Early prognostic value of the medical emergency team calling criteria in patients admitted to intensive care from the emergency department

OBJECTIVES: To evaluate the early prognostic value of the medical emergency team (MET) calling criteria in patients admitted to intensive care from the emergency department. DESIGN: Retrospective cohort study. SETTING: Emergency department and department of intensive care medicine of a 960-bed tertiary referral hospital. PATIENTS: A total of 452 consecutive adult patients admitted to intensive care from the emergency department from January 1, 2004, to December 31, 2004. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: MET calling criteria were retrospectively extracted from patient records, and the sum of positive criteria was calculated for the first hour in the emergency department (METinitial) and subsequently until admission to the intensive care unit in a series of time periods. The maximum number of positive MET calling criteria during any time period was defined (METmax). Logistic regression analysis revealed METinitial (odds ratio [OR] 3.392, 95% confidence interval [CI] 2.534-4.540) and METmax (OR 3.867, 95% CI 2.816-5.312) to be significant predictors of hospital mortality, the need for mechanical ventilation (METinitial: OR 4.151, 95% CI 3.53-4.652; METmax: OR 4.292, 95% CI 3.151-5.846), and occurrence of hemodynamic instability (METinitial: OR 1.548, 95% CI 1.258-1.905; METmax: OR 1.685, 95% CI 1.355-2.094) (all p < .0001). CONCLUSIONS: MET scores collected early after admission or throughout the stay in the emergency department allow for simple identification of patients at risk of unfavorable outcome during the subsequent intensive care unit stay.

Xenograft rejection: IgG1, complement and NK cells team up to activate and destroy the endothelium

Acute vascular rejection represents a formidable barrier to clinical xenotransplantation and it is known that this type of rejection can also be initiated by xenoreactive antibodies that have limited complement-activating ability. Using a sophisticated mouse model, a recent study has provided in vivo evidence for the existence of an IgG(1)-mediated vascular rejection, which uniquely depends on both the activation of complement and interactions with FcgammaRIII on natural killer (NK) cells.

How the Entrepreneurial Top Management Team Setup Influences Firm Performance and the Ability to Raise Capital: A Literature Review

This paper reviews research findings on entrepreneurial top management teams within the last 20 years. It concentrates on team-based management factors and their influence on a new venture’s growth and ability to raise capital. This paper integrates recent findings and provides an overview of the current state of research. Moreover, it contributes to the overall topic by proposing five clusters of major team-specific influences, derives determinants of success and failure, and reveals recommendations for further research.

Safety climate and its association with office type and team involvement in primary care

OBJECTIVE To assess differences in safety climate perceptions between occupational groups and types of office organization in primary care. METHODS Primary care physicians and nurses working in outpatient offices were surveyed about safety climate. Explorative factor analysis was performed to determine the factorial structure. Differences in mean climate scores between staff groups and types of office were tested. Logistic regression analysis was conducted to determine predictors for a 'favorable' safety climate. RESULTS 630 individuals returned the survey (response rate, 50%). Differences between occupational groups were observed in the means of the 'team-based error prevention'-scale (physician 4.0 vs. nurse 3.8, P < 0.001). Medical centers scored higher compared with single-handed offices and joint practices on the 'team-based error prevention'-scale (4.3 vs. 3.8 vs. 3.9, P < 0.001) but less favorable on the 'rules and risks'-scale (3.5 vs. 3.9 vs. 3.7, P < 0.001). Characteristics on the individual and office level predicted favorable 'team-based error prevention'-scores. Physicians (OR = 0.4, P = 0.01) and less experienced staff (OR 0.52, P = 0.04) were less likely to provide favorable scores. Individuals working at medical centers were more likely to provide positive scores compared with single-handed offices (OR 3.33, P = 0.001). The largest positive effect was associated with at least monthly team meetings (OR 6.2, P < 0.001) and participation in quality circles (OR 4.49, P < 0.001). CONCLUSIONS Results indicate that frequent quality circle participation and team meetings involving all team members are effective ways to strengthen safety climate in terms of team-based strategies and activities in error prevention.

A Team-Oriented Investigation of ERP Post-Implementation Integration Projects: How Cross-Functional Collaboration Influences ERP Benefits

The benefits companies achieve by implementing an ERP system vary considerably. Many companies need to adapt their ERP integration solution in the post-implementation stage. But after the completion of such a usually very complex integration project, benefits do not emerge by all means. A misfit between the organization and the IS, especially the aspect of cross-functional team collaboration, could explain these divergences. Using an initial theoretical framework, we conducted a single case study to explore the team-oriented perceptions in a post-implementation ERP integration project. To analyze the benefits and the influences in greater depth we disentangled the integration benefits into their particular parts (process, system and information quality). Our findings show that post-implementation ERP integration changes are not always perceived as beneficiary by the involved teams and that cross-functional collaboration has an important influence.

Emotional contagion in team sports and its impact on individual performance – an experimental study

In sport psychology research about emotional contagion in sport teams has been scarce (Reicherts & Horn, 2008). Emotional contagion is a process leading to a specific emotional state in an individual caused by the perception of another individual’s emotional expression (Hatfield, Cacioppo & Rapson, 1994). Apitzsch (2009) described emotional contagion as one reason for collapsing sport teams. The present study examined the occurrence of emotional contagion in dyads during a basketball task and the impact of a socially induced emotional state on performance. An experiment with between-subjects design was conducted. Participants (N=81, ♀=38, M=21.33 years, SD=1.45) were randomly assigned to one of two experimental conditions, by joining a confederate to compose a same gender, ad hoc team. The team was instructed to perform a basketball task as quickly as possible. The between-factor of the experimental design was the confederate’s emotional expression (positive or negative valence). The within-factor was participants’ emotional state, measured pre- and post-experimentally using PANAS (Krohne, Egloff, Kohlmann & Tausch, 1996). The basketball task was video-taped and the number of frames participants needed to complete the task was used to determine the individual performance. The confederate’s emotional expression was appraised in a significantly different manner across both experimental conditions by participants and video raters (MC). Mixed between-within subjects ANOVAs were conducted to examine the impact of the two conditions on participants’ scores on the PANAS subscales across two time periods (pre- and post-experimental). No significant interaction effects but substantial main effects for time were found on both PANAS subscales. Both groups showed an increase in positive and a reduction in negative PANAS scores across these two time periods. Nevertheless, video raters assessment of the emotional states expressed by participants was significantly different between the positive (M=3.23, SD=0.45) and negative condition (M=2.39, SD=0.53; t=7.64, p<.001, eta squared=.43). An independent-samples t-test indicated no difference in performance between conditions. Furthermore, no significant correlation between the extent of positive or negative emotional contagion and the number of frames was observed. The basketball task lead to an improvement of the emotional state of participants, independently of the condition. Even though participants PANAS scores indicated a tendency to emotional contagion, it was not statistically significant. This could be explained by the low task duration of approximately three minutes. Moreover, the performance of participants was unaffected by the experimental condition or the extent of positive or negative emotional contagion. Apitzsch, E. (2009). A case study of a collapsing handball team. In S. Jern & J. Näslund (Eds.), Dynamics within and outside the lab. Proceedings from The 6th Nordic Conference on Group and Social Psychology, May 2008, Lund, pp. 35-52. Hatfield, E., Cacioppo, J. T. & Rapson, R. L. (1994). Emotional contagion. Cambridge: University Press. Krohne, H. W., Egloff, B., Kohlmann, C.-W. & Tausch, A. (1996). Untersuchungen mit einer deutschen Version der „Positive und Negative Affect Schedule“ (PANAS). Diagnostica, 42 (2), 139-156. Reicherts, M. & Horn, A. B. (2008). Emotionen im Sport. In W. Schlicht & B. Strauss (Eds.), Enzyklopädie der Psychologie. Grundlagen der Sportpsychologie (Bd. 1) (S. 563-633). Göttingen: Hogrefe.

National youth team football players between the conflicting priorities of sports success and vocational training

In view of the risks involved in relying on a professional career in football as a way of making a future living, most players on Swiss National Youth Football Teams pursue some form of vocational training at the same time. This paper investigates the question under what conditions a successful football career is possible when faced with such a dual burden. In order to examine the development process as holistically as possible, a person-oriented approach was chosen. 159 former Swiss National Youth Team players were retrospectively interviewed about their careers, and the data were analysed using the LICUR method (Bergman, Magnusson, & El-Khouri, 2003). This involves identifying certain patterns in the relevant variables of sports career, vocational career and family support, and then comparing these with the performance at the age of peak performance. Through this, it was possible to identify promising patterns of development. It turns out that the critical transition, at the age of about 15–16 years, is characterised overall by stability. The most successful patterns display above-average family support accompanied by above-average professional talent promotion in the clubs. In this constellation, the football players who are later successful pursue vocational training courses leading to low levels of educational qualification.

Modified Team-based Learning (TBL) as a tool in Problem-based learning (PBL); Observations and Lessons from Year One

Both TBL and PBL attempt to maximally engage the learner and both are designed to encourage interactive teaching / learning. PBL is student centered. TBL, in contrast, is typically instructor centered. The PBL Executive Committee of the UTHSC-Houston Medical School, in an attempt to capture the pedagogical advantages of PBL and of TBL, implemented a unique PBL experience into the ICE/PBL course during the final block of PBL instruction in year 2. PBL cases provided the content knowledge for focused learning. The subsequent, related TBL exercises fostered integration / critical thinking about each of these cases. [See PDF for complete abstract]

The implicit achievement motive predicts match performance and the explicit motive choices for goal distances in team sports

Motivational research over the past decade has provided ample evidence for the existence of two distinct motivational systems. Implicit motives are affect-based needs and have been found to predict spontaneous behavioral trends over time. Explicit motives in contrast represent cognitively based self-attributes and are preferably linked to choices. The present research examines the differentiating and predictive value of the implicit vs. explicit achievement motives for team sports performances. German students (N = 42) completed a measure of the implicit (Operant Motive Test) and the explicit achievement motive (Achievement Motive Scale-Sport). Choosing a goal distance is significantly predicted by the explicit achievement motive measure. By contrast, repeated performances in a team tournament are significantly predicted by the indirect measure. Results are in line with findings showing that implicit and explicit motive measures are associated with different classes of behavior.

A Multidisciplinary Team Experience with Food Insecurity & Failure to Thrive

Food insecurity (FI) affects millions of people in the United States and is associated with medical problems, as well as poorer physical and emotional-behavioral adjustment. Failure to thrive is a condition where children fail to gain an appropriate amount of weight, and it can cause long-term effects on cognitive and psychomotor development. While the extent to which FI may contribute to FTT is unclear, FI may contribute both directly through inadequate caloric or nutrient intake and indirectly through increased family stress, parental depression and a chaotic family environment. We present an overview of how FI and FTT may interact, followed by a case study from our multidisciplinary clinic for children with FTT. The importance of screening for FI as well as FTT is discussed. We describe ways for individuals, organizations, and agencies to help reduce the effects of FI in both individuals and their communities.

Territorial Cohesion through Spatial Policies: An Analysis with Cultural Theory and Clumsy Solutions

The European Territorial Cohesion Policy has been the subject of numerous debates in recent years. Most contributions focus on understanding the term itself and figuring out what is behind it, or arguing for or against a stronger formal competence of the European Union in this field. This article will leave out these aspects and pay attention to (undefined and legally non-binding) conceptual elements of territorial cohesion, focusing on the challenge of linking it within spatial policies and organising the relations. Therefore, the theoretical approach of Cultural Theory and its concept of clumsy solution are applied to overcome the dilemma of typical dichotomies by adding a third and a fourth (but not a fifth) perspective. In doing so, normative contradictions between different rational approaches can be revealed, explained and approached with the concept of ‘clumsy solutions’. This contribution aims at discussing how this theoretical approach helps us explain and frame a coalition between the Territorial Cohesion Policy and spatial policies. This approach contributes to finding the best way of linking and organising policies, although the solution might be clumsy according to the different rationalities involved.