Home About us Contact
|
Home About us Contact | ||
|
|
||
Better Information (good + information)
Selected AbstractsA survey of the quality and accuracy of information leaflets about skin cancer and sun-protective behaviour available from UK general practices and community pharmaciesJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 5 2009S Nicholls Abstract Background, Better information promotes sun protection behaviour and is associated with earlier presentation and survival for malignant melanoma. Aim, To assess the quality of patient information leaflets about skin cancer and sun-protective behaviour available from general practices and community pharmacies. Design of study, A structured review of patient information leaflets. Setting, All community pharmacies and general practices in one Primary Care Trust were invited to supply leaflets. Methods, Readability was assessed using the SMOG scoring system. Presentation and content were reviewed using the Ensuring Quality Information for Patients (EQIP) guidelines. Three consultant dermatologists assessed each leaflet for accuracy. Results, Thirty-one different patient information leaflets were returned. Thirteen (42%) were published in the previous 2 years, but 10 (32%) were over 5 years old. Nine (29%) leaflets were produced by the NHS or Health Education Authority, and 8 (27%) were linked to a commercial organization. One leaflet had readability in the primary education range (SMOG score = 6), and none with the recommended range for health education material (SMOG score , 5). Two leaflets (6%) were in the highest quartile of EQIP score for presentation and content. Five leaflets (17%) had a major inaccuracy such as over-reliance on sun screen products instead of shade and clothing. Conclusions, Leaflets were of variable quality in presentation and content. All required a reading age higher than recommended. All leaflets with major inaccuracies had links with commercial organizations. This study raises important issues about the potential conflict between marketing and health messages in the way sun creams are promoted. Conflicts of interest None declared [source] Latest news and product developmentsPRESCRIBER, Issue 17 2007Article first published online: 6 NOV 200 Drug information stilllacking for mentally ill Half of people with mental illness still have no say in the medication they are prescribed and one-third are not informed about side-effects, according to the latest report by the Healthcare Commission and the Commission for Social Care Inspection (www.health-carecommission.org.uk). The annual national review of adult mental health services found overall improvement among local intervention teams in 2005/06 compared with the preceding year, though all could improve further and the performance of 46 per cent were rated as only fair or weak. A survey of 7446 people with schizophrenia also showed that only 46 per cent had access to psychological treatments. More incentives for shift of care in Scotland Scotland has made good progress on shifting NHS care into the community but joined-up thinking, better information and incentives are needed to overcome barriers to better management of long-term conditions in adults, says Audit Scotland (www.audit-scotland.gov.uk). Reviewing progress on the 2005 strategy document Delivering for Health, Audit Scotland found good progress on asthma and diabetes services , partly due to the effects of the GMS contract. Better information about clinical activity, costs and effectiveness is needed to help redesign services. Patients with more than one long-term condition do not receive co-ordinated care and many want greater involvement in their care, the report concluded. Acorn, QOF and Guy Rotherham awards Entries are invited for the 2007 annual Acorn, QOF and Guy Rotherham Awards. The awards are run in association with the NHS Alliance, Improvement Foundation, British Cardiac Society, British Cardiac Patients Society and Prescriber. The CHD QOF Award, sponsored by Schering-Plough, recognises the achievement of an individual practice that gains maximum points in the CHD and heart failure QOF domains, and a second award is given to the primary care organisation (PCO) that achieves the best average scores across its practices. The entry form can be found at www.escriber.com. The closing date is 12 October. Entries are also invited for the Guy Rotherham Award from PCOs that can demonstrate they have delivered a high-impact change resulting in better outcomes and services for patients. For online entry go to www.improvementfoundation.org/guy rotherhamaward. Closing date is 5 October. Award winners will receive free entry for three to the NHS Alliance conference and the conference dinner. The winner of the Guy Rotherham Award will also receive £3000. NICE scores five out of six NICE acted unreasonably in relying solely on the Mini-Mental State Examination (MMSE) to define severity of Alzheimer's disease in its updated technology appraisals, with the effect of discriminating against people with learning or language difficulties, the High Court has ruled. The five other claims by Eisai that NICE acted unreasonably and irrationally were not upheld. This was the first court action against NICE in its eight-year history. It has now promised to publish revised appraisals on its website on 7 September and is consulting with Eisai, Shire Pharmaceuticals and the Alzheimer's Society on the best approach. PPRS reform follows Office of Fair Trading report The Government is to renegotiate the Pharmaceutical Price Regulation Scheme (PPRS) following the critical report by the Office of Fair Trading (OFT). In February, the OFT recommended renegotiation of the PPRS to reward innovation and obtain better value for patients. In particular, it called for a pricing scheme based on value for patients, ie effectiveness, rather than profit controls. The DoH, acknowledging the report's complexity, says it will take four principles into account in its negotiations during the forthcoming months: value for money, promoting innovation, assisting the uptake of new cost-effective medicines and promoting market stability. MHRA launches e-bulletin The MHRA (www.mhra.gov.uk) has next issue can be downloaded. The launched an electronic bulletin to August bulletin includes items on provide health professionals with antidepressants and suicide, updates about the safe use of medi-adverse effects of dopamine ago-cines. Users need to sign up to nists and information about smokreceive an e-mail alert when the ing cessation and isotretinoin. DURG call for abstracts The Drug Utilisation Research Group is calling for abstracts for its 19th annual meeting ,Target-driven medicine , is this the end of prescribing freedom?' to be held on 7 February 2008 at the Royal Society of Medicine, London. Abstracts are requested on any aspects of drug utilisation research. A bursary of £500 will be awarded for the best abstract received. The closing date for receipt of abstracts is 26 November. Further information about abstract submission is available at www.durg.org.uk. GP prescribing up by half Prescription volume and costs in England increased by approximately half over the decade to 2006, according to data published by the Information Centre for Health and Social Care (www.ic.nhs.uk). The number of items dispensed per year increased by 55 per cent and the cost by 60 per cent in real terms. The average number of items per head of population was 10.0 in 1996 and 14.8 in 2006; older people received 21.2 items per head in 1996 but 40.8 in 2006. MR morphines similar Modified-release preparations of morphine are equivalent in the treatment of severe pain, according to a new review by Bandolier (www.jr2.ox.ac.uk). The analysis of 54 randomised trials, which reviewed the release mechanisms and clinical data for four brands, showed these preparations provide effective analgesia for malignant and nonmalignant pain; about 4 per cent of patients were unable to tolerate the adverse effects of morphine. NSAIDs compared in OA Etoricoxib (Arcoxia) and naproxen are equally effective in the long-term treatment of osteoarthritis (Ann Rheum Dis 2007;66:945,51). Extension studies for two one-year trials showed that, after a total of 138 weeks, the two drugs had almost identical effects on pain and function assessments. All treatments were generally well tolerated, but serious cardiovascular effects were more common with etoricoxib and serious GI effects more common with naproxen. CPN nystatin allowed Community practitioner nurses (CPNs) may now prescribe oral nystatin (Nystan) to treat oral thrush in neonates, following a special amendment to the regulations limiting their prescribing to licensed indications. CPNs may now prescribe oral nystatin at the dose recommended in the BNF for Children provided they are sure of the diagnosis. In doing so, they accept clinical and medicolegal responsibility for their actions. There are no other exceptions to the prohibition of off-label prescribing. Copyright © 2007 Wiley Interface Ltd [source] Communicating throughout Katrina: Competing and Complementary Conceptual Lenses on Crisis CommunicationPUBLIC ADMINISTRATION REVIEW, Issue 2007James L. Garnett Hurricane Katrina was as much a communication disaster as it was a natural and bureaucratic disaster. Communication gaps, missed signals, information technology failures, administrative buffering, turf battles, and deliberate and unintentional misinterpretations delayed and handicapped both the recognition of the crisis that Katrina posed and the response to its devastation. This essay views crisis communication through four conceptual lenses: (1) crisis communication as interpersonal influence, (2) crisis communication as media relations, (3) crisis communication as technology showcase, and (4) crisis communication as interorganizational networking. A conceptual framework is presented that compares these lenses with regard to agency, transparency, technology, and chronology. The planning, response, and recovery stages of the Hurricane Katrina disaster are viewed through these communication conceptual lenses, illustrating key facets of each perspective and adding to our deepening understanding of the events. Many of the problems we have identified can be categorized as "information gaps",or at least problems with information-related implications, or failures to act decisively because information was sketchy at best. Better information would have been an optimal weapon against Katrina. Information sent to the right people at the right place at the right time. Information moved within agencies, across departments, and between jurisdictions of government as well. Seamlessly. Securely. Efficiently , One would think we could share information by now. But Katrina again proved we cannot. ,U.S. House Select Bipartisan Committee With the floodwalls gashed and hemorrhaging billions of gallons of water into the city, it was only a matter of a few hours on Monday before the communications citywide began to fail , Communication was about to become the biggest problem of the catastrophe. ,Christopher Cooper and Robert Block, Disaster: Hurricane Katrina and the Failure of Homeland Security Truth became a casualty, news organizations that were patting their own backs in early September were publishing protracted mea culpas by the end of the month. ,Matt Welch, "They Shoot Helicopters, Don't They?" [source] Effects of alternative styles of risk information on EMF risk perceptionBIOELECTROMAGNETICS, Issue 7 2010Jesper Bo Nielsen Abstract Risk scenarios characterized by exposures to new technologies with unknown health effects, together with limited appreciation of benefits pose a challenge to risk communication. The present report illustrates this situation through a study of the perceived risk from mobile phones and mobile masts in residential areas. Good information should objectively convey the current state of knowledge. The research question is then how to inform lay people so that they trust and understand the information. We used an Internet-based survey with 1687 Danish participants randomized to three types of information about radiation from mobile phones and masts. The objective was to study whether different types of information were rated as equally useful, informative, comprehensible, and trustworthy. Moreover, an important issue was whether information would influence risk perception and intended behavior. The conclusion is that lay people rate information about risks associated with a new and largely unknown technology more useful and trustworthy when provided with brief statements about how to handle the risk, rather than more lengthy technical information about why the technology may or may not entail health hazards. Further, the results demonstrate that information may increase concern among a large proportion of the population, and that discrepancies exist between expressed concern and intended behavior. Bioelectromagnetics 31:504,512, 2010. © 2010 Wiley-Liss, Inc. [source] Classification of atopic hand eczema and the filaggrin mutationsCONTACT DERMATITIS, Issue 5 2008Charlotte Giwercman Hand eczema is a common disease with various risk factors of which atopic dermatitis is known to be one of the most important. Recently, two mutations in the gene coding for filaggrin, a protein important for the skin barrier, have repeatedly been shown to be associated with atopic dermatitis. Moreover, one study point towards an association between the filaggrin null alleles and the subgroup of patients having both hand eczema and atopic dermatitis. For the remainder of hand eczema patients, still unknown genetic risk factors exist. We propose that in future, classification of atopic hand eczema should distinguish between patients with and without the filaggrin null alleles and to further differentiate between associations with type I allergy, type IV allergy and exposure to irritants, respectively. Furthermore, we suggest future studies of atopic hand eczema to analyse for the filaggrin mutations. We believe this will increase the possibility of subgrouping this otherwise heterogenic disease and thereby enable a better phenotype,genotype characterization of hand eczema. This could improve the preventive initiatives, secure better information of patients about the prognosis for their disease, and possibly enable targeted treatment. [source] Strategic Decisions of New Technology Adoption under Asymmetric Information: A Game-Theoretic Model*DECISION SCIENCES, Issue 4 2003Kevin Zhu ABSTRACT In this paper we explore strategic decision making in new technology adoption by using economic analysis. We show how asymmetric information affects firms' decisions to adopt the technology. We do so in a two-stage game-theoretic model where the first-stage investment results in the acquisition of a new technology that, in the second stage, may give the firm a competitive advantage in the product market. We compare two information structures under which two competing firms have asymmetric information about the future performance (i.e., postadoption costs) of the new technology. We find that equilibrium strategies under asymmetric information are quite different from those under symmetric information. Information asymmetry leads to different incentives and strategic behaviors in the technology adoption game. In contrast to conventional wisdom, our model shows that market uncertainty may actually induce firms to act more aggressively under certain conditions. We also show that having better information is not always a good thing. These results illustrate a key departure from established decision theory. [source] Psychobiological models of adolescent risk: Implications for prevention and interventionDEVELOPMENTAL PSYCHOBIOLOGY, Issue 3 2010Julia Jackson-Newsom Abstract Psychobiological models of risk have much to contribute to the prevention of and intervention with risky behavior among adolescents. Emerging research is beginning to provide better information about mechanisms underlying individual differences in risky behavior (e.g., differences in self-regulation) and providing insight into unique vulnerabilities that occur during adolescence (e.g., increases in reward seeking). This work suggests ways in which prevention programming can be designed to be sensitive to both individual differences and developmental timing. Psychobiological models of risk also have practical implications for the manner and methods of conducting prevention and intervention work. Future work in both the etiology and prevention of risky behavior can benefit from ongoing dialogue and has the potential to result in a more sophisticated understanding of the mechanisms of change related to risky behavior. © 2010 Wiley Periodicals, Inc. Dev Psychobiol 52: 295,297, 2010 [source] Should we beware of the Precautionary Principle?ECONOMIC POLICY, Issue 33 2001Christian Gollier How should society deal with risks when there is scientific uncertainty about the size of these risks? There has been much recent discussion of the Precautionary Principle, which states that lack of full scientific knowledge should not be used as a reason to postpone cost,effective preventive measures. We show in this paper that the Precautionary Principle contradicts one important intuition about the right way to act in the face of risk, namely the principle of ,looking before you leap'. When we expect to learn more about the future, the effectiveness of our preventive measures will be greater if we learn before we act. However, a number of other ways of taking uncertainty into account are consistent with a reasonable interpretation of the Precautionary Principle. First, postponing preventive measures may increase our vulnerability to damage, which induces a precautionary motive for risk,prevention, similar to the precautionary savings motive. Secondly, stronger preventive actions often yield more flexibility for the future, so that acting early has an option value. Thirdly, when better information comes from a process of learning,by,doing, the risk associated with early events is amplified by the information they yield about the future. This plays a role analogous to that of an increase in risk aversion, making us more cautious. Fourthly, because imperfect knowledge of the risk makes it difficult to insure, the social cost of risk should include a risk premium. Finally, uncertainty about the economic environment enjoyed by future generations should be taken into account. This raises the benefit of acting early to prevent long,term risks. If the Precautionary Principle sometimes gives good and sometimes gives bad advice, there is no escape from the need to undertake a careful cost,benefit analysis. We show that standard cost,benefit analysis can be refined to take account of scientific uncertainty, in ways that balance the Precautionary Principle against the benefits of waiting to learn before we act. Furthermore, it is important that they be used to do so, for instinct is an unreliable guide in such circumstances. Abandoning cost,benefit analysis in favour of simple maxims can result in some seriously misleading conclusions. [source] DOES MORE TRANSPARENCY GO ALONG WITH BETTER GOVERNANCE?ECONOMICS & POLITICS, Issue 2 2006ROUMEEN ISLAM This paper explores the link between information flows and governance. It develops a new indicator, the transparency index, which measures the frequency with which governments update economic data that they make available to the public. The paper also uses the existence of a Freedom of Information Act and the length of time for which it has been in existence as an indicator reflecting the overall legislative environment for transparency. Measures of the type developed in this paper have hitherto not been used in the cross-country literature on governance and growth. Cross-country regression estimation shows that countries with better information flows as measured by these indices also govern better. [source] Delegation, Committees, and ManagersJOURNAL OF ECONOMICS & MANAGEMENT STRATEGY, Issue 1 2007Birger Wernerfelt Attempts to economize on decision-making time imply that groups of peers may delegate authority to a small committee of managers even though this means that the information and preferences of the uninvolved players are neglected. Decisions are more likely to be delegated to players with better information and more representative preferences. The possibility of ex post protests may force managers to take the preferences of others into account but may also give them incentives to ignore their private information. The argument may explain employees' willingness to let bosses decide, and thus throw some light on the theory of the firm. [source] Regulating a Monopolist with Unknown Demand: Costly Public Funds and the Value of Private InformationJOURNAL OF PUBLIC ECONOMIC THEORY, Issue 5 2004Iñaki Aguirre In this paper, we analyze the optimal regulation policy when the regulated firm has better information concerning the market demand than the regulator. We show that introducing a cost on public funds into the Planner's objective function does not lead to qualitative results similar to those obtained by introducing distributional considerations. In particular we show that under constant marginal cost the full information policy is not implementable and that the optimal regulatory policy results in informational rents. The social value of private information and the firm's informational rents are both increasing functions of the cost of the public funds. [source] Single nucleotide polymorphisms in the interferon-, and interleukin-10 genes do not influence chronic hepatitis C severity or T-cell reactivity to hepatitis C virusLIVER INTERNATIONAL, Issue 2 2004William G.H. Abbott Abstract: Background: The mechanisms by which interferon-, (IFN-,) contributes to inter-individual heterogeneity in the severity of chronic hepatitis C (CH-C) are unknown. In 116 consecutive patients with CH-C, we tested the hypothesis that host genetic factors regulating IFN-, production and activity influence the severity of liver damage and hepatitis C virus (HCV)-specific T-cell reactivity. Methods: We determined the genotypes of functionally significant polymorphisms in the IFN-, gene and in the promoter of interleukin-10 (IL-10), a cytokine that counteracts IFN-,. We also measured concanavalin A (Con A)-stimulated IL-10 and IFN-, production, and the frequency of virus-specific T-cells, producing IFN-, or IL-10. Results: The grade of inflammation and the stage of fibrosis of CH-C showed no associations with either the IFN-, or IL-10 promoter polymorphisms or with Con A-stimulated IL-10 or IFN-, production. Similarly, there were no associations between HCV-specific T-cell frequencies and these host genetic factors. On multivariate analysis, the grade of inflammation and the duration of HCV infection accounted for only 37% of the variance in the stage of CH-C (P<0.0001). This percentage did not increase by including any genetic variables in the analyses. Conclusion: Future studies investigating the entire cytokine gene sequences will provide better information regarding genetic variations responsible for inter-individual differences in the severity of CH-C. [source] Interior regularity criterion via pressure on weak solutions to the Navier,Stokes equationsMATHEMATISCHE NACHRICHTEN, Issue 1-2 2007Tomoyuki Suzuki Abstract Consider the nonstationary Navier,Stokes equations in , × (0, T), where , is a bounded domain in ,3. We prove interior regularity for suitable weak solutions under some condition on the pressure in the class of scaling invariance. The notion of suitable weak solutions makes it possible to obtain better information around the singularities. (© 2007 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim) [source] MIB-1 immunolabeling: A valuable marker in prediction of benign recurring meningiomasNEUROPATHOLOGY, Issue 5 2007Mahesha Vankalakunti Histological analysis has limited value to predict biological behavior of meningiomas. We investigated the utility of cell proliferative indicator in the evaluation of histologically benign meningiomas. We selected 25 benign non-recurrent meningiomas, 15 benign recurrent meningiomas after complete surgical resection, 30 atypical meningiomas, and 15 anaplastic meningiomas out of 384 cases studied. MIB-1 Labeling Index was evaluated by two methods: Highest Labeling Index (HLI) and Random Labeling Index (RLI). There was no dependable histological parameter to predict recurrence among benign-looking meningiomas. HLI had significant difference when compared with RLI in all categories. The mean MIB-1 HLI values ± SD were 3.47 ± 2.0% for benign meningiomas, 5.08 ± 4.0% for atypical meningiomas and 11.66 ± 7.06% for anaplastic meningiomas. In comparison, the mean MIB-1 HLI of benign non-recurrent meningiomas were 2.66 ± 1.7% and with recurrence were 4.21 ± 2.78% (P = 0.0339). Using receiver operating characteristic, it was seen that neoplasm recurred with the MIB-1 HLI of > 2.6 having the sensitivity of 64.6% and specificity of 68% among benign (grade I) meningiomas. MIB-1 positive tumor cells were maximally aggregated at the periphery of excised specimen. MIB-1 HLI, integrated with standard histopathology can provide better information about the disease biological nature in benign meningiomas. [source] APA national audit of pediatric opioid infusionsPEDIATRIC ANESTHESIA, Issue 2 2010FFPMRCA, FRCPCH, NEIL S. MORTON MD Summary Introduction:, A prospective audit of neonates, infants, and children receiving opioid infusion techniques managed by pediatric acute pain teams from across the United Kingdom and Eire was undertaken over a period of 17 months. The aim was to determine the incidence, nature, and severity of serious clinical incidents (SCIs) associated with the techniques of continuous opioid infusion, patient-controlled analgesia, and nurse-controlled analgesia in patients aged 0,18. Methods:, The audit was funded by the Association of Paediatric Anaesthetists (APA) and performed by the acute pain services of 18 centers throughout the United Kingdom. Data were submitted weekly via a web-based return form designed by the Document Capture Company that documented data on all patients receiving opioid infusions and any SCIs. Eight categories of SCI were identified in advance, and the reported SCIs were graded in terms of severity (Grade 1 (death/permanent harm); Grade 2 (harm but full recovery and resulting in termination of the technique or needing significant intervention); Grade 3 (potential but no actual harm). Data were collected over a period of 17 months (25/06/07-25/11/08) and stored on a secure server for analysis. Results:, Forty-six SCIs were reported in 10 726 opioid infusion techniques. One Grade 1 incident (1 : 10 726) of cardiac arrest occurred and was associated with aspiration pneumonitis and the underlying neurological condition, neurocutaneous melanosis. Twenty-eight Grade 2 incidents (1 : 383) were reported of which half were respiratory depression. The seventeen Grade 3 incidents (1 : 631) were all drug errors because of programming or prescribing errors and were all reported by one center. Conclusions:, The overall incidence of 1 : 10 000 of serious harm with opioid infusion techniques in children is comparable to the risks with pediatric epidural infusions and central blocks identified by two recent UK national audits (1,2). Avoidable factors were identified including prescription and pump programming errors, use of concurrent sedatives or opioids by different routes and overgenerous dosing in infants. Early respiratory depression in patients with specific risk factors, such as young age, neurodevelopmental, respiratory, or cardiac comorbidities, who are receiving nurse-controlled analgesia or continuous opioid infusion suggests that closer monitoring for at least 2 h is needed for these cases. As a result of this audit, we can provide parents with better information on relative risks to help the process of informed consent. [source] Parents should be given better information to manage their child's pain after day surgeryPEDIATRIC ANESTHESIA, Issue 5 2006Isabeau Walker FRCA No abstract is available for this article. [source] Special needs of children with type 1 diabetes at primary school: perceptions from parents, children, and teachersPEDIATRIC DIABETES, Issue 1 2009Blanca Amillategui Objective:, To identify the special needs of children with type 1 diabetes at primary school taking into account the perceptions reported by parents, children, and teachers. Methods:, This was a cross-sectional survey carried out at nine public hospitals with a cohort of 6- to 13-yr-old children. Parents were personally informed about the objectives of the survey and the necessity to involve their children and the teachers. The self-reporting questionnaire included demographic information as well as some questions that helped to evaluate the general situation of children with type 1 diabetes at primary school, main worries about the disease, and possible improvement measures. Results:, A total of 430 questionnaires were completed and validated of which 39% were filled in by parents, 35% by children, and 26% by teachers. The majority of children were 10,13 yr old and came from public schools. At school, most children required glucose monitoring, but few of them (9,12%) needed insulin administration. Some parents (7%) experienced problems at their schools when they informed them about their children's disease, 2% were finally not accepted, and 1% were forced to change school. Major children's concerns included the ability to recognize hypoglycemia or to self-administer insulin. Parents, teachers, and children demanded better information at school about diabetes and about emergency management. Conclusions:, The three population groups agreed about the necessity of having more available information on diabetes at schools. Although some discriminatory behavior was still occurring, it seemed it has been diminishing in recent years. [source] Latest news and product developmentsPRESCRIBER, Issue 17 2007Article first published online: 6 NOV 200 Drug information stilllacking for mentally ill Half of people with mental illness still have no say in the medication they are prescribed and one-third are not informed about side-effects, according to the latest report by the Healthcare Commission and the Commission for Social Care Inspection (www.health-carecommission.org.uk). The annual national review of adult mental health services found overall improvement among local intervention teams in 2005/06 compared with the preceding year, though all could improve further and the performance of 46 per cent were rated as only fair or weak. A survey of 7446 people with schizophrenia also showed that only 46 per cent had access to psychological treatments. More incentives for shift of care in Scotland Scotland has made good progress on shifting NHS care into the community but joined-up thinking, better information and incentives are needed to overcome barriers to better management of long-term conditions in adults, says Audit Scotland (www.audit-scotland.gov.uk). Reviewing progress on the 2005 strategy document Delivering for Health, Audit Scotland found good progress on asthma and diabetes services , partly due to the effects of the GMS contract. Better information about clinical activity, costs and effectiveness is needed to help redesign services. Patients with more than one long-term condition do not receive co-ordinated care and many want greater involvement in their care, the report concluded. Acorn, QOF and Guy Rotherham awards Entries are invited for the 2007 annual Acorn, QOF and Guy Rotherham Awards. The awards are run in association with the NHS Alliance, Improvement Foundation, British Cardiac Society, British Cardiac Patients Society and Prescriber. The CHD QOF Award, sponsored by Schering-Plough, recognises the achievement of an individual practice that gains maximum points in the CHD and heart failure QOF domains, and a second award is given to the primary care organisation (PCO) that achieves the best average scores across its practices. The entry form can be found at www.escriber.com. The closing date is 12 October. Entries are also invited for the Guy Rotherham Award from PCOs that can demonstrate they have delivered a high-impact change resulting in better outcomes and services for patients. For online entry go to www.improvementfoundation.org/guy rotherhamaward. Closing date is 5 October. Award winners will receive free entry for three to the NHS Alliance conference and the conference dinner. The winner of the Guy Rotherham Award will also receive £3000. NICE scores five out of six NICE acted unreasonably in relying solely on the Mini-Mental State Examination (MMSE) to define severity of Alzheimer's disease in its updated technology appraisals, with the effect of discriminating against people with learning or language difficulties, the High Court has ruled. The five other claims by Eisai that NICE acted unreasonably and irrationally were not upheld. This was the first court action against NICE in its eight-year history. It has now promised to publish revised appraisals on its website on 7 September and is consulting with Eisai, Shire Pharmaceuticals and the Alzheimer's Society on the best approach. PPRS reform follows Office of Fair Trading report The Government is to renegotiate the Pharmaceutical Price Regulation Scheme (PPRS) following the critical report by the Office of Fair Trading (OFT). In February, the OFT recommended renegotiation of the PPRS to reward innovation and obtain better value for patients. In particular, it called for a pricing scheme based on value for patients, ie effectiveness, rather than profit controls. The DoH, acknowledging the report's complexity, says it will take four principles into account in its negotiations during the forthcoming months: value for money, promoting innovation, assisting the uptake of new cost-effective medicines and promoting market stability. MHRA launches e-bulletin The MHRA (www.mhra.gov.uk) has next issue can be downloaded. The launched an electronic bulletin to August bulletin includes items on provide health professionals with antidepressants and suicide, updates about the safe use of medi-adverse effects of dopamine ago-cines. Users need to sign up to nists and information about smokreceive an e-mail alert when the ing cessation and isotretinoin. DURG call for abstracts The Drug Utilisation Research Group is calling for abstracts for its 19th annual meeting ,Target-driven medicine , is this the end of prescribing freedom?' to be held on 7 February 2008 at the Royal Society of Medicine, London. Abstracts are requested on any aspects of drug utilisation research. A bursary of £500 will be awarded for the best abstract received. The closing date for receipt of abstracts is 26 November. Further information about abstract submission is available at www.durg.org.uk. GP prescribing up by half Prescription volume and costs in England increased by approximately half over the decade to 2006, according to data published by the Information Centre for Health and Social Care (www.ic.nhs.uk). The number of items dispensed per year increased by 55 per cent and the cost by 60 per cent in real terms. The average number of items per head of population was 10.0 in 1996 and 14.8 in 2006; older people received 21.2 items per head in 1996 but 40.8 in 2006. MR morphines similar Modified-release preparations of morphine are equivalent in the treatment of severe pain, according to a new review by Bandolier (www.jr2.ox.ac.uk). The analysis of 54 randomised trials, which reviewed the release mechanisms and clinical data for four brands, showed these preparations provide effective analgesia for malignant and nonmalignant pain; about 4 per cent of patients were unable to tolerate the adverse effects of morphine. NSAIDs compared in OA Etoricoxib (Arcoxia) and naproxen are equally effective in the long-term treatment of osteoarthritis (Ann Rheum Dis 2007;66:945,51). Extension studies for two one-year trials showed that, after a total of 138 weeks, the two drugs had almost identical effects on pain and function assessments. All treatments were generally well tolerated, but serious cardiovascular effects were more common with etoricoxib and serious GI effects more common with naproxen. CPN nystatin allowed Community practitioner nurses (CPNs) may now prescribe oral nystatin (Nystan) to treat oral thrush in neonates, following a special amendment to the regulations limiting their prescribing to licensed indications. CPNs may now prescribe oral nystatin at the dose recommended in the BNF for Children provided they are sure of the diagnosis. In doing so, they accept clinical and medicolegal responsibility for their actions. There are no other exceptions to the prohibition of off-label prescribing. Copyright © 2007 Wiley Interface Ltd [source] Social Networks and Technology Adoption in Northern Mozambique,THE ECONOMIC JOURNAL, Issue 514 2006Oriana Bandiera We present evidence on how farmers' decisions to adopt a new crop relate to the adoption choices of their network of family and friends. We find the relationship to be inverse-U shaped, suggesting social effects are positive when there are few adopters in the network, and negative when there are many. We also find the adoption decisions of farmers who have better information about the new crop are less sensitive to the adoption choices of others. Finally, we find that adoption decisions are more correlated within family and friends than religion-based networks, and uncorrelated among individuals of different religions. [source] Doctors in a Wired World: Can Professionalism Survive Connectivity?THE MILBANK QUARTERLY, Issue 3 2002David Blumenthal The Information Revolution Has Raised Myriad questions about how the health care system will function in the future (Gingrich and Magaziner 2000; National Research Council 2000). The consensus seems to be that new information technologies will significantly affect almost every aspect of health care, from the way that employers and individuals purchase health insurance to the way that doctors and patients provide and receive care (National Research Council 2000). Although peer-reviewed evidence to support these predictions is scarce, the available data suggest that the major health care actors are actively experimenting with the new capabilities to exchange information. A February 2002 survey by Harris Interactive (www.Harrisinteractive.com) found that 137 million Americans were users of the Internet and the World Wide Web and 110 million reported going on-line at least three times a month to look for health care information (Landro 2002). An earlier survey by the Pew Charitable Trusts reported that of those Americans who used the Internet for health care purposes, 92 percent found the information useful. The information revolution has the potential to reduce the asymmetry of information between patients and doctors and thereby to undermine a central pillar of physicians' claim to professional status: the possession of distinctive competence based on technical know-how selflessly applied and collectively monitored. A close analysis of the information revolution's likely effects suggests that for some patients with some conditions, their access to more and better information will indeed reduce the magic, mystery, and power of the medical profession. However, the information revolution also offers opportunities for physicians to bolster the cognitive and moral bases of professionalism. To seize those opportunities, physicians must master new roles and skills and avoid unacceptable conflicts of interest. [source] Daubenton's bat distribution along rivers , developing and testing a predictive modelAQUATIC CONSERVATION: MARINE AND FRESHWATER ECOSYSTEMS, Issue S1 2010Steve D. Langton Abstract 1.This study aimed to develop and test a predictive model of Daubenton's bat Myotis daubentonii distribution and abundance at waterway sites in England and Wales. 2.A preliminary ,core' model to predict Daubenton's bat distribution, developed in 2003 and containing terms relating to biological water quality, waterway width, mean annual discharge and the presence of trees, was re-fitted to more comprehensive datasets. A ,data mining' exercise was conducted after testing the core model, in order to investigate other important variables and to suggest alternative models, with the overall aim of improving the confidence and utility of the results. 3.On average, Daubenton's bat activity was higher on larger waterways with abundant woodland nearby. There was, however, considerable variation in the levels of activity predicted by the models, possibly due to site-specific factors. 4.Daubenton's bat activity was significantly related to aquatic macroinvertebrate diversity, demonstrating the potential relevance of this species as an indicator of a pollution-sensitive biodiversity group. High aquatic macroinvertebrate diversity was associated with good chemical water quality. 5.The analysis demonstrates that Daubenton's bat activity on rivers can be predicted from habitat and water quality data, although the precision of these predictions is low. Where practical, field surveys yield better information. Copyright © 2009 John Wiley & Sons, Ltd. [source] The origin of cutoff frequencies for torsional tube waves propagating in the solar atmosphereASTRONOMISCHE NACHRICHTEN, Issue 6 2010R. Hammer Abstract Torsional waves supported by magnetic flux tubes have long been thought to bear a high potential for supplying energy and momentum to the upper solar atmosphere, thereby contributing to its heating and to the driving of dynamic events like spicules. This hope rested on the belief that their propagation is not impeded by cutoff restrictions, unlike longitudinal and kink waves. We point out that this applies only to thin, isothermal tubes. When they widen in the chromosphere, and as a result of temperature gradients, cutoff restrictions arise. We compare them to recent observational reports of such waves and of vortex motions and find that their long period components are already affected by cutoff restrictions. An observational strategy is proposed that should permit the derivation of better information on vortex flows from off-center observations with next generation telescopes (© 2010 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim) [source] Bayes' Theorem to estimate population prevalence from Alcohol Use Disorders Identification Test (AUDIT) scoresADDICTION, Issue 7 2009David R. Foxcroft ABSTRACT Aim The aim in this methodological paper is to demonstrate, using Bayes' Theorem, an approach to estimating the difference in prevalence of a disorder in two groups whose test scores are obtained, illustrated with data from a college student trial where 12-month outcomes are reported for the Alcohol Use Disorders Identification Test (AUDIT). Method Using known population prevalence as a background probability and diagnostic accuracy information for the AUDIT scale, we calculated the post-test probability of alcohol abuse or dependence for study participants. The difference in post-test probability between the study intervention and control groups indicates the effectiveness of the intervention to reduce alcohol use disorder rates. Findings In the illustrative analysis, at 12-month follow-up there was a mean AUDIT score difference of 2.2 points between the intervention and control groups: an effect size of unclear policy relevance. Using Bayes' Theorem, the post-test probability mean difference between the two groups was 9% (95% confidence interval 3,14%). Interpreted as a prevalence reduction, this is evaluated more easily by policy makers and clinicians. Conclusion Important information on the probable differences in real world prevalence and impact of prevention and treatment programmes can be produced by applying Bayes' Theorem to studies where diagnostic outcome measures are used. However, the usefulness of this approach relies upon good information on the accuracy of such diagnostic measures for target conditions. [source] Relatives in end-of-life care , part 1: a systematic review of the literature the five last years, January 1999,February 2004JOURNAL OF CLINICAL NURSING, Issue 9 2006Birgitta Andershed PhD Aim., To review systematically research conducted during the past five years focusing on the relatives' situation and needs in end-of-life care. Background and aim., That relatives make a large contribution in the care of the dying is well-known. In this situation, relatives often have to solve many new practical problems in the care as well as dealing with the sorrow of both themselves and the dying person. In recent years, palliative care has been developed in many countries and many new studies have been carried out. Methods., A systematic search of the literature was performed in the CINAHL and Medline databases. Of the 94 papers analysed, there were 59 qualitative and 35 quantitative studies with differing designs. The studies were carried out in 11 countries and were published in 34 different journals. Results., The results were categorized in two main themes with several subthemes: (1) being a close relative , the situation: (i) exposed position , new responsibility, (ii) balance between burden and capacity and (iii) positive values; (2) being a close relative , needs: (i) good patient care, (ii) being present, (iii) knowing and communicating and (iv) support from and trusting relationship with the professional. The relative's feelings of security and trust in the professional were found to be of great importance. Conclusion., More than twice as many studies had a descriptive/explorative design, which is of importance in the assessment of evidence. However, different studies complement one another and in summary, it can be said that analytic evidence is unequivocal: good patient care, communication, information and the attitude of the professional are of decisive importance regarding relatives' situation. These results are also in accord with earlier review studies. Relevance to clinical practice., Staff members have a great deal of responsibility for assuring that the patient feels as good as possible, facilitating relatives' involvement based on the family's wishes and limiting the stress and difficulties experienced by the family. The results showed that the relative's satisfaction could depend on the attitude of the professional as well as on good communication, good listening and good information. This can also be viewed as a prerequisite for the professional to get to know the family and to provide ,care in the light'. [source] HIGH-RESOLUTION MAGIC ANGLE SPINNING NMR ANALYSIS OF WHOLE CELLS OF CHAETOCEROS MUELLERI (BACILLARIOPHYCEAE) AND COMPARISON WITH 13C-NMR AND DISTORTIONLESS ENHANCEMENT BY POLARIZATION TRANSFER 13C-NMR ANALYSIS OF LIPOPHILIC EXTRACTS,JOURNAL OF PHYCOLOGY, Issue 3 2004Matilde S. Chauton Lipid composition in extracted samples of Chaetoceros muelleri Lemmermann was studied with 13C-NMR and distortionless enhancement by polarization transfer (DEPT) 13C-NMR, resulting in well-resolved 13C-NMR spectra with characteristic resonance signals from carboxylic, olefinic, glyceryl, methylene, and methyl groups. The application of a DEPT pulse sequence aided in the assignment of methylene and methine groups. Resonance signals were compared with literature references, and signal assignment included important unsaturated fatty acids such as eicosapentaenoic and docosahexaenoic and also phospholipids and glycerols. Results from the extracted samples were used to assign resonance signals in a high-resolution magic angle spinning (HR MAS) DEPT 13C spectrum from whole cells of C. muelleri. The NMR analysis on whole cells yielded equally good information on fatty acids and also revealed signals from carbohydrates and amino acids. Broad resonance signals and peak overlapping can be a problem in whole cell analysis, but we found that application of HR MAS gave a well-resolved spectrum. The chemical shift of metabolites in an NMR spectrum depends on the actual environment of nuclei during analysis, and some differences could therefore be expected between extracted and whole cell samples. The shift differences were small, and assignment from analysis of lipophilic extract could be used to identify peaks in the whole cell spectrum. HR MAS 13C-NMR therefore offers a possibility for broad-range metabolic profiling directly on whole cells, simultaneously detecting metabolites that are otherwise not detected in the same analytical set up and avoiding tedious extraction procedures. [source] United States Department of Agriculture,Agricultural Research Service research on pest biology: weeds,,PEST MANAGEMENT SCIENCE (FORMERLY: PESTICIDE SCIENCE), Issue 6-7 2003Frank Forcella Abstract Over 125 permanent full-time scientists conduct research within the USDA Agricultural Research Service (ARS) on issues related to weeds. The research emphasis of most of these scientists involves ecology and management or biological control of weeds. Many scientists perform research on weed biology as components of their primary projects on weed control and integrated crop and soil management. Describing all ARS projects involved with weed biology is impossible, and consequently only research that falls within the following arbitrarily chosen topics is highlighted in this article: dormancy mechanisms; cell division; diversity of rangeland weeds; soil resources and rangeland weeds; poisonous rangeland plants; horticultural weeds; weed traits limiting chemical control; aquatic and semi-aquatic weeds; weed/transgenic wheat hybrids; seedbanks, seedling emergence and seedling populations; and weed seed production. Within these topics, and others not highlighted, the desire of ARS is that good information on weed biology currently translates or eventually will translate into practical advice for those who must manage weeds. Published in 2003 for SCI by John Wiley & Sons, Ltd. [source] Public Budget Choices and Private Willingness to PayPUBLIC BUDGETING AND FINANCE, Issue 2 2010BRANDON C. KOFORD Efficient allocation of public funds depends upon good information about citizens' values. The purpose of this paper is to demonstrate how citizens' values can be obtained by eliciting marginal willingness to tradeoff (MWTTO) ratios for public spending categories and linking these ratios to individual, private willingness to pay. The link enables estimation of the willingness to pay for an expansion to any of the budget categories based on the elicited willingness to pay and the marginal willingness to tradeoff ratios. Tradeoff ratios and willingness to pay are estimated for public budget categories in Kentucky based on a representative sample surveyed by mail and the web in 2007. Estimates show that individuals are willing to pay the most for an expansion to educational services, followed by health care. [source] Predicting the unexpected: using a qualitative model of a New Zealand dryland ecosystem to anticipate pest management outcomesAUSTRAL ECOLOGY, Issue 4 2009DAVID S. L. RAMSEY Abstract Pest management is expensive and there is often uncertainty about the benefits for the resources being protected. There can also be unintended consequences for other parts of the ecosystem, especially in complex food webs. In making decisions managers generally have to rely on qualitative information collected in a piecemeal fashion. A method to assist decision making is a qualitative modelling approach using fuzzy cognitive maps, a directed graphical model related to neural networks that can take account of interactions between pests and conservation assets in complex food webs. Using all available information on relationships between native and exotic resources and consumers, we generated hypotheses about potential consequences of single-species and multi-species pest control on the long-term equilibrium abundances of other biotic components of an ecosystem. We applied the model to a dryland ecosystem in New Zealand because we had good information on its trophic structure, but the information on the strength of species interactions was imprecise. Our model suggested that pest control is unlikely to significantly boost native invertebrates and lizards in this ecosystem, suggesting that other forms of management may be required for these groups. Most of the pest control regimes tested resulted in greater abundances of at least one other pest species, which could potentially lead to other management problems. Some of the predictions were unexpected, such as more birds resulting from possum and mouse control. We also modelled the effects of an increase in invasive rabbits, which led to unexpected declines of stoats, weasels, mice and possums. These unexpected outcomes resulted from complex indirect pathways in the food web. Fuzzy cognitive maps allow rapid construction of prototype models of complex food webs using a wide range of data and expert opinion. Their utility lies in providing direction for future monitoring efforts and generating hypotheses that can be tested with field experiments. [source] | |||||||||||||||||||