It is often assumed that Chinese people tend to have a more positive attitude toward aging and old age than Americans, due to the cultural generalization of collectivism versus individualism. This study aimed to critically examine this assumption by using first-hand empirical data collected in a Chinese and an American university (standardized surveys and in-depth focus group interviews). Respectively, 980 college students in China and 332 college students in the U.S. were recruited for the standardized surveys; whereas two focus-group interviews in each country (4 participants per group) were conducted to collect more in-depth information. Contrary to the common assumption, this study revealed that Chinese students actually hold more negative attitudes toward aging and older people compared to their American peers. It was also found that females tend to hold more positive attitudes than male students across both cultures, though American female students hold more positive attitudes than Chinese female students. Chinese students' interactions with seniors are often limited to their grandparents whereas American students tend to reach out to non-grandparent seniors in larger communities. Chinese students' more negative attitudes toward aging and older people may be a result of a combination of educational, social, and economic factors-a higher level of age segregation (geographically, socially, and intellectually) and a lack of gerontological curriculum in Chinese educational system, the caregiving burden faced by the one-child generation compounded with lack of governmental support for caregiving, as well as the rising youth-oriented consumerist culture.
Although the International Committee of Medical Journal Editors has published clear guidance on the authorship of scientific papers, short-term contract research workers, who perform much of the research that is reported in the biomedical literature, are often at a disadvantage in terms of recognition, reward and career progression. This article identifies several professional, ethical and operational issues associated with the assignment of authorship, describes how a university department of primary care set about identifying and responding to the concerns of its contract research staff on authorship and describes a set of guidelines that were produced to deal with the ethical and professional issues raised. These guidelines include directions on how authorship should be negotiated and allocated and how short-term researchers can begin to develop as authors. They also deal with the structures required to support an equitable system, which deals with the needs of short-term researchers in ways that are realistic in the increasingly competitive world of research funding and publication, and may offer a model for more formal guidelines that could form part of institutional research policy.
Introduction
Venous thromboembolism (VTE) is a common and serious complication of systemic anticancer therapies. Delays in presentation increase risk of death or long‐term morbidity.
Background
A patient charity developed an information video for patients receiving systemic anticancer therapy including what to do if they developed symptoms of VTE. This was introduced into clinical practice in a regional cancer center and its impact compared with a district general hospital where the video was not used.
Methods
A mixed‐methods approach was used, comprising clinical audit data, patient surveys, and key informant interviews. The time between development of VTE symptoms and seeking medical evaluation was routinely recorded on patients attending a regional cancer‐associated thrombosis service with systemic anticancer therapy–provoked VTE. The video was then embedded into clinical practice at the regional cancer center for 3 months. The primary outcome was the difference in time to presentation with VTE symptoms, between patients attending the regional cancer center and the district general hospital (which acted as control). Other outcomes included impact on radiology resources, patient knowledge, and perspectives of chemotherapy nurses.
Results
Addition of the video was associated with a lower mean time to presentation from 8.9 to 2.9 days (0.33 hazard ratio; 95% confidence interval, 4.5‐7.4; P < .0001). This may reflect greater awareness of VTE, resulting in earlier clinical presentation when they developed attributable symptoms.
Conclusion
The video was associated with reduced delays in diagnosis of systemic anticancer therapy–associated VTE by 6 days, thereby reducing long‐term complications.
safety), accessible both locally for palliative care teams to support service planning and bench-marking, and nationally for policy and strategy judgements.
IntroductionCare homes (CHs) play a vital role in the delivery of care towards the end of life (National Institute for Health Research 2017; Public Health England 2017) yet little is known about specialist palliative care (SPC) support in this setting.AimTo increase understanding of how SPC services support adult CHs in England and identify from a SPC provider perspective the challenges and enablers to good quality SPC.MethodSPC services working directly with CHs in the community in England were invited to complete an online survey. Content analysis enabled qualitative data to be described.Results108 services participated. A range of challenges were identified including CH staff turnover lack of funding and retention of CH staff knowledge skills and competency.Proposed ways to reduce/resolve challenges included:Increased commissioning of SPC staff to work directly with CHs particularly to provide education/trainingStrategic centralised and longer–term approaches to funding to facilitate continuity of support to CHsMandatory SPC core competencies and accessible training for CH staff to facilitate the prioritisation and uptake of trainingIncreased collaboration within and across organisations including regulators commissioners and providers of SPC CH and GP services to increase consistency and quality of SPC education and resident careConclusionsThe data are of national relevance and enhances our understanding of the challenges and potential enablers to CH support from a SPC provider perspective. Increased funding and cross-organisational collaboration are thought to be important instruments for change. The views of others including CH staff should be sought.References. National Institute for Health Research. Advancing care – Research with care homes 2017. Available at: https://www.dc.nihr.ac.uk/themed-reviews/care-home-research.htm [Accessed: 29th May 2018]. Public Health England. Briefing 1 – Care home bed provision and potential end of life care need in people aged 75 or older in England2017. Available at: http://www.endoflifecareintelligence.org.uk/resources/publications/carehomes [Accessed: 29th May 2018]
A samplin g m ethod,. called th~ chain ratio m ethod, is appli ed in es t imat in g t he distribll-tlOn of m a il by dest lllatlOn. Vana nces and coe ffi cie nts of vari ation for the estimato rs are gi ve n. The details a nd r esults of t hree a ppli cations of t hi s samplin g m ethod to outgoin g first-class lette r mai l a rc give n. These studies ,yere condu cted by t he National BUI'ea u of Stall clarcls i n San Francisco, Los Augeles, and Baltimore. I Prese nt address: University of Bnffalo. 2 Italicized terms h ave special meanings in this stud y and arc clefined in srcLion 2. 1 of this paper or in the Postal T erm Glm~s(lTY, U .S. . Post Office D epa rtment, A u!!ust 1956, P.O .D. Publi cation 18_ 3 l. . "igures i n brackets ind icate the liter ature references at t l lC I)nci of this paper.
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