bluuebunny/crossref_metadata_2025_split huggingface dataset:
Providers Do Not Verify Patient Identity during Computer Order Entry
Authors: Henneman Philip L. , Fisher Donald L. , Henneman Elizabeth A. , Pham Tuan A. , Mei Yi Y. , Talati Rakesh , Nathanson Brian H. , Roche Joan 
Published: July 2008

AbstractIntroduction:  Improving patient identification (ID), by using two identifiers, is a Joint Commission safety goal. Appropriate identifiers include name, date of birth (DOB), or medical record number (MRN).Objectives:  The objectives were to determine the frequency of verifying patient ID during computerized provider order entry (CPOE).Methods:  This was a prospective study using simulated scenarios with an eye‐tracking device. Medical providers were asked to review 10 charts (scenarios), select the patient from a computer alphabetical list, and order tests. Two scenarios had embedded ID errors compared to the computer (incorrect DOB or misspelled last name), and a third had a potential error (second patient on alphabetical list with same last name). Providers were not aware the focus was patient ID. Verifying patient ID was defined as looking at name and either DOB or MRN on the computer.Results:  Twenty‐five of 25 providers (100%; 95% confidence interval [CI] = 86% to 100%) selected the correct patient when there was a second patient with the same last name. Two of 25 (8%; 95% CI = 1% to 26%) noted the DOB error; the remaining 23 ordered tests on an incorrect patient. One of 25 (4%, 95% CI = 0% to 20%) noted the last name error; 12 ordered tests on an incorrect patient. No participant (0%, 0/107; 95% CI = 0% to 3%) verified patient ID by looking at MRN prior to selecting a patient from the alphabetical list. Twenty‐three percent (45/200; 95% CI = 17% to 29%) verified patient ID prior to ordering tests.Conclusions:  Medical providers often miss ID errors and infrequently verify patient ID with two identifiers during CPOE.ACADEMIC EMERGENCY MEDICINE 2008; 15:1–8 © 2008 by the Society for Academic Emergency Medicine
The Eight Cs: A Guide to Success in an International Emergency Medicine Educational Collaboration
Authors: Weiner Scott G. , Kelly Sean P. , Rosen Peter , Ban Kevin M. 
Published: July 2008

AbstractThe Tuscan Emergency Medicine Initiative (TEMI) is a comprehensive emergency medicine (EM) training program designed to build an EM training infrastructure in Tuscany, Italy. The program has successfully trained a team of instructors using a train‐the‐trainers model, certified 350 physicians who are already practicing in emergency departments (EDs), and established a master’s program as a bridge to specialty training at the region’s three universities. Using lessons learned from this program, the authors identify eight factors (The Eight Cs) that can serve as a guide to implementing a collaborative EM program in other environments: collaboration, context, culture, credibility, consulting, consistency, critique, and conclusion. Each of these topics is described in detail and may be useful to other international interventions.ACADEMIC EMERGENCY MEDICINE 2008; 15:1–5 © 2008 by the Society for Academic Emergency Medicine
An Assessment of the Faculty Development Needs of Junior Clinical Faculty in Emergency Medicine
Authors: Farley Heather , Casaletto Jennifer , Ankel Felix , Young Kelly D. , Hockberger Robert 
Published: July 2008

AbstractObjectives:  Academic physicians must be able to access the resources necessary to support their ongoing professional development and meet requirements for continued academic advancement. The authors sought to determine the self‐perceived career development needs of junior clinical faculty in emergency medicine (EM) and the availability of educational resources to meet those needs.Methods:  An educational “needs assessment” survey was distributed to 954 American College of Emergency Physicians (ACEP) members listed in the ACEP database as being faculty at EM residency programs in the United States and having graduated from an EM residency within the past 7 years. Respondents were asked to rank the importance of 22 areas of faculty development to their own professional growth and then to indicate whether educational resources in each area were available to them. Respondents were also asked to note the educational formats they prefer. A search for currently available resources in each topic area was undertaken and compared to the survey results.Results:  A total of 240 responses were received. Self‐perceived career development needs were identified in the following areas: bedside teaching, lecture development, business skills, managerial skills, educational research, mentorship and career counseling, interpersonal skills, leadership skills, scholarly writing skills, physician wellness, and knowledge of the faculty development process. While a review of currently available educational resources revealed lectures, conferences, and online materials pertinent to most of these topics, a relative lack of resources in the areas of mentorship and physician wellness was identified.Conclusions:  Junior clinical faculty in EM perceive a lack of educational resources in a number of areas of faculty development. The academic community of EM should strive to improve awareness of and access to currently existing resources and to develop additional resources to address the area of physician wellness. The lack of mentorship in academic EM continues to be a problem in search of a solution.ACADEMIC EMERGENCY MEDICINE 2008; 15:1–5 © 2008 by the Society for Academic Emergency Medicine
Emergency Department Case‐finding for High‐risk Older Adults: The Brief Risk Identification for Geriatric Health Tool (BRIGHT)
Authors: Boyd Michal , Koziol‐McLain Jane , Yates Kim , Kerse Ngaire , McLean Chris , Pilcher Carole , Robb Gillian 
Published: July 2008

AbstractObjective:  The objective was to test the ability of the Brief Risk Identification for Geriatric Health Tool (BRIGHT) to identify older emergency department (ED) patients with functional and physical impairment.Methods:  This was a cross‐sectional study in which 139 persons ≥75 years, who presented to an urban New Zealand ED over a 12‐week period, completed the 11‐item BRIGHT case‐finding tool. Then, within 10 days of their index ED visit, 114 persons completed a comprehensive geriatric assessment. A “yes” response to at least 3 of the 11 BRIGHT items was considered “positive.” Primary outcome measures were instrumental activities of daily living (IADL), cognitive performance scale (CPS), and activities of daily living (ADL).Results:  The BRIGHT‐identified IADL deficit (64% prevalence) with a sensitivity of 0.76, specificity of 0.79, and receiver operating characteristic (ROC) of 0.83 (95% confidence interval [CI] = 0.74 to 0.91, p < 0.01); cognitive deficit (35% prevalence) sensitivity of 0.78, specificity of 0.54, and ROC of 0.66 (95% CI = 0.55 to 0.76, p = 0.006); and ADL deficit (29% prevalence) sensitivity of 0.83, specificity of 0.53, and ROC of 0.64 (95% CI = 0.53 to 0.75, p = 0.020). Positive likelihood ratios (LR+) for the three outcomes of interest were 3.6, 1.7, and 1.8, respectively. Negative likelihood ratios (LR−) were 0.3, 0.4, and 0.3.Conclusions:  The 11‐item BRIGHT successfully identifies older adults in the ED with decreased function and may be useful in differentiating elder patients in need of comprehensive assessment.ACADEMIC EMERGENCY MEDICINE 2008; 15:598–606 © 2008 by the Society for Academic Emergency Medicine
Actual Financial Comparison of Four Strategies to Evaluate Patients with Potential Acute Coronary Syndromes
Authors: Chang Anna Marie , Shofer Frances S. , Weiner Mark G. , Synnestvedt Marie B. , Litt Harold I. , Baxt William G. , Hollander Judd E. 
Published: July 2008

AbstractObjectives:  Small studies have shown that a negative computed tomography coronary angiogram (CTA) in low‐risk chest pain patients predicts a low rate of 30‐day adverse events. The authors hypothesized that an immediate CTA strategy would be as effective but less costly than alternative strategies for evaluation of patients with potential acute coronary syndrome (ACS).Methods:  The authors retrospectively compared four strategies for evaluation of patients after initial physician determination that the patient required admission and testing to rule out ACS. Patients were frequency‐matched by age, race, gender, thrombolysis in myocardial infarction (TIMI) score, and initial electrocardiogram (ECG). The four groups were immediate CTA in the emergency department (ED) without serial markers (n = 98); clinical decision unit/observation unit (CDU) with biomarkers and CTA (n = 102); CDU evaluation with serial cardiac biomarkers and stress testing (n = 154); and usual care, defined as admission with serial biomarkers and hospitalist‐directed evaluation (n = 289). The main outcomes were actual cost of care (facility direct and indirect fixed, facility variable direct labor and supply costs), length of stay (LOS), diagnosis of coronary artery disease (CAD), and safety (30‐day death or myocardial infarction [MI]).Results:  Patients in each group were of similar age (mean ± standard deviation [SD] 46 ± 9 years), race (62% African American), and gender (57% female) and had similar TIMI scores (100% between 0–2). Comparing immediate CTA versus CDU CTA versus CDU stress versus usual care, median costs were less ($1,240 vs. 2,318 vs. 4,024 vs. 2,913; p < 0.01), and LOS was shorter (8.1 hr vs. 20.9 hr vs. 26.2 hr vs. 30.2 hr; p < 0.01). Diagnosis of CAD was similar (5.1% vs. 5.9% vs. 5.8% vs. 6.6%; p = 0.95), but fewer patients had 30‐day death/MI (0% vs. 0% vs. 0.7% vs. 3.1%; p = 0.04) or 30‐day readmission (0% vs. 3.2% vs. 2.3% vs. 12.2%; p < 0.01).Conclusions:  Compared to the other strategies, immediate CTA was as safe, identified as many patients with CAD, had the lowest cost, had the shortest LOS, and allowed discharge for the majority of patients. Larger prospective studies should confirm safety before immediate CTA replaces other strategies to rule out possible ACS.ACADEMIC EMERGENCY MEDICINE 2008; 15:649–655 © 2008 by the Society for Academic Emergency Medicine
Comparison of Adverse Events during Procedural Sedation between Specially Trained Pediatric Residents and Pediatric Emergency Physicians in Israel
Authors: Shavit Itai , Steiner Ivan P , Idelman Sigalit , Mosleh Mohamed , Hadash Amir , Biniamini Lilach , Lezinger Mirit , Kozer Eran 
Published: July 2008

AbstractObjectives:  The aim was to compare the rate of procedural sedation–related adverse events of pediatric residents with specific training in “patient safety during sedation” and pediatric emergency physicians (PEPs) who completed the same course or were teaching faculty for it.Methods:  This prospective single‐blinded, nonrandomized study was conducted in two university‐affiliated pediatric emergency departments (PEDs) in Israel. Pediatric residents who were authorized to perform unsupervised sedations had previously completed a course in patient safety during sedation. Unsupervised sedations by residents were defined as sedations where the entire procedure was performed independently. Study subjects had autonomy in choosing medications for sedation. Adverse events were defined as transient hypoxia (oxygen saturation ≤ 90%) or apnea. Adverse outcomes were situations where intubation or hospitalization directly related to sedation complications would occur. Sedations over 12 consecutive months were recorded, and rates of adverse events in each group were compared.Results:  A total of 984 eligible sedations were recorded, 635 by unsupervised residents and 349 by PEPs. A total of 512 (80.6%) sedations were performed by residents when attending physicians were not in the ED. The total adverse event rate was 24/984 (2.44%). When the two groups used a similar type drugs, residents had 8/635 (1.26%) events, compared to 11/328 (3.35%) by PEPs. There was no statistically significant difference in the rates of hypoxia or apnea between the two groups (p = 0.29 and p = 0.18, respectively). Adverse outcomes did not occur.Conclusions:  Unsupervised pediatric residents with training in patient safety during sedation performed procedural sedations with a rate of adverse events similar to that of PEPs.ACADEMIC EMERGENCY MEDICINE 2008; 15:1–6 © 2008 by the Society for Academic Emergency Medicine
Inappropriate Use of Antibiotics for Acute Asthma in United States Emergency Departments
Authors: Vanderweil Stefan G. , Tsai Chu‐Lin , Pelletier Andrea J. , Espinola Janice A. , Sullivan Ashley F. , Blumenthal David , Camargo Jr Carlos A. 
Published: July 2008

AbstractObjectives: The aim was to examine the use of antibiotics to treat asthma patients in U.S. emergency departments (EDs). The authors sought to investigate inappropriate antibiotic prescriptions by identifying the frequency and predictors of antibiotics prescribed for asthma exacerbations using data from two sources, the National Hospital Ambulatory Medical Care Survey (NHAMCS) and the National Emergency Department Safety Study (NEDSS).Methods: The authors used data from NHAMCS and NEDSS to identify the proportion of ED visits for asthma exacerbations that resulted in the prescription of an antibiotic. NHAMCS provided national data from 1993 through 2004, while NEDSS provided data from 63 primarily academic EDs from 2003 through 2006. Univariate analysis and multivariate logistic regression modeling were used to identify variables associated with antibiotic administration.Results: Analysis of NHAMCS data revealed that 22% (95% confidence interval [CI] = 20% to 24%) of acute asthma visits resulted in an antibiotic prescription from 1993 through 2004, with no significant change in prescribing frequency over the 12‐year period. NEDSS data from 2003 through 2006 showed that 18% (95% CI = 17% to 19%) of acute asthma cases in academic EDs received an antibiotic. Multivariate modeling of NHAMCS data revealed that African American patients (odds ratio [OR] = 0.8; 95% CI = 0.6 to 0.97) and patients in urban EDs (OR = 0.5; 95% CI = 0.4 to 0.7) were less likely to receive antibiotics for asthma exacerbations than white patients and patients in nonurban EDs, respectively. NHAMCS analysis also found that patients in the South were more likely to receive antibiotics than those in the Northeast (OR = 1.4; 95% CI = 1.1 to 1.9). A NEDSS multivariate model found a similar difference, with African Americans (OR = 0.6; 95% CI = 0.4 to 0.8) and Hispanics (OR = 0.6; 95% CI = 0.4 to 0.8) being less likely than whites to receive an antibiotic.Conclusions: ED treatment of acute asthma with unnecessary antibiotics is likely to contribute to bacterial antibiotic resistance. Interventions are needed to reduce inappropriate antibiotic prescriptions and to address disparities in asthma care.
Impact of integrated pest management on food and horticultural crops in Africa
Authors: Nwilene F. E. , Nwanze K. F. , Youdeowei A. 
Published: July 2008

AbstractIn sustainable agricultural development, integrated pest management (IPM) can play a key role in the reduction of crop losses, thereby increasing productivity while minimizing environmental contamination and health hazards. In recent years, agricultural research and development partners have pioneered outstanding contributions in IPM, notably in varietal resistance against pests, biological control of alien invasive species, substitution of inorganic pesticides with biopesticides, new export market opportunities, and new tools in biotechnology. Success stories are not limited to these areas, but are also found in the areas of human capital development, information management, and participatory approaches. The potential of IPM to contribute to poverty alleviation and food security is, however, poorly realized in Africa due to a myriad of factors, including inadequate deployment of high‐yielding crop varieties, harmful pesticide regimes, political instability, conflicts in social values and civil wars, inappropriate agricultural policies, biased global trade policies, lack of market information, and poor rural infrastructures. Few African countries have adopted IPM as the official national crop protection policy and there is no framework for resource allocation to support widespread promotion of research and training in IPM. This calls for reshaping and revisiting a number of policies related to food production and agricultural development, in order to encourage partnership and participation in the identification, analysis, advocacy, and follow‐up of agricultural policy issues as well as public awareness of the effect of pests and diseases on food security and the environment.
Intrinsic competition between the parasitoids Eretmocerus mundus and Encarsia formosa in Bemisia tabaci
Authors: Moretti Riccardo , Calvitti Maurizio 
Published: July 2008

AbstractImmature stages of Eretmocerus mundus Mercet and Encarsia formosa Gahan (both Hymenoptera: Aphelinidae) compete in larvae of their host, Bemisia tabaci (Gennadius) (Homoptera: Aleyrodidae). Laboratory tests were carried out on excised tree tobacco leaves, exposing B. tabaci nymphs to one of the parasitoid species alone or to both species, one after the other, to obtain multi‐parasitization. Parasitization by E. mundus and E. formosa was allowed on specific host stages in order to obtain interactions between different immature stages of the two parasitoids (eggs, and first, second, and third instars). The outcome from each multi‐parasitization treatment was verified by analysing data on parasitoid adult emergence. Observations under a stereomicroscope and dissections of multi‐parasitized hosts were also performed in order to demonstrate any factors potentially determining the outcome of competition. Eretmocerus mundus clearly prevailed over E. formosa when multi‐parasitism occurred. A higher percentage of adults emerging from multi‐parasitized hosts belonged to this parasitoid species (68.0–88.9% depending on the treatment). The lowest percent emergence by E. mundus (68.0%) and total percent emergence of parasitoid adults (52.2%) were obtained when E. mundus first instars interacted with hosts parasitized by E. formosa third instars. Observations and dissections showed that first‐instar E. mundus induced mortality in E. formosa immatures at penetration into the hosts, although they encountered greater difficulty in exploiting hosts inside which E. formosa had reached the third stage of development. In contrast, development of E. formosa immatures was not immediately inhibited if parasitization took place on hosts inside which E. mundus larvae had already penetrated. In this case, however, E. mundus also prevailed over E. formosa (72.5% of the emerged adults). Implications for the use of these parasitoid species against B. tabaci in biological control programmes are discussed.
The cost of defense in social insects: insights from the honey bee
Authors: Rivera‐Marchand Bert , Giray Tugrul , Guzmán‐Novoa Ernesto 
Published: July 2008

AbstractDefense is one of the most important factors affecting life history. The relationship of defense to life history traits as well as its possible costs has been reviewed extensively for many groups, including plants. However, defense in social insects, such as honey bees, has never been examined from a trade‐off perspective, although defense in honey bees, Apis mellifera L. (Hymenoptera: Apidae), has been widely studied. In this review, we discuss the life history traits of honey bees, particularly traits related to defense. We then examine trade‐offs in the context of resource availability. Lastly, we offer suggestions for future research on trade‐offs in honey bees and other social insects.
Effect of anti‐hail nets on Cydia pomonella behavior in apple orchards
Authors: Tasin Marco , Demaria Daniele , Ryne Camilla , Cesano Alessandro , Galliano Aldo , Anfora Gianfranco , Ioriatti Claudio , Alma Alberto 
Published: July 2008

AbstractOver the last 10 years, the use of nets to protect pome fruit from hailstorms has increased. In this study, we investigated the effect of these nets on the behavior of the codling moth, Cydia pomonella (L.) (Lepidoptera: Tortricidae), a major pest of apple, Malus domestica Borkh. (Rosaceae). Experiments were carried out in net‐covered and uncovered apple orchards treated with conventional insecticides. The number of codling moth males caught in pheromone‐ and virgin female‐baited traps was significantly reduced in net‐covered compared to uncovered plots. In addition, inhibition of mating by the net was demonstrated by significant reductions in mating of tethered virgin females. Fruit injury was consistently lower in net‐covered plots vs. uncovered plots. Because of the reductions in male trap catch, the reduced female mating frequency, and the lower level of damage, we conclude that flat anti‐hail nets have a disruptive effect on the reproductive behavior of the codling moth.
Reframing Sacred Values
Authors: Atran Scott , Axelrod Robert 
Published: July 2008

Sacred values differ from material or instrumental values in that they incorporate moral beliefs that drive action in ways dissociated from prospects for success. Across the world, people believe that devotion to essential or core values — such as the welfare of their family and country, or their commitment to religion, honor, and justice — are, or ought to be, absolute and inviolable.Counterintuitively, understanding an opponent's sacred values, we believe, offers surprising opportunities for breakthroughs to peace. Because of the emotional unwillingness of those in conflict situations to negotiate sacred values, conventional wisdom suggests that negotiators should either leave sacred values for last in political negotiations or should try to bypass them with sufficient material incentives. Our empirical findings and historical analysis suggest that conventional wisdom is wrong. In fact, offering to provide material benefits in exchange for giving up a sacred value actually makes settlement more difficult because people see the offering as an insult rather than a compromise. But we also found that making symbolic concessions of no apparent material benefit might open the way to resolving seemingly irresolvable conflicts.We offer suggestions for how negotiators can reframe their position by demonstrating respect and/or by apologizing for what they sincerely regret. We also offer suggestions for how to overcome barriers by refining sacred values to exclude outmoded claims, exploiting the inevitable ambiguity of sacred values, shifting the context, provisionally prioritizing values, and reframing responsibility.
Juvenile‐onset OCD: clinical features in children, adolescents and adults
Authors: Mancebo M. C. , Garcia A. M. , Pinto A. , Freeman J. B. , Przeworski A. , Stout R. , Kane J. S. , Eisen J. L. , Rasmussen S. A. 
Published: July 2008

Objective:  To examine clinical correlates of juvenile‐onset OCD across the lifespan.Method:  Data collected at the intake interview from 257 consecutive participants with juvenile‐onset OCD (20 children, 44 adolescents and 193 adults) in a naturalistic study of the clinical course of OCD were examined. Participants and parents of juvenile participants completed a structured diagnostic interview, rater‐administered severity measures and self‐report questionnaires.Results:  Children and adolescents (i.e. juveniles) shared similar features with the exception of age at onset and OCD symptom expression. Clinically meaningful differences between juvenile and adult participants were also found. Compared with adults, juveniles were more likely to be male, recall an earlier age at OCD onset and have different lifetime comorbidity patterns.Conclusion:  Juvenile‐onset OCD symptom expression is remarkably similar across the lifespan. However, findings also suggest clinically meaningful differences between juveniles and adults. Future work using a prospective design will improve our understanding of course patterns of juvenile‐onset OCD.