetrating trauma.
TUBERCULOUS PERITONITIS IN NO RISK PATIENTS: DIAGNOSTIC APPROACH
Authors: Tazzioli Giovanni , Farinetti Alberto , Gelmini Roberta , Longo Giuseppe , Barbolini Giuseppe , Saviano Massimo 
Published: April 2005

Background:  Incidence of tubercoulosis is increasing in Western countries particularly in immigrants from endemic areas and in patients with HIV or immunocompromised. The disease is unusual in patients without risk factors. In these conditions the diagnosis of tuberculous peritonitis is often delayed, resulting in high morbidity and mortality.Methods:  We describe a case of tuberculous peritonitis in a man suffering from ascites referred for presumed peritoneal carcinosis. The finding of no malignancies in the peritoneal fluid must rise the suspect of tuberculosis that, if misdiagnosed, is fatal. The patient was submitted to diagnostic videolaparoscopy and multiple biopsies were done. The definitive histological diagnosis was chronic granulomatous flogosis with giant cells, focally necrotizing, caused by peritoneal tubercolosis.Results:  The patient was submitted to chemotherapy with isoniazide, rifampicine, piazafoline, ethambutol and streptomycine which determined the resolution of the clinical picture.Conclusions:  We believe the diagnostic procedure of choice is videolaparoscopy when tubercolous peritonitis is suspected. This technique allows to obtain selective biopsies of peritoneal nodules and to collect samples for specific cultural and cytohistological exams. The operation is safe, reliable with few complications and permits a prompt diagnosis necessary to cure the patient.
ILEOSTOMY CLOSURE WITHOUT CONTRAST STUDY IS SAFE IN SELECTED PATIENTS
Authors: Cowan Timothy , Hill Andrew G. 
Published: April 2005

Background:  Following anterior resection of the rectum it is common to defunction the anastomosis with an ileostomy. Prior to closure of this, a contrast study is usually performed to check for healing. Several patients at our institution have not undergone a contrast study prior to closure. The present study aimed to compare outcome in this group with patients who had undergone contrast radiology.Methods:  A retrospective review of patients undergoing anterior resection with an ileostomy was performed. We only included those patients who had a straight colorectal/coloanal anastomosis that could be examined clinically and had a smooth postoperative course with no evidence of pelvic sepsis.Results:  Fifty‐nine patients fulfilled the criteria for the study. Thirty‐five patients had a contrast study. These showed two leaks and five strictures. The anastomosis was 0−7 cm from the anal verge in 31 patients (16 contrast studies). It was above 7 cm in 28 patients (19 contrast studies). No patient had pelvic sepsis after ileostomy reversal.Conclusions:  In patients with an ileostomy following anterior resection, with a clinically examinable anastomosis and a smooth postoperative course, a radiological examination of the anastomosis prior to ileostomy closure appears unnecessary.
STAPHYLOCOCCAL POST‐STERNOTOMY MEDIASTINITIS: FIVE YEAR AUDIT
Authors: Upton Arlo , Roberts Sally A. , Milsom Paget , Morris Arthur J. 
Published: April 2005

Background:  The reported rate of post‐sternotomy mediastinitis is between 0.8 and 2.3%, with up to 79% of cases caused by staphylococci. Mediastinitis is associated with significant morbidity and mortality. Obesity and diabetes are the only risk factors consistently identified. The aims of the present study were to determine the incidence and risk factors for staphylococci post‐sternotomy mediastinitis and to audit its management.Methods:  The clinical records of patients with staphylococcal post‐sternotomy mediastinitis between 1 January 1998 and 31 May 2003 were retrospectively reviewed. Information collected included patient demographics, comorbidities, operation type, microbiology findings, surgical and medical management, and outcome. Data collected on cases were compared with data collected in a prospective database of all patients undergoing cardiac surgery.Results:  The incidence of staphylococcal post‐sternotomy mediastinitis was 1.2% (60 cases in 5176 median sternotomies). Staphylococcus aureus was isolated in 49 (82%) cases and coagulase‐negative staphylococci in 11 (18%) cases. Eight (16%) S. aureus isolates were methicillin‐resistant. Risk factors associated with mediastinitis were ethnicity, diabetes mellitus, emergency surgery, ejection fraction and length of preoperative hospital stay. In‐hospital mortality was 15%. Eighteen per cent of cases were not cured by initial therapy.Conclusion:  Staphylococcal mediastinitis is a serious complication with significant rates of relapse and mortality. This audit has lead to an evaluation of our clinical pathways to ensure that prevention and management of surgical site infection is optimized.
Anesthesia in a child with homozygous porphobilinogen deaminase deficiency: a severe form of acute intermittent porphyria
Authors: SHEPPARD LORCAN , DORMAN TERESA 
Published: April 2005

SummaryWe report a case history of the anesthetic management of a child with a severe form of acute intermittent porphyria (AIP). AIP is an autosomal dominant condition with incomplete penetrance, caused by deficiency of porphobilinogen deaminase, an enzyme found in the synthetic pathway for heme. Anesthesia and surgery may present many precipitants for a potentially fatal acute porphyric attack. These include fasting, dehydration, stress, infection and drugs. Here, we describe the safe use of sevoflurane in the maintenance of anesthesia. Its relative insolubility and low metabolism suggest that sevoflurane may be a reasonable agent for anesthesia in the porphyric patient.
Ventilation with the laryngeal tube in pediatric patients undergoing elective ambulatory surgery
Authors: GENZWUERKER HARALD V. , HOHL EVA Ch. , RAPP HANS‐JUERGEN 
Published: April 2005

SummaryBackground : The laryngeal tube is a new supraglottic alternative for securing the airway. Few data on the use of this airway device in pediatric patients are so far available. Experiences of the study are reported.Methods : Use of the laryngeal tube for ventilation during intermittent positive‐pressure ventilation was studied in an open, noncomparative observational study in 80 pediatric patients (age: 2–12 years) undergoing elective ambulatory surgery. Insertion success, time to achieve a patent airway, and occurrence of adverse events were documented.Results : Mean (sd) patient age was 5.8 (2.3) years. The laryngeal tube was placed at the first attempt in 90% of patients, a second attempt was necessary in 6%. Ventilation was not possible after two attempts in three patients. Mean (sd) tidal volume was 10.1 (2.0) ml·kg−1 with a mean (sd) peak airway pressure of 15.6 (2.1) cmH2O. Chin lift was applied to improve ventilation in 15 patients (18.8%). Laryngospasm occurred in one patient, but ventilation was possible after adapting depth of anesthesia. Mean (sd) time for airway maintenance was 11.2 (3.7) s. No gastric insufflation of air occurred, no traces of blood could be detected after removal of the device. One patient complained of mild problems (swallowing, VAS 1). Mean (sd) anesthesia time was 44 (9) min.Conclusions : In the age group studied, the laryngeal tube provides a rapid, patent airway in the majority of patients with a low complication rate.
Combined propofol and remifentanil intravenous anesthesia for pediatric patients undergoing magnetic resonance imaging
Authors: TSUI BAN C.H. , WAGNER ALESE , USHER ANDREW G. , CAVE DOMINIC A. , TANG CATHY 
Published: April 2005

SummaryBackground : A prospective observational case series of children receiving light general anesthesia for magnetic resonance imaging (MRI) was performed. Our purpose was to examine the merit of anesthesia and recovery/discharge times of combined remifentanil and propofol total intravenous anesthesia (TIVA) in spontaneously breathing children.Methods : After IRB approval and informed consent, 56 patients receiving Remi/Propofol TIVA (Remifentanil 10 μg·ml−1 Propofol 10 mg·ml−1) were observed. Blood pressure, respiratory rate, endtidal CO2 (PECO2), oxygen saturation and temperature were recorded at the start and finish of anesthesia. In addition, induction and recovery times were noted. Recovery time was from scan completion until discharge from the initial recovery area. Discharge time was from scan completion to discharge home.Results : Fifty‐six patients received Remi/Propofol TIVA. The mean Remi/Propofol recovery and discharge times were 8.9 and 28.2 min, respectively. There was a statistically significant decrease in respiratory rate and increase in CO2 from the start to the end of the procedure. During the scan, seven patients moved. One patient experienced postprocedure nausea and or vomiting.Conclusions : The combination of remifentanil and propofol for TIVA may be an effective method of light general anesthesia in pediatric patients undergoing MRI.
Anatomical considerations of the pediatric ilioinguinal/iliohypogastric nerve block
Authors: VAN SCHOOR A.N. , BOON J.M. , BOSENBERG A.T. , ABRAHAMS P.H. , MEIRING J.H. 
Published: April 2005

SummaryBackground : The ilioinguinal/iliohypogastric nerve block is safe, effective and easy to perform in order to provide analgesia for a variety of inguinal surgical procedures in pediatric patients. A relatively high failure rate of 10–25% has been reported, even in experienced hands. The aim of this study was to determine the exact anatomical position of the ilioinguinal and iliohypogastric nerves in relation to an easily identifiable constant bony landmark, the anterior superior iliac spine (ASIS) in neonates and infants. The current ilioinguinal/iliohypogastric nerve block techniques were also evaluated from an anatomical perspective.Method : Dissections were performed on a sample of 25 infant and neonatal cadavers (mean weight = 2.2 kg; mean height = 45.6 cm). The distance from the ASIS to both the ilioinguinal and iliohypogastric nerves, on a line connecting the ASIS to the umbilicus was carefully measured using a digital caliper. Three techniques, commonly used in clinical practice, were simulated on the anatomical specimens.Result : The left and right ilioinguinal nerves were closer to the ASIS than previously described, i.e. 1.9 ± 0.9 mm (mean ± sd) and 2.0 ± 0.7 mm, respectively. The mean distance from the left and right iliohypogastric nerves to the ASIS are 3.3 ± 0.8 mm and 3.9 ± 1.0 mm, respectively.Conclusions : We suggest that the high failure rate of the ilioinguinal/iliohypogastric nerve block in this age group could be due to lack of specific spatial knowledge of the anatomy of these nerves in infants and neonates. This cadaver‐based study suggests an insertion point closer to the ASIS, approximately 2.5 mm (range: 1.0–4.9) from the ASIS on a line drawn between the ipsilateral ASIS and the umbilicus.
Welfare Losses Due to Livestock Grazing on Public Lands: A Count Data Systemwide Treatment
Authors: Shonkwiler J. Scott , Englin Jeffrey 
Published: April 2005

AbstractBackcountry hikers' willingness‐to‐pay for removing grazing from trails in the Hoover Wilderness is analyzed using a multinomial Dirichlet negative binomial distribution. This multivariate discrete distribution allows the direct calculation of seasonal welfare measures that are derived from an incomplete demand specification. The welfare maximizing choice of activities is examined on a trail‐by‐trail basis using the results of the analysis. Our findings suggest that a mix of hiking and grazing activities provide the greatest social welfare.
The Amenity and Disamenity Impacts of Agriculture: Estimates from a Hedonic Pricing Model
Authors: Ready Richard C. , Abdalla Charles W. 
Published: April 2005

AbstractThe positive and negative externalities from farmland are increasingly a focus of public policy discussion about agriculture and land use. A GIS‐based hedonic pricing model shows that agricultural open space increases nearby residential property values, but larger‐scale animal operations and mushroom production have negative impacts. Animal production facilities with as few as 200 animal equivalent units reduce nearby property values, but larger facilities do not necessarily generate larger impacts. Because they tend to occur together, the negative impacts of animal agriculture and the positive impacts of open space must be simultaneously modeled to avoid omitted variable bias.
When Two Wrongs Make a Right: Second‐Best Point‐Nonpoint Trading Ratios
Authors: Horan Richard D. , Shortle James S. 
Published: April 2005

AbstractMost research on point‐nonpoint trading focuses on the choice of trading ratio (the rate point source controls trade for nonpoint controls), although the first‐best ratio is jointly determined with the optimal number of permits. In practice, program managers often do not have control over the number of permits—only the trading ratio. The trading ratio in this case can only be second‐best. We derive the second‐best trading ratio and, using a numerical example of trading in the Susquehanna River Basin, we find the values are in line with current ratios, but for different reasons than those that are normally provided.
Computational Methods for Measuring the Difference of Empirical Distributions
Authors: Poe Gregory L. , Giraud Kelly L. , Loomis John B. 
Published: April 2005

AbstractThis paper presents a simple computational method for measuring the difference of independent empirical distributions estimated by bootstrapping or other resampling approaches. Using data from a field test of external scope in contingent valuation, this complete combinatorial method is compared with other methods (empirical convolutions, repeated sampling, normality, nonoverlapping confidence intervals) that have been suggested in the literature. Tradeoffs between methods are discussed in terms of programming complexity, time and computer resources required, bias, and the precision of the estimate.
The Crowding Effects of Basic and Applied Research: A Theoretical and Empirical Analysis of an Agricultural Biotech Industry
Authors: Malla Stavroula , Gray Richard 
Published: April 2005

AbstractGame theory is used to examine the incentives for private firms to fund applied research to improve differentiated crop varieties sold to compete with a public generic variety. We distinguish between applied research, modeled as a stochastic search process, and basic research, which improves applied research productivity. Propositions derived from the theoretical model are tested using empirical evidence from the canola crop research industry. The results show consistency between the analytical findings and the econometric results, supporting the validity of the framework and underlining the need to disaggregate the crowding effects of basic and applied public research.
Politics, Economics, and the Regulation of Direct Interstate Shipping in the Wine Industry
Authors: Riekhof Gina M. , Sykuta Michael E. 
Published: April 2005

AbstractIn 1986, California passed legislation restricting the direct importation of wine from another state by California residents unless the originating state allowed direct shipment from California wineries to residents in that state. The result has been a patchwork of direct shipment regulations across states. We examine how various economic and public interest factors affect the likelihood that a state adopts a change in its direct shipment regulation and the nature of that change. Our results suggest that private and public sector economic considerations lie at the root of direct shipment regulations in the wine industry.
How Do Journal Quality, Co‐Authorship, and Author Order Affect Agricultural Economists' Salaries?
Authors: Hilmer Christiana E. , Hilmer Michael J. 
Published: April 2005

AbstractUtilizing an original data set containing annual salaries and peer‐reviewed publication histories for 326 faculty members from top‐ranked Ph.D.‐granting programs, we examine the labor market for academic agricultural economists. The results suggest that higher quality publications have a greater impact on annual earnings, that sole authored articles have a higher return than multi‐authored articles, and that no wage premium exists for being the lead author of a non‐alphabetic article.
CADASIL: underdiagnosed in psychiatric patients?
Authors: Leyhe T. , Wiendl H. , Buchkremer G. , Wormstall H. 
Published: April 2005

Objective:  Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is exclusively related to symptoms of the central nervous system. Retrospectively in up to 15% the initial presentation is psychiatric disturbances. In these cases the diagnosis often is delayed or missed.Method:  Two cases of CADASIL diagnosed in a psychiatric hospital are presented.Results:  Both patients were admitted to the gerontopsychiatric department (one because of a suicidal attempt and a depressive episode, the other because of cognitive decline and progressive personal neglect). Brain magnetic resonance imaging (MRI) showed severe leukoencephalopathy in the absence of cardiovascular risk factors. In both cases, diagnosis of CADASIL was made by the identification of specific granular osmiophilic material in skin biopsies.Conclusion:  Brain MRI should be performed in all cases of late onset of severe psychiatric symptoms. CADASIL should be considered as a possible differential diagnosis whenever a marked leukoencephalopathy is detectable. Diagnosis can be verified by taking a skin biopsy or by specific genetic testing.