BackgroundMany clinicians depend solely on journal abstracts to guide clinical decisions.ObjectivesThis study aims to determine if there are differences in the accuracy of responses to simulated cases between resident physicians provided with an abstract only and those with full-text articles. It also attempts to describe their information-seeking behaviour.MethodsSeventy-seven resident physicians from four specialty departments of a tertiary care hospital completed a paper-based questionnaire with clinical simulation cases, then randomly assigned to two intervention groups—access to abstracts-only and access to both abstracts and full-text. While having access to medical literature, they completed an online version of the same questionnaire.FindingsThe average improvement across departments was not significantly different between the abstracts-only group and the full-text group (p=0.44), but when accounting for an interaction between intervention and department, the effect was significant (p=0.049) with improvement greater with full-text in the surgery department. Overall, the accuracy of responses was greater after the provision of either abstracts-only or full-text (p<0.0001). Although some residents indicated that ‘accumulated knowledge’ was sufficient to respond to the patient management questions, in most instances (83% of cases) they still sought medical literature.ConclusionsOur findings support studies that doctors will use evidence when convenient and current evidence improved clinical decisions. The accuracy of decisions improved after the provision of evidence. Clinical decisions guided by full-text articles were more accurate than those guided by abstracts alone, but the results seem to be driven by a significant difference in one department.

Background: Increased emphasis has been given to the practice of evidence-based medicine (EBM) worldwide. Access to quality health information is essential to the practice of EBM in developing countries. Objectives: To understand the information needs and sources of information of physicians from low-and middle-income countries (LMICs). Methods: Medical doctors and students participated in an 18-question online or paper study. Results: Of the 156 respondents from six LMICs, 146 (94%) came from the Philippines. Eighty-eight per cent encountered at least one clinical question daily, while 58% were very likely to search for answers. A basic mobile phone was the most used device at home (94%) and at work (82%). More than half had Internet connectivity at home (62%) and just under half at work (46%). In decreasing order, short messaging services (SMS), email, instant messaging and multimedia messaging services (MMS) were the most commonly used messaging tools at home and at work. The primary source for medication questions was a formulary, but for diagnostic dilemmas, colleagues were consulted first. PubMed use was high for therapy and management questions. Conclusion: The use of health information from the Internet through mobile devices may be increasing. Access to health information was higher at home than at work. These results may be useful when planning resources for healthcare givers in resource-poor settings.

Background: Medical education in pathology and histology in low-resource countries face many obstacles because of equipment cost and telecommunication deficiencies. Digital Pathology may provide solutions. We report student experience to virtual slides on a local network and a remote image server. Methods: Using an iPad tablet device, fifty 3rd and 4th year medical students viewed digital pathology slides from a Web server at the National Library of Medicine and a mirror server on the local network. Results: The quality of images from both servers was found to be satisfactory, but the local server was deemed faster and preferred by the participants in this study (p < 0.005). Conclusions: Virtual slides on a local network server may provide solutions to equipment and technical obstacles and could enhance student learning in developing countries.

The inaccuracies do not seem to affect the conclusion and interpretation overall. Structured abstracts appear to be informative and may be useful to practitioners as a resource for guiding clinical decisions.

Hypertension is the most frequently managed condition by Australian general practitioners (GP). Knowledge of hypertension and blood pressure (BP) values may motivate individuals to seek GP management. Our study aims to determine the associations of knowledge of BP values, BP perception, GP health seeking, and self-rated health (SRH) in a rural population. Two-hundred and seventy-eight (278) residents responded to the health survey on socio-demographic profile, medical history, BP knowledge and perception, SRH, and GP visit frequency. Associations were evaluated using Chi-squared test and multivariate logistic regression. Cohort mean age was 63.6 (12.4) years with 63.3% females. Hypertension (37.8%) was the most common condition. GP visits were made at least once every month (19.1%), every 2–6 months (35.6%), >6 months (11.5%), or only when needed (29.5%). Univariate analyses showed age, education, alcohol consumption, comorbidities, hypertension status, and SRH were significantly associated with visit frequency. After adjustments, hypertension status (OR = 3.6, 95% CI [1.7, 7.9]) and poor SRH (OR = 3.1, 95% CI [1.4, 7.0]) were significantly associated with frequent monthly visits. Our cohort demonstrated that having hypertension and poor self-rated health were associated with frequent monthly GP visits. The perception of high blood pressure does not drive seeking additional GP input.

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Advanced information technologies and government policies provide the foundational substrate for smart cities. Translating this substrate into appropriate citizen services requires something more: an express recognition of citizen values and a projection of value that these services can generate for the citizens. We devise a method to design such citizen services by extending prior work in a number of streams including scenario-based design, service blueprinting, and the universality of basic human values. Our work follows a design science orientation treating these prior research streams as kernel theories. We describe our contribution as a method for Design of Smart Citizen Service 设计智慧市民服 务 (Shèjì Zhìhuì Shìmín Fúwù), appropriate for the context where we do our work. The paper outlines the method, illustrates it with scenarios for long-term care; and concludes with pointers to future work and implications for research and practice.

Atrial fibrillation (AF) is a common cardiac arrhythmia, and pathological burden can be influenced by environmental factors. The rural environment may influence the burden of AF, although no systematic review studies have been conducted to address this issue. We performed a systematic review of AF screening studies conducted in rural global populations to determine the burden, risk factors, and screening methods surrounding AF in these settings. Out of the 1792 articles gathered from a keyword search of medical databases and reference lists, 18 publications from 11 countries were included in our analysis. The pooled prevalence of AF across the studies was 2.05% (95% confidence interval, 1.97%-2.13%) and ranged from 0.3% to 10.87%. Only one study utilized a handheld electrocardiogram to screen AF, while the rest used the 12-lead electrocardiogram. AF risk factors reported across studies varied and included increasing age, male gender, hypertension, diabetes, prior myocardial infarction or stroke, obesity, hyperlipidemia/hypercholesterolemia, alcohol consumption, and heart failure. However, none of the studies assessed all risk factors. We suggest that future research on AF in rural communities examine a complete checklist of AF risk factors to better understand their influence on AF burden and development. This will aid in understanding rural prevention strategies and the management of detected AF cases specific to rural areas. At present, the burden of AF in rural communities is poorly understood and has been underreported.