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1. A multi-technique detection of an eccentric giant planet around accelerating star HD 57625

Author

Barbato, D., Mesa, D., D'Orazi, V., Desidera, S., Ruggieri, A., Farinato, J., Marafatto, L., Carolo, E., Vassallo, D., Ertel, S., Hom, J., Anche, R. M., Battaini, F., Becker, A., Bergomi, M., Biondi, F., Cardwell, A., Cerpelloni, P., Chauvin, G., Chinellato, S., Desgrange, C., Di Filippo, S., Dima, M., Machado, T. S. Gomes, Gratton, R., Greggio, D., Henning, Th., Kenworthy, M., Laudisio, F., Lazzoni, C., Leisenring, J., Lessio, L., Lorenzetto, A., Mohr, L., Montoya, M., Rodeghiero, G., Patience, J., Power, J., Ricci, D., Santhakumari, K. K. R., Sozzetti, A., Umbriaco, G., Pallauta, M. Vega, Viotto, V., and Wagner, K.

Subjects
Astrophysics - Earth and Planetary Astrophysics, Astrophysics - Instrumentation and Methods for Astrophysics, Astrophysics - Solar and Stellar Astrophysics
Abstract

The synergy between different detection methods is a key asset in exoplanetology, allowing for both precise characterization of detected exoplanets and robust constraints even in the case of non-detection. Recently, the interplay between imaging, radial velocities and astrometry has produced significant advancements in exoplanetary science. We report a first result of an ongoing survey performed with SHARK-NIR, the new high-contrast near-infrared imaging camera at the Large Binocular Telescope, in parallel with LBTI/LMIRCam in order to detect planetary companions around stars with significant proper motion anomaly. In this work we focus on HD 57625, a F8 star for which we determine a $4.8^{+3.7}_{-2.9}$Ga age, exhibiting significant astrometric acceleration and for which archival radial velocities hint at the presence of a previously undetected massive long-period companion. We analyse the imaging data we collected with SHARK-NIR and LMIRCam in synergy with the available public SOPHIE radial velocity time series and Hipparcos-Gaia proper motion anomaly. With this joint multi-technique analysis, we aim at characterizing the companion responsible for the astrometric and radial velocity signals. The imaging observations result in a non-detection, indicating the companion to be in the substellar regime. This is confirmed by the synergic analysis of archival radial velocity and astrometric measurements resulting in the detection of HD 57625 b, a ${8.43}_{-0.91}^{+1.10}$M$_{\rm Jup}$ planetary companion with an orbital separation of ${5.70}_{-0.13}^{+0.14}$au and ${0.52}_{-0.03}^{+0.04}$ eccentricity. HD 57625 b joins the small but growing population of giant planets in outer orbits with true mass determination provided by the synergic usage of multiple detection methods, proving once again the importance of multi-technique analysis in providing robust characterization of planetary companions., Comment: 12 pages, 8 figures, accepted for publication in A&A

Published
2024
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2. Deep imaging of three accelerating stars using SHARK-NIR and LMIRCam at LBT

Author

Mesa, D., Gratton, R., D'Orazi, V., Carolo, E., Vassallo, D., Farinato, J., Marafatto, L., Wagner, K., Hom, J., Ertel, S., Henning, Th., Desgrange, C., Barbato, D., Bergomi, M., Cerpelloni, P., Desidera, S., Di Filippo, S., Doelman, D., Machado, T. S. Gomes, Greggio, D., Grenz, P., Kenworthy, M., Laudisio, F., Lazzoni, C., Leisenring, J., Lorenzetto, A., Santhakumari, K. K. R., Ricci, D., Snik, F., Umbriaco, G., Pallauta, M. C. Vega, and Viotto, V.

Subjects
Astrophysics - Earth and Planetary Astrophysics, Astrophysics - Instrumentation and Methods for Astrophysics, Astrophysics - Solar and Stellar Astrophysics
Abstract

The combination of detection techniques enhances our ability to identify companions orbiting nearby stars. We employed high-contrast imaging to constrain mass and separation of possible companions responsible for the significant proper motion anomalies of the nearby stars HIP 11696, HIP 47110 and HIP 36277. These targets were observed using the LBT's high-contrast camera, SHARK-NIR, in H-band using a Gaussian coronagraph, and with the LMIRCam instrument in the L'-band and using a vAPP coronagraph. Both observations were conducted simultaneously. Additionally, constraints at short separations from the host star are derived analyzing the renormalized unit weight error (RUWE) values from the Gaia catalogue. We find that the companion responsible for the anomaly signal of HIP 11696 is likely positioned at a distance from 2.5 to 28 astronomical units from its host. Its mass is estimated to be between 4 and 16 Jupiter masses, with the greater mass possible only at the upper end of the separation range. Similar limits were obtained for HIP 47110 where the companion should reside between 3 and 30 au with a mass between 3 and 10 MJup. For HIP 36277, we identified a faint stellar companion at large separation, though it might be substellar depending on the assumed age for the star. Considering the older age, this object accounts for the absolute value of the PMa vector but not for its direction. Additionally, we found a substellar candidate companion at a closer separation that could explain the PMa signal, considering a younger age for the system., Comment: 12 pages, 9 figures, accepted for publication on MNRAS

Published
2024

3. A temperate super-Jupiter imaged with JWST in the mid-infrared

Author

Matthews, E. C., Carter, A. L., Pathak, P., Morley, C. V., Phillips, M. W., P. M., S. Krishanth, Feng, F., Bonse, M. J., Boogaard, L. A., Burt, J. A., Crossfield, I. J. M., Douglas, E. S., Henning, Th., Hom, J., Ko, C.-L., Kasper, M., Lagrange, A.-M., Petit dit de la Roche, D., and Philipot, F.

Published
2024
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4. Gemini Planet Imager Spectroscopy of the Dusty Substellar Companion HD 206893 B

Author

Ward-Duong, K., Patience, J., Follette, K., De Rosa, R. J., Rameau, J., Marley, M., Saumon, D., Nielsen, E. L., Rajan, A., Greenbaum, A. Z., Lee, J., Wang, J. J., Czekala, I., Duchêne, G., Macintosh, B., Ammons, S. Mark, Bailey, V. P., Barman, T., Bulger, J., Chen, C., Chilcote, J., Cotten, T., Doyon, R., Esposito, T. M., Fitzgerald, M. P., Gerard, B. L., Goodsell, S. J., Graham, J. R., Hibon, P., Hom, J., Hung, L. -W., Ingraham, P., Kalas, P., Konopacky, Q., Larkin, J. E., Maire, J., Marchis, F., Marois, C., Metchev, S., Millar-Blanchaer, M. A., Oppenheimer, R., Palmer, D., Perrin, M., Poyneer, L., Pueyo, L., Rantakyrö, F. T., Ren, B., Ruffio, J. -B., Savransky, D., Schneider, A. C., Sivaramakrishnan, A., Song, I., Soummer, R., Tallis, M., Thomas, S., Wallace, J. Kent, Wiktorowicz, S., and Wolff, S.

Subjects
Astrophysics - Earth and Planetary Astrophysics, Astrophysics - Solar and Stellar Astrophysics
Abstract

We present new near-infrared Gemini Planet Imager (GPI) spectroscopy of HD 206893 B, a substellar companion orbiting within the debris disk of its F5V star. The $J$, $H$, $K1$, and $K2$ spectra from GPI demonstrate the extraordinarily red colors of the object, confirming it as the reddest substellar object observed to date. The significant flux increase throughout the infrared presents a challenging atmosphere to model with existing grids. Best-fit values vary from 1200 K to 1800 K for effective temperature and from 3.0 to 5.0 for log($g$), depending on which individual wavelength band is fit and which model suite is applied. The extreme redness of the companion can be partially reconciled by invoking a high-altitude layer of sub-micron dust particles, similar to dereddening approaches applied to the peculiar red field L-dwarf population. However, reconciling the HD 206893 B spectra with even those of the reddest low-gravity L-dwarf spectra still requires the contribution of additional atmospheric dust, potentially due to the debris disk environment in which the companion resides. Orbit fitting from four years of astrometric monitoring is consistent with a $\sim$30-year period, orbital inclination of 147$^{\circ}$, and semimajor axis of 10 au, well within the estimated disk inner radius of $\sim$50 au. As one of very few substellar companions imaged interior to a circumstellar disk, the properties of this system offer important dynamical constraints on companion-disk interaction and provide a benchmark for substellar and planetary atmospheric study., Comment: Accepted for publication in AJ (October 15, 2020). 35 pages, 20 figures, with tables and appendices presented in their entirety

Published
2020
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5. Imaging the 44 AU Kuiper Belt-analogue debris ring around HD 141569A with GPI polarimetry

Author

Bruzzone, J. S., Metchev, S., Duchene, G., Millar-Blanchaer, M. A., Dong, R., Wang, J. J., Graham, J. R., Mazoyer, J., Wolff, S., Ammons, S. M., Schneider, A. C., Greenbaum, A. Z., Matthews, B. C., Arriaga, P., Bailey, V. P., Barman, T., Bulger, J., Chilcote, J., Cotten, T., De Rosa, R. J., Doyon, R., Fitzgerald, M. P., Follette, K. B., Gerard, B. L., Goodsell, S. J., Hibon, P., Hom, J., Hung, L. -W., Ingraham, P., Kalas, P., Konopacky, Q., Larkin, J. E., Macintosh, B., Maire, J., Marchis, F., Marois, C., Morzinski, K. M., Nielsen, E. L., Oppenheimer, R., Palmer, D., Patel, R., Patience, J., Perrin, M., Poyneer, L., Pueyo, L., Rajan, A., Rameau, J., Rantakyro, F. T., Savransky, D., Sivaramakrishnan, A., Song, I., Soummer, R., Thomas, S., Wallace, J. K., Ward-Duong, K., and Wiktorowicz, S.

Subjects
Astrophysics - Solar and Stellar Astrophysics, Astrophysics - Earth and Planetary Astrophysics
Abstract

We present the first polarimetric detection of the inner disk component around the pre-main sequence B9.5 star HD 141569A. Gemini Planet Imager H-band (1.65 micron) polarimetric differential imaging reveals the highest signal-to-noise ratio detection of this ring yet attained and traces structure inwards to 0.25" (28 AU at a distance of 111 pc). The radial polarized intensity image shows the east side of the disk, peaking in intensity at 0.40" (44 AU) and extending out to 0.9" (100 AU). There is a spiral arm-like enhancement to the south, reminiscent of the known spiral structures on the outer rings of the disk. The location of the spiral arm is coincident with 12CO J=3-2 emission detected by ALMA, and hints at a dynamically active inner circumstellar region. Our observations also show a portion of the middle dusty ring at ~220 AU known from previous observations of this system. We fit the polarized H-band emission with a continuum radiative transfer Mie model. Our best-fit model favors an optically thin disk with a minimum dust grain size close to the blow-out size for this system: evidence of on-going dust production in the inner reaches of the disk. The thermal emission from this model accounts for virtually all of the far-infrared and millimeter flux from the entire HD 141569A disk, in agreement with the lack of ALMA continuum and CO emission beyond ~100 AU. A remaining 8-30 micron thermal excess a factor of ~2 above our model argues for a yet-unresolved warm innermost 5-15 AU component of the disk., Comment: 16 pages, 8 figures, accepted at AJ

Published
2019
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6. Deep imaging of three accelerating stars using SHARK-NIR and LMIRCam at LBT.

Author

Mesa, D, Gratton, R, D'Orazi, V, Carolo, E, Vassallo, D, Farinato, J, Marafatto, L, Wagner, K, Hom, J, Ertel, S, Henning, Th, Desgrange, C, Barbato, D, Bergomi, M, Cerpelloni, P, Desidera, S, Filippo, S Di, Doelman, D, Machado, T S Gomes, and Greggio, D

Subjects
AGE of stars, NATURAL satellites, PLANETARY systems, ABSOLUTE value, STELLAR orbits
Abstract

The combination of detection techniques enhances our ability to identify companions orbiting nearby stars. We employed high-contrast imaging to constrain mass and separation of possible companions responsible for the significant proper motion anomalies of the nearby stars HIP 11696, HIP 47110, and HIP 36277. These targets were observed using the LBT's high-contrast camera, SHARK-NIR, in H band using a Gaussian coronagraph, and with the LMIRCam instrument in the L ' band and using a vAPP coronagraph. Both observations were conducted simultaneously. Additionally, constraints at short separations from the host star are derived analysing the renormalized unit weight error values from the Gaia catalogue. We find that the companion responsible for the anomaly signal of HIP 11696 is likely positioned at a distance from 2.5 to 28 astronomical units from its host. Its mass is estimated to be between 4 and 16 Jupiter masses, with the greater mass possible only at the upper end of the separation range. Similar limits were obtained for HIP 47110 where the companion should reside between 3 and 30 au with a mass between 3 and 10 MJup. For HIP 36277, we identified a faint stellar companion at large separation, though it might be substellar depending on the assumed age for the star. Considering the older age, this object accounts for the absolute value of the PMa vector but not for its direction. Additionally, we found a substellar candidate companion at a closer separation that could explain the PMa signal, considering a younger age for the system. [ABSTRACT FROM AUTHOR]

Published
2025
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7. The Gemini Planet Imager Exoplanet Survey: Giant Planet and Brown Dwarf Demographics from 10 to 100 au

Author

Nielsen, EL, De Rosa, RJ, Macintosh, B, Wang, JJ, Ruffio, JB, Chiang, E, Marley, MS, Saumon, D, Savransky, D, Mark Ammons, S, Bailey, VP, Barman, T, Blain, C, Bulger, J, Burrows, A, Chilcote, J, Cotten, T, Czekala, I, Doyon, R, Duchene, G, Esposito, TM, Fabrycky, D, Fitzgerald, MP, Follette, KB, Fortney, JJ, Gerard, BL, Goodsell, SJ, Graham, JR, Greenbaum, AZ, Hibon, P, Hinkley, S, Hirsch, LA, Hom, J, Hung, LW, Ilene Dawson, R, Ingraham, P, Kalas, P, Konopacky, Q, Larkin, JE, Lee, EJ, Lin, JW, Maire, J, Marchis, F, Marois, C, Metchev, S, Millar-Blanchaer, MA, Morzinski, KM, Oppenheimer, R, Palmer, D, Patience, J, Perrin, M, Poyneer, L, Pueyo, L, Rafikov, RR, Rajan, A, Rameau, J, Rantakyrö, FT, Ren, B, Schneider, AC, Sivaramakrishnan, A, Song, I, Soummer, R, Tallis, M, Thomas, S, Ward-Duong, K, and Wolff, S

Subjects
instrumentation: adaptive optics, planetary systems, planets and satellites: detection, astro-ph.EP, Astronomy & Astrophysics, Astronomical and Space Sciences
Abstract

We present a statistical analysis of the first 300 stars observed by the Gemini Planet Imager Exoplanet Survey. This subsample includes six detected planets and three brown dwarfs; from these detections and our contrast curves we infer the underlying distributions of substellar companions with respect to their mass, semimajor axis, and host stellar mass. We uncover a strong correlation between planet occurrence rate and host star mass, with stars M ∗ >1.5 M o more likely to host planets with masses between 2 and 13M Jup and semimajor axes of 3-100 au at 99.92% confidence. We fit a double power-law model in planet mass (m) and semimajor axis (a) for planet populations around high-mass stars (M ∗ >1.5 M o) of the form , finding α = -2.4 +0.8 and β = -2.0 +0.5, and an integrated occurrence rate of % between 5-13M Jup and 10-100 au. A significantly lower occurrence rate is obtained for brown dwarfs around all stars, with % of stars hosting a brown dwarf companion between 13-80M Jup and 10-100 au. Brown dwarfs also appear to be distributed differently in mass and semimajor axis compared to giant planets; whereas giant planets follow a bottom-heavy mass distribution and favor smaller semimajor axes, brown dwarfs exhibit just the opposite behaviors. Comparing to studies of short-period giant planets from the radial velocity method, our results are consistent with a peak in occurrence of giant planets between ∼1 and 10 au. We discuss how these trends, including the preference of giant planets for high-mass host stars, point to formation of giant planets by core/pebble accretion, and formation of brown dwarfs by gravitational instability.

Published
2019

8. Cable links and l-space surgeries

Author

Gorsky, E and Hom, J

Subjects
Cable link, L-space, surgery, Heegaard Floer homology, math.GT, Pure Mathematics, Mathematical Physics
Abstract

An L-space link is a link in S3 on which all sufficiently large integral surgeries are L-spaces. We prove that for m; n relatively prime, the r-component cable link Krm;rn is an L-space link if and only if K is an L-space knot and n/m ≥2g.K/ - 1. We also compute HFL– and HFL of an L-space cable link in terms of its Alexander polynomial. As an application, we confirm a conjecture of Licata [7] regarding the structure of HFL for.n; n/ torus links.

Published
2017

9. Point-of-care ultrasonography by pediatric emergency medicine physicians

Author

Shook, JE, Ackerman, AD, Chun, TH, Conners, GP, Dudley, NC, Fuchs, SM, Gorelick, MH, Lane, NE, Moore, BR, Wright, JL, Bird, SB, Blomkalns, AL, Carmody, K, Clem, KJ, Courtney, DM, Diercks, DB, Fields, M, Hockberger, RS, Holmes, JF, Hudak, L, Jones, AE, Kaji, AH, Martin, IBK, Moore, C, Panebianco, N, Benjamin, LS, Barata, IA, Alade, K, Arms, J, Avarello, JT, Baldwin, S, Brown, K, Cantor, RM, Cohen, A, Dietrich, AM, Eakin, PJ, Gausche-Hill, M, Gerardi, M, Graham, CJ, Holtzman, DK, Hom, J, Ishimine, P, Jinivizian, H, Joseph, M, Mehta, S, Ojo, A, Paul, AZ, Pauze, DR, Pearson, NM, Rosen, B, Russell, WS, Saidinejad, M, Sloas, HA, Schwartz, GR, Swenson, O, Valente, JH, Waseem, M, Whiteman, PJ, Woolridge, D, Noble, V, Storti, E, Tsung, J, and Volpicelli, G

Subjects
Emergency Care, Clinical Research, 8.1 Organisation and delivery of services, Generic health relevance, Pediatrics, Medical and Health Sciences, Psychology and Cognitive Sciences
Abstract

Point-of-care ultrasonography is increasingly being used to facilitate accurate abstract and timely diagnoses and to guide procedures. It is important for pediatric emergency medicine (PEM) physicians caring for patients in the emergency department to receive adequate and continued point-of-care ultrasonography training for those indications used in their practice setting. Emergency departments should have credentialing and quality assurance programs. PEM fellowships should provide appropriate training to physician trainees. Hospitals should provide privileges to physicians who demonstrate competency in point-of-care ultrasonography. Ongoing research will provide the necessary measures to define the optimal training and competency assessment standards. Requirements for credentialing and hospital privileges will vary and will be specific to individual departments and hospitals. As more physicians are trained and more research is completed, there should be one national standard for credentialing and privileging in point-of-care ultrasonography for PEM physicians.

Published
2015

11. Direct Effects of Nitric Acid on Forest Trees

Author

Bytnerowicz, A., Padgett, P., Percy, K., Krywult, M., Riechers, G., Hom, J., Caldwell, M. M., editor, Heldmaier, G., editor, Lange, O. L., editor, Mooney, H. A., editor, Schulze, E.-D., editor, Sommer, U., editor, Miller, Paul R., editor, and McBride, Joe R., editor

Published
1999
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13. US Local Public Health Department Spending Between 2008 and 2016 Did Not Increase for Communities in Need

Author

Connolly J, Kelly S, Shultz K, Reszczynski O, Chaiyachati Kh, Venkataramani A, Mitra N, and Hom J

Subjects
Economic growth, medicine.medical_specialty, Public health, medicine, Business
Abstract

BackgroundGreater US local public health department (LPHD) spending has been associated with decreases in population-wide mortality. We examined the association between changes in LPHD spending between 2008 and 2016 and county-level sociodemographic indicators of public health need.MethodsMultivariable linear regression was used to estimate the association between changes in county-level per-capita LPHD spending and 2008 sociodemographic indicators of interest: percent of population that was over 65 years old, Black, Hispanic, in poverty, unemployed, and uninsured. A second model assessed the relationship between changes in LPHD spending and sociodemographic shifts between 2008 and 2016.ResultsLPHD spending increases were associated with higher percentage points of 2008 adults over 65 years of age (+$0.53 per higher percentage point; 95% CI: +$0.01 to +$1.06) and unemployment (+$1.31; 95% CI: -$2.34 to -$0.27). Spending did not increase for communities with a higher proportion of people who identified as Black or Hispanic, or those with a greater proportion of people in poverty or uninsured, using either baseline or sociodemographic shifts between 2008 and 2016.ConclusionFuture LPHD funding decisions should consider increasing investments in counties serving disadvantaged communities to counteract the social, political, and structural barriers which have historically prevented these communities from achieving better health.

Published
2021
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16. Results from a direct imaging search for disks and planets around A/F-stars in Scorpius-Centaurus

Author

Worthen, K., Hom, J., Patience, J., Esposito, T., Duchene, G., Kalas, P., Jang-Condell, H., Saboi, K., Arriaga, P., Mazoyer, J., Wolff, S.G., Millar-Blanchaer, M., Fitzgerald, M., Perrin, M., Chen, C., Macintosh, B., Matthews, B., Wang, J., Graham, J., Marchis, F., Ammons, S., Bailey, V., Barman, T., Bulger, J., Chilcote, J., Cotten, T., Rosa, R..De., Doyon, R., Follette, K., Goodsell, S., Greenbaum, A., Hibon, P., Ingraham, P., Konopacky, Q., Larkin, J., Maire, J., Marley, M., Marois, C., Matthews, E., Metchev, S., Nielsen, E., Oppenheimer, R., Palmer, D., Poyneer, L., Pueyo, L., Rajan, A., Rameau, J., Rantakyro, F., and Ren, B.

Published
2020

17. Gemini Planet Imager Spectroscopy of the Dusty Substellar Companion HD 206893 B

Author

Ward-Duong, K., primary, Patience, J., additional, Follette, K., additional, Rosa, R. J. De, additional, Rameau, J., additional, Marley, M., additional, Saumon, D., additional, Nielsen, E. L., additional, Rajan, A., additional, Greenbaum, A. Z., additional, Lee, J., additional, Wang, J. J., additional, Czekala, I., additional, Duchêne, G., additional, Macintosh, B., additional, Ammons, S. Mark, additional, Bailey, V. P., additional, Barman, T., additional, Bulger, J., additional, Chen, C., additional, Chilcote, J., additional, Cotten, T., additional, Doyon, R., additional, Esposito, T. M., additional, Fitzgerald, M. P., additional, Gerard, B. L., additional, Goodsell, S. J., additional, Graham, J. R., additional, Hibon, P., additional, Hom, J., additional, Hung, L.-W., additional, Ingraham, P., additional, Kalas, P., additional, Konopacky, Q., additional, Larkin, J. E., additional, Maire, J., additional, Marchis, F., additional, Marois, C., additional, Metchev, S., additional, Millar-Blanchaer, M. A., additional, Oppenheimer, R., additional, Palmer, D., additional, Perrin, M., additional, Poyneer, L., additional, Pueyo, L., additional, Rantakyrö, F. T., additional, Ren, B., additional, Ruffio, J.-B., additional, Savransky, D., additional, Schneider, A. C., additional, Sivaramakrishnan, A., additional, Song, I., additional, Soummer, R., additional, Tallis, M., additional, Thomas, S., additional, Wallace, J. Kent, additional, Wiktorowicz, S., additional, and Wolff, S., additional

Published
2020
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21. Characterizing Inpatient Medicine Resident Electronic Health Record Usage Patterns Using Event Log Data

Author

Ouyang D, Chi J, Chen Jh, Hom J, and Wang Jk

Subjects
020205 medical informatics, business.industry, Event (computing), health care facilities, manpower, and services, Psychological intervention, 02 engineering and technology, Burnout, EPIC, medicine.disease, 3. Good health, 03 medical and health sciences, 0302 clinical medicine, Workflow, Chart, Electronic health record, Log data, health services administration, 0202 electrical engineering, electronic engineering, information engineering, Medicine, 030212 general & internal medicine, Medical emergency, business, health care economics and organizations
Abstract

Amid growing rates of burnout, physicians report increasing electronic health record (EHR) usage alongside decreasing clinical facetime with patients. There exists a pressing need to improve physician-computer-patient interactions by streamlining EHR workflow.To identify interventions to improve EHR design and usage, we systematically characterize EHR activity among internal medicine residents at a tertiary academic hospital across various inpatient rotations and roles from June 2013 to November 2016.Logged EHR timestamps were extracted from Stanford Hospital’s EHR system (Epic) and cross-referenced against resident rotation schedules. We tracked the quantity of EHR logs across 24-hour cycles to reveal daily usage patterns. In addition, we decomposed daily EHR time into time spent on specific EHR actions (e.g. chart review, note entry and review, results review).In examining 24-hour usage cycles from general medicine day and night team rotations, we identified a prominent trend in which night team activity promptly ceased at the shift’s end, while day team activity tended to linger post-shift. Across all rotations and roles, residents spent on average 5.38 hours (standard deviation=2.07) using the EHR. PGY1 (post-graduate year one) interns and PGY2+ residents spent on average 2.4 and 4.1 times the number of EHR hours on information review (chart, note, and results review) as information entry (note and order entry).Analysis of EHR event log data can enable medical educators and programs to develop more targeted interventions to improve physician-computer-patient interactions, centered on specific EHR actions.

Published
2018
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22. Evaluation and management of children with acute mental health or behavioral problems. Part II: Recognition of clinically challenging mental health related conditions presenting with medical or uncertain symptoms

Author

Chun, TH, Mace, SE, Katz, ER, Shook, JE, Callahan, JM, Conners, GP, Conway, EE, Dudley, NC, Gross, TK, Lane, NE, Macias, CG, Timm, NL, Bullock, K, Edgerton, E, Haro, TM, Joseph, M, Mickalide, A, Moore, BR, Remick, KE, Snow, SK, Tuggle, DW, Wright-Johnson, C, Ackerman, AD, Benjamin, L, Fuchs, SM, Gorelick, MH, Sirbaugh, P, Wright, JL, Tellez, S, Benjamin, LS, Alade, K, Arms, J, Avarello, JT, Baldwin, S, Barata, IA, Brown, K, Cantor, RM, Cohen, A, Dietrich, AM, Eakin, PJ, Gausche-Hill, M, Gerardi, M, Graham, CJ, Holtzman, DK, Hom, J, Ishimine, P, Jinivizian, H, Mehta, S, Ojo, A, Paul, AZ, Pauze, DR, Pearson, NM, Rosen, B, Russell, WS, Saidinejad, M, Schwartz, GR, Sloas, HA, Valente, JH, Waseem, M, Whiteman, PJ, Woolridge, D, DeMoor, C, Dy, JM, Fox, S, Hoffman, RJ, Hostetler, M, Markenson, D, Sorrentino, A, Witt, M, Sullivan, D, and Wauson, S

Subjects
Psychiatric Status Rating Scales, Serotonin Syndrome, Emergency Medical Services, Medical And Health Sciences, Adolescent, Primary Health Care, Autism Spectrum Disorder, Mental Disorders, Developmental Disabilities, education, Uncertainty, Pediatrics, AMERICAN ACADEMY OF PEDIATRICS Committee on Pediatric Emergency Medicine, Diagnosis, Differential, Medically Unexplained Symptoms, Humans, Neuroleptic Malignant Syndrome, Triage, AMERICAN COLLEGE OF EMERGENCY PHYSICIANS Pediatric Emergency Medicine Committee, Child, Psychology And Cognitive Sciences, Central Nervous System Agents
Abstract

© Copyright 2016 by the American Academy of Pediatrics. This document is copyrighted and is property of the American Academy of Pediatrics and its Board of Directors. All authors have fi led confl ict of interest statements with the American Academy of Pediatrics. Any confl icts have been resolved through a process approved by the Board of Directors. The American Academy of Pediatrics has neither solicited nor accepted any commercial involvement in the development of the content of this publication. Clinical reports from the American Academy of Pediatrics benefi t from expertise and resources of liaisons and internal (AAP) and external reviewers. However, clinical reports from the American Academy of Pediatrics may not refl ect the views of the liaisons or the organizations or government agencies that they represent. The guidance in this report does not indicate an exclusive course of treatment or serve as a standard of medical care. Variations, taking into account individual circumstances, may be appropriate. All clinical reports from the American Academy of Pediatrics automatically expire 5 years after publication unless reaffi rmed, revised, or retired at or before that time.

Published
2016
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23. Executive summary: Evaluation and management of children with acute mental health or behavioral problems. Part II: Recognition of clinically challenging mental health related conditions presenting with medical or uncertain symptoms

Author

Chun, TH, Mace, SE, Katz, ER, Shook, JE, Callahan, JM, Conners, GP, Conway, EE, Dudley, NC, Gross, TK, Lane, NE, Macias, CG, Timm, NL, Bullock, K, Edgerton, E, Moore, BR, Haro, TM, Joseph, M, Mickalide, A, Remick, KE, Snow, SK, Tuggle, DW, Wright-Johnson, C, Ackerman, AD, Benjamin, L, Fuchs, SM, Gorelick, MH, Sirbaugh, P, Wright, JL, Tellez, S, Benjamin, LS, Barata, IA, Alade, K, Arms, J, Avarello, JT, Baldwin, S, Brown, K, Cantor, RM, Cohen, A, Dietrich, AM, Eakin, PJ, Gausche-Hill, M, Gerardi, M, Graham, CJ, Holtzman, DK, Hom, J, Ishimine, P, Jinivizian, H, Mehta, S, Ojo, A, Paul, AZ, Pauze, DR, Pearson, NM, Rosen, B, Russell, WS, Saidinejad, M, Sloas, HA, Schwartz, GR, Swenson, O, Valente, JH, Waseem, M, Whiteman, PJ, Woolridge, D, DeMoor, C, Dy, JM, Fox, S, Hoffman, RJ, Hostetler, M, Markenson, D, Sorrentino, A, Witt, M, Sullivan, D, and Wauson, S

Subjects
Male, Problem Behavior, PEDIATRIC EMERGENCY MEDICINE COMMITTEE, Medical And Health Sciences, Mental Disorders, Uncertainty, AMERICAN ACADEMY OF PEDIATRICS, COMMITTEE ON PEDIATRIC EMERGENCY MEDICINE, AMERICAN COLLEGE OF EMERGENCY PHYSICIANS, Child Behavior Disorders, Pediatrics, Mental Health, Humans, Female, Child, Psychology And Cognitive Sciences
Abstract

© Copyright 2016 by the American Academy of Pediatrics. The number of children and adolescents seen in emergency departments (EDs) and primary care settings for mental health problems has skyrocketed in recent years, with up to 23% of patients in both settings having diagnosable mental health conditions. 1 -4 Even when a mental health problem is not the focus of an ED or primary care visit, mental health conditions, both known and occult, may challenge the treating clinician and complicate the patient's care.4 Although the American Academy of Pediatrics (AAP) has published a policy statement on mental health competencies and a Mental Health Toolkit for pediatric primary care providers, no such guidelines or resources exist for clinicians who care for pediatric mental health emergencies. 5, 6 Many ED and primary care physicians report paucity of training and lack of confidence in caring for pediatric psychiatry patients. The 2 clinical reports support the 2006 joint policy statement of the AAP and the American College of Emergency Physicians on pediatric mental health emergencies, 7 with the goal of addressing the knowledge gaps in this area. Although written primarily from the perspective of ED clinicians, it is intended for all clinicians who care for children and adolescents with acute mental health and behavioral problems. They are organized around the common clinical challenges pediatric caregivers face, both when a child or adolescent presents with a psychiatric chief complaint or emergency (part I) and when a mental health condition may be an unclear or complicating factor in a non-mental health ED presentation (part II). Part I of the clinical reports includes discussions of Medical Clearance of Pediatric Psychiatric Patients, Suicide and Suicidal Ideation, Restraint of the Agitated Patient Including Verbal, Chemical, and Physical Restraint, and Coordination of Care With the Medical Home, and it can be accessed online at www.pediatrics.org/cgi/doi/10.1542/peds. 2016-1570. This executive summary is an overview of part II of the clinical reports. Full text of the following topics can be accessed online at www.pediatrics.org/cgi/doi/10.1542/peds. 2016-1573.

Published
2016
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24. Executive summary: Evaluation and management of children and adolescents with acute mental health or behavioral problems. Part I: Common clinical challenges of patients with mental health and/or behavioral emergencies

Author

Chun, TH, Mace, SE, Katz, ER, Shook, JE, Callahan, JM, Conners, GP, Conway, EE, Dudley, NC, Gross, TK, Lane, NE, Macias, CG, Timm, NL, Bullock, K, Edgerton, E, Moore, BR, Haro, TM, Joseph, M, Mickalide, A, Remick, KE, Snow, SK, Tuggle, DW, Wright-Johnson, C, Ackerman, AD, Benjamin, L, Fuchs, SM, Gorelick, MH, Sirbaugh, P, Wright, JL, Tellez, S, Benjamin, LS, Barata, IA, Alade, K, Arms, J, Avarello, JT, Baldwin, S, Brown, K, Cantor, RM, Cohen, A, Dietrich, AM, Eakin, PJ, Gausche-Hill, M, Gerardi, M, Graham, CJ, Holtzman, DK, Hom, J, Ishimine, P, Jinivizian, H, Mehta, S, Ojo, A, Paul, AZ, Pauze, DR, Pearson, NM, Rosen, B, Russell, WS, Saidinejad, M, Sloas, HA, Schwartz, GR, Swenson, O, Valente, JH, Waseem, M, Whiteman, PJ, Woolridge, D, DeMoor, C, Dy, JM, Fox, S, Hoffman, RJ, Hostetler, M, Markenson, D, Sorrentino, A, Witt, M, Sullivan, D, and Wauson, S

Subjects
Mental Health Services, Male, Problem Behavior, PEDIATRIC EMERGENCY MEDICINE COMMITTEE, Medical And Health Sciences, Adolescent, Mental Disorders, Pediatrics, COMMITTEE ON PEDIATRIC EMERGENCY MEDICINE, Mental Health, AMERICAN COLLEGE OF EMERGENCY PHYSICIANS, AMERICAN ACADEMY OF PEDIATRICS, Humans, Female, Emergencies, Child, Psychology And Cognitive Sciences
Abstract

© Copyright 2016 by the American Academy of Pediatrics. The number of children and adolescents seen in emergency departments (EDs) and primary care settings for mental health problems has skyrocketed in recent years, with up to 23% of patients in both settings having diagnosable mental health conditions. 1 -4 Even when a mental health problem is not the focus of an ED or primary care visit, mental health conditions, both known and occult, may challenge the treating clinician and complicate the patient's care.4 Although the American Academy of Pediatrics has published a policy statement on mental health competencies and a Mental Health Toolkit for pediatric primary care providers, no such guidelines or resources exist for clinicians who care for pediatric mental health emergencies. 5, 6 Many ED and primary care physicians report a paucity of training and lack of confidence in caring for pediatric psychiatry patients. The 2 clinical reports (www.pediatrics.org/cgi/doi/10.1542/peds. 2016-1570 and www.pediatrics.org/cgi/doi/10.1542/peds. 2016-1573) support the 2006 joint policy statement of the American Academy of Pediatrics and the American College of Emergency Physicians on pediatric mental health emergencies, 7 with the goal of addressing the knowledge gaps in this area. Although written primarily from the perspective of ED clinicians, they are intended for all clinicians who care for children and adolescents with acute mental health and behavioral problems. The clinical reports are organized around the common clinical challenges pediatric caregivers face, both when a child or adolescent presents with a psychiatric chief complaint or emergency (part I) and also when a mental health condition may be an unclear or complicating factor in a non-mental health clinical presentation (part II). Part II of the clinical reports (www.pediatrics.org/cgi/doi/10.1542/peds. 2016-1573) includes discussions of somatic symptom and related disorders, adverse effects of psychiatric medications including neuroleptic malignant syndrome and serotonin syndrome, caring for children with special needs such as autism and developmental disorders, and mental health screening. This executive summary is an overview of part I of the clinical reports. The full text of the below topics can be accessed online at (www.pediatrics.org/cgi/doi/10.1542/peds. 2016-1570). Key considerations are shown in the following sections.

Published
2016
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25. Evaluation and management of children and adolescents with acute mental health or behavioral problems. Part I: Common clinical challenges of patients with mental health and/or behavioral emergencies

Author

Chun, TH, Mace, SE, Katz, ER, Shook, JE, Callahan, JM, Conners, GP, Conway, EE, Dudley, NC, Gross, TK, Lane, NE, Macias, CG, Timm, NL, Bullock, K, Edgerton, E, Haro, TM, Joseph, M, Mickalide, A, Moore, BR, Remick, KE, Snow, SK, Tuggle, DW, Wright-Johnson, C, Ackerman, AD, Benjamin, L, Fuchs, SM, Gorelick, MH, Sirbaugh, P, Wright, JL, Tellez, S, Benjamin, LS, Barata, IA, Alade, K, Arms, J, Avarello, JT, Baldwin, S, Brown, K, Cantor, RM, Cohen, A, Dietrich, AM, Eakin, PJ, Gausche-Hill, M, Gerardi, M, Graham, CJ, Holtzman, DK, Hom, J, Ishimine, P, Jinivizian, H, Mehta, S, Ojo, A, Paul, AZ, Pauze, DR, Pearson, NM, Rosen, B, Russell, WS, Saidinejad, M, Sloas, HA, Schwartz, GR, Swenson, O, Valente, JH, Waseem, M, Whiteman, PJ, Woolridge, D, DeMoor, C, Dy, JM, Fox, S, Hoffman, RJ, Hostetler, M, Markenson, D, Sorrentino, A, Witt, M, Sullivan, D, and Wauson, S

Subjects
Restraint, Physical, Mental Health Services, PEDIATRIC EMERGENCY MEDICINE COMMITTEE, Emergency Medical Services, Medical And Health Sciences, COMMITTEE ON PEDIATRIC EMERGENCY MEDICINE, AND AMERICAN COLLEGE OF EMERGENCY PHYSICIANS, Adolescent, Mental Disorders, Suicide, Attempted, Combined Modality Therapy, Pediatrics, United States, Suicidal Ideation, Hospitalization, Benzodiazepines, Tranquilizing Agents, Risk Factors, Patient-Centered Care, AMERICAN ACADEMY OF PEDIATRICS, Humans, Emergencies, Child, Psychology And Cognitive Sciences
Published
2016
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26. The severity of pandemic H1N1 influenza in the United States, from April to July 2009: a Bayesian analysis

Author

Medina, W, Michelangelo, D, Milhofer, J, Milyavskaya, I, Misener, M, Mizrahi, J, Moskin, L, Motherwell, M, Myers, C, Nair, HP, Nguyen, T, Nilsen, D, Nival, J, Norton, J, Oleszko, W, Olson, C, Paladini, M, Palumbo, L, Papadopoulos, P, Parton, H, Paternostro, J, Paynter, L, Perkins, K, Perlman, S, Persaud, H, Peters, C, Pfeiffer, M, Platt, R, Pool, L, Punsalang, A, Rasul, Z, Rawlins, V, Reddy, V, Rinchiuso, A, Rodriguez, T, Rosal, R, Ryan, M, Sanderson, M, Scaccia, A, Seligson, AL, Seupersad, J, SevereDildy, J, Siddiqi, A, Siemetzki, U, Glaser, M, Girdharrie, L, Singh, T, Slavinski, S, Slopen, M, Snuggs, T, Starr, D, Stayton, C, Fung, L, Fu, J, Friedman, S, Frieden, T, France, AM, Stoute, A, Terlonge, J, Ternier, A, Thorpe, L, Travers, C, Tsoi, B, Turner, K, Tzou, J, Vines, S, Waddell, EN, Walker, D, Warner, C, Weisfuse, I, Weiss, D, WilliamsAkita, A, Wilson, E, Fitzgerald, K, Harper, S, Hasnain, Q, Hedge, S, Heller, M, Hendrickson, D, Herskovitz, A, Hinterland, K, Holmes, R, Hom, J, Hon, J, Hopke, T, Hsieh, J, Hughes, S, Immerwahr, S, Incalicchio, AM, Jasek, J, Jimenez, J, Johns, M, Jones, L, Jordan, H, Kambili, C, Kang, J, Kapell, D, Karpati, A, Kerker, B, Konty, K, Kornblum, J, Krigsman, G, Laraque, F, Layton, M, Lee, E, Lee, L, Lee, S, Lim, S, Marx, M, McGibbon, E, Mahoney, K, Marin, G, Matte, T, McAnanama, R, McKay, R, McKay, C, McVeigh, K, Medina, E, Fireteanu, AM, Fine, A, FilsAime, C, Fernandez, M, Feliciano, R, Farley, S, Evans, M, Eisenhower, D, Egger, J, Edwin, B, Edghill, Z, Wong, M, Wu, C, Yang, D, Younis, M, Yusuff, S, Zimmerman, C, Zucker, J, Eavey, J, Durrah, J, Duquaine, D, DiGrande, L, DiCaprio, K, Diaz, L, Deocharan, B, Del Cid, O, DeGrechie, S, DeGrasse, A, Darkins, B, Daniels, A, Da Costa, CA, Crouch, B, Coyle, C, Costarella, R, Corey, C, Cook, D, Cook, H, Cone, J, Cimini, D, Chamany, S, Camurati, L, Campbell, M, Cajigal, A, Cai, L, Butts, B, Burke, M, Bregman, B, Bornschlegel, K, Blank, S, Betz, J, Berger, M, Berg, D, Bell, G, Begier, E, Beaudry, G, Beatrice, ST, Barbot, O, Balter, S, Backman, P, Atamian, J, Aston, C, AgborTabi, E, Adman, G, Adamski, A, Ackelsberg, J, Lipsitch, M, Biedrzycki, P, Finelli, L, Cooper, BS, Riley, S, Reed, C, Hagy, A, De Angelis, D, Presanis, AM, Goranson, C, Griffing, F, Gupta, L, Hamilton, C, Hanson, H, HartmanO'Connell, I, and Team, The New York City Swine Flu Investigation

Subjects
medicine.medical_specialty, Pediatrics, Hospitalization - statistics and numerical data, medicine.medical_treatment, Population, Public Health and Epidemiology/Infectious Diseases, Influenza, Human - classification - epidemiology, Disease Outbreaks, 03 medical and health sciences, 0302 clinical medicine, Influenza A Virus, H1N1 Subtype, Epidemiology, Pandemic, Severity of illness, Infectious Diseases/Viral Infections, medicine, Credible interval, 030212 general & internal medicine, Young adult, education, Mechanical ventilation, 0303 health sciences, education.field_of_study, 030306 microbiology, business.industry, Incidence (epidemiology), virus diseases, Bayes Theorem, General Medicine, 3. Good health, Medicine, business, Research Article
Abstract

Marc Lipsitch and colleagues use complementary data from two US cities, Milwaukee and New York City, to assess the severity of pandemic (H1N1) 2009 influenza in the United States., Background Accurate measures of the severity of pandemic (H1N1) 2009 influenza (pH1N1) are needed to assess the likely impact of an anticipated resurgence in the autumn in the Northern Hemisphere. Severity has been difficult to measure because jurisdictions with large numbers of deaths and other severe outcomes have had too many cases to assess the total number with confidence. Also, detection of severe cases may be more likely, resulting in overestimation of the severity of an average case. We sought to estimate the probabilities that symptomatic infection would lead to hospitalization, ICU admission, and death by combining data from multiple sources. Methods and Findings We used complementary data from two US cities: Milwaukee attempted to identify cases of medically attended infection whether or not they required hospitalization, while New York City focused on the identification of hospitalizations, intensive care admission or mechanical ventilation (hereafter, ICU), and deaths. New York data were used to estimate numerators for ICU and death, and two sources of data—medically attended cases in Milwaukee or self-reported influenza-like illness (ILI) in New York—were used to estimate ratios of symptomatic cases to hospitalizations. Combining these data with estimates of the fraction detected for each level of severity, we estimated the proportion of symptomatic patients who died (symptomatic case-fatality ratio, sCFR), required ICU (sCIR), and required hospitalization (sCHR), overall and by age category. Evidence, prior information, and associated uncertainty were analyzed in a Bayesian evidence synthesis framework. Using medically attended cases and estimates of the proportion of symptomatic cases medically attended, we estimated an sCFR of 0.048% (95% credible interval [CI] 0.026%–0.096%), sCIR of 0.239% (0.134%–0.458%), and sCHR of 1.44% (0.83%–2.64%). Using self-reported ILI, we obtained estimates approximately 7–9× lower. sCFR and sCIR appear to be highest in persons aged 18 y and older, and lowest in children aged 5–17 y. sCHR appears to be lowest in persons aged 5–17; our data were too sparse to allow us to determine the group in which it was the highest. Conclusions These estimates suggest that an autumn–winter pandemic wave of pH1N1 with comparable severity per case could lead to a number of deaths in the range from considerably below that associated with seasonal influenza to slightly higher, but with the greatest impact in children aged 0–4 and adults 18–64. These estimates of impact depend on assumptions about total incidence of infection and would be larger if incidence of symptomatic infection were higher or shifted toward adults, if viral virulence increased, or if suboptimal treatment resulted from stress on the health care system; numbers would decrease if the total proportion of the population symptomatically infected were lower than assumed. Please see later in the article for the Editors' Summary, Editors' Summary Background Every winter, millions of people catch influenza—a viral infection of the airways—and about half a million people die as a result. In the US alone, an average of 36,000 people are thought to die from influenza-related causes every year. These seasonal epidemics occur because small but frequent changes in the virus mean that an immune response produced one year provides only partial protection against influenza the next year. Occasionally, influenza viruses emerge that are very different and to which human populations have virtually no immunity. These viruses can start global epidemics (pandemics) that kill millions of people. Experts have been warning for some time that an influenza pandemic is long overdue and in, March 2009, the first cases of influenza caused by a new virus called pandemic (H1N1) 2009 (pH1N1; swine flu) occurred in Mexico. The virus spread rapidly and on 11 June 2009, the World Health Organization declared that a global pandemic of pH1N1 influenza was underway. By the beginning of November 2009, more than 6,000 people had died from pH1N1 influenza. Why Was This Study Done? With the onset of autumn—drier weather and the return of children to school help the influenza virus to spread—pH1N1 cases, hospitalizations, and deaths in the Northern Hemisphere have greatly increased. Although public-health officials have been preparing for this resurgence of infection, they cannot be sure of its impact on human health without knowing more about the severity of pH1N1 infections. The severity of an infection can be expressed as a case-fatality ratio (CFR; the proportion of cases that result in death), as a case-hospitalization ratio (CHR; the proportion of cases that result in hospitalization), and as a case-intensive care ratio (CIR; the proportion of cases that require treatment in an intensive care unit). Because so many people have been infected with pH1N1 since it emerged, the numbers of cases and deaths caused by pH1N1 infection are not known accurately so these ratios cannot be easily calculated. In this study, the researchers estimate the severity of pH1N1 influenza in the US between April and July 2009 by combining data on pH1N1 infections from several sources using a statistical approach known as Bayesian evidence synthesis. What Did the Researchers Do and Find? By using data on medically attended and hospitalized cases of pH1N1 infection in Milwaukee and information from New York City on hospitalizations, intensive care use, and deaths, the researchers estimate that the proportion of US cases with symptoms that died (the sCFR) during summer 2009 was 0.048%. That is, about 1 in 2,000 people who had symptoms of pH1N1 infection died. The “credible interval” for this sCFR, the range of values between which the “true” sCFR is likely to lie, they report, is 0.026%–0.096% (between 1 in 4,000 and 1 in 1,000 deaths for every symptomatic case). About 1 in 400 symptomatic cases required treatment in intensive care, they estimate, and about 1 in 70 symptomatic cases required hospital admission. When the researchers used a different approach to estimate the total number of symptomatic cases—based on New Yorkers' self-reported incidence of influenza-like-illness from a telephone survey—their estimates of pH1N1 infection severity were 7- to 9-fold lower. Finally, they report that the sCFR and the sCIR were highest in people aged 18 or older and lowest in children aged 5–17 years. What Do These Findings Mean? Many uncertainties (for example, imperfect detection and reporting) can affect estimates of influenza severity. Even so, the findings of this study suggest that an autumn–winter pandemic wave of pH1N1 will have a death toll only slightly higher than or considerably lower than that caused by seasonal influenza in an average year, provided pH1N1 continues to behave as it did during the summer. Similarly, the estimated burden on hospitals and intensive care facilities ranges from somewhat higher than in a normal influenza season to considerably lower. The findings of this study also suggest that, unlike seasonal influenza, which kills mainly elderly adults, a high proportion of deaths from pH1N1infection will occur in nonelderly adults, a shift in age distribution that has been seen in previous pandemics. With these estimates in hand and with continued close monitoring of the pandemic, public-health officials should now be in a better position to plan effective strategies to deal with the pH1N1 pandemic. Additional Information Please access these Web sites via the online version of this summary at http://dx.doi.org/10.1371/journal.pmed.1000207. The US Centers for Disease Control and Prevention provides information about influenza for patients and professionals, including specific information on pandemic H1N1 (2009) influenza Flu.gov, a US government Web site, provides access to information on H1N1, avian and pandemic influenza The World Health Organization provides information on seasonal influenza and has detailed information on pandemic H1N1 (2009) influenza (in several languages) The UK Health Protection Agency provides information on pandemic influenza and on pandemic H1N1 (2009) influenza More information for patients about H1N1 influenza is available through Choices, an information resource provided by the UK National Health Service

Published
2016

27. Best practices for improving flow and care of pediatric patients in the emergency department

Author

Barata, I, Brown, KM, Fitzmaurice, L, Griffin, ES, Snow, SK, Shook, JE, Ackerman, AD, Chun, TH, Conners, GP, Dudley, NC, Fuchs, SM, Gorelick, MH, Lane, NE, Moore, BR, Wright, JL, Benjamin, LS, Alade, K, Arms, J, Avarello, JT, Baldwin, S, Cantor, RM, Cohen, A, Dietrich, AM, Eakin, PJ, Gausche-Hill, M, Gerardi, M, Graham, CJ, Holtzman, DK, Hom, J, Ishimine, P, Jinivizian, H, Joseph, M, Mehta, S, Ojo, A, Paul, AZ, Pauze, DR, Pearson, NM, Rosen, B, Russell, WS, Saidinejad, M, Sloas, HA, Schwartz, GR, Swenson, O, Valente, JH, Waseem, M, Whiteman, PJ, Woolridge, D, Vicioso, M, Herrin, SA, Nagle, JT, Cadwell, SM, Goodman, RL, Johnson, ML, Frankenberger, WD, Renaker, AM, and Tomoyasu, FS

Subjects
Medical And Health Sciences, education, Emergency Nurses Association Pediatric Committee, American Academy of Pediatrics Committee on Pediatric Emergency Medicine, Pediatrics, humanities, American College of Emergency Physicians Pediatric Emergency Medicine Committee, Critical Pathways, Humans, InformationSystems_MISCELLANEOUS, Child, Emergency Service, Hospital, Emergency Treatment, Psychology And Cognitive Sciences, Quality of Health Care
Abstract

Copyright © 2015 by the American Academy of Pediatrics. This report provides a summary of best practices for improving flow, reducing waiting times, and improving the quality of care of pediatric patients in the emergency department.

Published
2015
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28. Point-of-care ultrasonography by Pediatric Emergency medicine physicians

Author

Marin, JR, Lewiss, RE, Shook, JE, Ackerman, AD, Chun, TH, Conners, GP, Dudley, NC, Fuchs, SM, Gorelick, MH, Lane, NE, Moore, BR, Wright, JL, Bird, SB, Blomkalns, AL, Carmody, K, Clem, KJ, Courtney, DM, Diercks, DB, Fields, M, Hockberger, RS, Holmes, JF, Hudak, L, Jones, AE, Kaji, AH, Martin, IBK, Moore, C, Panebianco, N, Benjamin, LS, Barata, IA, Alade, K, Arms, J, Avarello, JT, Baldwin, S, Brown, K, Cantor, RM, Cohen, A, Dietrich, AM, Eakin, PJ, Gausche-Hill, M, Gerardi, M, Graham, CJ, Holtzman, DK, Hom, J, Ishimine, P, Jinivizian, H, Joseph, M, Mehta, S, Ojo, A, Paul, AZ, Pauze, DR, Pearson, NM, Rosen, B, Russell, WS, Saidinejad, M, Sloas, HA, Schwartz, GR, Swenson, O, Valente, JH, Waseem, M, Whiteman, PJ, Woolridge, D, Noble, V, Storti, E, Tsung, J, and Volpicelli, G

Subjects
World Interactive Network Focused on Critical Ultrasound, Medical And Health Sciences, Society for Academic Emergency Medicine, Academy of Emergency Ultrasound, Evidence-Based Medicine, American College of Emergency Physicians, Pediatric Emergency Medicine Committee, Point-of-Care Systems, American Academy of Pediatrics, Committee on Pediatric Emergency Medicine, Pediatrics, United States, Emergency Medicine, Humans, Interdisciplinary Communication, Education, Medical, Continuing, Curriculum, Cooperative Behavior, Credentialing, Child, Emergency Service, Hospital, Psychology And Cognitive Sciences, Ultrasonography
Abstract

Copyright © 2015 by the American Academy of Pediatrics. Emergency physicians have used point-of-care ultrasonography since the abstract 1990s. Pediatric emergency medicine physicians have more recently adopted this technology. Point-of-care ultrasonography is used for various scenarios, particularly the evaluation of soft tissue infections or blunt abdominal trauma and procedural guidance. To date, there are no published statements from national organizations specifically for pediatric emergency physicians describing the incorporation of point-of-care ultrasonography into their practice. This document outlines how pediatric emergency departments may establish a formal point-of-care ultrasonography program. This task includes appointing leaders with expertise in point-of-care ultrasonography, effectively training and credentialing physicians in the department, and providing ongoing quality assurance reviews.

Published
2015
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29. Death of a child in the emergency department

Author

O'Malley, P, Barata, I, Snow, S, Shook, JE, Ackerman, AD, Chun, TH, Conners, GP, Dudley, NC, Fuchs, SM, Gorelick, MH, Lane, NE, Moore, BR, Wright, JL, Benjamin, LS, Alade, K, Arms, J, Avarello, JT, Baldwin, S, Brown, K, Cantor, RM, Cohen, A, Dietrich, AM, Eakin, PJ, Gausche-Hill, M, Gerardi, M, Graham, CJ, Holtzman, DK, Hom, J, Ishimine, P, Jinivizian, H, Joseph, M, Mehta, S, Ojo, A, Paul, AZ, Pauze, DR, Pearson, NM, Rosen, B, Russell, WS, Saidinejad, M, Sloas, HA, Schwartz, GR, Swenson, O, Valente, JH, Waseem, M, Whiteman, PJ, Woolridge, D, Vicioso, M, Herrin, SA, Nagle, JT, Cadwell, SM, Goodman, RL, Johnson, ML, Frankenberger, WD, Renaker, AM, and Tomoyasu, FS

Subjects
death of a child, Medical And Health Sciences, Tissue and Organ Procurement, Adolescent, emergency department, Resuscitation, Infant, Newborn, Infant, Emergency Nurses Association Pediatric Committee, American Academy of Pediatrics Committee on Pediatric Emergency Medicine, Pediatrics, Organizational Policy, Death, Professional-Family Relations, American College of Emergency Physicians Pediatric Emergency Medicine Committee, Child, Preschool, Humans, Autopsy, Hospital Mortality, Child, Emergency Service, Hospital, Psychology And Cognitive Sciences, Bereavement
Abstract

The death of a child in the emergency department (ED) is one of the most challenging problems facing ED clinicians. This revised technical report and accompanying policy statement reaffirm principles of patient- and family-centered care. Recent literature is examined regarding family presence, termination of resuscitation, bereavement responsibilities of ED clinicians, support of child fatality review efforts, and other issues inherent in caring for the patient, family, and staff when a child dies in the ED. Appendices are provided that offer an approach to bereavement activities in the ED, carrying out forensic responsibilities while providing compassionate care, communicating the news of the death of a child in the acute setting, providing a closing ritual at the time of terminating resuscitation efforts, and managing the child with a terminal condition who presents near death in the ED. Copyright © 2014 by the American Academy of Pediatrics.

Published
2014
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32. Grand Rounds

Author

Fayolle, G., primary, Levick, W., additional, Lajiness-O'Neill, R., additional, Fastenau, P., additional, Briskin, S., additional, Bass, N., additional, Silva, M., additional, Critchfield, E., additional, Nakase-Richardson, R., additional, Hertza, J., additional, Loughan, A., additional, Perna, R., additional, Northington, S., additional, Boyd, S., additional, Anderson, A., additional, Peery, S., additional, Chafetz, M., additional, Maris, M., additional, Ramezani, A., additional, Sylvester, C., additional, Goldberg, K., additional, Constantinou, M., additional, Karekla, M., additional, Hall, J., additional, Edwards, M., additional, Balldin, V., additional, Strutt, A., additional, Pavlik, V., additional, Marquez de la Plata, C., additional, Cullum, M., additional, lacritz, l., additional, Reisch, J., additional, Massman, P., additional, Royall, D., additional, Barber, R., additional, Younes, S., additional, Wiechmann, A., additional, O'Bryant, S., additional, Patel, K., additional, Suhr, J., additional, Chari, S., additional, Yokoyama, J., additional, Bettcher, B., additional, Karydas, A., additional, Miller, B., additional, Kramer, J., additional, Zec, R., additional, Fritz, S., additional, Kohlrus, S., additional, Robbs, R., additional, Ala, T., additional, Gifford, K., additional, Cantwell, N., additional, Romano, R., additional, Jefferson, A., additional, Holland, A., additional, Newton, S., additional, Bunting, J., additional, Coe, M., additional, Carmona, J., additional, Harrison, D., additional, Puente, A., additional, Terry, D., additional, Faraco, C., additional, Brown, C., additional, Patel, A., additional, Watts, A., additional, Kent, A., additional, Siegel, J., additional, Miller, S., additional, Ernst, W., additional, Chelune, G., additional, Holdnack, J., additional, Sheehan, J., additional, Duff, K., additional, Pedraza, O., additional, Crawford, J., additional, Miller, L., additional, Hobson Balldin, V., additional, Benavides, H., additional, 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additional, Frawley, J., additional, Welch, M., additional, Jennette, K., additional, Rinehardt, E., additional, Schoenberg, M., additional, Strober, L., additional, Genova, H., additional, Wylie, G., additional, DeLuca, J., additional, Chiaravalloti, N., additional, Ibrahim, E., additional, Seiam, A., additional, Bohlega, S., additional, Lloyd, H., additional, Goldberg, M., additional, Marceaux, J., additional, Fallows, R., additional, McCoy, K., additional, Yehyawi, N., additional, Luther, E., additional, Hilsabeck, R., additional, Fulton, R., additional, Stevens, P., additional, Erickson, S., additional, Dodzik, P., additional, Williams, R., additional, Dsurney, J., additional, Najafizadeh, L., additional, McGovern, J., additional, Chowdhry, F., additional, Acevedo, A., additional, Bakhtiar, A., additional, Karamzadeh, N., additional, Amyot, F., additional, Gandjbakhche, A., additional, Haddad, M., additional, Johnson, M., additional, Wade, J., additional, Harper, L., additional, 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additional, McClaughlin, S., additional, Mooney, S., additional, Seats, E., additional, Carnell, V., additional, Raintree, J., additional, Brown, D., additional, Hodges, C., additional, Amerson, E., additional, Kennedy, C., additional, Moore, J., additional, Ferris, C., additional, Roebuck-Spencer, T., additional, Vincent, A., additional, Bryan, C., additional, Catalano, D., additional, Warren, A., additional, Monden, K., additional, Driver, S., additional, Chau, P., additional, Seegmiller, R., additional, Baker, M., additional, Malach, S., additional, Mintz, J., additional, Villarreal, R., additional, Peterson, A., additional, Leininger, S., additional, Strong, C., additional, Donders, J., additional, Merritt, V., additional, Vargas, G., additional, Rabinowitz, A., additional, Arnett, P., additional, Whipple, E., additional, Schultheis, M., additional, Robinson, K., additional, Iacovone, D., additional, Biester, R., additional, Alfano, D., additional, Nicholls, M., additional, Klas, P., additional, Jeffay, E., additional, Zakzanis, K., additional, Vandermeer, M., additional, Womble, M., additional, Corley, E., additional, Considine, C., additional, Fichtenberg, N., additional, Harrison, J., additional, Pollock, M., additional, Mouanoutoua, A., additional, Brimager, A., additional, Lebby, P., additional, Sullivan, K., additional, Edmed, S., additional, Kieffer, K., additional, McCarthy, M., additional, Wiegand, L., additional, Lindsey, H., additional, Hernandez, M., additional, Noniyeva, Y., additional, Lapis, Y., additional, Padua, M., additional, Poole, J., additional, Brooks, B., additional, McKay, C., additional, Meeuwisse, W., additional, Emery, C., additional, Mazur-Mosiewicz, A., additional, Sherman, E., additional, Kirkwood, M., additional, Gunner, J., additional, Miele, A., additional, Silk-Eglit, G., additional, Lynch, J., additional, McCaffrey, R., additional, Stewart, J., additional, Tsou, J., additional, Scarisbrick, D., additional, Chan, R., additional, Bure-Reyes, A., additional, Cortes, L., additional, Gindy, S., additional, Biddle, C., additional, Shah, D., additional, Jaberg, P., additional, Moss, R., additional, Horner, M., additional, VanKirk, K., additional, Dismuke, C., additional, Turner, T., additional, Muzzy, W., additional, Dunnam, M., additional, Warner, G., additional, Donnelly, K., additional, Donnelly, J., additional, Kittleson, J., additional, Bradshaw, C., additional, Alt, M., additional, Margolis, S., additional, Ostroy, E., additional, Higgins, K., additional, Eng, K., additional, Akeson, S., additional, Wall, J., additional, Davis, J., additional, Hansel, J., additional, Wang, B., additional, Gervais, R., additional, Greiffenstein, M., additional, Denning, J., additional, VonDran, E., additional, Campbell, E., additional, Brockman, C., additional, Teichner, G., additional, Waid, R., additional, Buican, B., additional, Armistead-Jehle, P., additional, Bailie, J., additional, Dilay, A., additional, Cottingham, M., additional, Boyd, C., additional, Asmussen, S., additional, Neff, J., additional, Schalk, S., additional, Jensen, L., additional, DenBoer, J., additional, Hall, S., additional, Holcomb, E., additional, Axelrod, B., additional, Demakis, G., additional, Rimland, C., additional, Ward, J., additional, Ross, M., additional, Bailey, M., additional, Stubblefield, A., additional, Smigielski, J., additional, Geske, J., additional, Karpyak, V., additional, Reese, C., additional, Larrabee, G., additional, Allen, L., additional, Celinski, M., additional, Gilman, J., additional, LaDuke, C., additional, DeMatteo, D., additional, Heilbrun, K., additional, Swirsky-Sacchetti, T., additional, Dedman, A., additional, Withers, K., additional, Deneen, T., additional, Fisher, J., additional, Spray, B., additional, Savage, R., additional, Wiener, H., additional, Tyer, J., additional, Ningaonkar, V., additional, Devlin, B., additional, Go, R., additional, Sharma, V., additional, Fontanetta, R., additional, Calderon, C., additional, Coad, S., additional, Fontaneta, R., additional, Vertinski, M., additional, Verbiest, R., additional, Snyder, J., additional, Kinney, J., additional, Rach, A., additional, Young, J., additional, Crouse, E., additional, Schretlen, D., additional, Weaver, J., additional, Buchholz, A., additional, Gordon, B., additional, Macciocchi, S., additional, Seel, R., additional, Godsall, R., additional, Brotsky, J., additional, DiRocco, A., additional, Houghton-Faryna, E., additional, Bolinger, E., additional, Hollenbeck, C., additional, Hart, J., additional, Lee, B., additional, Strauss, G., additional, Adams, J., additional, Martins, D., additional, Catalano, L., additional, Waltz, J., additional, Gold, J., additional, Haas, G., additional, Brown, L., additional, Luther, J., additional, Goldstein, G., additional, Kelley, E., additional, Raba, C., additional, Trettin, L., additional, Solvason, H., additional, Buchanan, R., additional, Baldock, D., additional, Etherton, J., additional, Phelps, T., additional, Richmond, S., additional, Tapscott, B., additional, Thomlinson, S., additional, Cordeiro, L., additional, Wilkening, G., additional, Parikh, M., additional, Graham, L., additional, Grosch, M., additional, Hynan, L., additional, Weiner, M., additional, Cullum, C., additional, Menon, C., additional, Lacritz, L., additional, Castro-Couch, M., additional, Irani, F., additional, Houshyarnejad, A., additional, Norman, M., additional, Fonseca, F., additional, Browne, B., additional, Alvarez, J., additional, Jiminez, Y., additional, Baez, V., additional, Resendiz, C., additional, Scott, B., additional, Farias, G., additional, York, M., additional, Lozano, V., additional, Mahoney, M., additional, Hernandez Mejia, M., additional, Pacheco, E., additional, Homs, A., additional, Ownby, R., additional, Nici, J., additional, Hom, J., additional, Lutz, J., additional, Dean, R., additional, Finch, H., additional, Pierce, S., additional, Moses, J., additional, Mann, S., additional, Feinberg, J., additional, Choi, A., additional, Kaminetskaya, M., additional, Pierce, C., additional, Zacharewicz, M., additional, Gavett, B., additional, Horwitz, J., additional, Ory, J., additional, Carbuccia, K., additional, Morra, L., additional, Garcon, S., additional, Lucas, M., additional, Donovick, P., additional, Whearty, K., additional, Campbell, K., additional, Camlic, S., additional, Brinckman, D., additional, Ehrhart, L., additional, Weisser, V., additional, Medaglia, J., additional, Merzagora, A., additional, Reckess, G., additional, Ho, T., additional, Testa, S., additional, Woolery, H., additional, Farcello, C., additional, Klimas, N., additional, Meyer, J., additional, Barwick, F., additional, Drayer, K., additional, Galusha, J., additional, Schmitt, A., additional, Livingston, R., additional, Stewart, R., additional, Quarles, L., additional, Pagitt, M., additional, Barke, C., additional, Baker, A., additional, Baker, N., additional, Cook, N., additional, Ahern, D., additional, Correia, S., additional, Resnik, L., additional, Barnabe, K., additional, Gnepp, D., additional, Benjamin, M., additional, Zlatar, Z., additional, Garcia, A., additional, Harnish, S., additional, Crosson, B., additional, Vaughan, L., additional, Fedio, A., additional, Sexton, J., additional, Cummings, S., additional, Logemann, A., additional, Lassiter, N., additional, Fedio, P., additional, Gremillion, A., additional, Nemeth, D., additional, Whittington, T., additional, Reckow, J., additional, Lewandowski, C., additional, Cole, J., additional, Lewandowski, A., additional, Spector, J., additional, Ford-Johnson, L., additional, Lengenfelder, J., additional, Sumowski, J., additional, Morse, C., additional, McKeever, J., additional, Zhao, L., additional, Leist, T., additional, Marcinak, J., additional, Piecora, K., additional, Al-Khalil, K., additional, Martin, P., additional, Thompson, L., additional, Kowalczyk, W., additional, 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additional, Jerard, T., additional, Sakhai, S., additional, Barney, S., additional, McGoldrick, K., additional, Sordahl, J., additional, Torrence, N., additional, and John, S., additional

Published
2012
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38. The development of low temperature curing adhesives

Author

Green, H. E, Sutherland, J. D, Hom, J. M, and Sheppard, C. H

Subjects
Nonmetallic Materials
Abstract

An approach for the development of a practical low temperature (293 K-311 K/68 F-100 F) curing adhesive system based on a family of amide/ester resins was studied and demonstrated. The work was conducted on resin optimization and adhesive compounding studies. An improved preparative method was demonstrated which involved the reaction of an amine-alcohol precursor, in a DMF solution with acid chloride. Experimental studies indicated that an adhesive formulation containing aluminum powder provided the best performance when used in conjunction with a commercial primer.

Published
1975

41. Development of Multiplex PCR-Ligase Detection Reaction Assay for Detection of West Nile Virus

Author

Rondini, S., primary, Pingle, M. R., additional, Das, S., additional, Tesh, R., additional, Rundell, M. S., additional, Hom, J., additional, Stramer, S., additional, Turner, K., additional, Rossmann, S. N., additional, Lanciotti, R., additional, Spier, E. G., additional, Muñoz-Jordán, J., additional, Larone, D., additional, Spitzer, E., additional, Barany, F., additional, and Golightly, L. M., additional

Published
2008
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47. Is there a Gulf War Syndrome? Searching for syndromes by factor analysis of symptoms.

Author

Haley RW, Kurt TL, Hom J, Haley, R W, Kurt, T L, and Hom, J

Abstract

Objective: To search for syndromes in Persian Gulf War veterans.Participants: Two hundred forty-nine (41%) of the 606 Gulf War veterans of the Twenty-fourth Reserve Naval Mobile Construction Battalion living in 5 southeastern states participated; 145 (58%) had retired from service, and the rest were still serving in the battalion.Design: Participants completed a standardized survey booklet measuring the anatomical distributions or characteristics of each symptom, a booklet measuring wartime exposures, and a standard psychological personality assessment inventory. Two-stage factor analysis was used to disentangle ambiguous symptoms and identify syndromes.Main Outcome Measures: Factor analysis-derived syndromes.Results: Of 249 participants, 175 (70%) reported having had serious health problems that most attributed to the war, and 74 (30%) reported no serious health problems. Principal factor analysis yielded 6 syndrome factors, explaining 71% of the variance. Dichotomized syndrome indicators identified the syndromes in 63 veterans (25%). Syndromes 1 ("impaired cognition," characterized by problems with attention, memory, and reasoning, as well as insomnia, depression, daytime sleepiness, and headaches), 2 ("confusion-ataxia," characterized by problems with thinking, disorientation, balance disturbances, vertigo, and impotence), and 3 ("arthro-myo-neuropathy," characterized by joint and muscle pains, muscle fatigue, difficulty lifting, and extremity paresthesias) represented strongly clustered symptoms; whereas, syndromes 4 ("phobia-apraxia"), 5 ("fever-adenopathy"), and 6 ("weakness-incontinence") involved weaker clustering and mostly overlapped syndromes 2 and 3. Veterans with syndrome 2 were 12.5 times (95% confidence interval, 3.5-44.8) more likely to be unemployed than those with no health problems. A psychological profile, found in 48.4% of those with the syndromes, differed from posttraumatic stress disorder, depression, somatoform disorder, and malingering.Conclusion: These findings support the hypothesis that clusters of symptoms of many Gulf War veterans represent discrete factor analysis-derived syndromes that appear to reflect a spectrum of neurologic injury involving the central, peripheral, and autonomic nervous systems. [ABSTRACT FROM AUTHOR]

Published
1997
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