A replication of Dawson\u27s study on differences in final arrangements for cremation using a rural population vs an urban population

A study completed by Dawson, Santos, and Burdick in 1990 surveyed close survivors of deceased persons from six metropolitan areas of the United States to investigate the differences in final arrangements when burial or cremation was employed as the method of body disposition. The present study chose to replicate the cremation aspect of Dawson’s study in rural Nebraska. However, as work progressed, it became clear the small number o f responses received would not be statistically significant. At this point, a qualitative aspect was introduced into the study. Nine case studies were obtained to provide a broader scope of understanding regarding the differences in final arrangements for cremation. Several important differences were found with regard to cremation practices in a rural versus a metropolitan setting. These differences included where the services were held, the frequency of services even being held, use of flowers and monies for remembrance items, and the frequency of social gatherings after a service. As all of these areas ranked higher in the rural setting than the metropolitan setting, it is interesting to note the aspect of tradition still plays a large role primarily due to its familiarity to the surviving family members. In both the surveys and the case studies, it was overwhelmingly obvious the decision for cremation was the preference of the deceased. This study did not address specific personal beliefs that may have contributed to this decision. However, this study found the majority o f the case studies had disease ravaged bodies which may have been a factor for cremation as these individuals may have not been comfortable with their body image. Again, the present study did not ask for cause of death in the quantitative aspect of this study which may have shed additional light on this area. As traditions gradually fade with regard to ethnic and religious concerns, and as individuals wish to exert more control over our dying, death and final disposition, more people will opt for more non-traditional methods of body disposition, including cremation

The management of diabetic ketoacidosis in children

The object of this review is to provide the definitions, frequency, risk factors, pathophysiology, diagnostic considerations, and management recommendations for diabetic ketoacidosis (DKA) in children and adolescents, and to convey current knowledge of the causes of permanent disability or mortality from complications of DKA or its management, particularly the most common complication, cerebral edema (CE). DKA frequency at the time of diagnosis of pediatric diabetes is 10%–70%, varying with the availability of healthcare and the incidence of type 1 diabetes (T1D) in the community. Recurrent DKA rates are also dependent on medical services and socioeconomic circumstances. Management should be in centers with experience and where vital signs, neurologic status, and biochemistry can be monitored with sufficient frequency to prevent complications or, in the case of CE, to intervene rapidly with mannitol or hypertonic saline infusion. Fluid infusion should precede insulin administration (0.1 U/kg/h) by 1–2 hours; an initial bolus of 10–20 mL/kg 0.9% saline is followed by 0.45% saline calculated to supply maintenance and replace 5%–10% dehydration. Potassium (K) must be replaced early and sufficiently. Bicarbonate administration is contraindicated. The prevention of DKA at onset of diabetes requires an informed community and high index of suspicion; prevention of recurrent DKA, which is almost always due to insulin omission, necessitates a committed team effort

An Evaluation of Self-Reported Publications in Orthopaedic Sports Medicine Fellowship Applications.

BackgroundOrthopaedic sports medicine fellowship positions are increasing in popularity, as evidenced by the increasing number of applicants to these programs. As positions have become more competitive, greater emphasis has been placed on an applicant's research experience. However, there has been a lack of research evaluating the accuracy of self-reported publications from fellowship applications.PurposeTo evaluate the accuracy of self-reported research publications and the outcomes of studies submitted for publication by applicants to an Accreditation Council for Graduate Medical Education (ACGME)-accredited sports medicine fellowship in the United States (US).Study designCross-sectional study.MethodsDemographic and research publication data were retrospectively collected from 435 applications to an ACGME-accredited orthopaedic sports medicine fellowship program at a single high-volume academic institution from 2013 to 2017. All self-reported manuscript publications and studies in progress were analyzed with a minimum 2-year follow-up. "Submitted" publications were reviewed by searching the originally submitted journal and all publicly available sources. Publications were verified on PubMed, MEDLINE, and other open access journals. Journal impact factors were collected through use of InCites Journal Citation Reports.ResultsOnly 5.7% (85/1504) of papers reported as "completed" were inaccurately self-reported, with 44 (51.8%) remaining unverified and 41 (48.2%) reporting discordant authorship, in which the published study listed a different author order than reported on the application. Further, 28.3% (197/696) of papers self-reported as "submitted" remained unpublished, 21.8% (152/696) were published in a different journal than originally reported, and 7.6% (53/696) were published with a different authorship order than reported. Among 95 applicants whose papers were published in different journals than originally reported, the mean impact factor of the final accepting journal was significantly lower than that of the journal of original submission (0.97 ± 0.13 vs 3.91 ± 0.79, respectively; 95% CI of the difference, 1.34-4.54; P < .01). Univariate analysis showed no significant relationships between variables of interest (age, sex, US Medical Licensing Examination Step 1 score, American Orthopaedic Association membership, medical school ranking, and advanced degree) and the presence of an inaccuracy.ConclusionThere is a low rate of inaccurate self-reporting of "completed" publications on applications for orthopaedic sports medicine fellowships. The majority of papers listed as "submitted" on these applications were not published in the journals to which they were originally submitted

An Evaluation of Self-Reported Publications in Orthopaedic Sports Medicine Fellowship Applications.

BackgroundOrthopaedic sports medicine fellowship positions are increasing in popularity, as evidenced by the increasing number of applicants to these programs. As positions have become more competitive, greater emphasis has been placed on an applicant's research experience. However, there has been a lack of research evaluating the accuracy of self-reported publications from fellowship applications.PurposeTo evaluate the accuracy of self-reported research publications and the outcomes of studies submitted for publication by applicants to an Accreditation Council for Graduate Medical Education (ACGME)-accredited sports medicine fellowship in the United States (US).Study designCross-sectional study.MethodsDemographic and research publication data were retrospectively collected from 435 applications to an ACGME-accredited orthopaedic sports medicine fellowship program at a single high-volume academic institution from 2013 to 2017. All self-reported manuscript publications and studies in progress were analyzed with a minimum 2-year follow-up. "Submitted" publications were reviewed by searching the originally submitted journal and all publicly available sources. Publications were verified on PubMed, MEDLINE, and other open access journals. Journal impact factors were collected through use of InCites Journal Citation Reports.ResultsOnly 5.7% (85/1504) of papers reported as "completed" were inaccurately self-reported, with 44 (51.8%) remaining unverified and 41 (48.2%) reporting discordant authorship, in which the published study listed a different author order than reported on the application. Further, 28.3% (197/696) of papers self-reported as "submitted" remained unpublished, 21.8% (152/696) were published in a different journal than originally reported, and 7.6% (53/696) were published with a different authorship order than reported. Among 95 applicants whose papers were published in different journals than originally reported, the mean impact factor of the final accepting journal was significantly lower than that of the journal of original submission (0.97 ± 0.13 vs 3.91 ± 0.79, respectively; 95% CI of the difference, 1.34-4.54; P < .01). Univariate analysis showed no significant relationships between variables of interest (age, sex, US Medical Licensing Examination Step 1 score, American Orthopaedic Association membership, medical school ranking, and advanced degree) and the presence of an inaccuracy.ConclusionThere is a low rate of inaccurate self-reporting of "completed" publications on applications for orthopaedic sports medicine fellowships. The majority of papers listed as "submitted" on these applications were not published in the journals to which they were originally submitted

The Outcomes of "Submitted" Publications From Applicants to Orthopaedic Surgery Residency Programs: A Retrospective Review of 1303 Residency Applications.

PurposeTo evaluate research listed as "Submitted" on orthopaedic surgery residency applications for eventual publication rates and quality.SignificanceAs the orthopaedic surgery residency selection process becomes increasingly competitive, the number of research publications listed on applications continually increases. However, the utility of using publications listed as "Submitted" in the applicant evaluation process remains unknown.MethodsDemographic and publication data were retrospectively collected from 1303 applications to an orthopaedic surgery residency program. The PubMed database was used to verify "Submitted" publications for (1) publication fruition or (2) publication mismatch, defined as discordance between the listed journal of submission and the eventual journal of publication.ResultsA total of 594 applications (45.6%) listed ≥1 publication as "Submitted." Out of 1636 "Submitted" publications, 565 were unverifiable (32.5%). Of the 1071 verified publications, 362 (33.8%) experienced publication mismatch. Within this subgroup, a significant difference existed between the mean impact factors of the listed journal of submission and the eventual journal of publication (1.5 ± 2.7 versus 3.0 ± 2.5, P < 0.01). Demographic data were not predictive of having an unverified publication.ConclusionPublications listed as "Submitted" in orthopaedic surgery residency applications frequently remain unpublished or are published in less impactful journals than originally intended