bluuebunny/crossref_metadata_2025_split huggingface dataset:
Computerized Physician Order Entry and Online Decision Support
Authors: Handler Jonathan A. , Feied Craig F. , Coonan Kevin , Vozenilek John , Gillam Michael , Peacock Peter R. , Sinert Rich , Smith Mark S. 
Published: November 2004

AbstractComputerized physician order entry (CPOE) and decision support systems (DSS) can reduce certain types of error but often slow clinicians and may increase other types of error. The net effect of these systems on an emergency department (ED) is unknown. The consensus participants combined published evidence with expert opinion to outline recommendations for success. These include seamless integration of CPOE and DSS into systems and workflow; ensuring access to Internet‐based and other online support material in the clinical arena; designing systems specifically for the ED and measuring their impact to ensure an overall benefit; ensuring that CPOE systems provide error and interaction checking and facilitate weight‐ and physiology‐based dosing; using interruptive alerts only for the highest‐severity events; providing a simple, vendor‐independent interface for institutional customization of CPOE alert thresholds; maximizing the use of automated systems and passive data capture; and ensuring the widespread availability of CPOE and DSS using secure wireless and portable technologies where appropriate. Decisions regarding CPOE and DSS in the ED should be guided by the ED chair or designee. Much of what is believed to be true regarding CPOE and DSS has not been adequately studied. Additional CPOE and DSS research is needed quickly, and this research should receive funding priority. DSS and CPOE hold great promise to improve patient care, but not all systems are equal. Evidence must guide these efforts, and the measured outcomes must consider the many factors of quality care.
Supporting Clinical Practice at the Bedside Using Wireless Technology
Authors: Bullard Michael J. , Meurer David P. , Colman Ian , Holroyd Brian R. , Rowe Brian H. 
Published: November 2004

Abstract Objectives: Despite studies that show improvements in both standards of care and outcomes with the judicious application of clinical practice guidelines (CPGs), their clinical utilization remains low. This randomized controlled trial examined the use of a wirelessly networked mobile computer (MC) by physicians at the bedside with access to an emergency department information system, decision support tools (DSTs), and other software options. Methods: Each of ten volunteer emergency physicians was randomized using a matched‐pair design to work five shifts in standard fashion (desktop computer [DC] access) and five shifts with a wirelessly networked MC. Work pattern issues and electronic CPG/DST use were compared using end‐of‐shift satisfaction questionnaires and review of a CPG/DST database. Repeated‐measures analysis of variance was used to examine between‐shift differences. Results: A total of 100 eight‐hour shifts were evaluated; 99% compliance with postshift questionnaires was achieved. Using a seven‐point Likert scale (MC values first), MCs were rated as being as fast (5.04 vs. 4.54; p = 0.13) and convenient (5.08 vs. 4.14; p = 0.07) as DCs. Overall, physicians rated MCs to be less efficient (3.18 vs. 4.30; p = 0.02) but encouraged more frequent use of DSTs (4.10 vs. 3.47; p = 0.03) without impacting doctor–patient communication (2.78 vs. 2.96; p = 0.51). During the study period, physician use of an intranet Web application (eCPG) was more frequent during shifts assigned to the MC when compared with the DC (eCPG uses/shift, 3.6 vs. 2.0; p = 0.033). Conclusions: The MC technology permitted physicians to access information at the bedside and increased the use of CPG/DST tools. According to physicians, patients appeared to accept their use of information technology to assist in decision making. Development of improved computer technology may address the major limitation of MC portability.
Virtual TeleStroke Support for the Emergency Department Evaluation of Acute Stroke
Authors: Schwamm Lee H. , Rosenthal Eric S. , Hirshberg Alan , Schaefer Pamela W. , Little Elizabeth A. , Kvedar Joseph C. , Petkovska Iva , Koroshetz Walter J. , Levine Steven R. 
Published: November 2004

Abstract Objectives: Telemedicine‐enabled acute stroke consultation (TeleStroke) may be useful to determine eligibility for treatment with tissue plasminogen activator (tPA) and provide support to emergency departments without on‐site stroke expertise. Methods: Emergency physicians consulted with stroke neurologists via two‐way videoconferencing in the evaluation of patients with possible acute stroke. History, neurologic examination, and computed tomography of the head were reviewed to determine eligibility for treatment with tPA. Interpretations of computed tomography were compared for inter‐rater reliability between the neurologist and the neuroradiologist using a conventional workstation. Videotape and written records were analyzed to determine time intervals, patient management, and user satisfaction. Results: The authors reviewed data from 24 patients evaluated over 27 months at an island‐based hospital. The mean National Institutes of Health Stroke Scale score was 5.7 (range, 0–22). Fifteen patients arrived at the emergency department less than three hours after symptom onset; 12 were presented for TeleStroke consultation within three hours after symptom onset. Eight of these 12 (75%) had acute ischemic stroke, and six of these eight potentially eligible patients (75%) received intravenous tPA. There was very good agreement among all remote readers for detecting the one case of imaging exclusion (subdural hemorrhage). There were no protocol violations, and a mean (± SD) consult‐to‐needle time of 36 (± 15) minutes and door‐to‐needle time of 106 (± 22) minutes was achieved. Transfer was avoided in 11 patients. Physicians believed that TeleStroke consultation improved care in >95% of the cases. Conclusions: TeleStroke videoconferencing can support emergency department–based evaluation of acute stroke and may facilitate tPA delivery in neurologically underserved facilities. A prospective, randomized trial is needed to determine if these systems are superior to traditional telephone consultation.
Automating Research Data Collection
Authors: Shapiro Jason S. , Bessette Michael J. , Baumlin Kevin M. , Ragin Deborah Fish , Richardson Lynne D. 
Published: November 2004

AbstractThis article reviews the capabilities, advantages, and disadvantages of three forms of automated data collection—scannable data forms, Web‐based forms, and handheld computers—compared with the current standard of data entry by hand on paper forms. Each of these methods is reviewed with respect to ease of use, experience required of designer, end‐user training requirements, costs, flexibility, speed, accuracy/error rate, potential for data loss, need for technical support, and equipment and/or software requirements. A discussion of their appropriate application to various kinds of studies is included, followed by examples of research studies using each of these methods.
A fault-tolerant architecture for computer-based railway vehicle brake systems
Authors: Johansson R 
Published: November 2004

In this paper a computer architecture is presented which is suitable for distributed control systems where fault tolerance is desired. The architecture is designed for implementation mainly with standard components ‘off the shelf’ (COTS). In particular there is only a comparable small device called fault-tolerant communication control (FTCC) that requires extensive redundancy. The FTCC is used to close control loops as tightly to the controlled physical device as possible, gaining from the excess computing capacity that a distributed system offers but at the same time removing the impact of increased fault intensity from an increased number of processing elements. The architecture is preferable for applications where there is some kind of natural inherent redundancy. As a starting point, and also as a case, a state-of-the-art brake control system for railway vehicles is considered. Common computer architectures designed to handle safety-critical applications are recaptured and a feasible solution arrived at in the shape of a slightly modified distributed architecture. This revised distributed architecture is then applied and a revised brake control system is described. The FTCC device has been implemented, but without redundancy, with standard VHDL (very high speed integrated circuit hardware description language) tools and tested in a simulator environment. Results are promising and indicate that the FTCC device has a great potential in future ‘control-by-wire’ designs.
Growth of multiple rolling contact fatigue cracks driven by rail bending modelled using a boundary element technique
Authors: Fletcher D I , Hyde P , Kapoor A 
Published: November 2004

Examination of rails on which large rolling contact fatigue cracks have developed, either at the gauge corner or on the rail head, typically reveals that the cracks have not developed in isolation but occur at intervals along a length of track. Individual cracks are typically separated from one another by a few millimetres, although the reasons for this spacing between the cracks are not yet understood. This paper presents an investigation into the interaction between adjacent long cracks (tens of millimetres) that are at the beginning of their bending-stress-driven propagation phase. Results are presented as plots of stress intensity factor around crack fronts for single- and multiple-crack situations, for which crack growth rates are predicted. The work focuses particularly on the degree to which single-crack models may be misleading when dealing with a rail containing multiple cracks. The work has application in improving the modelling of crack growth in rails, leading to improved asset management and risk assessment.
Heat convection and design of brake discs
Authors: Sakamoto H 
Published: November 2004

An evaluation method of heat convection from brake discs using analytical and experimental approaches is described. Brake discs may be wheel or axle mounted and either ventilated or solid. The majority of brake discs are the ventilated type because of the cooling effect of the fins. In this study, the cooling efficiency of ventilated discs was investigated through the basic equation for heat convection, brake tests and measurements of the flow volume through the fins. It is concluded that a cooling rate parameter α [= (heat convection × convection area)/(specific heat × disc mass)] derived from the basic equation for heat convection can express the cooling efficiency of a disc. The parameter α can also be used to estimate the maximum temperature accumulated in a disc after several cycles of braking to a stop. As for the design of the brake discs, the heat convection area is more important than the thickness or number of fins. Also the air velocity through the fins should be taken into consideration.
Development and preliminary validation of the Glasgow Content of Thoughts Inventory (GCTI): A new measure for the assessment of pre‐sleep cognitive activity
Authors: Harvey Karen J. , Espie Colin A. 
Published: November 2004

Objective: To develop a self‐report measure (the Glasgow Content of Thoughts Inventory [GCTI]) for the assessment of pre‐sleep cognitive activity in adults with sleep‐onset insomnia.Design: A psychometric, scale development approach was used.Method: Over three consecutive nights, 12 people with insomnia provided ‘live’ audio‐recordings of pre‐sleep thought content, which were used to generate an item pool. The results were compared to the content and categorical structure of pre‐sleep cognitive activity identified by Wicklow and Espie (2000), and commonalities in thought content were used to generate a draft scale. Following further piloting, a 25‐item scale was developed and administered to two groups (29 people with insomnia and 29 good sleepers), along with other self‐report measures, objective (actigraphic recordings) and subjective (diary) sleep indices, and results analysed to evaluate the psychometric properties of the scale.Results: The GCTI demonstrated evidence of construct validity, successfully discriminated between individuals with insomnia and good sleepers, and was significantly correlated with existing measures of sleep disturbance. A score of 42 yielded a sensitivity of 100% and specificity of 83%. The GCTI demonstrated good test– retest reliability (ICC = .88) and internal consistency (α = .87).Conclusions: The GCTI appears to be a valid and reliable instrument for use with patients with sleep‐onset insomnia.
Illness representations in depression
Authors: Fortune Gillian , Barrowclough Christine , Lobban Fiona 
Published: November 2004

Background and objectives: Illness representations in physical health problems have been studied extensively using the Self‐regulation Model (SRM) focusing on five dimensions of illness beliefs (identity, consequences, causes, timeline and control, or cure). Associations have been found between beliefs about illness and a range of health outcomes. This study aimed to examine models of depression, to assess whether the five dimensions of the SRM are relevant, to compare depression models with those for physical illness, and to examine the psychometric properties of the Illness Perception Questionnaire (IPQ) when used with depression.Design and method: A sample of 101 women either currently depressed or with a history of depression was asked to write about their experiences of physical sickness and depression. Their responses were analysed in terms of the dimensions of beliefs expressed and the two experiences were compared. The IPQ was also administered to assess the women's perceptions of depression.Results: The women used the same five dimensions of illness as identified in the SRM in describing both their experience of depression and physical sickness. There was evidence of some consistency across the models of the two illnesses in terms of their content and structure. The IPQ was a reliable measure for depressed experiences and discriminated between women who were currently depressed or not. Comparing the women's descriptions of their depression with their IPQ scores showed some relationships between their responses on the two different measures, at least for the consequences and cause dimensions.Conclusion: The SRM model and associated methodology may provide an appropriate framework to further explore illness representations in depression. Problems inherent in the study of illness models in depression including the influence of mood on the model are described. Applications of this research area to the understanding of treatment preferences and adherence to treatment in mood disorders are discussed.
Parent training for Attention Deficit/Hyperactivity Disorder: Is it as effective when delivered as routine rather than as specialist care?
Authors: Sonuga‐Barke Edmund J.S. , Thompson Margaret , Daley David , Laver‐Bradbury Cathy 
Published: November 2004

Background: The effectiveness of parent training (PT) when delivered as part of specialist tier‐two services for preschool AD/HD children has been recently demonstrated.Aims: To assess the effectiveness of the same PT programme when delivered as part of routine primary care by non‐specialist nurses.Method: A sample of 89 3‐year‐old children with preschool AD/HD took part in a controlled trial of an eight‐week (one hour a week), health visitor delivered, PT package. Children, allocated randomly to PT (n = 59) and waiting list control (WLC; n = 30) groups, were compared.Results: PT did not reduce AD/HD symptoms. Maternal well‐being decreased in both PT and WLC groups.Conclusions: While PT is an effective intervention for preschool AD/HD when delivered in specialized settings, these benefits do not appear to generalize when programme are delivered as part of routine primary care by non‐specialist nurses.
Childhood sexual abuse, stressful life events and risk for major depression in women
Authors: KENDLER KENNETH S. , KUHN JONATHAN W. , PRESCOTT CAROL A. 
Published: November 2004

Background. In animals, early trauma can produce long-lasting changes in sensitivity to the pathogenic effects of stress. To explore whether similar processes occur in humans, we examine whether childhood sexual abuse (CSA) in women alters sensitivity in adulthood to the depressogenic effects of stressful life events (SLEs).Method. A history of CSA was obtained from a population-based sample of 1404 female adult twins. Cox Proportional hazard models were used to predict onsets of episodes of DSM-III-R major depression (MD) in the past year from previously assessed levels of neuroticism (N), CSA and past-year SLEs scored on long-term contextual threat.Results. In the best-fit model, onset of MD was predicted by CSA, SLEs and N. Individuals with CSA (and especially with severe CSA) had both an overall increased risk for MD and a substantially increased sensitivity to the depressogenic effects of SLEs. A ‘dose–response’ relationship between severity of CSA and sensitivity to SLEs was clearer in those with low to average levels of N than in those with high levels of N.Conclusion. As documented with physiological responses to a standardized laboratory stressor, CSA increases stress sensitivity in women in a more naturalistic setting. Both genetic and early environmental risk factors can produce long-term increase in the sensitivity of individuals to depressogenic life experiences.
Craniological differentiation amongst wild‐living cats in Britain and southern Africa: natural variation or the effects of hybridisation?
Authors: Yamaguchi Nobuyuki , Kitchener Andrew C. , Driscoll Carlos A. , Ward Jennifer M. , Macdonald David W. 
Published: November 2004

AbstractThe natural morphological variation in the wildcat, Felis silvestris, and morphological changes possibly caused by introgressive hybridisation with the domestic cat, F. catus, were examined, based on up to 39 variables concerning cranial morphology. The samples of wild‐living cats originated from Scotland and southern Africa and consisted of both classical wildcat and other pelage types. Principal component and cluster analyses suggested that introgressive hybridisation occurred in both areas, with the consequence that the characteristics of local wildcat populations had been altered in terms of the frequencies of occurrence of certain characters, especially those concerning cranial capacity. In both regions the clustering patterns of wild‐living cats can be interpreted as containing four main groups. One of these consisted mainly of ‘non‐wildcats’ and groups furthest from the ‘non‐wild’ cluster consisted of the highest proportion of ‘wildcats’ (c. 80%). We propose that where a population is heavily introgressed, the only feasible way to define a wildcat is on the basis of inter‐correlated features and conservationists must take a population‐based approach to assess the extent of introgression. This approach may provide an operational standard for assessing the impact of hybridisation between wildcats and domestic cats throughout the species' range; it suggests that the Scottish wildcats may be critically endangered.
Having your wildlife and eating it too: an analysis of hunting sustainability across tropical ecosystems
Authors: Robinson John G. , Bennett Elizabeth L. 
Published: November 2004

AbstractUnsustainable hunting of wildlife or bushmeat for human consumption across the tropics threatens both wildlife populations and the livelihoods of people who depend on these resources. The probability that hunting can be sustainable depends in part on ecological conditions that affect the ‘supply’ of and ‘demand’ for wildlife resources. In this study, supply is estimated across a number of tropical ecosystem types by calculating the theoretical ‘maximum sustainable offtake’ in kg/km2 for harvestable wildlife. Demand is estimated from observed harvests in kg/km2. We examine how supply and demand vary across relatively undisturbed ecosystems, indexed by annual rainfall. Supply is potentially highest in dry forests and wetter savannah grasslands and decreases in moist forests and more xeric grasslands. Demand tends to exceed supply in moist forests and xeric grasslands. Analogous to this ecological variation along the rainfall gradient is the gradient created by the conversion of tropical forests by humans. We hypothesise that the wild meat supply is greater in secondary forests and forest–farm–fallow mosaics than in undisturbed forests and test this with available data. We conclude that the probability that hunting will be sustainable varies with ecosystem type and degree of human disturbance and should influence where land is zoned for protected areas and where for wildlife harvests.
High offspring survival of the brown‐headed cowbird in an invaded habitat
Authors: Winfree Rachael 
Published: November 2004

AbstractThe brood parasitic brown‐headed cowbird (Molothrus ater) is considered an important threat to bird conservation in North America because it reduces the reproduction of its numerous host species. Prior to the colonisation of America by Europeans, the cowbird was largely confined to the North American prairie region, but it has since invaded forests and other habitats and is now one of the continent's most abundant breeding passerines. The objective of this study was to examine cowbird reproduction with different host communities to determine whether habitat‐specific reproduction might contribute to the cowbird's population expansion. Cowbird offspring survival was estimated with hosts breeding in fragmented deciduous forest (a newly invaded habitat) and old fields (a habitat more similar to the cowbird's original range). Offspring survival was 1.8–3.1 times higher in forest compared to old fields and was high enough to cause the cowbird population to increase with most forest hosts. The results suggest that increased offspring survival in an invaded habitat facilitates cowbird population growth. Land management for extensive, continuous forests, which cowbirds are known to avoid, could help control the cowbird population and reduce parasitism levels for the >140 species of cowbird hosts.
Inbreeding depression and founder diversity among captive and free‐living populations of the endangered pink pigeonColumba mayeri
Authors: Swinnerton Kirsty J. , Groombridge Jim J. , Jones Carl G. , Burn Robert W. , Mungroo Yousoof 
Published: November 2004

AbstractThe endemic pink pigeon has recovered from less than 20 birds in the mid‐1970s to 355 free‐living individuals in 2003. A major concern for the species' recovery has been the potential genetic problem of inbreeding. Captive pink pigeons bred for reintroduction were managed to maximise founder representation and minimise inbreeding. In this paper, we quantify the effect of inbreeding on survival and reproductive parameters in captive and wild populations and quantify DNA sequence variation in the mitochondrial d‐loop region for pink pigeon founders. Inbreeding affected egg fertility, squab, juvenile and adult survival, but effects were strongest in highly inbred birds (F≥0.25). Inbreeding depression was more apparent in free‐living birds where even moderate levels of inbreeding affected survival, although highly inbred birds were equally compromised in both captive and wild populations. Mitochondrial DNA haplotypic diversity in pink pigeon founders is low, suggesting that background inbreeding is contributing to low fertility and depressed productivity in this species, as well as comparable survival of some groups of non‐inbred and nominally inbred birds. Management of wild populations has boosted population growth and may be required long‐term to offset the negative effects of inbreeding depression and enhance the species' survival.