Emergency Medicine Residents and Statistics: What is the Confidence?

The objective of this study was to assess whether residents have the essential tools and a sense of competency when evaluating published studies, especially the statistics. Questionnaires were mailed to emergency medicine (EM) residency programs in the United States querying residents' demographics and training in statistics as well as their impressions and use of statistics in the current literature; a five-question statistical quiz was also included. Possible responses of—almost always, more than ½ time, ½ time, less than ½ time, almost never—were tallied individually as well as compared in groups of polarized answers: over 1/2 time (almost always + more than ½ time) vs. under ½ time (less than ½ time + almost never). There were 495 questionnaires returned from 42 centers. No significant difference was found when comparing quiz performance with participants' self-reported statistical knowledge. There were considerable differences in the polarized answers (Over vs. Under), whether statistics: were used appropriately (40% vs. 15%, respectively); were used to enhance weak data (54% vs. 13%, respectively); enhanced their understanding of information (38% vs. 24%, respectively); simplified complex data (26% vs. 41%, respectively); were understood by them (23% vs. 38%, respectively); confused them (37% vs. 24%, respectively); were skipped (52% vs. 23%, respectively). Participants felt there should be more statistical training (49% vs. 22%, Over vs. Under, respectively). There was no difference in respondents who did or did not read the statistics (39% vs. 34%, Over vs. Under, respectively). Many EM residents surveyed do not trust, read, or understand statistics presented in current journal articles. Residency programs may want to consider enhanced training in statistics.     

Perspectives of Alternative Medicine in the Field of Rehabilitation Medicine in Korea

1 Introduction. ′Medicine′ itself is not exactly a science, but it is an art——a healing art. Throughout history the humankind have used shamanism,witchcraft,religions,metaphysics,philosophy,science and/or technology as a tool in making better understanding and further improvement of healing art.     

Dissemination of Evidence-based Medicine and Abide to Regulation to Practice Medicine in China

Themulti pathogenetichumandiseasespectrumtendstostabilizeinthe 2 1stcentury ,whilethehumanbeingischallengedbythesuddenoutbreaksofnewcommunicablediseasestriggeredbymono pathogeneses.Astheresultoftheincreasingmedicalresearchinvestments,thedevelopmentofmedicalscienceandtechnologyandtherisinghealthcaredemandsofthepublic ,medicalcostsareskyrocketingataratethatexceedstheincreaseinaveragenationalincome .Inaddition ,theglobalhealthresources,whicharealreadyscarce ,areneitherproperlydistributednoreffici…     

Development of the Emergency Medicine in Hong Kong

The Hong Kong College of Emergency Medicine (HKCEM)will celebrate its 10~(th) anniversary in October 2006.There is certainly a much longer period of development of Emergency Medicine(EM)in Hong Kong.We shall try to describe the development in the last 5 decades.     

Testosterone and ageing: what have we learned since the Institute of Medicine report and what lies ahead?

A 2003 report by the Institute of Medicine (IOM) surveyed the literature on the benefits and risks of testosterone replacement therapy in older men and identified knowledge gaps and research needs. This review summarises some key studies published since the IOM report. The possible relationship of testosterone to risk of prostate cancer remains a concern; however, no new evidence has emerged to suggest that testosterone replacement therapy increases the risk. Recent studies have demonstrated that hypogonadism in men may be more prevalent than previously thought, is strongly associated with metabolic syndrome, and may be a risk factor for type 2 diabetes and cardiovascular disease. Clinical studies have shown that testosterone replacement therapy in hypogonadal men improves metabolic syndrome indicators and cardiovascular risk factors. Maintaining testosterone concentrations in the normal range has been shown to contribute to bone health, lean muscle mass, and physical and sexual function, suggesting that testosterone replacement therapy may help to prevent frailty in older men. Based on current knowledge, testosterone replacement therapy is unlikely to pose major health risks in patients without prostate cancer and may offer substantial health benefits. Larger, longer-term randomised studies are needed to fully establish the effects of testosterone replacement therapy.     

Making Great Efforts to Promote the Development and Application of Evidence-Based Medicine （English version）

Since the term “evidence-based medicine ( EBM ) ” was proposed and published firstly in JAMA by a Canadian scholar in 1992, a worldwide campaign of evidence-based practice has been undertaken which has benefited governments, doctors and the public. It has not only brought innovation to the global health industry, but been applied to many other related fields and industries. As a result, EBM was appraised by JAMA as one of the most powerful theories of the 20th century.     

The Growing Demand for Hospice and Palliative Medicine Physicians: Will the Supply Keep Up?

Context

The need for hospice and palliative care is growing rapidly as the population increases and ages and as both hospice and palliative care become more accepted. Hospice and palliative medicine (HPM) is a relatively new physician specialty, currently training 325 new fellows annually. Given the time needed to increase the supply of specialty-trained physicians, it is important to assess future needs to guide planning for future training capacity.

The “New” Field of Religion and Medicine

Meticulous diagnostic investigation is a primary therapeutic requisite in management of acute peptic ulcer. In general, current treatment conforms to past practices. Therapy must be highly individualized, and basic therapeutic principles must be followed. The authors state that combined aluminum hydroxide neutralizers, anticholinergic drugs and, possibly, tranquilizers are notable changes in ulcer treatment. They emphasize that exact management of early uncomplicated ulcer acts as a prophylaxis against intractability, recurrence, chronicity and complications.     

Integrative Medicine in the Oncology Setting,What Does the Research Show?

Most oncology patients are using some form of complementary alternative medicine (CAM). These can include acupuncture, massage, yoga, homeopathy, energy work, spiritual healers, vitamins and supplements, mind-body interventions, diets, and many other modalities. Although many of these interventions are safe and beneficial, some of them can be harmful. Unfortunately, because of time constraints, knowledge deficits, and the acuity of our patients, assessment of the use of CAM is often overlooked. As nurse practitioners, we must educate ourselves about the evidence for safety and efficacy of these interventions.