The Blackboard or Virtual Reality

Abstract

Instructional technology used effectively can enhance significantly what we do in the classroom. Used thoughtlessly, it can confuse and annoy the student. This article presents a series of specific examples and caveats while exploring the creation and use of electronic resources in a variety of classes. The electronic resources covered in this article include Web pages, virtual reality (specifically, a MOO), and interactive exercises. While examples are drawn primarily from the author's experience teaching Classics, the lessons learned apply to all fields. The article concludes with a case study of how to develop materials for a class on the story of Baucis and Philemon from Ovid's Metamorphoses.     

Internet Information on Heart Disease in Men

Summary

Finding information on heart disease in men might seem as easy as logging on to a favorite search engine, finding the right category, and perusing the available links. However, in trying several prominent search engines, this turned out not to be the case. One important reason for the lack of information is that heart disease has declined 60% since 1950. Nevertheless, heart disease is still the leading killer among men. An advanced search on a search engine (heart disease as a phrase and man or men) still yields an unwieldy number of pages, about 90,000. In an effort to bridge this gap, the author examines a number of governmental, organizational, and consumer Web sites containing high-quality information on heart disease.     

Trends in Use and Outcomes of Same-Day Discharge Following Elective Percutaneous Coronary Intervention

ObjectivesThe aims of this study were to describe trends and hospital variation in same-day discharge following elective percutaneous coronary intervention (PCI) and to evaluate the association between trends in same-day discharge and patient outcomes.BackgroundInsights on contemporary use of same-day discharge following elective PCI are limited.MethodsIn a sequential cross-sectional analysis of 819,091 patients undergoing elective PCI at 1,716 hospitals in the National Cardiovascular Data Registry CathPCI Registry from July 1, 2009, to December 31, 2017, overall and hospital-level trends in same-day discharge were assessed. Among the 212,369 patients who linked to Centers for Medicare and Medicaid Services data, the association between same-day discharge and 30-day mortality and rehospitalization was assessed.ResultsA total of 114,461 patients (14.0%) were discharged the same day as PCI. The proportion of patients with same-day discharge increased from 4.5% in the third quarter of 2009 to 28.6% in the fourth quarter of 2017. From 2009 to 2017, the rate of same-day discharge increased from 4.3% to 19.5% for femoral-access PCI and from 9.9% to 39.7% for radial-access PCI. Hospital-level variation in the use of same-day discharge persisted throughout (median odds ratio adjusted for year and radial access: 4.15). Risk-adjusted 30-day mortality did not change over time, while risk-adjusted rehospitalization decreased over time and more quickly for same-day discharge (P for interaction <0.001).ConclusionsIn the past decade, a large increase in the use of same-day discharge following elective PCI was not associated with worse 30-day mortality or rehospitalization. Hospital-level variation in same-day discharge may represent an opportunity to reduce costs without compromising patient outcomes.     

基于Web服务的药学信息服务系统设计

分析药学信息服务现状,设计基于SOA架构和Web服务技术的新型药学信息服务系统,介绍系统架构与功能环境,指出其功能相比传统药学信息系统更具优势,可提供药品检索、药学文献检索、药品专利检索、药品预警、药品曝光等服务.     

Screening Mammography: Revisiting Assumptions About Early Detection

Recommendations for the frequency of mammography screening vary across several professional advisory groups. In 2009, the United States Preventive Services Task Force Guidelines reduced screening to biennially for women 50-74 years old. Drivers of this change were false-positive results and unnecessary biopsies, exposure to radiation, and treatment of cancers that would never develop. Despite the recommendation, surveys show that screening has actually increased since the change. A review of the individual woman's risk and a more balanced approach addressing both the benefits and harms of screening is required so that patients can make an informed choice.     

各国助产人员从事助产服务现状

了解各国助产人员从事助产服务情况及我国助产的政策、执业范围、助产教育,旨在积极倡导助产改革,制定新的助产政策。认为政府应重新认识助产士职能,在循证的基础上改革助产政策,促进中国助产专业的发展和母婴健康。