Economic burden of dengue infections in India

Dengue infections are a significant cause of morbidity and mortality and lead to adverse economic effects in many developing tropical countries. In this study, we estimated the economic burden faced by India during the 2006 dengue epidemic. Costs incurred in managing a cohort of serologically confirmed dengue patients at a tertiary-level private hospital in north India were calculated. The median cost of treatment per hospitalised dengue patient was US$432.2 (95% CI US$343.6-625). A sensitivity analysis was performed to estimate the costs to the health system in India using a regression model. Variables with potentially large variations, including the ratio of unreported to reported cases and of hospitalised to ambulatory cases, the proportion requiring transfusions, loss of economic activities due to loss of workdays and deaths, were used. The average total economic burden was estimated to be US$27.4 million (95% CI US$25.7-29.1 million). Costs in the private heath sector were estimated to be almost four times public sector expenditures. Considerable economic losses (at a macro level) are incurred by developing countries like India during each dengue epidemic. Accurate estimates of the proportions of reported to unreported and of hospitalised to ambulatory dengue cases in India are needed to refine further the estimates of financial burden due to dengue in India.     

Fifty years of treating stuttering in young children

Developmental stuttering involves a disruption in the smooth connection of sounds or syllables that is characterised by multiple interruptions within a word, such as repetitions of sounds, syllables and parts of words, elongation of words and blockades. During the course of the past fifty years, three phases can be distinguished in the management of developmental stuttering, characterised by a shift in stress from the environmental factors to the role of the organic, i.e. non-psychological, factors. Initially, the parents of toddlers and pre-school children were advised to pay no attention to stuttering behaviour. Then the problem would disappear the quickest of its own accord. After 1985, the stress came to be placed on reducing the level of expectations, for example by speaking to the child more slowly and using shorter and less complex sentences. Another new aspect was that the parents learned to discuss stuttering with the child in a sympathetic and accepting manner. Since 2000, an approach has been introduced in the Netherlands in which parents are taught to respond verbally to both fluent and non-fluent speech. Emphasis is given to rewarding fluent speech, such as in the Australian Lidcombe Program, but the parents are also taught to react to stuttered speech once in a while. At present, early treatment is accepted as a way of preventing chronic stuttering, even if this means that some children will be treated that would have recovered in any case and even though the exact yield is not yet clear. Clinical practice shows that early treatment almost always succeeds in limiting the severity of stuttering to a mild form.     

Fifty years of an organized blood transfusion service in Scotland

The activities of an enthusiastic Edinburgh dentist in recruiting donors in the early 1930s led up to the establishment of a Scottish National Blood Transfusion Association in 1940. From this has developed the present Service with five Regional Centres and a major manufacturing Protein Fractionation Centre.     

Fifty years of nutrition counseling. Remarks and perspectives

Fifty years of nutrition information and education did not reach their goals. Nutrition-dependent diseases, obesity, and misinformation are still increasing. Cognitive information about nutrition does not induce changes in primary emotion-controlled eating habits. Better knowledge of nutrition on the part of consumers mainly activates their bad conscience when they rate their own eating habits. Future prevention campaigns, which clearly address consumer needs using social marketing principles, will be better able to change eating behavior.     

胃肠道癌症病人营养状况对生活质量的影响

  目的  采用NRS - 2002法评估胃癌住院患者营养风险,分析营养风险与营养不良、生活质量之间的相关性以及年龄、性别、病期对其影响。  方法  采用营养风险筛查工具2002（NRS2002）对2017年6月1日 — 8月31日期间在湖南省肿瘤医院住院的112例胃癌患者进行营养风险评估,并使用胃癌患者生活质量问卷（QLQ-STO22）对其生活质量进行评价,同时检测其身高、体重、总蛋白、血红蛋白等生理指标,评价营养不良状况。  结果   112例胃癌患者中存在营养风险比例为70.5 %,患者年龄（χ² = 4.824,P = 0.028）、病期（χ² = 5.320,P = 0.021）是营养风险的影响因素;低体重（51.49 ± 8.54） kg、低BMI（19.48 ± 2.67） kg/m²、低总蛋白、血清白蛋白、血红蛋白[分别为（60.91 ± 8.74）、（38.90 ± 4.87）、（103.99 ± 16.45）g/L]是胃癌患者营养风险的影响因素（P < 0.05）;营养风险与胃癌患者生活质量具有相关性,营养风险对患者吞咽、返流症状、进食受限、味道改变领域的得分均有明显影响（P < 0.05）。  结论   胃癌患者营养风险越大,营养不良发生率越高,患者生活质量下降越快;应重视对胃癌患者进行早期的营养风险筛查,开展合理的营养干预,改善患者的营养状况和生活质量。     

Fifty years of impact factor: pros and cons

BACKGROUND: The Impact Factor (IF) was thought up 50 years ago, and it is currently the best available bibliometric index. Despite its shortcomings, the IF is widely used and offers, at present, the best simple tool to help libraries decide which journals to purchase. DISCUSSION: The use of the term "impact factor" has gradually evolved, especially in Europe, to include both journal and author impact. With this meaning, it has become the most used tool in evaluating scientific quality in decisions regarding funding and academic career. This ambiguity and use of IF to compare authors may be misleading. There is poor correlation between the citation frequency of a certain article and the IF of the journal in which it is published. There is a marked bias towards the English language journals compared with those in other languages. Even within the field of Occupational Medicine, the distribution of IF exhibits a wide spread between specialty subsets. CONCLUSION: The IF is a flawed measure of quality of academic staff performance. Searching for the highest IF is not equal to searching for the truth. There is still much work to be done to develop truly objective measures of scientific quality. Like all measures, the use of IF has to be tempered with knowledge of its limitations and common sense.     

中国卫生监督五十年的法理学研究

本文通过回顾中国卫生监督五十多年的发展历程,从法理学角度,研究半个多世纪中国卫生监督工作的发展和变迁,探讨中国卫生监督的概念及其内涵的演变,研究当前中国卫生监督体系建设,提出提高卫生监督员法律素质的基本途径,为进一步深化卫生监督体制改革,加强卫生监督体系建设,提高卫生行政执法能力和水平提供法理学指导。     

Fifty years of medical education research: waves of migration

Medical Education 2011; 45 : 785–791 Context Medical education research has been an academic pursuit for over 50 years, tracing its roots back to the Office of Medical Education at the State University of New York at Buffalo, New York, with George Miller. As the field has matured, the nature of the questions posed and the disciplinary bases of its practitioners have evolved. Methods I identify three chronological ‘generations’ of academics who have contributed to the field, at intervals of roughly 10–15 years. Results Members of the first generation came from diverse and unrelated academic backgrounds and essentially learned their craft on the job. A second generation, emerging in the 1980s and 1990s, consisted of individuals with PhD‐level training in relevant fields such as psychology, psychometrics and sociology, who actively chose a career in health sciences education, often during graduate work. These individuals brought a strong disciplinary orientation to their research. Finally, the proliferation of graduate programmes in medical education means that we are now seeing the evolution of a new type of academic, often a health professional, whose only discipline is medical education. Conclusions I propose that we should strike a balance between seeking to create a separate specialty of medical education and continuing to actively recruit from other academic disciplines. I believe that the strong disciplinary roots of these individuals are a critical element in the continuing growth and progress of medical education research.