Browsing by Subject "Observation"
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Item Open Access A comparison of temperament in nonhuman apes and human infants.(Dev Sci, 2011-11) Herrmann, Esther; Hare, Brian; Cissewski, Julia; Tomasello, MichaelThe adaptive behavior of primates, including humans, is often mediated by temperament. Human behavior likely differs from that of other primates in part due to temperament. In the current study we compared the reaction of bonobos, chimpanzees, orangutans, and 2.5-year-old human infants to novel objects and people - as a measure of their shyness-boldness, a key temperamental trait. Human children at the age of 2.5 years avoided novelty of all kinds far more than the other ape species. This response was most similar to that seen in bonobos and least like that of chimpanzees and orangutans. This comparison represents a first step in characterizing the temperamental profiles of species in the hominoid clade, and these findings are consistent with the hypothesis that human temperament has evolved since our lineage diverged from the other apes in ways that likely have broad effects on behavior. These findings also provide new insights into how species differences in ecology may shape differences in temperament.Item Open Access Care of the Patient with Chest Pain in the Observation Unit.(Emergency medicine clinics of North America, 2017-08) Borawski, Joseph B; Graff, Louis G; Limkakeng, Alexander TCare of the patient presenting to an emergency department (ED) with chest pain remains a common yet challenging aspect of emergency medicine. Acute coronary syndrome presents in nonspecific fashion. The development and evolution of the ED-based observation unit has helped to safely assess and diagnose those most at risk for an adverse cardiac event. Furthermore, there are several provocative testing modalities to help assess for coronary artery disease. This article serves to describe and discuss the modern ED-based observation unit approach to patients with chest pain and/or angina equivalents presenting to an ED.Item Open Access Identification of chest pain patients appropriate for an emergency department observation unit.(Emergency medicine clinics of North America, 2001-02) Wilkinson, K; Severance, HThere are no perfect tests or algorithms to exclude ACI. Because acute coronary occlusion often occurs in patients with low-grade coronary stenosis, the diagnostic goal of a chest pain diagnostic protocol is not to identify patients with CAD, but rather to identify patients who may be safely discharged home without the development of complications such as MI, unstable angina, death, shock, or CHF over the next 1 to 6 months. There is an advantage to evaluating patients at the time of their symptoms. Patients who have a small plaque that is ruptured, leading to intracoronary thrombosis and ischemia, will manifest ischemia on diagnostic testing that could missed in routine outpatient testing when their plaque were stable. The diagnosis and risk stratification of acute coronary ischemia in the ED depends on a careful history and interpretation of the ECG. Multiple regression models using readily available data (e.g., history, physical examination, and ECG) provide the best tools for risk stratification. If one is deciding how to select patients for an EDOU chest pain evaluation, diagnostic tools that have previously been tested and validated in this setting are preferable. These include the Multicenter Chest Pain Study derived tools (i.e., Goldman, Lee), the ACI and ACI-TIPI tools, and sestamibi risk stratification tools. This is not to say that other tools may not play a role at individual institutions. It is probably better to select a consistent approach and evaluate its performance, rather than to allow random variation to dictate practice. The future direction probably will involve standardization of the ED chest pain population. This allows outcome and cost-effectiveness comparative research of various strategies for patients with normal or nondiagnostic ECGs and normal biomarkers. Although this approach allows more precise stratification, the risk will never be zero, meaning that there will never be a substitute for good clinical judgment and close follow-up care.Item Open Access Reproductive improvement and senescence in a long-lived bird.(Proc Natl Acad Sci U S A, 2010-04-27) Rebke, Maren; Coulson, Tim; Becker, Peter H; Vaupel, James WHeterogeneity within a population is a pervasive challenge for studies of individual life-histories. Population-level patterns in age-specific reproductive success can be broken down into relative contributions from selective disappearance, selective appearance of individuals into the study population, and average change in performance for survivors (average ontogenetic development). In this article, we provide an exact decomposition. We apply our formula to data on the reproductive performance of a well characterized population of common terns (Sterna hirundo). We show that improvements with age over most of adult life and senescence at old ages are primarily due to a genuine change in the mean among surviving individuals rather than selective disappearance or selective appearance of individuals. Average ontogenetic development accounts for approximately 87% of the overall age-specific population change.