Faculty Bibliography

Russ Knocke, chief press secretary for the Homeland Security Department, would not confirm the agent's rationale for releasing the man, saying only that the case was under investigation by its internal affairs and inspector general's offices. And in yet another twist to the story that seems to grow murkier with each new revelation, Speaker's father-in-law, Robert Cooksey, is a tuberculosis researcher who has worked at the Centers for Disease Control. Also, Italian officials said that they had not learned about the case until Speaker left Italy. Cesare Fassari, a spokesman for Italy's Health Ministry, said that had the Italian health officials been notified in time, they would have 'intercepted the man and invited him to be treated in a hospital' with his permission

The CDC confirmed that the strain of tuberculosis that Speaker has does not match any of the strains in its laboratories. And [Robert Cooksey] said, 'My son-in-law's TB did not originate from myself or the CDC's labs, which operate under the highest levels of biosecurity.' Although health officials said there was a low risk of Speaker transmitting tuberculosis to his fellow passengers, the case raised troubling new questions about the nation's ability to defend its borders against the entry of dangerous infectious diseases and about CDC's ability to handle such threats. Dr. Gwen A. Huitt, an infectious disease expert at the center, said her initial impression was that Speaker was infected with the TB strain by someone else. Huitt said Speaker had traveled extensively over the last six years to countries where tuberculosis is more common

The centers said that the strain of tuberculosis that Mr. Speaker has does not match any of the strains in its laboratories. And Dr. [Robert C. Cooksey] said, ''My son-in-law's TB did not originate from myself or the C.D.C.'s labs, which operate under the highest levels of biosecurity.'' Also, Italian officials said that they did not learn about the case until Mr. Speaker had left Italy. Cesare Fasari, a spokesman for Italy's Health Ministry, said that had the Italian health officials been notified in time, they would have ''intercepted the man and invited him to be treated in a hospital'' with his permission. Mr. [Jason Vik] spoke angrily about Mr. Speaker's behavior. ''He stepped on a plane with 487 people, one of the largest aircraft that Boeing makes, and he put us all at risk, just so he could go get married,'' he said

Although trauma is widespread in Africa, Africans are unrepresented in the literature on posttraumatic stress disorder (PTSD). The authors used confirmatory factor analysis of responses to the Harvard Trauma Questionnaire to model PTSD symptom structure in a sample of African refugees presenting at a U.S. torture treatment clinic. They tested four models that are proposed in the literature and one based on their clinical experience in which some symptoms of hyperarousal were integrated into intrusion. Their findings support a preference for a 4-factor aroused intrusion model. Discussion focuses on interpretation of models, the role of numbing and avoidance, and the limitations of Euro American symptoms in non-Euro American populations.

PURPOSE: Peer assessment is a valuable source of information about medical students' professionalism. How best to facilitate peer assessment of students' professional behavior remains to be answered, however. This report extends previous research through a multi-institutional study of students' perspectives about system characteristics for peer assessment of professionalism. It examines whether students from different schools and year levels prefer different characteristics of peer assessment to assess each other candidly, or whether a single system can be designed. It then identifies the characteristics of the resulting preferred system(s). METHOD: At the beginning of academic year 2004-2005, students (1,661 of 2,115; 78%) in years one through four at four schools replied to a survey about which peer assessment characteristics - related to, for example, who receives the assessment, its anonymity, and timing - would prevent or encourage their participation. Multivariate analysis of variance was used to detect differences among institutions and students from each year level. RESULTS: Students across year levels and schools generally agreed about the characteristics of peer assessment. They prefer a system that is 100% anonymous, provides immediate feedback, focuses on both unprofessional and professional behaviors, and uses peer assessment formatively while rewarding exemplary behavior and addressing serious repetitive professional lapses. The system, they emphasize, must be embedded in a supportive environment. CONCLUSIONS: Students' agreement about peer-assessment characteristics suggests that one system can be created to meet the majority of students' preferences. Once implemented, the system should be monitored for student acceptability to maximize participation and to determine the formative and summative value of the process.

OBJECTIVE: Despite demonstrated benefits, few healthcare organizations have implemented clinical event monitors to detect adverse drug events (ADEs). The objective of this study was to conduct a systematic review of pharmacy and laboratory signals used by clinical event monitors to detect ADEs in hospitalized adults. DESIGN: We performed a comprehensive search of MEDLINE, CINHAL and EMBASE to identify studies published between 1985 through 2006. Studies were included if they: described a clinical event monitor to detect ADEs in an adult hospital setting; described laboratory or pharmacy ADE signals; and, provided positive predictive values (PPVs) or information to allow the calculation of PPVs for individual ADE signals. MEASUREMENTS: We calculated overall estimates of PPVs and 95% confidence intervals (CIs) for signals reported in 2 or more studies and contained no evidence heterogeneity. Results were examined by signal category: medication levels, laboratory tests, or antidotes. RESULTS: We identified 12 observational studies describing 36 unique ADE signals. Fifteen signals (3 antidotes, 4 medication levels, and 8 laboratory values) contained no evidence of heterogeneity. The pooled PPVs for these individual signals ranged from 0.03 [CI=0.03-0.03] for hypokalemia, to 0.50 [CI=0.39-0.61] for supratherapeutic quinidine level. In general, antidotes (range=0.09-0.11) had the lowest PPVs, followed by laboratory values (0.03-0.27), and medication levels (0.03-0.50). CONCLUSION: Results from this study should help clinical information system and computerized decision support producers develop or improve existing clinical event monitors to detect ADEs in their own hospitals by prioritizing those signals with the highest PPVs [corrected]

Over the next few years, the author is certain that statins will emerge from the false and unsubstantiated rumors of associated memory loss and receive the full recognition they deserve for battling heart disease before it ever becomes clinically apparent. Of course, the first such study has slipped below the media radar. The METEOR trial and future studies with larger cohorts may prove beyond a doubt that the author is right, but he is already sure of it, based on his clinical reasoning combined with the clinical trials conducted on sick patients