bluuebunny/crossref_metadata_2025 huggingface dataset:
Piezoelectric Characterization of (0.6)BiFeO3–(0.4)PbTiO3 Multiferroic Ceramics
Authors: Freitas Valdirlei F. , Santos Ivair A. , Botero Ériton , Fraygola Barbara M. , Garcia Ducinei , Eiras José A.
Published: October 2010

In this work, the full piezoelectric characterization of high‐energy ball‐milled (HEBM) (0.6)BiFeO3–(0.4)PbTiO3 (HE‐BF PT60/40) multiferroic magnetoelectric ceramics was performed. The whole set of piezoelectric, mechanical, and elastic coefficients was obtained. The results revealed piezoelectric coefficients, namely d31=−41.6 × 10−12 m/V and g31=−9.65 × 10−3 Vm/N (at room temperature), as high as those of other commercial piezoceramics. In fact, HE‐BFPT60/40 piezoceramics produced by HEBM showed three times higher piezoelectric coefficients than those previously reported for conventionally synthesized piezoceramics. The thermal stability of d31 and g31 piezoelectric coefficients near room temperature, as well as the weak ferromagnetic response of HE‐BFPT60/40 samples, make the (0.6)BiFeO3–(0.4)PbTiO3 multiferroic magnetoelectric ceramics potential candidates for applications in future multifunctional piezo‐magnetic–electric devices.
Rotating Resident Didactics in the Emergency Department: A Cross‐sectional Survey on Current Curricular Practices
Authors: Branzetti Jeremy B. , Aldeen Amer Z. , Mark Courtney D.
Published: October 2010

Objectives:  Rotating (non–emergency medicine [EM]) residents perform clinical rotations in many academic emergency departments (EDs). The primary objective of this work was to quantify characteristics of rotating residents and the didactic curricula offered to them during their EM rotations. Secondary objectives were to identify barriers to instituting such didactics and to establish ideal curricular contents.

Methods:  A Web‐based survey was administered by e‐mail to residency directors of all U.S. allopathic EM residency programs. Consent was obtained in the first part of the survey, and the study was deemed exempt from full review by the institutional review board. Questions solicited information regarding type and quantity of rotating residents in their main EDs, the “didactic educational format” available to rotating residents, and ideal and actual didactic curricular contents. Statistics were reported as proportions and means with 95% confidence intervals (CIs) and medians with interquartile ranges (IQRs).

Results:  Surveys were sent to 143 programs, and the response rate was 71%. Ninety‐nine percent of respondents had rotating residents in their EDs, and the median number per month was 4 (IQR = 3–6). Five percent of respondents had established didactic curricula specifically for rotating residents, and 64% sent them to either EM resident or medical student lectures. Thirty‐one percent of programs reported no didactics, and 65% of these felt there was no need for such education. Resuscitation, trauma, and toxicology were cited as the most important subjects for actual and ideal curricula.

Conclusions:  Most academic EDs have rotating residents, but very few provide didactic education specific to their learning needs and almost a third provide no didactics.

ACADEMIC EMERGENCY MEDICINE 2010; 17:S49–S53 © 2010 by the Society for Academic Emergency Medicine
Exploring Patterns of Health Service Use in Older Emergency Department Patients
Authors: Nicole Hastings S. , Horney Carolyn , Landerman Lawrence R. , Sanders Linda L. , Hocker Michael B. , Schmader Kenneth E.
Published: October 2010

Objectives:  Study objectives were to identify groups of older patients with similar patterns of health care use in the 12 months preceding an index outpatient emergency department (ED) visit and to identify patient‐level predictors of group membership.

Methods:  Subjects were adults ≥ 65 years of age treated and released from an academic medical center ED. Latent cluster analysis (LCA) models were estimated to identify groups with similar numbers of primary care (PC), specialist, and outpatient ED visits and hospital days within 12 months preceding the index ED visit.

Results:  In this sample (n = 308), five groups with distinct patterns of health service use emerged. Low Users (35%) had fewer visits of all types and fewer hospital days compared to sample means. Low Users were more likely to be female and had fewer chronic health conditions relative to the overall sample (p < 0.05). The ED to Supplement Primary Care Provider (PCP) (23%) group had more PCP visits, but also significantly more ED visits. Specialist Heavy (22%) group members had twice as many specialist visits, but no difference in PCP visits. Members of this class were more likely to be white and male (p < 0.05). High Users (15%) received more care in all categories and had more chronic baseline health conditions (p < 0.05) but no differences in demographic characteristics relative to the whole sample. The ED and Hospital as Substitution Care (6%) group had fewer PC and specialist visits, but more ED visits and hospital days.

Conclusions:  In this sample of older ED patients, five groups with distinct patterns of health service use were identified. Further study is needed to determine whether identification of these patient groups can add important information to existing risk‐assessment methods.

ACADEMIC EMERGENCY MEDICINE 2010; 17:1086–1092 © 2010 by the Society for Academic Emergency Medicine
Use of Bedside Ultrasound to Assess Degree of Dehydration in Children With Gastroenteritis
Authors: Chen Lei , Hsiao Allen , Langhan Melissa , Riera Antonio , Santucci Karen A.
Published: October 2010

Objectives:  Prospectively identifying children with significant dehydration from gastroenteritis is difficult in acute care settings. Previous work by our group has shown that bedside ultrasound (US) measurement of the inferior vena cava (IVC) and the aorta (Ao) diameter ratio is correlated with intravascular volume. This study was designed to validate the use of this method in the prospective identification of children with dehydration by investigating whether the IVC/Ao ratio correlated with dehydration in children with acute gastroenteritis. Another objective was to investigate the interrater reliability of the IVC/Ao measurements.

Methods:  A prospective observational study was carried out in a pediatric emergency department (PED) between November 2007 and June 2009. Children with acute gastroenteritis were enrolled as subjects. A pair of investigators obtained transverse images of the IVC and Ao using bedside US. The ratio of IVC and Ao diameters (IVC/Ao) was calculated. Subjects were asked to return after resolution of symptoms. The difference between the convalescent weight and ill weight was used to calculate the degree of dehydration. Greater than or equal to 5% difference was judged to be significant. Linear regression was performed with dehydration as the dependent variable and the IVC/Ao as the independent variable. Pearson’s correlation coefficient was calculated to assess the degree of agreement between observers.

Results:  A total of 112 subjects were enrolled. Seventy‐one subjects (63%) completed follow‐up. Twenty‐eight subjects (39%) had significant dehydration. The linear regression model resulted in an R2 value of 0.21 (p < 0.001) and a slope (B) of 0.11 (95% confidence interval [CI] = 0.08 to 0.14). An IVC/Ao cutoff of 0.8 produced a sensitivity of 86% and a specificity of 56% for the diagnosis of significant dehydration. Forty‐eight paired measurements of IVC/Ao ratios were made. The Pearson correlation coefficient was 0.76.

Conclusions:  In this pilot study the ratio of IVC to Ao diameters, as measured by bedside US, was a marginally accurate measurement of acute weight loss in children with dehydration from gastroenteritis. The technique demonstrated good interrater reliability.

ACADEMIC EMERGENCY MEDICINE 2010; 17:1042–1047 © 2010 by the Society for Academic Emergency Medicine
Inaccuracy of the Global Assessment Score in the Emergency Medicine Standard Letter of Recommendation
Authors: Oyama Leslie C. , Kwon Manon , Fernandez Jorge A. , Fernández‐Frackelton Madonna , Campagne Danielle D. , Castillo Edward M. , Lin Michelle
Published: October 2010

Objectives:  The standard letter of recommendation (SLOR) is used by most emergency medicine (EM) faculty to submit evaluations for medical students applying for EM residency programs. In the global assessment score (GAS) section, there is a crucial summative question that asks letter writers to estimate the applicant’s rank order list (ROL) position in their own program. The primary aim of the study was to determine if these estimated global assessment tiers agreed with the actual ROL, using the criteria recommended by the Council of Emergency Medicine Residency Directors (CORD).

Methods:  Data from SLORs written by EM faculty from five California institutions were retrospectively collected from the 2008–2009 residency application year. Descriptive and comparative statistical analyses were performed using the documented GAS tiers and actual ROL positions.

Results:  A total of 105 SLORs were reviewed from the five participating institutions. Three SLORs were excluded and 102 were analyzed. Only 27 (26%) SLORs documented a GAS tier that accurately predicted the applicant’s actual ROL position. The GAS tier overestimated the applicant’s position on the ROL in 67 (66%) SLORs, whereas it underestimated the position in eight (8%) SLORs. Accuracy was poor regardless of the number of letter writers on the SLOR (p = 0.890), the writer’s administrative title (p = 0.326), whether the student was a home or visiting student (p = 0.801), or if the student had prior EM rotation experience (p = 0.793).

Conclusions:  Standard letter of recommendation writers are inaccurate in estimating the ROL position of the applicant using the GAS tier criteria. The GAS tiers were accurate only 26% of the time. Because of the valuable role that the SLOR plays in determining an applicant’s competitiveness in the National Resident Matching Program (NRMP) in EM, future discussion should focus on improving the consistency and accuracy of the GAS section. Furthermore, there needs to be a national dialogue to reassess the utility of the criterion‐based GAS within the SLOR.

ACADEMIC EMERGENCY MEDICINE 2010; 17:S38–S41 © 2010 by the Society for Academic Emergency Medicine
Feasibility and Reliability of the SHOT: A Short Scale for Measuring Pretreatment Severity of Alcohol Withdrawal in the Emergency Department
Authors: Gray Sara , Borgundvaag Bjug , Sirvastava Anita , Randall Ian , Kahan Meldon
Published: October 2010

Background:  Use of a symptom‐triggered scale to measure the severity of alcohol withdrawal could reduce the rate of seizures and other complications. The current standard scale, the Clinical Institute of Withdrawal Assessment (CIWA), takes a mean (±SD) of 5 minutes to complete, requiring 30 minutes of nursing time per patient when multiple measures are required.

Objectives:  The objective was to assess the feasibility and reliability of a brief scale of alcohol withdrawal severity.

Methods:  The SHOT is a brief scale designed to assess alcohol withdrawal in the emergency department (ED). It includes four items: sweating, hallucinations, orientation, and tremor (SHOT). It was developed based on a literature review and a consensus process by emergency and addiction physicians. The SHOT was first piloted in one ED, and then a prospective observational study was conducted at a different ED to measure its feasibility and reliability. Subjects included patients who were in alcohol withdrawal. One nurse administered the SHOT and CIWA, and the physician repeated the SHOT independently. The SHOT was done only at baseline, before treatment was administered.

Results:  In the pilot study (12 patients), the SHOT took 1 minute to complete on average, and the CIWA took 5 minutes. Sixty‐one patients participated in the prospective study. For the SHOT and the CIWA done by the same nurse, the kappa was 0.88 (95% confidence interval [CI] = 0.52 to 1.0; p < 0.0001), and the Pearson’s r was 0.71 (p < 0.001). The kappa for the nurse’s CIWA score and the physician’s SHOT score was 0.61 (95% CI = 0.25 to 0.97; p < 0.0006), and the Pearson’s r was 0.48 (p = 0.002). The SHOTs performed by the nurse and physician agreed on the need for benzodiazepine treatment in 30 of 37 cases (82% agreement, kappa = 0.35, 95% CI = 0.03 to 0.67; p < 0.02). The mean (±SD) time taken by nurses and physicians to complete the SHOT was 1 (± 0.52) minute (median = 0.6 minutes). Seventeen percent of patients scored positive on the SHOT for hallucinations or disorientation.

Conclusions:  The SHOT has potential as a feasible and acceptable tool for measuring pretreatment alcohol withdrawal severity in the ED. Further research is needed to validate the SHOT, to assess the utility of serial measurements of the SHOT, and to demonstrate that its use reduces length of stay and improves clinical outcomes.

ACADEMIC EMERGENCY MEDICINE 2010; 17:1048–1054 © 2010 by the Society for Academic Emergency Medicine
An Evaluation of Resident Work Profiles, Attending–Resident Teaching Interactions, and the Effect of Variations in Emergency Department Volume on Each
Authors: Thibodeau Lorraine G. , Geary Sean P. , Werter Christopher
Published: October 2010

Objectives:  This study examines the effect of variations in emergency department (ED) volume on physician work efficiency (new patients per hour) and work profile (patient‐related activities, including both direct and indirect patient care) and whether these differ between first‐ (Postgraduate Year [PGY]1) and third‐ (PGY3) year residents. The authors also determine if changes in volume are associated with changes in teaching interactions between attending and resident physicians.

Methods:  This was a prospective observational study of resident and attending physicians in the ED. Research assistants (RAs) followed ED residents during clinical shifts and recorded a multitude of data including the amount of time spent in specific activities, the number of new patients seen, and the frequency of attending physician teaching interactions.

Results:  Third‐year residents see more new patients per hour (1.79 vs. 1.16, p < 0.001) than do their first‐year counterparts. In addition, third‐year residents spend almost 50% less time with each patient (10.7 minutes vs. 19.4 minutes, p < 0.001), and first‐year residents spend three times as much time per shift discussing patients with attending physicians (59.4 minutes vs. 27.3 minutes, p = 0.002). More of the PGY1/attending interactions resulted in educational exchanges (54.9% vs. 34.6%, p = 0.003). PGY1 residents also spend more time on dictations per patient (9.6 minutes vs. 5.4 minutes, p = 0.01) and more time on paperwork per patient (18.5 minutes vs. 6.5 minutes, p = 0.007). As ED volume tripled, PGY1 residents were able to increase their patient load to a greater extent than were PGY3 residents by decreasing the length of each patient encounter as volume increased. Overall, ED volume had no effect on the number of teaching interactions, although the length of exchange decreased as volume increased.

Conclusions:  Third‐year residents see and carry more patients than do their first‐year counterparts. They do so primarily by decreasing the amount of time spent with patients and attendings and working more efficiently overall. However, they are not as capable of altering their work profiles in the face of increased volume as their first‐year counterparts. While the length of teaching interactions is decreased as volume increases, the number of those interactions resulting in teaching remains constant regardless of volume.

Academic Emergency Medicine 2010; 17:S62–S66 © 2010 by the Society for Academic Emergency Medicine
Best Educational Practices in Pediatric Emergency Medicine During Emergency Medicine Residency Training: Guiding Principles and Expert Recommendations
Authors: Cloutier Robert L. , Walthall Jennifer D. H. , Mull Colette C. , Nypaver Michele M. , Baren Jill M.
Published: October 2010

The state of pediatric emergency medicine (PEM) education within emergency medicine (EM) residency programs is reviewed and discussed in the context of shifting practice environments and new demands for a greater focus on the availability and quality of PEM services. The rapid growth of PEM within pediatrics has altered the EM practice landscape with regard to PEM. The authors evaluate the composition, quantity, and quality of PEM training in EM residency programs, with close attention paid to the challenges facing programs. A set of best practices is presented as a framework for discussion of future PEM training that would increase the yield and relevance of knowledge and experiences within the constraints of 3‐ and 4‐year residencies. Innovative educational modalities are discussed, as well as the role of simulation and pediatric‐specific patient safety education. Finally, barriers to PEM fellowship training among EM residency graduates are discussed in light of the shortage of practitioners from this training pathway and in recognition of the ongoing importance of the EM voice in PEM.

ACADEMIC EMERGENCY MEDICINE 2010; 17:S104–S113 © 2010 by the Society for Academic Emergency Medicine
Emergency Medicine Quality Improvement and Patient Safety Curriculum
Authors: Kelly John J. , Thallner Elaine , Broida Robert I. , Cheung Dickson , Meisl Helmut , Hamedani Azita G. , Klauer Kevin , Welch Shari J. , Beach Christopher
Published: October 2010

ACADEMIC EMERGENCY MEDICINE 2010; 17:e110–e129 © 2010 by the Society for Academic Emergency Medicine

Preface

All of us who have worked on this curriculum are career emergency physicians (EPs) who have become leaders with a focus on emergency medicine (EM) quality and safety.

About 2 years ago, I approached my colleagues of the American College of Emergency Physicians Quality Improvement and Patient Safety (ACEP QIPS) Section and dreamed an idea of creating an EM quality and safety curriculum: an outline that would explain a topic few EPs understand. That outline would be used as a curriculum to teach our EM residents (and even our attendings, physician’s assistants, and nurse leaders) about EM quality and safety.

My goal is for this curriculum to become an integral part of every EM residency program and department. We know that quality and safety in patient care does not happen by accident. We must teach these concepts to everyone on our emergency department (ED) team. The safety of our patients depends on this.

I would like to thank each of the authors who spent many months on this project, along with the ACEP QIPS Section and ACEP Quality and Performance Committee.

Also, I would like to thank ACEP staff Angela Franklin and Idania Lorenti for their help in getting this project to completion. I must also sincerely acknowledge the early work and ideas generated by Drs. Shari Welch and David John: their contributions clearly helped shape this article.

—John J. Kelly, DO
Budgets, Plans and Politics: Questioning the Role of Expert Knowledge in Disaster Reconstruction
Authors: Barrios Roberto
Published: October 2010

Keywords:

commentary,

disaster,

urban planning,

governmentality,

urban anthropology,

international development,

Honduras,

New Orleans,

Hurricane Katrina,

ecology and environment,

development
Greening in the Red Zone: Green Space and Disaster Resistance, Recovery and Resilience
Authors: Tidball Keith G
Published: October 2010

Keywords:

commentary,

community gardening,

community gardens,

development,

ecology and environment,

botany and plants,

urban anthropology
Creole, Cajun and Cutting Edge Cuisine in New Orleans
Authors: Beriss David
Published: October 2010

Keywords:

association affairs,

AAA Annual Meeting,

2010 Annual Conference
Within‐field distribution of Aphis gossypii and aphidophagous lady beetles in chili, Capsicum annuum
Authors: Rahman Touhidur , Roff Mohammad Nor Mohd , Ghani Idris Bin Abd
Published: October 2010

Understanding the spatial distribution of insect pests and their natural enemies can be very important for a successful integrated pest management approach. In Malaysia, Aphis gossypii Glover (Hemiptera: Aphididae) is the only aphid species colonizing and responsible for significant crop losses in chili, Capsicum annuum L. (Solanaceae). Several species of aphidophagous lady beetles (Coleoptera: Coccinellidae) occur naturally, of which three species [Menochilus sexmaculatus (Fabricius), Coelophora inaequalis (Fabricius), and Coccinella transversalis (Fabricius)] predominate in chili ecosystems. In this study, we investigated the spatial distribution of A. gossypii and associated lady beetle predators during two growing seasons of C. annuum, using Spatial Analysis by Distance Indices (SADIE). Both aphid and lady beetle populations were spatially aggregated, the strength of aggregation being strongest mid‐way through the cropping cycle. We concluded that the aggregated distribution of adult lady beetles is driven by the spatial distribution of A. gossypii.
Obstruction of the lung capillaries by blood platelet aggregates and leucocytes in sudden infant death syndrome
Authors: HANSSEN TOR‐ARNE , JØRGENSEN LEIF
Published: October 2010

Hanssen T‐A, Jørgensen L. Obstruction of the lung capillaries by blood platelet aggregates and leucocytes in sudden infant death syndrome. APMIS 2010; 118: 958–67.

Altogether 34 cases of sudden infant death were studied postmortem with particular emphasis on the pathological changes in the lungs. Light microscopy, including application of immunohistochemical methods, and transmission electron microscopy were used for the identification of blood platelets and white blood cell types in alveolar capillaries. The main findings were platelet aggregates and a varying number of neutrophil polymorphonuclear granulocytes in the lung capillaries, mixed with a smaller number of lymphocytes. The findings may be interpreted as an early sign of inflammation with capillary thrombosis, resulting in ischaemia, i.e. arrest of flow. In 21% of the cases, inflammatory cells had also expanded focally into alveolar spaces, creating the picture of localized areas of bronchopneumonia. An infant dying suddenly of a traumatic head injury served as a control. Neither platelets nor leucocytes were observed in the alveolar capillaries of this infant. In conclusion, in lungs from cases of sudden infant death syndrome, the alveolar capillaries are obstructed by platelet aggregates and leucocytes, interpreted as signs of an initial stage of lung inflammation with ischaemia.
Cues for cannibalism: cane toad tadpoles use chemical signals to locate and consume conspecific eggs
Authors: Crossland Michael R. , Shine Richard
Published: October 2010

Although animals of many species kill and consume conspecifics, most such cases probably involve serendipitous encounters between the individuals concerned. In some taxa, however, cannibalism is an active process, with predatory individuals searching out and consuming specific types of conspecific prey items. Although anuran tadpoles often have been reported to consume conspecific eggs, this behaviour has been interpreted as a by‐product of usual foraging behaviours rather than a result of targeted searching. Our field and laboratory studies in tropical Australia show that the tadpoles of invasive cane toadsBufo marinusare strongly attracted to chemical cues from conspecific eggs; the effective cues are released late in embryonic development, as the jelly coat breaks down. Tadpoles of native Australian frog species were attracted to the eggs of toads only rarely. If deployed as bait in traps, chemical cues from toad eggs could provide a way to selectively remove toad larvae from waterbodies.
Infection Rates of Rifampin/Gentamicin-Coated Titan Coloplast Penile Implants. Comparison with Inhibizone-Impregnated AMS Penile Implants
Authors: Dhabuwala Chirpriya , Sheth Sheila , Zamzow Brent
Published: October 2010

Introduction

It is a common practice to soak Titan® Coloplast penile implants in antibiotic solution prior to implantation. Experience with Inhibizone impregnation suggests that rifampin coating significantly reduces infection rates of penile implant surgery. In this article we describe the results of coating Titan Coloplast penile implants with rifampin/gentamicin solution.

Aim

To compare infection rates of Titan® Coloplast penile implants coated with vancomycin/gentamycin, rifampin/gentamicin, and Inhibizone-impregnated American Medical Systems (AMS) penile implants.

Methods

Chart review was done for all Mentor/Coloplast and AMS implant surgeries performed at our center between the dates January 1, 2002 and February 8, 2010. Infection rates for Titan® Coloplast penile implants coated with vancomycin/gentamycin, rifampin/gentamicin, and Inhibizone-impregnated (AMS) penile implants were compared.

Main Outcome Measures

Infection rates for penile implants coated with different antibiotics.

Results

Infection rates for Titan® Coloplast penile implants coated with vancomycin/gentamycin and Inhibizone-impregnated (AMS) penile implants was 4.4% and 1.3%, respectively (P = 0.05). None of the rifampin/gentamicin-coated Titan® Coloplast penile implants have developed infection. Rifampin is the common antibiotic both in rifampin/gentamicin-coated Coloplast implants and Inhibizone®. The infection rate in this combined rifampin/gentamicin-coated Titan Coloplast implants and Inhibizone-coated AMS implants group was 0.63% (P = 0.03).

Conclusion

Both rifampin/gentamicin-coated Titan® Coloplast penile implants and Inhibizone-impregnated (AMS) penile implants appear to have lower infection rates compared with vancomycin/gentamycin-coated Titan® Coloplast penile implants The present study does not suggest superiority of rifampin/gentamicin-coated Titan® Coloplast penile implants or Inhibizone-impregnated (AMS) penile implants but we strongly suggest that all Titan® Coloplast penile implants should be coated with rifampin/gentamicin solution.
Managing the ecology of foliar pathogens: ecological tolerance in crops
Authors: Newton A.C. , Gravouil C. , Fountaine J.M.
Published: October 2010

The phyllosphere is a rich and varied microbial community comprising organisms with diverse functional types. Its composition is strongly influenced by both genotypic and environmental factors, many of which can be manipulated by breeding, agronomy and crop protection strategies in an agricultural context. These factors also affect the complex interactions between the microbes, which in turn affect their interaction with their host plant. Whether or not an organism becomes pathogenic and the subsequent expression of disease are also influenced by all these factors. Understanding the population dynamic balance between the organisms of the phyllosphere as an ecological system should lead to new approaches in agronomy, crop protection and breeding that enhance sustainability, where the previously presumed requirement to eliminate putative pathogens is replaced by management that favours dominance of beneficial organisms and contains putative pathogens in asymptomatic or stable states.
Retention, turnover and return – a longitudinal study of allied health professionals in Britain
Authors: Loan‐Clarke John , Arnold John , Coombs Crispin , Hartley Ruth , Bosley Sara
Published: October 2010

Problems of retention and turnover of allied health professionals are under‐researched. A longitudinal (two‐year) study of four allied health professions (AHPs) in the British health‐care system sampled from three categories – stayers, leavers and returners. Qualitative data identified respondents' (n = 1925) own reasons for staying within the National Health Service (NHS), leaving it or returning to it. Data at the second stage of the study (n = 719) additionally identified reasons for staying in non‐NHS employment. Responses show key differences among stayers, leavers and returners for their employment choice decisions. Differences between AHPs in the NHS and those working outside it are also identified. Longitudinal data revealed the influence of the changing employment context on employment choice decisions. Findings are related to the policy context and relevant theoretical literature. Recommendations for future research, particularly focusing on stayers so as to enhance retention strategies, are made.
Managing under pressure: HRM in hospitals
Authors: Townsend Keith , Wilkinson Adrian
Published: October 2010

Health reforms in the last 25 years focused largely on structural change, cost containment and the introduction of market mechanisms, and the importance of the management of HR has often been overlooked. Pressures for efficiency and effectiveness are particularly pronounced in the hospital sector, which is the most resource‐intensive component of the health care system. One important aspect of improving and maintaining service delivery in hospitals is to better manage the HR function. This paper highlights the importance and complexities of HRM in hospitals throughout the world.
Habitat fragmentation, climate change, and inbreeding in plants
Authors: Leimu Roosa , Vergeer Philippine , Angeloni Francesco , Ouborg N. Joop
Published: October 2010

Habitat fragmentation and climate change are recognized as major threats to biodiversity. The major challenge for present day plant populations is how to adapt and cope with altered abiotic and biotic environments caused by climate change, when at the same time adaptive and evolutionary potential is decreased as habitat fragmentation reduces genetic variation and increases inbreeding. Although the ecological and evolutionary effects of fragmentation and climate change have been investigated separately, their combined effects remained largely unexplored. In this review, we will discuss the individual and joint effects of habitat fragmentation and climate change on plants and how the abilities and ways in which plants can respond and cope with climate change may be compromised due to habitat fragmentation.
Ecology of hantavirus in a changing world
Authors: Dearing M. Denise , Dizney Laurie
Published: October 2010

Hantavirus is a genus of virus represented by 45 different species and is hosted by small mammals, predominantly rats and mice. Roughly, half of all hantaviruses cause diseases in humans that vary in morbidity from mild to severe. The natural and anthropogenic changes occurring in the environment appear to be impacting the ecology of hantaviruses and their natural hosts as well as the incidence of hantaviral diseases in humans. Although such studies are limited at this time, there is evidence that natural climate cycles such as El Niño as well as anthropogenic climate change enhance hantavirus prevalence when host population dynamics are driven by food availability. Climate appears to have less of an effect on hantavirus when host populations are controlled by predators. Human alteration to the landscape also appears to enhance hantavirus prevalence when the disturbance regime enriches the environment for the host, for example, agriculture. More long‐term studies on multiple species of hantavirus are needed to accurately predict the outcome of changing environmental conditions on prevalence in hosts as well as disease incidence in humans.
Bioaccumulation syndrome: identifying factors that make some stream food webs prone to elevated mercury bioaccumulation
Authors: Ward Darren M. , Nislow Keith H. , Folt Carol L.
Published: October 2010

Mercury is a ubiquitous contaminant in aquatic ecosystems, posing a significant health risk to humans and wildlife that eat fish. Mercury accumulates in aquatic food webs as methylmercury (MeHg), a particularly toxic and persistent organic mercury compound. While mercury in the environment originates largely from anthropogenic activities, MeHg accumulation in freshwater aquatic food webs is not a simple function of local or regional mercury pollution inputs. Studies show that even sites with similar mercury inputs can produce fish with mercury concentrations ranging over an order of magnitude. While much of the foundational work to identify the drivers of variation in mercury accumulation has focused on freshwater lakes, mercury contamination in stream ecosystems is emerging as an important research area. Here, we review recent research on mercury accumulation in stream‐dwelling organisms. Taking a hierarchical approach, we identify a suite of characteristics of individual consumers, food webs, streams, watersheds, and regions that are consistently associated with elevated MeHg concentrations in stream fish. We delineate a conceptual, mechanistic basis for explaining the ecological processes that underlie this vulnerability to MeHg. Key factors, including suppressed individual growth of consumers, low rates of primary and secondary production, hydrologic connection to methylation sites (e.g., wetlands), heavily forested catchments, and acidification are frequently associated with increased MeHg concentrations in fish across both streams and lakes. Hence, we propose that these interacting factors define a syndrome of characteristics that drive high MeHg production and bioaccumulation rates across these freshwater aquatic ecosystems. Finally, based on an understanding of the ecological drivers of MeHg accumulation, we identify situations when anthropogenic effects and management practices could significantly exacerbate or ameliorate MeHg accumulation in stream fish.
Impacts of biofuels on climate change, water use, and land use
Authors: Delucchi Mark A.
Published: October 2010

Governments worldwide are promoting the development of biofuels in order to mitigate the climate impact of using fuels. In this article, I discuss the impacts of biofuels on climate change, water use, and land use. I discuss the overall metric by which these impacts have been measured and then present and discuss estimates of the impacts. In spite of the complexities of the environmental and technological systems that affect climate change, land use, and water use, and the difficulties of constructing useful metrics, it is possible to make some qualitative overall assessments. It is likely that biofuels produced from crops using conventional agricultural practices will not mitigate the impacts of climate change and will exacerbate stresses on water supplies, water quality, and land use, compared with petroleum fuels. Policies should promote the development of sustainable biofuel programs that have very low inputs of fossil fuels and chemicals that rely on rainfall or abundant groundwater, and that use land with little or no economic or ecological value in alternative uses.
Annual influenza vaccination: coverage and attitudes of primary care staff in Australia
Authors: Ward Kirsten , Seale Holly , Zwar Nicholas , Leask Julie , MacIntyre C. Raina
Published: October 2010

Please cite this paper as:Wardet al.(2011) Annual influenza vaccination: coverage and attitudes of primary care staff in Australia. Influenza and Other Respiratory Viruses 5(2), 135–141.

Background Annual influenza vaccination is recommended for all Australian health care workers (HCWs) including those working in primary health care. There is limited published data on coverage, workplace provision, attitudes and personal barriers to influenza vaccination amongst primary health care staff. The aim of this study was to contribute to the limited literature base in this important area by investigating these issues in the primary health care setting in New South Wales (NSW), Australia.

Methods A postal survey was sent to general practitioners (GPs) and practice nurses (PNs) from inner city, semi‐urban and rural areas of NSW, Australia. There were 139 responses in total (response rate 36%) from 79 GPs (response rate 30%) and 60 PNs (response rate 46%).

Results Reported influenza vaccination coverage in both 2007 and 2008 was greater than 70%, with GPs reporting higher coverage than PNs in both years. The main barriers identified were lack of awareness of vaccination recommendations for general practice staff and concern about adverse effects from the vaccine.

Conclusions Rates of influenza vaccination coverage reported in this study were higher than in previous studies of hospital and institutional HCWs, though it is possible that the study design may have contributed to these higher results. Nevertheless, these findings highlight that more needs to be done to understand barriers to vaccination in this group, to inform the development of appropriate strategies to increase vaccination coverage in primary health care staff, with a special focus on PNs.
The influence of the assessment method on the incidence of visual field progression in glaucoma: a network meta‐analysis
Authors: Ernest Paul J. G. , Viechtbauer Wolfgang , Schouten Jan S. A. G. , Beckers Henny J. M. , Hendrikse Fred , Prins Martin H. , Webers Carroll A. B.
Published: October 2010

Purpose:  To study and quantify the difference in incidence of progression between methods for the assessment of glaucomatous visual field progression.

Methods:  We identified 2450 articles published up to April 2009 in the following data sources: PubMed, EMBASE, and Cochrane. Ten studies covering 30 methods were included. All studies aimed to compare different methods for the assessment of glaucomatous visual field progression in the same study population. A network meta‐analysis using a mixed‐effects model was performed to combine within‐study between‐method comparisons with indirect comparisons from other studies. The summarized incidence of progression was calculated for every method, and methods were ranked according to this incidence.

Results:  In total, methods were compared in 1040 eyes of 948 patients with glaucoma. On average, 21% of the eyes progressed. When all 30 methods were ranked, the incidence ranged from 2% to 62%. These incidences are corrected for a baseline mean deviation (MD) value of −7 decibels and a mean follow‐up time of 6 years. Besides the assessment method, the incidence was only determined by the follow‐up period and baseline MD value, leaving no unexplained variance in the incidence of progression.

Conclusion:  The incidence of progression varies considerably between different studies. This is mainly caused by the variety of methods used to assess progression but also by differences in follow‐up time and baseline visual field loss.
Joint Mail‐In Rebate Decisions in Supply Chains Under Demand Uncertainty
Authors: Geng Qin , Mallik Suman
Published: October 2010

We study the joint decisions of offering mail‐in rebates (MIRs) in a single‐manufacturer–single‐retailer supply chain using a game theoretic framework. Either party can offer an MIR to the end consumer if it is in his best interest. The consumer demand is stochastic and depends on the product price and the amount of MIRs. When the retail price is exogenous, we show the existence of a unique Nash equilibrium under both additive and multiplicative demand functions and characterize it completely. We show that any of the following four scenarios can be the equilibrium: both parties offer MIR, only one party offers MIR, none offers MIR. When the retail price is a decision variable for the retailer and the rebate redemption rate increases with the amount of MIR, we once again prove the existence of a unique Nash equilibrium where both the retailer and the manufacturer offer MIRs. Using a numerical study, we show that the average post‐purchase price of the product is higher not only than the perceived pre‐purchase price but also than the newsvendor optimal price without an MIR. This implies that an MIR makes a product look cheaper while the consumers actually pay more on average.
Estimating the wood density of species for carbon stock assessments
Authors: Flores Olivier , Coomes David A.
Published: October 2010

1. Studies of forest carbon stocks and fluxes rely on estimates of specific wood density to convert tree diameter and height measurements made within permanent plots into carbon stock estimates. However, measurements of wood density are often available for only a subset of species. As there is strong phylogenetic trait conservatism of wood density, missing data are usually estimated by averaging the wood densities of other species within the same genus or family, using whatever data are available locally.

2. The Global Wood Density (GWD) database (http://hdl.handle.net/10255/dryad.235) provides wood densities for 8412 species from around the world, providing an opportunity to utilize data from further afield when faced with missing values in a study area. We investigated whether the GWD provides better estimates than local data sets when conventional averaging methods (AM) are used. Secondly, we develop Hierarchical Bayesian Models (HBM) that incorporate phylogenetic covariance to estimate missing wood densities.

3. Using AM, we found that correlations between observations and estimates were higher when the GWD was used in place of local data sets, mostly because of larger sample size. Missing wood densities were more accurately estimated from the global data set than from local data sets, indicating that the GWD should be used as a common standard when calculating carbon stocks.

4. Estimates based on including phylogenetic dependency in HBMs were also closely correlated to observations, but were no better than those obtained from the simpler AM. Estimations based on HBM could become more useful when phylogenetic trees resolved to the species level are available. Until such improvements are made, we conclude that building more data into the reference data set, rather than improving the method itself, is the most productive way to refine estimates of unknown wood densities.
A Turbulent Energy Dissipation Model for Flows With Drag Reduction
Authors: Hassid Samuel , Poreh Michael
Published: October 2010

A turbulent-energy-dissipation model is proposed for flows with and without drag reduction. The model is based on an eddy diffusivity approximation in the momentum equation, and on transport equations for the turbulent energy and the turbulent energy dissipation. The model describes the mean velocity profile and the turbulent energy distribution as a function of the reduction in the friction coefficient. It also yields a turbulent length scale which is shown to grow with drag reduction. The predictions of the model are in good agreement with the available experimental data.
A Theoretical Investigation on the Structure of Fan Wakes
Authors: Raj R. , Lumley J. L.
Published: October 2010

An analytical study is presented of the mean and turbulent characteristics of axial turbulent wakes behind a rotating fan. Simplified solutions are presented governing the mean radial and axial velocity profiles and their decay rate. An estimate is made of the relative order of magnitude of various turbulence quantities. The effect of rotation on the turbulence structure is described. Sufficient physical interpretations and explanations are presented for insight into and formulation of the problem.
Air-Vapor Dynamics in Large-Scale Atmospheric Spray Cooling Systems
Authors: Chaturvedi Sushil , Porter R. W.
Published: October 2010

Atmospheric spray cooling systems are alternatives to cooling towers and cooling ponds. A quantity NTU containing the spray drop-wise parameters allows prediction of cooling range if local wet-bulb temperature is known. The essential problem is predicting local wet-bulb proceeding windward through the spray field. Theory was developed for this purpose involving wind attenuation and turbulent diffusion. Experiments were performed on a large flow-through spray canal involving segments with two types of floating spray modules. Previous experimental data are available for a fixed manifolded spray pond. A comparison of theory and experiments shows reasonable agreement.
Influence of the Side Walls on the Turbulent Center-Plane Boundary-Layer in a Square Duct
Authors: de Brederode V. , Bradshaw P.
Published: October 2010

Measurements in the entry region of a square duct (specifically, a wind-tunnel working section) show that the direct effect of stress-induced secondary flows in the corners on the center-plane boundary layer is negligible for boundary layers thinner than about one-fourth of the duct width. Further, the effects of streamwise pressure gradient and of quasi-collinear lateral convergence tend to cancel so that the velocity profiles and skin friction are quite close to those on a flat plate. This shows that the boundary layer on the floor of a wind tunnel of constant, square cross section can be used to simulate a flat-plate flow even when the boundary layer thickness is as large as one-fourth of the tunnel height.
Leading-Edge Correction for the Supercavitating Flat-Plate Hydrofoil
Authors: Plotkin Allen
Published: October 2010

A leading-edge correction is obtained via the method of matched asymptotic expansions to the first-order linearized solution for the potential flow past a supercavitating flat-plate hydrofoil at zero cavitation number. The composite expansions for the pressure on the plate and the shape of the upper cavity are seen to compare well with the exact solution due to Rayleigh.
Predicting the Thermal Conductivity of Foam Neoprene at Elevated Ambient Pressure
Authors: Bardy Erik , Mollendorf Joseph
Published: October 2010

The purpose of this paper is to present a correlation for predicting the thermal conductivity of foam neoprene at varying ambient pressure. In a previous study, the authors used well-known upper and lower bounds to develop the form of a semi-empirical correlation for the thermal conductivity of foam neoprene as a function of increasing ambient pressure. The correlation was in terms of three constants, which were determined by performing a nonlinear regression on experimentally measured thermal conductivity values of foam neoprene insulation at varying ambient pressure. In this present paper, we show that the three correlation constants can, alternately, be determined by using values of the constituent thermal conductivities (e.g., air and rubber) and the effective thermal conductivity at one pressure point only (reference pressure). Values predicted using the correlation were compared with previously measured values of the effective thermal conductivity of foam neoprene insulation under increased ambient pressure, up to 1.18 MPa. It was found that there was a maximum difference of approximately 14% between the predicted and measured values. It was also found that the accuracy of the correlation did not depend strongly on the reference pressure used. It was therefore concluded that the effective thermal conductivity of foam neoprene, as a function of increasing ambient pressure, can be predicted if the constituent thermal conductivities are known (air and rubber), as well as the effective thermal conductivity at one reference pressure.
Flow and Thermal Investigation of a Groove-Enhanced Minichannel Application
Authors: Solovitz Stephen A. , Conder Thomas E.
Published: October 2010

A grooved surface feature is considered as a potential thermal enhancement for electronics cooling with single-phase flow in minichannels. A power electronics module was initially designed using applied computational fluid dynamics (CFD) using a minichannel featuring a series of two-dimensional grooves. To validate these simulations, micro–particle image velocimetry (PIV) was used to examine the flow field at a turbulent Reynolds number of 5000. The velocity distribution was compared directly to CFD simulations of the same geometry. The flow structures matched quantitatively near the groove leading edge and on its windward side, but the flow speeds were significantly underpredicted on the leeward side, deviating by as much as 30% of the freestream speed. This discrepancy was attributable to the selection of the turbulence model in the simulations, which was determined using the micro-PIV results. Using a validated CFD model, simulations predict thermal enhancements on the order of 35%.