GPs' implicit prioritization through clinical choices – evidence from three national health services

Acknowledgments The authors are grateful for valuable comments and inputs from participants at a series of seminars and conferences as well as to our three anonymous referees.Peer reviewedPostprin

Open Access Monitor - DK (OAM-DK): Indsamling, dokumentation og administration af publiceringsudgifter til Open Access i Danmark

In a changing landscape of new Open Access modes, Denmark has adopted a so-called green Open Access strategy, according to which publications must be kept largely free of charge and publications must be archived in institutional repositories.Even so, Danish universities spend significant financial resources on Open Access publishing. Substantial fees are being paid to publish via the golden route in Open Access journals, but also in subscription-based journals via the hybrid model. The latter is especially interesting considering the practice of double-dipping, where universities not only pay for the right-to-read (via the national e-license portfolios) but also for the right-to-publish (via publication fees).This raises the question of the scale of resources being spent on Open Access publishing by Danish universities. This DEFF project follows similar efforts in the UK, Sweden, Norway, Germany and the Netherlands, monitoring how much is being spent on gold and hybrid publishing by Danish universities. The approach has been to identify the publishing ecology of Open Access and derived financial costs. Since it is difficult to gather invoice data, an economic model has been developed to estimate the total cost of publication at Danish universities.Results show that both gold and hybrid publishing practices and expenses related to Open Access publishing in the Danish universities are increasing substantially and that monitoring efforts are required.An executive summary with ten results and recommendations has been produced and is available here: https://zenodo.org/record/1544953.Read more about the project: https://bit.ly/oam-d

Revisiting the psychometric properties of a revised Danish version of the McGill ingestive skills assessment

Background: During a longstanding validation process of the Danish version of the McGill Ingestive Skills Assessment (MISA2-DK) for measuring mealtime performance in dysphagic clients, extensive revisions have been undertaken. Therefore, this study aimed to determine the psychometric properties of this revised version. Methods: In a cross-sectional study, 328 adults referred to occupational therapy for swallowing evaluation were included. MISA2-DK with 36 items distributed into four subscales (positioning for meals, self-feeding skills, liquid ingestion, and solid ingestion) was administered as observation during a meal. Statistical analysis included item analysis by the Rasch model and exploratory factor analysis (EFA). Results: The initial analysis of MISA2-DK presented misfit to the Rasch model, which was resolved by grouping items within subscales into testlets to adjust for local item dependency. However, when testing the items within each subscale, the subscale structure was not supported. The EFA and further item analysis by the Rasch model suggested a different distribution of items—namely, anticipation, bolus preparation, bolus propulsion, and airway protection. Conclusion: The total MISA2-DK score might provide a unidimensional measure of mealtime performance. However, for detailed information of qualitative aspects of dysphagic clients’ mealtime performance, the four EFA-derived subscale domains are recommended

Is Embedding Entailed in Consumer Valuation of Food Safety Characteristics?

Consumers’ preferences for food safety characteristics are investigated with particular focus on existence of an embedding effect. Embedding exists if consumer valuation of food safety is insensitive to scope. Two choice experiments have been conducted valuing food safety in respectively minced pork and chicken breasts, exemplified by avoiding human risks of Salmonella infections and strengthening the restrictions of using antibiotics in the pork production and in terms of avoiding human risks of Salmonella and Campylobacter infections respectively. The results showed no indications of an embedding effect between the food safety characteristics, in neither of the cases.Valuation, Choice Experiment, Market Goods, Food Safety, Embedding., Agricultural and Food Policy, Food Consumption/Nutrition/Food Safety,

Outlook of solar energy in Europe based on economic growth characteristics

Solar power production in Europe has raised from about 130 MW to 110 GW of installed capacity (corresponding to 90 GWh to 120 TWh in annual electricity generation) during the present century. Together with wind power, it constitutes the largest growth within renewable energy sources in the last decades. At present however, clear signs of saturation can be observed in the leading areas of solar power in Europe. Here, the development of solar power in Europe is analysed and, for the three leading countries (Germany, Italy, Spain) a logistic growth path at the national level and a proportionality between saturation level of the growth curve of each country and its gross domestic product (GDP) is found. The sum of the next three countries (France, UK, Belgium) is well described by a logistic path with a time offset relative to the first group of three, and the sum of the two logistic paths, representing in total about 85% of European solar power production, describes the growth pattern in the corresponding area very well. Based on this, an estimate of a future saturation level for solar power in Europe is obtained by extrapolation. Finally, a model based on logistic growth patterns and learning curves that links solar power production data to investment data, is proposed. The proposed model is validated and calibrated on historical European data and extrapolated into the future. In a future scenario where European investments continue to decrease, a saturation level that is fully in line with our GDP based 200 TWh/y estimate is found and the application of the findings is discussed in a global context

Skills Training in Laboratory and Clerkship: Connections, Similarities, and Differences

Context: During the third semester of a 6 year long curriculum medical students train clinical skills in the skills laboratory (2 hours per week for 9 weeks) as well as in an early, 8 week clinical clerkship at county hospitals. Objectives: to study students’ expectations and attitudes towards skills training in the skills laboratory and clerkship. Subjects: 126 medical students in their 3rd semester. Methods: During the fall of 2001 three consecutive, constructed questionnaires were distributed prior to laboratory training, following laboratory training but prior to clerkships, and following clerkships respectively. Results: Almost all (98%) respondents found that training in skills laboratory improved the outcome of the early clerkship and 70% believed in transferability of skills from the laboratory setting to clerkship. Still, a majority (93%) of students thought that the clerkship provided students with a better opportunity to learn clinical skills when compared to the skills laboratory. Skills training in laboratory as well as in clerkship motivated students for becoming doctors. Teachers in both settings were perceived as being committed to their teaching jobs, to demonstrate skills prior to practice, and to give students feed back with a small but significant more positive rating of the laboratory. Of the 22 skills that students had trained in the laboratory, a majority of students tried out skills associated with physical examination in the clerkship, whereas only a minority of students tried out more intimate skills. Female medical students tried significantly fewer skills during their clerkship compared to male students. Conclusions: Students believe that skills laboratory training prepare them for their subsequent early clerkship but favour the clerkship over the laboratory

The relative value of different QALY types

The oft-applied assumption in the use of Quality Adjusted Life Years (QALYs) in economic evaluation, that all QALYs are valued equally, has been questioned from the outset. The literature has focused on differential values of a QALY based on equity considerations such as the characteristics of the beneficiaries of the QALYs. However, a key characteristic which may affect the value of a QALY is the type of QALY itself. QALY gains can be generated purely by gains in survival, purely by improvements in quality of life, or by changes in both. Using a discrete choice experiment and a new methodological approach to the derivation of relative weights, we undertake the first direct and systematic exploration of the relative weight accorded different QALY types and do so in the presence of equity considerations; age and severity. Results provide new evidence against the normative starting point that all QALYs are valued equally.This study was funded by an Australian National Health and Medical Research Council project grant APP1047788