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Objectives. To evaluate the reporting quality of published randomized clinical trials (RCTs) in the Tai Chi literature following the publication of the CONSORT guidelines in 2001. Data Sources. The OVID MEDLINE and PUBMED databases. Review Methods. To survey the general characteristics of Tai Chi RCTs in the literature, we included any report if (i) it was an original report of the trial; (ii) its design was RCT; (iii) one of the treatments being tested was Tai Chi; and (iv) it was in English. In addition, we assessed the reporting quality of RCTs that were published between 2002 and 2007, using a modified CONSORT checklist of 40 items. The adequate description of Tai Chi interventions in these trials was examined against a 10-item checklist adapted from previous reviews. Results. The search yielded 31 Tai Chi RCTs published from 2002 to 2007 and only 11 for 1992–2001. Among trials published during 2002–2007, the most adequately reported criteria were related to background, participant eligibility and interpretation of the study results. Nonetheless, the most poorly reported items were associated with randomization allocation concealment, implementation of randomization and the definitions of period of recruitment and follow-up. In addition, only 23% of RCTs provided adequate details of Tai Chi intervention used in the trials. Conclusion. The findings in this review indicated that the reporting quality of Tai Chi intervention trials is sub-optimal. Substantial improvement is required to meet the CONSORT guidelines and allow assessment of the quality of evidence. We believe that not only investigators, but also journal editors, reviewers and funding agencies need to follow the CONSORT guidelines to improve the standards of research and strengthen the evidence base for Tai Chi and for complementary and alternative medicine.

Abstractemployment, and pre-employment BCG vaccination where appropriate. Background -This study was designed to (Thorax 1997;52:994-997) assess the current incidence of tuberculosis (TB) in National Health Service of England and to evaluate the effectiveness of occupational health screening Tuberculosis (TB) is a prescribed occupational and surveillance procedures.disease for health care workers. In a health care Methods -A four year prospective study setting infection usually arises from repeated (1992-5) was carried out with case asclose contact with patients who have sputum certainment through occupational health smear-positive pulmonary disease, or with departments and the Midlands Thoracic infected laboratory specimens or necroscopic Society registry of rare respiratory dismaterial. A study in England and Wales in the eases.1980s showed that the incidence of TB was Results No case was known to an ocsimilar to or lower than that of the general cupational health department that was not population for all occupational groups except notified by the registry and, in addition, mortuary attendants, 1 whilst a Scottish study the registry yielded a further six cases.showed similar findings with only medical There were 26 cases of active TB, of which laboratory technicians having an increased in-24 presented with symptoms and 12 had cidence.2 The risk to mortuary workers was no pre-employment screening. All except again highlighted more recently. 3 In contrast one doctor were foreign born -mainly to previous reports, however, a recent study from the Indian subcontinent (ISC) -and suggested that the incidence of TB is increased of recent UK entry, whilst all except one in all health service staff in England and Wales. 4 nurse were white females. The followingIn this study we have assessed the current are annual TB incidences per 10 4 (95% incidence of tuberculosis in National Health confidence interval): ISC and non-white Service hospital staff in the West Midlands doctors 17.0 (7.8 to 26.2), not significantly region of England and evaluated the effectgreater than in the local ISC and non-iveness of occupational health screening and white social class 1 working age population surveillance procedures.

Although medical trainees are expected to become expert quickly and safely, limited electronic methods are available to rehearse medical cognition for common outpatient and non-emergent inpatient problems. We conducted a series of formal observational sessions designed to determine what interaction requirements are desirable for student rehearsal of medical management by using an electronic patient. The studies utilized both manual and electronic methods for a student to evaluate and manage patients with medical and surgical problems. We observed the following major requirements for an effective simulation experience: the user must have a trial-and-error experience with the patient; the user must have unconstrained access to query and treat the patient; anatomic and physiologic values in the patient must change appropriately in response to user actions; and the user must be able to control certain time-related aspects of the simulation. When these requirements are implemented within a simulation, user-directed management of an electronic patient, by itself, becomes a strong aid to learning by trial- and-error techniques. We conclude that the heuristic patient is a practical and useful concept. Once fully developed, it would allow rehearsal of patient care decision making, intrinsically demonstrating trainee knowledge deficits, and resulting in self-directed learning.

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