Objectives This study was planned to evaluate the accuracy of computed tomography angiography (CTA) for suspected rupture of abdominal aortic aneurysm (AAA). Design Retrospective, observational ...study. Patients A total of 97 patients who underwent open aneurysm repair for suspected rupture of AAA. Methods The accuracy of preoperative and post hoc evaluation of CTA scans was evaluated by using the intra-operative findings as reference. Results At surgery, 58 patients were found to have a ruptured aneurysm. Interpretation of CTA findings at admission resulted in one false-negative and two false-positive diagnoses of aneurysm rupture as observed at surgery (sensitivity 98.3%, specificity 94.9%, positive predictive value 96.6%, negative predictive value 97.4%). Post hoc , blinded review of CTA findings resulted in one false-negative and three false-positive diagnoses of aneurysm rupture (sensitivity 98.3%, specificity 92.3%, positive predictive value 95.0%, negative predictive value 97.3%). Agreement between initial and post hoc assessment of CTA-findings was statistically significant (kappa 0.978, p < 0.0001). Conclusions CTA is highly accurate in the diagnosis of suspected rupture of AAA. The risk of false-positive diagnosis is very low and it is not likely to affect the correct analysis of the results of comparative studies on endovascular versus open repair of ruptured AAA.
Scholars have cited an antiracist identity as an ideal development status for Whites seeking to change systemic racism (Helms, 1995). However, little is known regarding the lived complexities of ...antiracist work itself. This article examines the experiences of one group of Whites (N = 10) committed to antiracist action. Outcomes indicate challenges that include backlash and struggles to identify more effective antiracist tactics. Coping mechanisms are considered in relation to counseling and counselor training practices.
This study explored the experiences of counselor students of color in two multicultural courses in a master-level counseling program. Participants revealed their feelings surrounding a need to assume ...a 'teaching role' with their White counterparts, to challenge racist and stereotypical viewpoints. Positive and negative experiences associated with this role were expressed. Findings are drawn upon to suggest more inclusive counselor education tactics.
This article presents findings from a study that explored the lived experiences of Whites committed to antiracism action—those who, according to Janet Helms's (1990, 1995, 2014) White racial identity ...model, exhibit characteristics of the autonomy status. Thematic outcomes indicated participants’ (N = 10) efforts to manage their own racism in ways that are both proactive and responsive in nature. Findings are compared with theoretical and empirical literature regarding the racial identity development of Whites committed to antiracist action.
Este artículo presenta los hallazgos obtenidos a partir de un estudio que exploró las experiencias vitales de personas blancas comprometidas con la acción antirracista. Según el modelo de identidad racial blanca de Janet Helms (1990, 1995, 2014), estas personas son aquellas que muestran características del estado de autonomía. Los resultados temáticos indicaron que los esfuerzos de los participantes (N = 10) por controlar su propio racismo son por naturaleza tanto proactivos como reactivos. Se comparan los hallazgos con la literatura teórica y empírica en torno al desarrollo de la identidad racial de personas blancas comprometidas con la acción antirracista.
Researchers assessed the longitudinal impacts of a master‐level, race‐based counseling course with White, graduate‐level counseling students (N = 35) over a 5‐year period. Impacts were assessed ...through interview and written data, as well as with the White Racial Consciousness Development Scale‐Revised (Claney & Parker, 1989; Lee et al., 2007). Students expressed an increased sense of responsibility to address racism, with examples of ways they addressed inequities and discrimination across contexts.
Resumen
Los investigadores evaluaron los impactos longitudinales de un curso de consejería de nivel máster basado en la raza con estudiantes de consejería blancos de posgrado (N = 35) durante un periodo de cinco años. La evaluación de los impactos se realizó a través de entrevistas y datos escritos, además del empleo de la Escala de Desarrollo de la Conciencia Racial Blanca – Revisada (WRCDS‐R; Claney & Parker, 1989; Lee et al., 2007). Los alumnos expresaron un aumento de su sentido de la responsabilidad para abordar el racismo, con ejemplos de formas en las que abordaron casos de desigualdad y discriminación en diversos contextos.
This qualitative study examined the experiences of 11 students of color who participated in 2 multicultural counseling courses in a master’s‐level counseling program at a predominantly White ...institution. Findings illustrate students’ learning experiences based on instructors’ racial and ethnic identities, including a pivotal transition from distrust to trust toward the White instructor. Implications for teaching race‐based topics with students of color are presented.
Este estudio cualitativo examinó las experiencias de 11 estudiantes de color que participaron en dos cursos de consejería multicultural en un programa de consejería de nivel máster en una institución predominantemente blanca. Los hallazgos ilustran las experiencias de aprendizaje de los alumnos basadas en las identidades raciales y étnicas de los docentes, incluyendo una transición fundamental desde la desconfianza hasta la confianza hacia el docente blanco. Se presentan las implicaciones para la enseñanza de temas basados en la raza con alumnos de color.
Background:
The aim of this study was to investigate the impact of transfusion of blood products on intermediate outcome after coronary artery bypass surgery.
Patients:
Complete data on perioperative ...blood transfusion in patients undergoing coronary artery bypass surgery were available from 2001 patients who were operated at our institution.
Results:
Transfusion of any blood product (relative risk = 1.678, 95% confidence interval = 1.087–2.590) was an independent predictor of all-cause mortality. The additive effect of each blood product on all-cause mortality (relative risk = 1.401, 95% confidence interval = 1.203–1.630) and cardiac mortality (relative risk = 1.553, 95% confidence interval = 1.273–1.895) was evident when the sum of each blood product was included in the regression models. However, when single blood products were included in the regression model, transfusion of fresh frozen plasma/Octaplas® was the only blood product associated with increased risk of all-cause mortality (relative risk = 1.692, 95% confidence interval = 1.222–2.344) and cardiac mortality (relative risk = 2.125, 95% confidence interval = 1.414–3.194). The effect of blood product transfusion was particularly evident during the first three postoperative months. Since follow-up was truncated at 3 months, transfusion of any blood product was a significant predictor of all-cause mortality (relative risk = 2.998, 95% confidence interval = 1.053–0.537). Analysis of patients who survived or had at least 3 months of potential follow-up showed that transfusion of any blood product was not associated with a significantly increased risk of intermediate all-cause mortality (relative risk = 1.430, 95% confidence interval = 0.880–2.323).
Conclusions:
Transfusion of any blood product is associated with a significant risk of all-cause and cardiac mortality after coronary artery bypass surgery. Such a risk seems to be limited to the early postoperative period and diminishes later on. Among blood products, perioperative use of fresh frozen plasma or Octaplas seems to be the main determinant of mortality.
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