Keeping up to date with the relevant literature: 'really simple syndication'-(RSS)-feeds within PubMed

For clinicians, researchers and policy makers in healthcare, it is important to keep up to date with the newest medical-scientific information. The large amount of new information makes this a difficult task. There are various techniques for keeping up to date, for instance reading systematic reviews, searching the literature at regular intervals oneself, and using the e-mail alerting services of, for example, PubMed. A new possibility is to be alerted to new scientific publications, for example, via a 'really simple syndication' (RSS)-feed. This option is now also made available by PubMed. In addition to PubMed, many other websites can now be searched systematically for new information by a RSS reader. With RSS feeds the user can be alerted to new information much faster than by an e-mail alerting service, so that one can anticipate new developments more rapidly.     

Habituation of salivation and motivated responding for food in children

Repeated presentation of food cues results in habituation in adults, as demonstrated by a decrement in salivary responding that is reversed by presenting a new food cue in adults. Food reinforced behavior in animals shows the same pattern of responding, with a decrease in responding to obtain the food, followed by a recovery of responding when a new food is presented. The present study assessed whether children would show the same pattern of a decrement of food reinforced responding followed by recovery of responding when a new food is presented for both salivation and food reinforcement tasks. Subjects were assigned to one of two groups that differed in the trial that the new food stimulus was presented to ensure recovery was specific to the introduction of the new food stimulus. In the salivation task, subjects were provided repeated olfactory presentations of a cheeseburger with apple pie as the new food stimulus, while in the food reinforcement task subjects worked for the opportunity to consume a cheeseburger, followed by the opportunity to work for consumption of apple pie. Subjects in both groups showed a decrement in salivary and food reinforced responding to repeated food cues followed by immediate recovery of responding on the trial when a new food was presented. Subjects increased their energy intake by over 30% in the food reinforcement task when a new food was presented. These results are consistent with the general process theory of motivation that suggests that changes in food reinforced responding may be due in part to habituation.     

The challenges for surveillance and control of zoonotic diseases in urban areas

The world is rapidly changing in many aspects concerning veterinary medicine, and man-animal relationships in urban areas represents a real challenge for the profession. Unlike the vertical approach of the academic teaching tradition, veterinary urban hygiene needs a strong holistic-epidemiologic support. Year by year, new animals, new animal uses, new fashions, new zoonoses, and new problems appeared amplified by media with the duty of the public veterinary services to solve them. The practical experience of many years of these continuous challenges is now concentrated on a new health sector: urban veterinary hygiene that now calls for a multidisciplinary and intersectoral collaboration with other professional categories to guarantee human, animal and environment health.     

Testing whether treatment is 'better' than control with ordered categorical data: an evaluation of new methodology

A new test procedure is presented for the problem of testing whether a treatment is better than a control when there is ordered categorical data. The new test is based on the methodology developed for general 'one-sided' alternatives by Cohen and Sackrowitz. An evaluation of the test is made by comparing the power and expected p-values of the test with those of the Wilcoxon-Mann-Whitney test in examples. As predicted by the theoretical work by Cohen and Sackrowitz, the new test is seen to be preferable to the Wilcoxon-Mann-Whitney test. Computer programs to assist implementation of the new test are made available.     

Decision making in acquiring medical technologies in Israeli medical centers: a preliminary study

OBJECTIVE: This preliminary study had two objectives: a) charting the considerations relevant to decisions about acquisition of new medical technology at the hospital level; and b) creating a basis for the development of a research tool that will examine the function of the Israeli health system in assessment of new medical technologies. METHODS: A comprehensive literature review and in-depth interviews with decision makers at different levels allowed formulation of criteria considered by decision makers when they decide to purchase and use (or disallow the use) of new medical technology. The resulting questionnaire was sent to medical center directors, along with a letter explaining the goals of the study. The questionnaire included 31 possible considerations for decision making concerning the acquisition of new medical technology by medical centers. The interviewees were asked to indicate the relevance of each consideration in the decision-making process. REULTS: The most relevant criteria for the adoption of new technologies related to the need for a large capital investment, clinical efficacy of the technology as well as its influence on side effects and complication rates, and a formal approval by the Ministry of Health. Most interviewees stated that pressures exerted by the industry, by patients, or by senior physicians in the hospital are less relevant to decision making. Very small and usually not statistically significant differences in the ranking of hospital directors were found according to the hospitals' ownership, size, or location. CONCLUSIONS: The present study is a basis for a future study that will map and describe the function of hospital decision makers within the area of new technology assessment and the decision-making process in the adoption of new healthcare technologies.     

Doomed to fail: the persistent search for a modernist mental health nurse identity

The perennial issue of the distinctiveness of the mental health nurse (MHN) is once again to the fore. Previous attempts to resolve this apparent identity crisis in the discipline have included proposals for new models, new research and new educational preparation as well as new alliances, and new ways of practising. Now the politically driven concept of the generic nurse is gaining enough momentum to potentially end the discussion once and for all. This paper takes a postmodernist approach to MHN identity that questions the requirement for MHNs to articulate their distinctiveness, and offers alternative constructions of this identity to those promulgated by policy makers and by other health disciplines.     

新媒体时代的医院危机传播

新媒体改变了传统媒体的传播生态,对医院危机传播产生了重大影响。新媒体提供了医院危机传播的新渠道、公众交流的新空间,以及舆论监督的新途径。为了做好新媒体时代的医院危机传播,在媒体介入前期,医院要制定危机传播预案,进行模拟危机演练;在舆论暴发期,医院要第一时间提供信息,建立医院新闻发言人制度,做好舆论监控引导;在舆论降温期,医院要及时总结经验教训,重塑医院形象。     

Research challenges arising from changes in worklife

Great challenges for occupational health research are set by the rapid changes in the world of work as a consequence of globalization, new technologies, demographic workforce changes, fragmentation of enterprises and work contracts, high time pressures, high demands for learning new skills, and growing worker mobility. The occupational health problems are of 2 types, the persistent and reemerging old problems of occupational injuries and diseases and new challenges from psychological stress, musculoskeletal disorders caused by computerized work, cognitive ergonomics in information-intensive work, the work ability of aging workers, and new trends in occupational allergies. The 3 roles of research, improvement of knowledge, improvement of understanding, and support of the development of work conditions in practice, all call for new initiatives in occupational health research. The new comprehensive strategy for the development and promotion of work ability has been found to respond effectively to these new needs.     

The multiplier effect of the health education-risk reduction program in 28 states and 1 territory.

The multiplier effect of the Health Education-Risk Reduction (HE-RR) Grants Program funded by the Public Health Service is examined to identify outcomes for the period 1978-81. Responses to a questionnaire from the directors of health education of 28 States and 1 Territory supplied the information concerning new health promotion activities generated by the program. The directors were asked to identify and give cost estimates of new activities that resulted from State-level and local intervention projects. A method for calculating the extent to which the HE-RR program influenced new health promotion activities that were funded by alternate sources was devised. The calculation, termed the new activity rate, was applied to the survey data. Rates calculated for the HE-RR program revealed that it generated nearly $4 million in new health promotion activities, most of them funded by the private and voluntary segments of society.     

Evaluating rapid tests for streptococcal pharyngitis: the apparent accuracy of a diagnostic test when there are errors in the standard of comparison

The evaluation of new rapid antigen detection tests for streptococcal pharyngitis is complicated by the presence of errors in the standard of comparison. Even "gold standard" throat cultures are not perfectly accurate. This article is an analysis of how errors in the comparison cultures affect the apparent accuracy of new tests for streptococcal pharyngitis. One of the questions addressed is whether throat cultures performed in a physician's office are accurate enough to use as a standard in a clinical trial of a new rapid test. While the accuracy of office cultures is accepted by many to be adequate for diagnostic purposes, this analysis shows that when evaluating a new test stricter conditions must be placed on the accuracy of the cultures used for comparison.     

Clinicians' opinions on new vaccination programs implementation

In Canada, several new vaccines were recently approved for clinical use or are expected to be soon. Decision-makers are faced with the choice whether or not to include these vaccines in publicly funded vaccination programs. The aim of this study was to assess Canadian pediatricians' and family physicians' opinions regarding 7 new vaccines, and perceived priority for the introduction of new programs. A self-administered, anonymous, mail-based questionnaire was sent during fall 2009 to a random sample of 1182 family physicians and to all 1852 Canadian pediatricians. Responses to 8 statements regarding frequency and severity of the diseases, efficacy and safety of the vaccines as well as feasibility of immunization programs were used to calculate priority scores to rank the 7 potential new vaccination programs (calculated scores ranging from 0 to 100). Overall response rate was 43%. The majority of respondents perceived the health and economic burden of diseases prevented by the seven new vaccines as important and considered new vaccines to be safe and effective. More than 90% of physicians strongly agreed or agreed that the new vaccines would be or are currently well accepted by the public and by the health professionals who administer vaccines, except for the HPV and rotavirus vaccines (respectively 30% and 29% strongly agreed or agreed). Mean priority scores were: 77.4 out of 100 for the measles, mumps, rubella and varicella (MMRV) combined vaccine; 75.6 for the hexavalent (DTaP-IPV-Hib-HBV) vaccine; 73.1 for the new pneumococcal conjugate vaccines; 69.8 for the meningococcal ACYW135; 68.9 for the combined hepatitis A and B; 63.5 for the human papillomavirus vaccine and 56.9 for the rotavirus vaccine. Health professionals' opinion is an important element to consider in the decision-making process regarding implementation of new immunization programs. Without health professional support, the introduction of a new vaccination program may be unsuccessful. In this study, the MMRV and the hexavalent (DTaP-IPV-Hib-HBV) vaccines received the highest ratings.     

职业病防治机构新职工岗前培训的有效实施策略

通过综合剖析职业病防治机构的特点以及新职工入职后所面临的新问题,探讨职业病防治机构新职工岗前培训的有效实施策略。职业病防治机构的岗前培训既是职业病医学教育的重要组成部分,又是人力资源开发的主要途径和手段。     

Non‐inferiority and superiority tests for partially matched data when a constraint is placed on the number of new tests

Studies for assessing non‐inferiority or superiority of a new diagnostic or screening test relative to a standard test use a complete matched‐pairs design in which results for both tests are obtained for all subjects. We present alternative tests for the situation where results on the standard test are obtained for all subjects but results on the new test are obtained for a subset of those subjects only. This situation is common when results for the standard test are available from a large biobank. We present a stratified random sampling procedure for drawing the subsample of subjects that receive the new diagnostic test with strata defined by the two outcome categories of the standard test. We derive appropriate statistical tests for non‐inferiority and superiority of the new diagnostic test. We will show how the number of subjects that receive the new test can be minimized by non‐proportional stratified random sampling. Copyright © 2012 John Wiley & Sons, Ltd.     

Priorities and benchmarks for new faculty in physical therapist education programs: perceptions of program directors

The purpose of this study was to establish development priorities, ideal workload and performance levels, and preferred faculty development activities for new faculty in professional-level physical therapist education programs. A preliminary questionnaire was sent to 183 directors of these programs to identify new faculty and their program directors. Eighty-five new faculty and 79 of their program directors were identified and sent comparable surveys with questions that pertained to the current and ideal teaching, scholarship, and service activities of the new faculty. Results indicated that both new faculty and program directors agreed on ideal workload levels and that workloads for new faculty should shift from teaching to scholarship. New faculty set performance levels that are significantly higher than those identified by their program directors. Development priorities for the new faculty varied from knowledge and skills in instruction as expressed by program directors to scholarship as expressed by new faculty. Individual consultations were the highest preferred faculty development activity reported by both groups. These findings provide direction for the content and delivery method for faculty development activities for new faculty in these and similar education programs.     

Influences on GPs' decision to prescribe new drugs-the importance of who says what

OBJECTIVES: The aim of this study was to understand the range of factors that influence GPs' uptake of new drugs METHODS: A total of 107 GPs selected purposively from high, medium and low new drug prescribing practices in two health authorities in the north west of England were interviewed using the critical incident technique with semi-structured interviews. Interview topics included reasons for prescribing new drugs launched between January 1998 and May 1999; reasons for prescribing the new drug rather than alternatives; and sources of information used for each prescribed drug. RESULTS: Important biomedical influences were the failure of current therapy and adverse effect profile. More influential than these, however, was the pharmaceutical representative. Hospital consultants and observation of hospital prescribing was cited next most frequently. Patient request for a drug, and patient convenience and acceptability were also likely to influence new drug uptake. Written information was of limited importance except for local guidelines. GPs were largely reactive and opportunistic recipients of new drug information, rarely reporting an active information search. The decision to initiate a new drug is heavily influenced by 'who says what', in particular the pharmaceutical industry, hospital consultants and patients. The decision to 'adopt' a new drug is clinched by subsequent personal clinical experience. CONCLUSIONS: Prescribing of new drugs is not simply related to biomedical evaluation and critical appraisal but, more importantly, to the mode of exposure to pharmacological information and social influences on decision making. Viewed within this broad context, prescribing variation becomes more understandable. Findings have implications for the implementation of evidence-based medicine, which requires a multifaceted approach.     

Multiple testing to establish superiority/equivalence of a new treatment compared with k standard treatments

In this paper we develop multiple hypotheses testing procedures to compare a new treatment with a set of standard treatments in a clinical trial. The aim is to classify the new treatment with respect to each of the standards, by specifying those to which the new treatment is superior, those to which the new treatment is equivalent and those to which one can establish neither superiority nor equivalence. We propose several stepwise procedures and compare them with respect to their familywise error rates and power. The step-down methods SD1 and SD2 test for superiority first, followed by tests for equivalence for those comparisons where we cannot establish superiority. The step-up methods SU1 and SU2 test for equivalence first, followed by tests for superiority for those comparisons where we can establish at least equivalence. The methods SD3 and SU3 apply the tests for superiority and equivalence in pairs. All the methods require that we specify a threshold value δ>0 in advance for defining equivalence. In applications where it is not possible to specify a value δ, we can use the method SD1 by testing for superiority first, followed by one-sided confidence limits on the efficacy differences for those comparisons where we cannot establish superiority. © 1997 John Wiley & Sons, Ltd.     

Commentary on health care reform and opportunities for dietitians

Health care in Canada is driven by global economic pressures. Financing solutions will be found through a national strategy for effective quality management of the health care delivery system. Achieving quality effectiveness will demand a new level of accountability and participation in planning from both users and providers. Restructuring and reform will support a shift from disease treatment and from traditional institutions to health promotion and primary care prevention in community based settings. Along with the shift in focus and delivery systems will be new opportunities for dietitians in new roles and in new settings. The specialized knowledge of dietitians, nourishing people under all life's circumstances, is highly valued by society. Now is not a time when dietitians can afford to be passive about our preferred role in the health system. This is a time to learn new skills and to move beyond the role boundaries of the past. This is a time to invest in research that leads to cost-effective, accountable practices.     

The new genetics and the politics of public health

The new genetics promises a new kind of public health practice in which the health of populations is defined by freedom from risk of genetic disease. This paper critically examines a number of assumptions underlying the genetic conception of health and discusses some likely implications of the increasing use of the technologies of genetic screening and genetic counselling in the fulfilment of public health objectives. It examines concepts of the body, the self and society underlying the search for genetic-based disease, and it unpacks the rhetoric of the ‘right to know’ and ‘informed choice’ which characterizes the discourse of the new genetics. The paper also explores some implications of the focus on ‘the family’ in genetic counselling, drawing particular attention to new inter-personal responsibilities and obligations implied by the need to know about the genetic health of one's family members and future offspring. The paper concludes by stressing the need for a thoroughgoing appraisal of the impact of the new genetics on public health practice.