Introduction: The use of observation units (OUs) following emergency departments (ED) visits as a model of care has increased exponentially in the last decade. About one-third of U.S. hospitals now have OUs within their facilities. While their use is associated with lower costs and comparable level of care compared to inpatient units, there is a wide variation in OUs characteristics and operational procedures. The objective of this research was to explore the variability in the initial costs of care of placing patients with non-specific chest pain in observation units (OUs) and the one-year outcomes.

Methods: The author retrospectively investigated medical insurance claims of 22,962 privately insured patients (2009-2011) admitted to 41 OUs. Outcomes included the one-year chest pain/cardiovascular related costs and primary and secondary outcomes. Primary outcomes included myocardial infarction, congestive heart failure, stroke or cardiac arrest, while secondary outcomes included revascularization procedures, ED revisits for angina pectoris or chest pain and hospitalization due to cardiovascular diseases. The author aggregated the adjusted costs and prevalence rates of outcomes for patients over OUs, and computed the weighted coefficients of variation (WCV)  to compare variations across OUs.

Results: There was minimal variability in the initial costs of care (WCV=2.2%), while the author noticed greater variability in the outcomes. Greater variability were associated with the adjusted cardiovascular-related costs of medical services (WCV=17.6%) followed by the adjusted prevalence odds ratio of patients experiencing primary outcomes (WCV=16.3%) and secondary outcomes (WCV=10%).

Conclusion: Higher variability in the outcomes suggests the need for more standardization of the observation services for chest pain patients. [West J Emerg Med. 2015;16(3):395–400.]

Mycorrhizae Applications in Horticultural Production on Plant growth and Nutrient Uptake Under Field Conditions Ibrahim ORTAS Department of Soil Science, University of Çukurova, Faculty of Agriculture, Adana, Turkey iortas@cu.edu.tr

Mycorrhiza application in horticultural production in East Mediterranean region was tested under field conditions for several years. At field conditions, effect of several mycorrhizal species inoculation on seedling survive and plant growth along has been studied. Mycorrhizal dependency of several plants and effect of mycorrhiza on plant growth and root infection also has been studied. The field experiments were set up on Arık soil series (Entic Chromoxerert), located in the Agricultural Faculty Research Farm, University of Çukurova, in the Eastern Mediterranean region of Turkey to determine the effects of several mycorrhizal inoculation on nutrient uptake and yield increases of cucumber, melon, watermelon and pumpkin. Several experiments were performed under filed condition for several years with several plant and mycorrhizae species. Control, Indigenous Mycorrhizae, G. Mosseae, G. Etunicatum, G.Clarum, G.Caledonium and Cocktail mycorrhizae were applied. Mainly seedling quality, seedling survives under filed conditions, and yield response to mycorrhizae was tested. In another experiment with and without P application were used with and without mycorrhizal inoculation. Fruits of plant were collected several times and plant leaves and root samples were taken for nutrient content and mycorrhizal colonization respectively in the blossoming period. After several years under field experiments, mycorrhizal inoculation effectively infected plant root and increased plant yield. So far results revealed that also indigenous mycorrhiza successfully infected plant roots resulting to a better plant growth. The effect of mycorrhizal inoculation on plant growth is changed by effectiveness of inoculum and time. For horticultural seedling quality and surviving it is very important. In all experiments first seedlings were produced for several reasons. In general horticultural fruits plants such as melon, watermelon, cucumber and pumpkin are mycorrhizal dependent plants. Usually plant P and Zn concentration were determined. Mycorrhiza inoculated plant have high P and Zn uptake. After several years’ field experiment, it has been concluded that for horticultural fruits plants significantly response to mycorrhizal species.