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In 1967 the existing schemes for ONCs and HNCs in Engineering were replaced by a new scheme.

Only a day or two ago the Stars and Stripes were floating over the House of Lords and the invigorating “Battle Hymn of the Republic” was sung at St. Paul's in the presence of the King Emperor. The events were unique, and to all Britons happy in prophecy. English librarians have long admired their American brethren and their work; and of late they had read with regret the rather querulous remarks in at least one American library journal about the restrictions on book imports incidental to the blockade, and such phrases as “we have friends in both countries,” which gave the impression that our American friends failed to distinguish between the moral value of right and wrong in this world‐struggle. All this was intensified by the fact that every Briton in his heart believes the American to be of his own household, “to come of the blood,” and the want of understanding which we thought we detected was a particularly bitter thing. Of course this was a superficial view, and many of us realized how great was the sympathy between the English speaking races, and how difficult for the American the interracial problems of his country. Now, however, the air has been clarified, and the English librarian may look upon his American brethren as at one with himself in the struggle to preserve that freedom in the world which pervades the literature of our common language.

A GOOD deal of fuss has been occasioned by the barring of several novels by the Libraries Association recently. Into the pros and cons of the matter—which have been over‐canvassed already—we do not propose to enter in detail: these circulating libraries and their customers can be left to reconcile their own differences of opinion. It is, however, unfortunate that a few commercial circulating libraries, when combining to form an association, should have chosen a title that was bound to be confused with that of the Library Association.

Food and its effect on public health is a subject which takes an important place in Part II of the Ministry of Health's Report for 1951, and the Ministry of Food, in recognising the seriousness of food poisoning, has given prominence to the section devoted to food contamination by including, in one of its October Bulletins, a summary of this part of the Report. Food poisoning is described in the Report as a problem which grows more and more important, and which calls for a much higher standard of hygiene in food handling and its preparation. Figures compiled from the reports of the Public Health Laboratory Service, from bacteriologists in certain hospital laboratories, and from medical officers of health show that the total number of incidents notified in 1951 was 64 per cent higher than the number notified in 1949, but there is evidence that the actual number of persons affected by food poisoning was far in excess of the number of cases reported. Laboratory facilities for the investigation of food poisoning vary considerably in different districts, and medical officers are not always informed in time to carry out a full investigation; it is, therefore, difficult to obtain an accurate picture. In 255 outbreaks (47 per cent of the total) the source of contamination was traced. Of these outbreaks 101 occurred in canteens, 41 in hotels, cafés and restaurants, 9 in butchers' shops, 83 in hospitals, nurseries and institutions, and 18 in other places. The number of outbreaks traced to canteens is disturbingly high, but it should be remembered that canteen outbreaks are investigated and reported more frequently than outbreaks originating in shops and restaurants. When infected persons disperse from restaurants to their homes before the onset of symptoms, tracing the source is always difficult and often impossible. There is no reason to suppose that food poisoning arises less often in restaurants than in canteens. The figures reflect the difficulties of discovering and investigating outbreaks where the patients live in a number of different areas; they do not indicate the relative incidence of poisoning in canteens and restaurants. The Report states that 48 per cent of all outbreaks in which the food responsible was identified were traced to processed and made‐up meat such as re‐heated meat, stews, sausages, brawn, rissoles, gravy and stock. Out of 435 outbreaks in which the food thought most likely to have been responsible was traced, other foods—in addition to the meat dishes mentioned above—contributing to this type of infection were trifles, ice‐cream, custards and cream buns, also ducks' eggs. Milk was mentioned in 16 outbreaks. Inadequate standards of personal hygiene and faulty methods in preparing food for large numbers were the main reasons for contamination. Harmful bacteria usually get into food from insufficiently cleansed hands. Every effort must, therefore, be made by employers to provide kitchens and water‐closets with hand‐basins, abundant hot water, soap, nail brushes and clean towels. Though education in the hygiene of food preparation is now spreading, it still lags far behind what is necessary. Members of the public can speed the progress by actively insisting that their food is prepared and served with due regard to cleanliness at all stages. Reverting to the fact that nearly half of the outbreaks traced to specific foods were associated with processed, made‐up, and re‐heated meat dishes, the Report states that, if all meat dishes were cooked shortly before they were to be consumed, and if they were eaten while they were still hot, there is no doubt that the incidence of food poisoning would show an immediate and substantial decline. If food has to be prepared in stages, then precautions should be taken to prevent the growth of bacteria. After cooking and rapid cooling, it should be refrigerated until it is wanted, If it is to be re‐heated, this should be done rapidly and the food brought to boiling point. The Report refers to the setting‐up, by the Ministries of Health and Food, during the year under review, of two Working Parties and a Committee; these bodies have been making enquiries and have produced reports on the precautions to be observed in various branches of the food industry. These reports, have already been referred to in previous articles. Although there is no doubt that great improvements have been made in the handling of food—due to the enthusiasm of Medical Officers of Health and Sanitary Inspectors—it is generally realised that a persistent drive, requiring a long sustained effort and embracing complete health education of the food trade and the consuming public, is needed before safe food becomes a reality. Public opinion has been given the necessary impetus, and, on the business side, it is now obvious that good sanitary practices are also good trade practices, and that there is no conflict between the two interests. The way in which premises, the design and condition of equipment, and the human element affect the practices which are enforced or permitted in any particular food business, has a part to play in achieving and maintaining a high standard of food hygiene. Many food handlers have a confused idea of the difference between detergent and sterilizing action, and of the fundamental principle that sterilization must follow, and not precede nor be substituted for, cleaning with a detergent. On the other hand, it is very encouraging to visit so many small catering businesses, such as transport and other workmen's cafés, where the owner is intensely proud to show off the improvements and the efforts he has made to raise his food handling to a higher standard. At the other end of the scale, some multiple caterers have utilised their highly organised resources continuously to improve their premises, equipment and methods. There is, we all agree, endless scope for further health education.

The purpose of this paper is to extend existing engagement research in two directions: first, it operationalizes the dynamic nature of the engagement process within a customer-brand dyad and, second, it tests the interrelationships with other network actors in a triadic network setting.

A 2×2 experimental design models the iterative nature of the engagement process based on repeated measures at three points in time, considering the contextual effects of connections with other customers and crowding-in effects based on monetary incentives.

This research demonstrates that in a utilitarian service setting, customer engagement does not emerge per se in the dyadic interaction between the customer and the brand. For high levels of engagement behavior to occur, incentives and ties to other network actors are essential. Further, the findings suggest a non-linear relationship between engagement behavior and its antecedents and consequences: engagement behavior must overcome a certain intensity threshold to unfold its effect.

Further research is needed to explore the dynamic nature of the engagement process in experiential and interactive service settings, and more complex network settings that may involve more actors and more complex relationships.

By facilitating connections between customers and compensating for low intrinsic interest, managers can facilitate actual engagement behavior even in utilitarian service contexts. Once engagement behavior has been triggered, an increased engagement disposition, higher satisfaction, higher involvement and higher loyalty follow.

This study empirically tests the dynamic nature of the engagement process within and beyond the dyad, and has revealed a non-linear pattern of customer engagement behavior within its nomological network.

This study aims to analyze the structural characteristics of knowledge exchange in Zhihu Lives to provide feasible suggestions for improving the creative enthusiasm of knowledge providers.

This paper uses the domain classification of Zhihu Lives to construct a cross-domain knowledge exchange network.

This research makes the following findings: the small-world effect exists in the sponsorship network and is conducive to enhancing the learning willingness of knowledge providers; significant sponsorships and strong learning willingness exist among knowledge providers; the knowledge exchange is obvious among the fields of education, reading and writing, business and lifestyle and the fields of music, film, games, art, the internet, science and technology, design, financial economy and occupation; and knowledge exchange is obvious among the internal fields of education, reading and writing, and business and life style, between the internal fields of music, film, and games and art and between the internal fields of the internet, science and technology, design, financial economy and occupation.

This study can provide practical suggestions for the following development of the platform by analyzing the special phenomenon of knowledge exchange in the present stage of knowledge exchange.

The purpose of this study is to evaluate the nutritional status of patients with end-stage kidney disease undergoing hemodialysis.

End-stage renal failure outpatients on hemodialysis were selected using simple random sampling technique from the dialysis unit of Sono Hospital Limited, Kushtia, Bangladesh. The nutritional status of 142 participant, of age 18-65 years, was screened. A direct method of nutritional assessment including anthropometric measurement, biochemical measurement, clinical assessment and dietary method was conducted. A logistic regression was applied to estimate the prevalence of malnutrition in hemodialysis patients.

In total 69.0 per cent participants were men and 31.0 per cent were women, whereas about 65.5 and 16.9 per cent patients of this study had a BMI of less than 23 kg/m² and 18.5 kg/m² (p < 0.05) where malnutrition was significantly prevalent. Mean ± SD hemoglobin level of both men and women participants was below the normal level which might increase the risk of malnutrition (p < 0.05). Of the total number of participants, 97.2 per cent were anemic, 66.9 per cent had anorexia, 63.4 per cent complained of nausea, 58.5 per cent complained of vomiting and 26.1 per cent complained of diarrhea, factors that can increase the risk of malnutrition in hemodialysis patients (p < 0.05). The creatinine and urea levels were higher in both men and women participants (p < 0.05). Results show significant difference in albumin levels among men and women (p < 0.05). The bicarbonate level was lower in both men and women, and the participants were suffering from metabolic acidosis (p < 0.05). About 87.3 per cent participants were taking inadequate amounts of protein which was a significant risk factor of malnutrition in hemodialysis patients (p < 0.01).

The result shows that renal failure is prevalent more in men than in women. The majority of patients on hemodialysis were at a risk of malnutrition including being underweight. Most of the patients were anemic. Malnutrition is related to low nutrient intake.

The purpose of this paper is to examine the doctor-patient relationship from the patients’ perspective. It tests a number of hypothesized relationships with respect to the interaction inside the doctor-patient relationship including the continuity of care, doctors’ practice orientation and performance, which help enhance the understanding of patient trust and satisfaction.

A quantitative survey using a closed-ended questionnaire provided a useable sample of 372 respondents.

There was an overall high level of patient trust in and satisfaction with GPs as well as good patient rapport with their GPs. Patients who were most satisfied with their doctor perceived them to be more trustworthy, were more satisfied with their performance and perceived them to have greater preference for a sharing orientation than those patients who were least satisfied.

The research findings suggest ways of maintaining and enhancing trust through training, continuing professional development, appraisals and assessments and revalidation of doctors. The skill sets and competencies related to trust and practice are presented in light of current practice trends and changing health care agendas, including the recent Department of Health White Paper, “Liberating the NHS” (2010). Since the questionnaire was able to discriminate between those patients who were most and least satisfied with their doctors, it identified what patients appreciate and are concerned about with respect to GPs and their practice.

The research provides new insights and understanding of how patient satisfaction in the GP-patient relationship is influenced by GPs’ trustworthiness, practice orientation and performance, for academic and practitioner communities.

In the early days of online communities, researchers tended to view lurkers negatively and considered them illegitimate and peripheral members. However, the tide of opinion about lurkers has gradually become more positive. To take a broad view, lurkers should be included in the knowledge sharing context because while they may not share knowledge directly, they are still stakeholders in online communities who benefit from the knowledge shared. This study aims to review the literature from a knowledge sharing perspective to provide a comprehensive understanding of lurkers in online communities and identify additional reasons behind lurking behavior.

Previous studies that examined reasons behind lurking behavior in the literature were reviewed.

A four-dimensional model is provided, which categorizes the additional reasons for lurking into four domains: individual, social, organizational and technological.

The model serves as a roadmap for future researchers in examining lurkers and lurking behavior. Lurkers should be redefined. De-lurking strategies were suggested following the reasons for lurking behavior in the four-dimensional model, but de-lurking strategies were not recommended in all circumstances. An increase in active lurkers is another option to bring more value to online communities.

The purpose of this paper is to study patients' attitudes to nurses and investigate what hampering factors occur in the actual nursing situation and what patient features might affect cooperative climates.

In‐depth interviews were conducted with 11 male inpatients suffering prostate cancer. The interviews were personal narrations based on open‐ended questions. The theoretical basis is founded in sense‐making, trust and competence.

Existential issues related to nursing care were interpreted by nurses as a need for (technical) information. However, respondents indicated a need for professional support regarding their whole life. The social climate seems not to be optimal for existential talk owing to hospital routines. Patients' personal traits also affect the propensity to cooperation, and three types were distinguished: cooperating patients; passive patients; and denying patients. Nurses' competence may be regarded as hierarchical levels from optimising single items, over system optimisation and to optimisation from the patient perspective. The study indicates that not even first‐level requirements are met.

Only patients' views were studied. Nurses' perceptions would add additional insights. Lack of personal relations and cooperation between patient and nurse may decrease service quality. Patient attitudes seem to be a major obstacle. For some patients, passively receiving technical information may be an excuse for not wanting to participate in mutual sense‐making. The supposed need for technical information may also be an excuse for nurses to avoid more sensitive issues.

Better quality of care involves changing patient perceptions and attitudes to what constitutes nursing competence.