bluuebunny/crossref_metadata_2025_split huggingface dataset:
Modelling detection probabilities to evaluate management and control tools for an invasive species
Authors: Christy Michelle T. , Yackel Adams Amy A. , Rodda Gordon H. , Savidge Julie A. , Tyrrell Claudine L. 
Published: December 2009

Summary 1. For most ecologists, detection probability (p) is a nuisance variable that must be modelled to estimate the state variable of interest (i.e. survival, abundance, or occupancy). However, in the realm of invasive species control, the rate of detection and removal is the rate‐limiting step for management of this pervasive environmental problem. 2. For strategic planning of an eradication (removal of every individual), one must identify the least likely individual to be removed, and determine the probability of removing it. 3. To evaluate visual searching as a control tool for populations of the invasive brown treesnake Boiga irregularis, we designed a mark–recapture study to evaluate detection probability as a function of time, gender, size, body condition, recent detection history, residency status, searcher team and environmental covariates. 4. We evaluated these factors using 654 captures resulting from visual detections of 117 snakes residing in a 5‐ha semi‐forested enclosure on Guam, fenced to prevent immigration and emigration of snakes but not their prey. Visual detection probability was low overall ( = 0·07 per occasion) but reached 0·18 under optimal circumstances. 5. Our results supported sex‐specific differences in detectability that were a quadratic function of size, with both small and large females having lower detection probabilities than males of those sizes. There was strong evidence for individual periodic changes in detectability of a few days duration, roughly doubling detection probability (comparing peak to non‐elevated detections). Snakes in poor body condition had estimated mean detection probabilities greater than snakes with high body condition. Search teams with high average detection rates exhibited detection probabilities about twice that of search teams with low average detection rates. Surveys conducted with bright moonlight and strong wind gusts exhibited moderately decreased probabilities of detecting snakes. 6.
Synthesis and applications. By emphasizing and modelling detection probabilities, we now know: (i) that eradication of this species by searching is possible, (ii) how much searching effort would be required, (iii) under what environmental conditions searching would be most efficient, and (iv) several factors that are likely to modulate this quantification when searching is applied to new areas. The same approach can be use for evaluation of any control technology or population monitoring programme.
Assessing ethical trade‐offs in ecological field studies
Authors: Parris Kirsten M. , McCall Sarah C. , McCarthy Michael A. , Minteer Ben A. , Steele Katie , Bekessy Sarah , Medvecky Fabien 
Published: December 2009

Summary1.Ecologists and conservation biologists consider many issues when designing a field study, such as the expected value of the data, the interests of the study species, the welfare of individual organisms and the cost of the project. These different issues or values often conflict; however, neither animal ethics nor environmental ethics provides practical guidance on how to assess trade‐offs between them.2.We developed a decision framework for considering trade‐offs between values in ecological research, drawing on the field of ecological ethics. We used a case study of the population genetics of three frog species, in which a researcher must choose between four methods of sampling DNA from the study animals. We measured species welfare as the reduction in population growth rate following sampling, and assessed individual welfare using two different definitions: (i) the level of suffering experienced by an animal, and (ii) the level of suffering combined with loss of future life.3.Tipping the tails of tadpoles ranked as the best sampling method for species welfare, while collecting whole tadpoles and buccal swabbing of adult frogs ranked best for the first and second definitions of individual welfare, respectively. Toe clipping of adult frogs ranked as the worst sampling method for species welfare and the first definition of individual welfare, and equal worst for the second definition of individual welfare.4.When considering species and individual welfare simultaneously, toe clipping was clearly inferior to the other sampling methods, but no single sampling method was clearly superior to the other three. Buccal swabbing, collecting tadpoles and tail tipping were all preferred options, depending on the definition of individual welfare and the level of precision with which we assessed species welfare.5.Synthesis and applications. The decision framework we present can be used by ecologists to assess ethical and other trade‐offs when planning field studies. A formal decision analysis makes transparent how a researcher might negotiate competing ethical, financial and practical objectives. Defining the components of the decision in this way can help avoid errors associated with human judgement and linguistic uncertainty.
Empirical comparison of density estimators for large carnivores
Authors: Obbard Martyn E. , Howe Eric J. , Kyle Christopher J. 
Published: December 2009

Summary 1. Population density is a critical ecological parameter informing effective wildlife management and conservation decisions. Density is often estimated by dividing capture–recapture (C–R) estimates of abundance () by size of the study area, but this relies on the assumption of geographic closure – a situation rarely achieved in studies of large carnivores. For geographically open populations is overestimated relative to the size of the study area because animals with only part of their home range on the study area are available for capture. This bias (‘edge effect’) is more severe when animals such as large carnivores range widely. To compensate for edge effect, a boundary strip around the trap array is commonly included when estimating the effective trap area (). Various methods for estimating the width of the boundary strip are proposed, but / estimates of large carnivore density are generally mistrusted unless concurrent telemetry data are available to define. Remote sampling by cameras or hair snags may reduce study costs and duration, yet without telemetry data inflated density estimates remain problematic. 2. We evaluated recently developed spatially explicit capture–recapture (SECR) models using data from a common large carnivore, the American black bear Ursus americanus, obtained by remote sampling of 11 geographically open populations. These models permit direct estimation of population density from C–R data without assuming geographic closure. We compared estimates derived using this approach to those derived using conventional approaches that estimate density as /. 3. Spatially explicit C–R estimates were 20–200% lower than densities estimated as /. AICc supported individual heterogeneity in capture probabilities and home range sizes. Variable home range size could not be accounted for when estimating density as /. 4.
Synthesis and applications. We conclude that the higher densities estimated as / compared to estimates from SECR models are consistent with positive bias due to edge effects in the former. Inflated density estimates could lead to management decisions placing threatened or endangered large carnivores at greater risk. Such decisions could be avoided by estimating density by SECR when bias due to geographic closure violation cannot be minimized by study design.
Therapeutic reasoning: from hiatus to hypothetical model
Authors: Bissessur Sanjay W. , Geijteman Eric C. T. , Al‐Dulaimy Muhammad , Teunissen Pim. W. , Richir Milan C. , Arnold Alf E. R. , De Vries Thep P. G. M. 
Published: December 2009

Abstract
Rationale  Extensive research has been conducted on clinical reasoning to gain better understanding of this process. Clinical reasoning has been defined as the process of thinking critically about the diagnosis and patient management. However, most research has focused on the process of diagnostic reasoning. Because of the lack of understanding regarding therapeutic reasoning, education in patient management decisions lacks a solid theoretical basis.
Aims and objective  To improve medical education, training and refresher courses with regard to therapeutic decision making.
Methods  A search on the literature about clinical reasoning has been conducted. Based on this literature a hypothetical model of therapeutic reasoning is developed.
Results  It is assumed on the literature about diagnostic and therapeutic reasoning that after the diagnosis has been formulated, the process of determining the therapy is initiated by a concept called the therapy script. Patient cases unconsciously elicit such scripts and they consist of relevant treatments, knowledge and clinical experiences. Analytical and non‐analytical processes determine the final choice of therapy. Subsequently, these processes adapt the therapy script continuously.
Conclusions  A hypothetical model of therapeutic reasoning has been developed in order to improve medical education, training and refresher courses with regard to therapeutic decision making. Future research should empirically test the validity of this hypothetical model in different phases of the medical education continuum.
Systematic reviews to support evidence‐based psychiatry: what about schizophrenia?
Authors: Morlino Massimo , Calento Antonio , Pannone Gennaro , Ventrella Gianluca , Schiavone Vittorio 
Published: December 2009

Abstract
Objective  To assess whether systematic reviews (SRs), the gold standard for scientific research, can offer valuable support in evidence‐based psychiatry in the treatment of schizophrenia.
Methods  We used three database services (Ovid, PubMed and Cochrane) to identify SRs related to schizophrenia, found 163 reviews and grouped them by topic. We then evaluated each study's conclusions and divided them into three groups based on results (ranging from certain to null conclusions).
Results  SRs of pharmacological treatments represented 59% of the studies sampled, only 23% of which had reached certain conclusions. Other clinical topics were less frequently represented and had achieved lower degrees of certainty.
Conclusions  Only 40 SRs (22 studies investigating pharmacological treatment) provided clear‐cut answers to clinical questions examined. Results therefore showed that SRs provide a certain but rather limited contribution to scientific evidence in the field of schizophrenia.
Practice guideline adherence and health care outcomes – use of prophylactic antibiotics during surgery in Taiwan
Authors: Hsu Chentong , Cheng Shou‐Hsia 
Published: December 2009

Abstract
Rationale, aims and objectives  To evaluate adherence to guidelines for prophylactic antibiotic use in total knee replacement (TKR) and total hip replacement (THR) procedures and to examine the associations between guideline adherence and health care outcomes.
Methods  Using nationwide health insurance claims data, all adult inpatients undergoing TKR or THR procedures at teaching hospitals from 2002 to 2006, were included. Guideline adherence rates were assessed every year according to the national guidelines introduced in 2004. Multiple regression analyses with generalized estimating equations models were used to examine the relationships between the deliberate variables.
Results  The guideline adherence rates stably increased from 14.07% in 2002 to 28.34% in 2006. The 2006 dataset included 12 863 observations. The results revealed that guideline adherence was negatively associated with length of stay and health care expenses with β = −0.0207 and −0.0087, respectively (P < 0.0001). The 30‐day readmission rate was 1.54% among the patients seen in 2006, and it was significantly different between the two groups, with 0.90% of the adherence group and 1.82% of the non‐adherence group being readmitted (P = 0.0002).
Conclusions  The guideline adherence for prophylactic use of antibiotics is improving in Taiwan and is associated with a shorter length of stay, fewer medical expenses and lower 30‐day readmission rates. Promoting evidence‐based practice guidelines may be beneficial to patients and health care providers.
Balancing health care evidence and art to meet clinical needs: policymakers' perspectives
Authors: Parker Louise E. , Ritchie Mona J. , Kirchner JoAnn E. , Owen Richard R. 
Published: December 2009

Abstract
Rationale, aims and objectives  Although many believe that evidence‐based practice (EBP) has great potential, critics have identified limitations including a focus on randomized clinical trial (RCT) evidence to the exclusion of other evidence types and a disregard for the art of medicine. Others have argued, however, that proper application of EBP involves reasoned consideration of a wide variety of information; thus, the dichotomy between medical science and art may be false. We explore the views of executive‐level policymakers from the Veterans Health Administration, a leader in the EBP movement, regarding what constitutes evidence and the relative importance of evidence versus practical needs when determining clinical policy.
Method  We conducted 26 semi‐structured qualitative interviews and performed a content analysis.
Results  Although informants generally believed in the value of EBP and the role of RCTs within it, they also valued other types of evidence. Further, they had concerns that were sometimes antithetical with strict adherence to an evidence‐based approach. These included practical concerns, fit with organizational values and with local circumstances, resources, political pressures and patient needs. They were especially concerned about how to address medical conditions that affect many individuals or high‐risk populations that have no evidence‐based treatment.
Conclusion  When possible, health care practice should be evidence‐based. When this is not possible, health care providers must turn to the art of medicine by using consensus‐based best practices. Further, it is important for policymakers and researchers to work in concert to develop EBPs that are practical and meet needs.
A model for reflection for good clinical practice
Authors: Balla John I. , Heneghan Carl , Glasziou Paul , Thompson Matthew , Balla Margaret E. 
Published: December 2009

Abstract
Rationale and aim  The rapidly changing knowledge base of clinical practice highlights the need to keep abreast of knowledge changes that are most relevant for the practitioner. We aimed to develop a model for reflection on clinical practice that identified the key elements of medical knowledge needed for good medical practice.
Method  The dual theory of cognition, an integration of intuitive and analytic processes, provided the framework for the study. The design looked at the congruence between the clinical thinking process and the dual theory. A one‐year study was conducted in general practice clinics in Oxfordshire, UK. Thirty‐five general practitioners participated in 20‐minute interviews to discuss how they worked through recently seen clinical cases. Over a one‐year period 72 cases were recorded from 35 interviews. These were categorized according to emerging themes, which were manually coded and substantiated with verbatim quotations.
Results  There was a close fit between the dual theory and participants' clinical thinking processes. This included instant problem framing, consistent with automatic intuitive thinking, focusing on the risk and urgency of the case. Salient features accounting for these choices were recognizable. There was a second reflective phase, leading to the review of initial judgements.
Conclusions  The proposed model highlights the critical steps in decision making. This allows regular recalibration of knowledge that is most critical at each of these steps. In line with good practice, the model also links the crucial knowledge used in decision making, to value judgments made in relation to the patient.
How far did we get? How far to go? A European survey on postgraduate courses in evidence‐based medicine
Authors: Kunz Regina , Nagy Eva , Coppus Sjors F.P.J. , Emparanza Jose I. , Hadley Julie , Kulier Regina , Weinbrenner Susanne , Arvanitis Theodoros N. , Burls Amanda , Cabello Juan B. , Decsi Tamas , Horvath Andrea R. , Walzak Jacek , Kaczor Marcin P. , Zanrei Gianni , Pierer Karin , Schaffler Roland , Suter Katja , Mol Ben W.J. , Khan Khalid S. 
Published: December 2009

Abstract
Background  Over the past decade, evidence‐based medicine (EBM) has gained recognition as a means to improve the quality of health care provision. However, little is known about learning opportunities to acquire EBM‐associated skills. The EUebm‐Unity partnership explored current educational activities for EBM practice for doctors across Europe.
Methods  We surveyed organizations offering postgraduate EBM courses across Europe inquiring about their course programme, teaching content and strategies, and interest in a Europe‐wide curriculum in EBM.
Results  One hundred and fifty‐six organizers in eight European countries reported 403 courses that had started first‐time from 1996 to 2006. Despite a steady increase, in absolute terms, the frequency of courses was low and varied from 1 first‐time offering of a course per 640 doctors (Spain) to 1 first‐time offering per 5600 doctors (Austria) over 10 years. Most adopted the McMaster EBM teaching concept of small group, problem‐based learning focussing on interventions, diagnostic tests and guidelines, and included efforts to link EBM to patient care. Teaching staff consisted of doctors from academic and non‐academic settings, supported by methodologists. Efforts to formally integrate EBM in postgraduate activities were only partially successful. Most organizations welcomed a standardized European qualification in EBM. A limitation of the survey is the lack of follow‐up information about the continuation of courses following the first‐time offering.
Conclusions  All countries offer some EBM courses with varying teaching intensity. Learning opportunities are insufficient to ensure widespread dissemination of knowledge and skills. Most countries welcome more efforts to develop inexpensive and feasible educational activities at a postgraduate level.
Use of a computer‐based simulated consultation tool to assess whether doctors explore sociocultural factors during patient evaluation
Authors: Perron Noëlle Junod , Perneger Thomas , Kolly Véronique , Dao Melissa Dominicé , Sommer Johanna , Hudelson Patricia 
Published: December 2009

Abstract
Rationale, aims and objectives  The delivery of patient‐centred care to diverse populations requires that doctors identify sociocultural factors that may affect care. We adapted a computer‐based simulated consultation tool and tested its utility for assessing whether doctors explore sociocultural factors during a patient evaluation, and whether they include such information in their case conclusions and follow‐up recommendations.
Methods  We developed two detailed patient ‘stories’ that involved sociocultural issues that doctors needed to identify and consider for adequate clinical management. They were incorporated into an existing ‘Virtual Internet Patient Simulation’ (VIPS) program designed to test clinical reasoning skills. Doctors and medical students (n = 618) were invited to access the program via Internet. For each consultation, participants were assigned a sociocultural score, corresponding to the number of sociocultural domains explored. Scores were then compared with subjective ratings of participants' performance by expert doctors.
Results  118 respondents completed at least one virtual consultation (19%), 92 conducted both. The mean number of sociocultural dimensions explored by doctors (i.e. sociocultural score) was 3.9 (standard deviation 2.6) for case 1, and 5.2 (standard deviation 2.3) for case 2. The two sociocultural scores were moderately correlated (Spearman r = 0.65, P < 0.001). Sociocultural scores correlated positively with experts' subjective ratings of participants' performance (Spearman r = 0.84 for case 1 and 0.78 for case 2, both P < 0.001).
Conclusions  The adapted computer‐based simulated consultation tool provided a feasible means to assess doctors' exploration of sociocultural issues during a clinical evaluation. Further validation of this method should be conducted by comparing VIPS results with other skills assessment methods such as objective structured clinical examination or direct observation of clinical performance.
Inhospital management of COPD exacerbations: a systematic review of the literature with regard to adherence to international guidelines
Authors: Lodewijckx Cathy , Sermeus Walter , Vanhaecht Kris , Panella Massimiliano , Deneckere Svin , Leigheb Fabrizio , Decramer Marc 
Published: December 2009

Abstract
Rationale  Chronic obstructive pulmonary disease (COPD) exacerbations are a leading cause of hospitalization. Suboptimal inhospital management is expected to lead to more frequent exacerbations and recurrent hospital admission, and is associated with increased mortality.
Aims  To explore inhospital management of COPD and to compare the results with recommendations from international guidelines.
Methods  A literature search was carried out for relevant articles published 2000–2009 in the databases Medline, Cochrane Library, Cumulative Index for Nursing and Allied Health Literature and Invert. In addition, the reference lists of the selected articles were examined. Main inclusion criteria were as follows: COPD, exacerbation, hospitalization, description of inpatient management, and clinical trials. Assessment and treatment strategies in different studies were analysed and compared with American Thoracic Society‐European Respiratory Society and Global Initiative for Chronic Obstructive Lung Disease guidelines. Outcomes were analysed.
Results  Seven eligible studies were selected. Non‐pharmacological treatment was infrequently explored. When compared with international guidelines, diagnostic assessment and therapy were suboptimal, especially non‐pharmacological treatment. Respiratory physicians were more likely to perform recommended interventions than non‐respiratory physicians.
Conclusions  Adherence to international guidelines is low for inhospital management of COPD exacerbations, especially in terms of non‐pharmacological treatment. Further investigation is recommended to explore strategies like care pathways that improve performance of recommended interventions.
Translating research into practice: transitional care for older adults
Authors: Naylor Mary D. , Feldman Penny Hollander , Keating Stacen , Koren Mary Jane , Kurtzman Ellen T. , Maccoy Maureen C. , Krakauer Randall 
Published: December 2009

Abstract
Rationale  Over the last decade, in order to close the safety and health care quality chasm, there has been a growing imperative to translate evidence‐based research into practice.
Aims and Objectives  This study examines the major facilitators and barriers of implementing in a large US insurance organization – Aetna Corporation – an evidence‐based model of care, the Transitional Care Model, which has been rigorously tested over the past twenty years by a multidisciplinary team at the University of Pennsylvania.
Methods  Semi‐structured interviews of 19 project leaders, case managers, and transitional care nurses were conducted during two phases of translation – start‐up and roll out. Qualitative analysis was used to identify more than a dozen key barriers to and facilitators of translation in these two critical phases.
Results  Six facilitators and seven barriers that are consistent with the literature were identified during and categorized as either start‐up or roll‐out.
Conclusion  The combined results have important practical implications for other, subsequent translational efforts and for assisting providers, policy makers, payers, and other change agents in integrating evidence‐based practice with “real world” management.