As the thermometer climbs higher and higher this summer, let's stay in our air-conditioned spaces a while longer and read up on a few hot topics that affect everyone involved in writing, reviewing, and helping others with publications. Here are a few questions that have come up recently that are well worth considering:

1. Are we teaching our students to critically read an entire article?

Those of use who work with students on a regular basis know that the ability to critically read the literature is a crucial skill for future clinicians and researchers. It is also arguably one of the more difficult skills to learn. Reading something deeply enough to detect scientific flaws requires training in the skill and then an investment of individual time and effort on the reader's part. After that, repeated use of this skill is a necessary first step to find scientific gaps that need exploring, or even to know what to believe or to trust. Thankfully, it's also a transferable skill, and I don't mind pointing out that it's sorely needed when digesting general news reports and marketing campaigns disguised as science.

Educators are understandably alarmed when they find that a student has cited a reference in a class paper but cannot describe any of the details of the study cited. When asked, some students and other novice writers will acknowledge that they stopped reading after the abstract, because it contained all the information they needed. I won't take up space listing the problems that are created when this occurs. We should acknowledge this as an educational gap and move students beyond it by supporting them while they complete the rework necessary for a legitimate critical appraisal of the literature. Educators and others working with new writers do not need to reinvent the wheel when teaching this skill. A number of university web sites have free resources and step by step guides that can be used by anyone who would like to be a more effective critical reader.

2. How should we report statistics?

One of the hottest topics in the scientific publishing world right now is what I call "devaluing the p value." This growing movement is an important one for both seasoned and novice researchers. A special issue of the journal The American Statistician in March of this year focused exclusively on this topic.

We have all known for some time that reports of statistical significance have often been misused in scientific reports. First, there is a big difference between statistical significance and scientific importance. I'm sure many of us can cite examples of published studies in which this was apparent. Secondly, by creating a "bright line" of p < .05 (for most studies in our field) as a measure of significance, it encourages readers to stop critically reading (see topic 1 above) and simply accept the results, ignoring nagging details like sample size, context, effect size, confidence intervals, and other impactful aspects of the study.

While JAANP has not yet formulated a statement requiring alternate ways of addressing tests of significance, we support authors who report all p values and who describe the likely interpretation and scientific meaning for readers. Stay tuned for much more to come on this topic.

3. Why does the journal publish studies with negative or insignificant results?

One of the reasons it is important to publish all statistical results related to a study is that it allows the reader to make a full assessment of the findings and their meaning (see topic 2 above). Selectively reporting results is also known as "p-hacking," or cherry picking the findings to submit for publication. A second important reason for doing this is that your research is important. It's really important. Sometimes research tells us what seems to be working so we can replicate it or start implementing it. At other times, it tells us that we can stop wasting our time. That includes not continuing to do things that have been shown to be ineffective. If you have important information, either positive or negative, put it in writing to share with others. You are performing a valuable service.

In this month's issue, Jennifer Ruel presents a brief report of a patient with iliac vein compression syndrome, also known as May-Thurner syndrome. This confounding condition can be encountered in any care setting and it often falls to the primary care provider to ensure that diagnosis is not delayed.

Aimee Falcone presents a systematic review to find effective interventions to improve influenza immunization rates. Fortunately, there are several interventions that can be used by nurse practitioners and other providers to enhance vaccination rates.

In an exploratory study of patients with a left ventricular assist device, Jennifer Kaiser found several predictors of rehospitalization, enabling nurse practitioners and other providers to better prevent costly and avoidable readmissions.

Liselotte Dyrbye et al. surveyed nurse practitioners and physician assistants using the Well-Being Index. The investigators studied the efficacy of the instrument in identifying levels of distress that place providers at risk.

What has changed in the 16 years since the Women's Health Initiative trial? Terri DeNeui, Judith Berg, and Alexandra Howson discuss current nomenclature and treatment options for women transitioning through menopause.

Wendy Wright et al. present a 4 year quality improvement project to increase provider adherence to national diabetes guidelines. Also related to diabetes care, Stefan Smolenski and Nancy George discuss the difficulties of managing ketosis-prone Type 2 diabetes mellitus. We hope you enjoy these new contributions to our science.