Kindergarten and first grade: A time for developing and nurturing gifted behaviors in young children

This article concludes that there is a tremendous need for gifted programs at the kindergarten and first grade levels. A review of the literature suggests that it is difficult to identify young gifted children through traditional screening techniques. The author concludes that Renzulli's Enrichment Triad Model may prove useful for identifying young gifted children.     

An analysis of the deep social structure preventing the development of a national policy for children and families in the United States

The United States is one of the few economically developed nations without a national policy supporting children and their families. This paper suggests that the United States has a unique national ideology, based on the “Calvinistic Ethic,” which results in opposition to not only social programs for children and families, but to all government supported welfare programs. Such an ethic is not found in European countries. Finally, since the United States does not have a national family policy, millions of children and their families go without health care, lack social services, and suffer from inadequate economic supports.     

Developing and running an EQA scheme in diagnostic histopathology

External quality assessment (EQA) schemes in histopathology form a key part of laboratory quality management, but their principal function is educational. ‘Test’ material is circulated to participants, who evaluate the material following their normal practice and return responses to an organizing laboratory for collation and evaluation. The test material must be representative of the routine workload, but not mundane. Unlike histopathology slide clubs, objective, quantitative, personal feedback for each participant is vital to ensure unambiguously the identification of areas requiring CPD. The objective evaluation of textual responses in EQA is problematic, but various approaches have been used successfully. The participants are individuals, not laboratories, so confidentiality is paramount. Mechanisms to investigate persistent substandard performance must exist, but should be used very rarely; self-improvement is the usual route to protecting standards of patient care.     

The social sciences and successful aging: Issues for Asia–Oceania

Aim:   This paper presents social science understandings of successful aging for a broad audience in multidisciplinary gerontology in Asia–Oceania.
Methods:   The international literature on social science aspects of successful aging is reviewed with a focus on Asia and social improvement.
Results:   New positive approaches to aging research are identifying opportunities for maintaining capacities and well-being over the life course. Successful aging, productive aging, and active aging are key concepts. Increasing life expectancy and fertility control are major social achievements that underpin population aging as the mainstream social transformation facing the world. Asia will be at the forefront of this change and the consequences will vary greatly between cultures, nations, and subgroups within them. Older people generally maintain good quality of life and the capacity to 'age well' is influenced by life-long maturation and emotional, social, and economic resources. Good health can be enhanced through positive actions such as physical activity, good nutrition, and not smoking. Mental capacities can also be improved and maintained throughout old age. In advanced old age, the 'fourth age', the focus turns to ameliorating the effects of loss and to maintaining dignity.
Conclusions:   The social sciences contribute knowledge useful for improving life experiences for older people and aging societies. Population aging is central to national economic development. Public policy and individual action concerning aging can benefit all age groups. To better inform these developments it is important to address the serious shortfall of social science research on aging in the Asia–Oceania region.     

分级诊疗背景下多病共存患者就医机构选择行为及其影响因素研究

背景 近年来,国内针对多病共存患者在分级诊疗背景下就医机构选择行为的研究较少,研究多病共存患者的就医机构选择行为有重要的现实意义。目的 以分级诊疗为视角,分析多病共存患者就医机构选择行为及其影响因素,为进一步落实分级诊疗制度和合理配置医疗资源提供研究参考。方法 采用随机抽样法,选取2019-06-01至2020-01-01在上海市杨浦区中心医院医疗联合体（上海市杨浦区中心医院和上海市杨浦区定海、延吉、长白社区卫生服务中心）就诊的多病共存患者为研究对象。采用自设问卷对其进行调查,收集多病共存患者的一般资料,了解其对分级诊疗政策的认知情况及实际遵守情况、在不同疾病控制状况下至社区卫生服务中心首诊的意愿,以及其选择就诊医疗机构时考虑的因素等。采用二分类Logistic回归分析多病共存患者此次因病就医是否选择至社区卫生服务中心首诊的影响因素。结果 共发放1 100份问卷,回收有效问卷1 072份,有效问卷回收率为97.45%。1 072例多病共存患者中,老年（≥60岁）多病共存患者占85.07%(912/1 072)。624例（58.21%）患者表示知晓分级诊疗制度;940例（87.69%）患...     

An assessment of PKI and networked electronic patient record system: lessons learned from real patient data exchange at the platform of OCHIS (Osaka Community Healthcare Information System)

To enhance medical cooperation between the hospitals and clinics around Osaka local area, the healthcare network system, named Osaka Community Healthcare Information System (OCHIS), was established with support of a supplementary budget from the Japanese government in fiscal year 2002. Although the system has been based on healthcare public key infrastructure (PKI), there remain security issues to be solved technically and operationally. An experimental study was conducted to elucidate the central and the local function in terms of a registration authority and a time stamp authority in contract with the Japanese Medical Information Systems Organization (MEDIS) in 2003. This paper describes the experimental design and the results of the study concerning message security.     

Cerebellar subjects show impaired coupling of reach and grasp movements

We examined how cerebellar deficits in isolated reaching or grasping movements contribute to abnormalities in a combined reach and grasp movement, and whether people with cerebellar damage show abnormalities in the spatiotemporal relationships of reach and grasp movements. We studied subjects with cerebellar damage and matched controls as they performed a combined reach and grasp, an isolated reach, and an isolated grasp. These movements were performed under slow-accurate and fast speed conditions. Subjects were also tested for their ability to correctly estimate the target size based on visual information. We measured the three-dimensional position of the index finger, thumb and wrist joint during all tasks. Results showed that cerebellar subjects overestimated the target size to a greater extent than did controls. During movement testing, cerebellar subjects were impaired on isolated reach and isolated grasp. However, they did not worsen parameters of reach or grasp movements during the combined reach and grasp. Instead there were distinct deficits in the coupling of the reach and grasp movement. Compared with controls, cerebellar subjects showed abnormalities in the sequence of the reach and grasp movement and highly variable timing of peak grip aperture. In the slow-accurate condition, cerebellar subjects decomposed the reach and grasp movement into separate reach then grasp components, and produced multiple peaks in grip aperture. In the fast condition, cerebellar subjects did not decompose, produced a single peak grip aperture, and dropped the target more often. These results indicate that cerebellar damage can cause a specific breakdown in the coupling of reach and grasp movements. The cerebellum may be involved in combining reach and grasp movements into a single motor program.     

Osteotomy around the knee: Assessment of quality,content and readability of online information

BackgroundAs knee osteotomy surgery becomes increasingly accessible, more patients may turn to the Internet for information. This study examined the source, quality, content and readability of online information regarding osteotomy around the knee.MethodsThe first 70 websites returned by the top four search engines were identified using the key words: “knee osteotomy” and “high tibial osteotomy.” The websites were categorised by type and assessed using the DISCERN score, Journal of the American Medical Association (JAMA) benchmark criteria and a novel Knee Osteotomy-Specific Score (KOSS). The presence of the Health On the Net (HON) code accreditation seal was noted. Readability of each website was assessed using eight readability formulae. The mean reading grade level (RGL) was compared to the 6th and 8th grade reading levels. The mean RGL of each category was also compared.ResultsOf the 45 unique websites analysed, the majority were Physician (33%) and Journal websites (31%). The mean DISCERN score was 36.7 (±8.9) which is classified as ‘poor.’ The mean JAMA benchmark criteria score was 2.04 (±1.5) and Physician websites were most likely to be scored zero. The mean KOSS was 15.4 (±5.7). The highest scoring website was a Commercial site but, overall, Journal category sites provided the best quality information. Websites that bore the HONcode seal obtained higher DISCERN, JAMA benchmark criteria and Knee Osteotomy - Specific Scores.The cumulative mean RGL was 13.2 (±2.2) which exceeded the 6th grade level by an average of 7.2 grade levels and the 8th grade level by an average of 5.2 grade levels. No website (0%) was written at or below either the 6th or the 8th grade reading levels. The mean Flesch Reading Ease Score of all websites was 41.13 (±14.7) which is classified as ‘difficult.’ Journal websites had the highest RGL.ConclusionThe information available online regarding osteotomy around the knee varies tremendously in quality and completeness. Physician sites predominate, but these were among the lowest scoring of all websites. Even where high quality information is available, it is set at too high a level to be easily understood.Level of evidenceSurvey of materials – Internet.     

Benefits of the DICOM Modality Performed Procedure Step

A few years ago, the Digital Imaging and Communications in Medicine standard introduced a network transaction that is initiated by modality equipment, mainly at the beginning and at the end of the acquisition. This transaction, the Modality Performed Procedure Step (MPPS), is sent to the Picture Archiving and Communication System and/or to the Radiology Information System. It carries information about what really has been performed by the modality equipment during acquisition. In this paper, we present MPPS and discuss its benefits. We show how MPPS enables efficient radiology workflow and how it ensures accuracy and completeness of imaging information. We think our paper helps bridge the gap between MPPS implementation and deployment. By understanding all the MPPS benefits, the end user becomes aware of the great enhancement in patient care that this transaction provides.