Determinants of acquisition of MR imaging units in an era of prospective payment

A survey was undertaken to examine the impact of Medicare's Prospective Payment System (PPS) and other recent changes in the health care environment on providers' decisions regarding acquisition of high-cost technologic equipment. The survey group included 199 hospitals and freestanding imaging centers known to have acquired magnetic resonance (MR) imaging units, as well as a random sample of 400 hospitals whose acquisition decisions were unknown to the authors. Fifty-eight percent of the known adopters and 61% of the randomly selected hospitals responded to the survey. Nonadopters' decisions were dominated by economic considerations, including the high cost of MR imagers and concerns about Medicare's reimbursement policies. Competition and a desire to provide the highest quality of care are counterbalancing the retardant effects of PPS, however, and are stimulating widespread diffusion of MR imagers.     

Simple epoxide analogs of trichothecans

To define clearly the epoxide grouping role in trichothecan biological activity, a series of hindered epoxides was prepared. They possessed alpha, alpha'-substitution reminiscent of the epoxide environment of the natural products. None of these analogs demonstrated biological activities similar to the natural toxins.     

The learning of radiological anatomy by medical students.

Teaching radiographic anatomy to pre-clinical medical students is important as it relates anatomical studies to clinical medicine and the same time prepares them for the radiology they will encounter in their clinical years. A programme is described in which radiographic anatomy is comprehensively covered without proving too great a commitment to clinical radiologists. The programmes consist of exhibits of X-rays in the dissecting room, slide-lecture demonstrations and a permanent museum of radiological anatomy. This programme has worked well and there has been a very favourable student response.     

North Carolina's nursing workforce: planning today for a reformed tomorrow

Nurses are the single largest component of North Carolina's health workforce, and nursing jobs are an essential driver of the state's economic recovery. We propose 5 recommendations for creating a nursing workforce system that, if implemented, would position the state to meet the future health care needs of North Carolinians.     

The Next Wave: Confexting

Radiology conferences enable participants the opportunity to ask experts questions through question and answer (Q and A) sessions or individually. Given the time limitations and intimidating circumstances, we incorporated conference text messaging (confexting) as a method of increasing interactivity between the audience and speakers. During a 5-day radiology conference, text messaging was utilized for anonymous interactivity between the audience and speakers during Q and A sessions. There were 324 text messages; 76 of these were either follow-up statements or questions related to earlier text messages. Forty-two questions were submitted via paper notes. There was a general trend of an increasing number of text messages and a decreasing number of paper notes. The anonymous text messaging system was found to be an effective method for interactivity between the audience and the speakers. The questions and answers could be presented in a PowerPoint format at the formal Q and A sessions. Questions texted to the authors during their talks could be immediately answered or addressed in subsequent talks. Although difficult for some individuals to embrace technology, confexting allows for interactivity and prompts discussion. Confexting is an effective method for interactivity between the audience and speakers not previously utilized in a conference setting. The anonymity and asynchronous communication enable conference participants to submit more questions than in the traditional setting. The speakers may be able to explain more thoroughly difficult concepts more thoroughly with additional slides at Q and A sessions or may immediately answer texted questions during their talks.     

An international call to arms to improve allied health workforce planning

Although the funding and organization of the health care systems in the United States and England are quite different, there are striking similarities in the allied health workforce planning challenges facing the two countries. This paper identifies some common issues facing workforce policy-makers in both countries and suggests key next steps to enhance workforce research and planning in both countries, including the creation of a national minimum data set for allied health professions.