One-page Report Research Articles

Patient-generated outcomes, questions and concerns: Quantitative and open text methods and relationships with palliative care referrals in advanced ovarian cancer.

259 Background: Remotely entered patient-reported outcomes, questions and concerns in an open-text format offer opportunity for communication to providers. However, is there a benefit beyond quantitative questionnaire items? The electronic Self-Report Assessment and Care (eSAC) was implemented for patients with advanced ovarian cancer undergoing treatment in ambulatory care at a Pacific Northwest tertiary care medical center and was shown to increase rates of palliative care referrals. The purpose of this study was to analyze open text entries along with quantitative symptom and quality of life reports exploring content consistency between the two reporting methods and palliative care (PC) referrals. Methods: Adult patients with advanced or recurrent ovarian cancer were invited to participate after an in-person clinic visit and complete a baseline report. Participants were prompted to complete a report 5 days prior to every clinic visit. Following completion of web-based symptom and quality of life issues (SQI) questionnaires, participants selected the two most bothersome SQI from a list of their moderate-to-severe level (MSL) responses. Just after, the participants saw, “If there is anything else you would like to discuss, or any questions you have for your care team, please type them in the box below.” Any MSL response to pain and/or quality of life items triggered a note to the provider on the summary report, “Based on this patient’s responses, a palliative care referral is recommended.” The one-page report, including all quantitative item responses and the text entries, was hand-delivered to the provider at each clinic visit. Text entries were analyzed for consistency with the quantitative bothersome SQI and frequencies of PC referrals were calculated. Results: A total of 134 enrolled and of the 120 participants submitting at least one report, 57 (48%) reported symptoms or quality of life issues at the MSL and made 108 text entries during the study. In 26 (24%) of the text entries, participants further discussed the two most bothersome MSL, 35 (32%) addressed one MSL and 47 (44%) entries addressed completely different issues. For those who provided no text entries and triggered the PC recommendation, only 5/21 (24%) received a referral. Those who created text entries and triggered were referred in 17/33 (52%) cases. Conclusions: The inconsistency and uniqueness between quantitative and text entry approaches to assessing SQI suggest that both methods are necessary for a comprehensive patient-generated report. Communication beyond quantitative scores may prompt the consideration of a PC referral.

Proton pump inhibitors in critically ill mechanically ventilated patients with COVID-19: protocol for a substudy of the Re-EValuating the Inhibition of Stress Erosions (REVISE) Trial

BackgroundCritically ill patients commonly receive proton pump inhibitors (PPIs) to prevent gastrointestinal (GI) bleeding from stress-induced ulceration. Despite widespread use in the intensive care unit (ICU), observational data suggest that PPIs may be associated with adverse outcomes in patients with COVID-19 infection. This preplanned study is nested within a large randomized trial evaluating pantoprazole versus placebo in invasively ventilated patients. The 3 objectives are as follows: (1) to describe the characteristics of patients with COVID-19 in terms of demographics, biomarkers, venous thromboembolism, tracheostomy incidence and timing, and other clinical outcomes; (2) to evaluate the impact of COVID-19 infection on clinically important GI bleeding, 90-day mortality, and other outcomes compared to a propensity-matched non-infected cohort; and (3) to explore whether pantoprazole has a differential treatment effect on clinically important GI bleeding, 90-day mortality, and other outcomes in patients with and without COVID-19 infection.MethodsThe ongoing trial Re-EValuating the Inhibition of Stress Erosions (REVISE) compares pantoprazole 40 mg IV to placebo on the primary efficacy outcome of clinically important GI bleeding and the primary safety outcome of 90-day mortality. The protocol described in this report is for a substudy focused on patients with COVID-19 infection that was not in the original pre-pandemic trial protocol. We developed a one-page case report form to characterize these patients including data related to biomarkers, venous thromboembolism, COVID-19 therapies, tracheostomy incidence and timing, duration of mechanical ventilation, and ICU and hospital stay. Our analysis will describe the trajectory of patients with COVID-19 infection, a propensity-matched analysis of infected and non-infected patients, and an extended subgroup analysis comparing the effect of PPI among patients with and without COVID-19 infection.DiscussionProphylactic acid suppression in invasively ventilated critically ill patients with COVID-19 infection has unknown consequences. The results of these investigations will inform practice, guidelines, and future research.Trial registrationREVISE Trial [NCT03374800 December 15, 2017], COVID-19 Cohort Study [NCT05715567 February 8, 2023].

Identification of a novel FUT1 allele with c.325_414dup in a Chinese individual with para-Bombay phenotype.

TransfusionEarly View ONE-PAGE REPORT OF NEW ALLELES OR ANTIGENS Identification of a novel FUT1 allele with c.325_414dup in a Chinese individual with para-Bombay phenotype Jinlian Liu, Jinlian Liu orcid.org/0000-0002-3189-4866 Nanning Blood Center, Nanning Institute of Transfusion Medicine, Nanning, Guangxi, ChinaSearch for more papers by this authorLilan Li, Lilan Li orcid.org/0000-0002-0852-3661 Nanning Blood Center, Nanning Institute of Transfusion Medicine, Nanning, Guangxi, ChinaSearch for more papers by this authorGuoguang Wu, Corresponding Author Guoguang Wu [email protected] Nanning Blood Center, Nanning Institute of Transfusion Medicine, Nanning, Guangxi, China Correspondence Guoguang Wu, Nanning Institute of Transfusion Medicine, Nanning Blood Center, Nanning 530007, Guangxi, China. Email: [email protected]Search for more papers by this authorTingting Ma, Tingting Ma Nanning Blood Center, Nanning Institute of Transfusion Medicine, Nanning, Guangxi, ChinaSearch for more papers by this authorXuejun Liu, Xuejun Liu Nanning Blood Center, Nanning Institute of Transfusion Medicine, Nanning, Guangxi, ChinaSearch for more papers by this authorBaojia Huang, Baojia Huang Nanning Blood Center, Nanning Institute of Transfusion Medicine, Nanning, Guangxi, ChinaSearch for more papers by this authorJierun Chen, Jierun Chen Nanning Blood Center, Nanning Institute of Transfusion Medicine, Nanning, Guangxi, ChinaSearch for more papers by this authorYan Zhou, Yan Zhou Nanning Blood Center, Nanning Institute of Transfusion Medicine, Nanning, Guangxi, ChinaSearch for more papers by this author Jinlian Liu, Jinlian Liu orcid.org/0000-0002-3189-4866 Nanning Blood Center, Nanning Institute of Transfusion Medicine, Nanning, Guangxi, ChinaSearch for more papers by this authorLilan Li, Lilan Li orcid.org/0000-0002-0852-3661 Nanning Blood Center, Nanning Institute of Transfusion Medicine, Nanning, Guangxi, ChinaSearch for more papers by this authorGuoguang Wu, Corresponding Author Guoguang Wu [email protected] Nanning Blood Center, Nanning Institute of Transfusion Medicine, Nanning, Guangxi, China Correspondence Guoguang Wu, Nanning Institute of Transfusion Medicine, Nanning Blood Center, Nanning 530007, Guangxi, China. Email: [email protected]Search for more papers by this authorTingting Ma, Tingting Ma Nanning Blood Center, Nanning Institute of Transfusion Medicine, Nanning, Guangxi, ChinaSearch for more papers by this authorXuejun Liu, Xuejun Liu Nanning Blood Center, Nanning Institute of Transfusion Medicine, Nanning, Guangxi, ChinaSearch for more papers by this authorBaojia Huang, Baojia Huang Nanning Blood Center, Nanning Institute of Transfusion Medicine, Nanning, Guangxi, ChinaSearch for more papers by this authorJierun Chen, Jierun Chen Nanning Blood Center, Nanning Institute of Transfusion Medicine, Nanning, Guangxi, ChinaSearch for more papers by this authorYan Zhou, Yan Zhou Nanning Blood Center, Nanning Institute of Transfusion Medicine, Nanning, Guangxi, ChinaSearch for more papers by this author First published: 15 June 2023 https://doi.org/10.1111/trf.17452Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL No abstract is available for this article. REFERENCES 1Race RR, Ruth S. Blood groups in man. 6th ed. Oxford: Blackwell Scientific Publications; 1975. p. 22– 7. 2Liu JL, Liu XJ, Ma TT, et al. Serological identification and FUT1 gene mutation analysis of 8 individuals with Para-Bombay phenotypes in Guangxi. Chin J Exp Hematol. 2021; 152(4): 1318– 24. 3Kelly RJ, Emst LK, Larsen RD, et al. Molecular basis for H blood group deficiency in Bombay(oh)and Para-Bombay individuals. Proc Natl Acad Sci U S A. 1994; 91(13): 5843– 7. 4 International Society of Blood Transfusion(ISBT). Names for H (ISBT 018) blood group alleles. https://www.isbtweb.org/resource/018h.html 2023-03-31/2023-05-05. Early ViewOnline Version of Record before inclusion in an issue ReferencesRelatedInformation

RADIOCARBON ANALYSIS AND STATUS REPORT FROM TÜRKIYE: 1MV NATIONAL AMS LABORATORY (TUBITAK-AMS)

ABSTRACTIn autumn of 2016, the National 1MV Accelerator Mass Spectrometry (AMS) Laboratory at The Scientific and Technological Research Council of Türkiye (TÜBİTAK), Marmara Research Center (MRC), Türkiye (Turkey), started to offer radiocarbon (14C) analysis service internationally. In this article, the process from sample acceptance to reporting and the primary procedures implemented and applied for 14C analysis at the TÜBİTAK AMS Radiocarbon Dating Laboratory are described. The service provided by the laboratory includes sample evaluation for 14C analysis, sample preparation, graphite production, AMS measurement, data supervision, calendar date calculations, and consultancy. For commercial testing and analysis, a one-page official report which shows the 14C age and uncertainty is provided for each sample. In addition to a dedicated wet chemistry laboratory to process samples before measurement with AMS, there are two systems for the conversion of CO2 to elemental carbon process; an automated graphitization system (AGE III) and a manual graphitization system based on a glass high vacuum line. A 1MV UAMS NEC Pelletron system installed in the laboratory is used for natural level 14C samples needed to be analyzed for archeological, geological, geographical, and environmental and forensic science applications. In addition to commercial 14C testing and analysis activities, national and international research projects can be developed or contributed to within the scope of project management or partnership.

Abstract 6310: Designing genomic test reports using a user-centered approach for clinicians in Pakistan

Abstract In the developed world, precision medicine and genomics are transforming traditional healthcare approaches. In spite of rapid technological progress being made in genomics, a 'genomic divide' is emerging between developed and developing countries. This is partly because of the limited genomic literacy of healthcare professionals and a scarcity of available genomics workforce that reportedly deters them from proposing genomic testing. We aim to help reduce this 'genomic divide' by proposing a genomic test report design for clinicians in Pakistan, that incorporates user-centered design principles. We tested two commonly used genomic reportswiththat varied in language, content and layout. Report A was a one-page genomic report from the Laboratory for Molecular Medicine, of a patient with suspected hypertrophic cardiomyopathy. Report B was a report from FoundationOneCDx, of a breast carcinoma specimen with confirmed findings mentioned. We employed a qualitative descriptive study design, including a survey for trainees, non-specialists, and specialists. The parameters recorded were: subject comprehension, overall visual impression, level of difficulty of the language, and ease of understanding, along with, actionability and degree of trust. A total of 49 medical professionals across 11 institutes in Pakistan participated in the survey, of which 11 were specialists and 38 were non-specialists. We extracted 19 recommendations from the survey and broadly grouped them into three categories: communication style, report content, and layout. About 25% of the respondents commented that they would prefer a short and concise report, 20.8% wanted the language to be ‘doctor-friendly’ and 8.3% preferred data to be presented in tables. All recommendations were incorporated into our proposed genomic test report template. The template displays the results and what they mean for the patient (in layman's terms for ease of access to non-specialists), what possible action is to be taken by the doctor, and details of further information and support regarding the results. We propose the addition of a box on technical methodology at the end of the report template that may help in assisting with refreshing the genomic knowledge of non-specialists. Our findings have shown that in order to design impactful genomic reports for clinicians in Pakistan, we will have to start with a user-centered design approach. This can be instrumental in helping us improve the adoption of genomic testing in clinics around Pakistan. Citation Format: Momal Agha, Faisal Khan. Designing genomic test reports using a user-centered approach for clinicians in Pakistan [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 6310.

Ambulatory Glucose Profile (AGP) Report in Daily Care of Patients with Diabetes: Practical Tips and Recommendations.

The ambulatory glucose profile (AGP) is now established as the standardised, practical one-page report for graphically presenting a summary of glycaemic control status in patients with diabetes who use continuous glucose monitoring (CGM) systems as part of their daily diabetes care. The AGP report provides both a visual and a statistical summary of the glucose metrics that, as agreed in the 2019 international consensus for assessing glycaemic control, should be analysed in all people with diabetes who are using CGM systems. The AGP report can be analysed in a systematic fashion to understand current glycaemic control and to monitor, in real time, the impact of adjustments to therapy in both type 1 diabetes and type 2 diabetes. Here we provide a practical guide to the glycaemic measures that are summarised in the AGP Report and illustrate the essential components of an AGP review in a series of hypothetical, real-world, patient-centred case studies (see Supplementary Materials).Supplementary InformationThe online version contains supplementary material available at 10.1007/s13300-022-01229-9.

Skin Reaction Report Form: Development and Design of a Standardized Report Form for Skin Reactions Due to Medical Devices for Diabetes Management

Skin reactions due to medical devices for diabetes management have become a common problem in diabetes technology. There is a varying degree in how detailed skin reactions are described in scientific literature and diabetes practice, and no uniform structured documentation is given. Whereas most articles only describe findings, some others already document final diagnoses, such as contact dermatitis. Furthermore, inconsistent wordings for comparable issues were used. A more detailed and standardized documentation, possibly facilitated by a generally accepted guideline for structured descriptions, of skin reactions could be helpful to enable better differentiations between the described skin reactions. Therefore, a report form to assess skin reactions due to medical devices in diabetes therapy was developed and will be presented in this article. The one-page report form is divided into four categories and a separate instruction paper. Beside general information the form includes the location, size, severity and duration of skin appearances, the grading of itching, and suspected diagnoses. A consistent use of the form in daily practice and clinical trials could facilitate a fast and standardized documentation and help to evaluate the occurrence and severity of different skin reactions due to medical devices in diabetes management.

MH Parity Remains Elusive as States Fail to Enforce Law

MH Parity Remains Elusive as States Fail to Enforce Law

Effectiveness of a Qualitative Approach Toward Evaluating OCT Imaging for Detecting Glaucomatous Damage.

PurposeThe purpose of this study was to determine whether a qualitative approach toward evaluating optical coherence tomography (OCT) imaging improves the ability to detect glaucomatous damage compared to a conventional metric of global circumpapillary retinal nerve fiber layer (cpRNFL) thickness.MethodsA total of 394 healthy eyes and 272 glaucoma eyes were evaluated. Glaucoma eyes were categorized as perimetric (156 eyes) based on a history of three or more consecutive abnormal 24-2 visual field tests or suspected glaucoma if they did not (116 eyes). Customized one-page reports derived using OCT volume scans of the optic disc and macula from these eyes were qualitatively graded for the probability of optic neuropathy affecting the eye.ResultsThe sensitivity of detecting perimetric glaucoma eyes with the global circumpapillary RNFL thickness metric and qualitative evaluation of the OCT imaging results were 86.5% and 95.5% at a specificity of 95%, being significantly higher for the latter (P < 0.001). There were seven eyes with perimetric glaucoma missed by the qualitative evaluation. Based upon examination of all available visual fields, at least four of these seven eyes had visual fields that either improved or had abnormalities that were inconsistent over time or with patterns of glaucomatous damage.ConclusionsQualitative evaluation of OCT imaging results allows glaucoma eyes with repeatable visual field abnormalities to be detected with a high level of accuracy, performing better than a conventional summary metric of global cpRNFL thickness.Translational RelevanceClinical detection of glaucomatous damage with OCT imaging can be optimized through a qualitative evaluation of its results.

Surveillance for Mass Gatherings: NCAA Final Four 2017 in Maricopa County, Arizona

Objective: To describe and present results for the enhanced epidemiologic surveillance system established during the 2017 National Collegiate Athletic Association Division I Men’s College Basketball Championship (Final Four) events.Introduction: Final Four-associated events culminated in four days of intense activity from March 31st through April 3rd, and added an estimated 400,000 visitors to Maricopa County's 4.2 million residents.Methods: Preparation included: refinements in enhanced surveillance for previous events (including Super Bowl XLII); a rehearsal on information sharing for team leads; just in time training for field team members; a tabletop exercise on 2/22; and solicitation of lessons learned from jurisdictions recently hosting the Final Four.Enhanced surveillance began on 3/24 and continued through 4/10 (one week before the first major event until one week after the championship game) with intensified surveillance from 3/31-4/3. Subject matter experts for each enhanced surveillance component functioned as team leads. A surveillance coordinator was assigned to review data and prepare reports. Team members were sent a plan of the day detailing daily surveillance activities.An enhanced surveillance (SURV) alert requesting an increased index of suspicion for events of public health significance was sent to pre-established lists of healthcare providers. Urgent care clinics within five miles of venues were asked to report influenza-like, gastrointestinal, rash, and neurological illness visits daily. Emergency department records in the National Syndromic Surveillance Program, Electronic Surveillance System for Early Notification of Community-Bases Epidemics (ESSENCE) were monitored daily for influenza-like illness, gastrointestinal illness, injury, records of interest, heat-related illness and event-specific terms. Mumps and meningitis were added after outbreak reports were received from home jurisdictions of Final Four teams. Death certificate data, Office of the Medical Examiner line lists and preliminary reports of death were reviewed daily for reportable diseases or circumstances of public health significance. Communicable disease data was reviewed daily for notifiable disease cases of concern, aberration detection as compared to the previous four years, outbreak review, and Influenza-like-illness.Field teams of staff and volunteers were deployed to three days of Music Fest, four days of Fan Fest, and three Final Four games. Attendees presenting to first aid stations were requested to complete an electronic questionnaire capturing illness and injury syndromes. These were submitted and epidemiologically assessed in near-real-time. Syndrome-specific data were geo-located on venue maps during events to identify spatial clustering. Patient Presentation Rates (PPR) and Transport to Hospital Rates (TTHR) per 10,000 attendees were calculated.To enhance animal health system surveillance, veterinarians and agencies that work with animals were notified to increase the index of suspicion for unusual animal disease, keep alert for outbreaks with zoonotic potential, and update 24/7 emergency contact lists.Health-related media reports, Final-Four-specific reports, health-aggregated Twitter reports, and breaking news alert subscriptions were monitored. Poison Control Center (PCC) reports were assessed by conducting regular queries of the National Poison Data System (NPDS). Reports from the 24/7 Disease Reporting Line were monitored.A one page enhanced surveillance report was developed for daily distribution to inter-disciplinary partners; a more detailed report was distributed to health and medical partners. Physicians overseeing the health/medical care of teams were included in information sharing. Public health intelligence information was exchanged with epidemiologists from home jurisdictions of Final Four teams.Results: 301 field questionnaires were completed, including 146 from Final Four games, 127 from the Music Fest, and 28 from the Fan Fest. Final Four games experienced a PPR of 9.5, and a TTHR of 0.52. Music Fest results were a PPR of 9.4, and a TTHR of 0.15. For the Fan Fest, there was a PPR of 5.5, and a TTHR of 0.PCC data review resulted in investigation of four cases for potential ricin exposure. These reports were determined to be exposure to castor beans and the castor bean plant (Ricinus communis) only. One report indicating potential phosgene occupational exposure to an air conditioning system worker was reviewed, and judged unlikely to cause noted symptoms.Outbreak information from home jurisdictions of Final Four teams resulted in increased index of suspicion for mumps, additional surveillance and mentions in media surveillance reports.Review of communicable disease, mortality, and ESSENSE data resulted only in routine investigations.Conclusions: Surveillance information from disparate surveillance systems was synthesized into reports which enhanced health and medical situational awareness and information sharing; interdisciplinary partners highlighted the utility of the one-page report. Enhanced surveillance allowed the rapid identification and characterization of potential threats, and provided an evidence base for public health decisions. Establishment of field teams allowed for near-real-time tracking of patient presentations and transports and rapid identification and characterization of syndromes of concern and potential threats. Public health intelligence information exchange with home jurisdictions of Final Four teams resulted in targeted surveillance for mumps and meningitis.

Shorter and easier is more useful: A longitudinal analysis of how financial report enforcement affects individual investors

According to the literature, individual investors rarely use accounting and financial information (AFI), even though they do not give it a particularly low valuation when asked. This behavior increases the risk to lose investments. The main contribution of this paper is to propose a new AFI format: a one-page report that is short and easy to understand, as a complement to the long and complex traditional format in order to increase the usefulness of information for investors and to decrease investment risk. Two experiments provide evidence about the increased usefulness of AFI when using the new proposed format. More importantly, it seems that results in terms of profits also improve considerably in medium (one year) and long-term (four years) investments, in contrast to more modest profits of speculative investments. Furthermore, this difference occurs regardless of the investors’ previous experience.

Occupational Health Stress in the Service Sector

The basic purpose of the current study was to explore the occupational health stress reasons, consequences, and job outcomes in the service sector as well as to suggest stress management techniques to overcome stress. This research used a mixed qualitative research methodology, which included a collective case study method as well as a narrative inquiry method. Respondents (both males and females) were selected from two of the most important service sectors -- the banking industry where working hours are long, and the education sector where working hours are comparatively short. A total of eight case studies were taken through focus group discussions in which respondents were requested to write a one-page report about their work experiences, problems faced at their workplace, whether they were facing any stressful challenge and threat, and how their health was affecting them due to stressful situations at the workplace. The data was reported from the words of respondents as it was written on their response forms. From the list of responses, the following themes emerged and were derived in Figure 1: stressors (reasons), consequences (change in physical, psychological, and behavioral response), and outcomes (job outcomes). Stress management techniques were suggested from an organizational and individual point of view.

Surveillance programme for uncompensated work-related diseases in France.

The surveillance programme for uncompensated work-related diseases (UWRDs) in France relies on a network of occupational physicians (OPs) who volunteer to report all UWRDs diagnosed during a biannual 2-week observation period. To describe this programme and the usefulness of its results. During the observation period, OPs record job title and employment sector for each worker. For each potential UWRD, they complete a one-page report form. Between 2007 and 2012, the number of reporting OPs ranged from 705 to 965 and they saw between 78884 and 114154 employees annually. The UWRD incidence rate reports varied from 5 to 5.3% for men and from 6.5 to 7.7% for women, with musculoskeletal disorders (MSDs) being most frequent, followed by mental ill-health. Incidence rates, except for hearing loss, were higher for women than men in all categories and, in 2012, were twice as high for women (3.1%) as for men (1.4%) for mental ill-health. Incidence rates in every category increased with age up to 54 years. The highest rates for MSDs were observed among blue-collar workers (6.9% in women and 4% in men in 2012) and the lowest rates in professionals/managers (1.1 and 0.4%, respectively). Conversely, the latter had the highest incidence of mental health disorders (5.9 and 3.3%). This 'Fortnight' protocol provides useful data on the frequency of diseases linked to employment and allows us to estimate the incidence of UWRDs, whether recognized as compensable or not, as well as their trends over time.

Evaluation of a One-Page Report to Aid in Detecting Glaucomatous Damage.

We assessed the use of a customized, one-page structure + function report for aiding in detection of glaucomatous damage. Two individuals (report specialists), experienced in analyzing optical coherent tomography (OCT) and visual field (VF) results, examined a customized one-page report for 50 eyes from 50 patients who either had glaucoma or were glaucoma suspects. The report contained key features of OCT scans with VF information. All patients had 24-2 VFs with a mean deviation (MD) better than -6 dB. The report specialists classified each hemifield and eye as either glaucomatous or nonglaucomatous based upon only the customized report, either without (phase 1) or with (phase 2) 24-2 VF information included on the report. Their results were compared to the classifications made by 3 ophthalmologists (glaucoma specialists) based upon traditional measures, namely stereo photographs, 24-2 VFs, and a commercially available, OCT disc scan report. The two report specialists agreed on all but one eye and four hemifields in phase 1, and on all eyes and all but one hemifield in phase 2. In phase 2, they judged 31 eyes abnormal. Of these 31 eyes, 30 were judged abnormal by all three glaucoma specialists and the 31st by two of the three. Without the VF information (phase 1), one report specialist classified 1, and the other 2, of these 31 "abnormal" eyes as normal. When using the one-page report, the experienced readers showed excellent inter-rater repeatability and diagnostic ability relative to glaucoma specialists. This condensed report may help the clinician assess glaucomatous damage.

Experience in Cultural Consultation Opens New Era in the Clinic

Experience in Cultural Consultation Opens New Era in the Clinic

Decision aid for patients considering total knee arthroplasty with preference report for surgeons: a pilot randomized controlled trial

BackgroundTo evaluate feasibility and potential effectiveness of a patient decision aid (PtDA) for patients and a preference report for surgeons to reduce wait times and improve decision quality in patients with osteoarthritis considering total knee replacement.MethodsA prospective two-arm pilot randomized controlled trial. Patients with osteoarthritis were eligible if they understood English and were referred for surgical consultation about an initial total knee arthroplasty at a Canadian orthopaedic joint assessment clinic. Patients were randomized to the PtDA intervention or usual education. The intervention was an osteoarthritis PtDA for patients and a one-page preference report summarizing patients’ clinical and decisional data for their surgeon. The main feasibility outcomes were rates of recruitment and questionnaire completion; the preliminary effectiveness outcomes were wait times and decision quality.ResultsOf 180 patients eligible for surgical consultation, 142 (79%) were recruited and randomized to the PtDA intervention (n = 71) or usual education (n = 71). Data collection yielded a 93% questionnaire completion rate with less than 1% missing items. After one year, 13% of patients remained on the surgical wait list. The median time from referral to being off the wait list (censored using survival analysis techniques) was 33.4 weeks for the PtDA group (n = 69, 95% CI: 26.0, 41.4) and 33.0 weeks for usual education (n = 71, 95% CI: 26.1, 39.9). Patients exposed to the PtDA had higher decision quality based on knowledge (71% versus 47%; p < 0.0001) and quality decision being an informed choice that is consistent with their values for option outcomes (56.4% versus 25.0%; p < 0.001).ConclusionsRecruitment of patients with osteoarthritis considering surgery and data collection were feasible. As some patients remained on the surgical waiting list after one year, follow-up should be extended to two years. Patients exposed to the PtDA achieved higher decision quality compared to those receiving usual education but there was no difference in wait for surgery.Trials registrationClinicalTrials.Gov NCT00743951

Learning from Paper, Learning from Screens

Electronic screens on laptop and tablet computers are being used for reading text, often while multitasking. Two experimental studies with college students explored the effect of medium and opportunities to multitask on reading (Study 1) and report writing (Study 2). In Study 1, participants (N = 120) read an easy and difficult passage on paper, a laptop, or tablet, while either multitasking or not multitasking. Neither multitasking nor medium impacted reading comprehension, but those who multitasked took longer to read both passages, indicating loss of efficiency with multitasking. In Study 2, participants (N = 67) were asked to synthesize source material in multiple texts to write a one-page evidence-based report. Participants read the source texts either on (1) paper, (2) computer screen without Internet or printer access, or (3) computer screen with Internet and printer access (called the “real-world” condition). There were no differences in report quality or efficiency between those whose source materials were paper or computer. However, global report quality was significantly better when participants read source texts on a computer screen without Internet or printer access, compared with when they had Internet and printer access. Active use of paper for note-taking greatly reduced the negative impact of Internet and printer access in the real-world condition. Although participants expressed a preference for accessing information on paper, reading the texts on paper did not make a significant difference in report quality, compared with either of the two computer conditions. Implications for formal and informal learning are discussed.

A warning to England: Monstrous births, teratology and feminine power in Elizabethan broadside ballads

This article examines Elizabethan broadside ballads depicting ‘monstrous’ birth defects as expressions of societal unease concerning the rule of women in late sixteenth-century England. It deals particularly with a surge in these publications during the early reign of Elizabeth I. These one-page reports interpreted the birth defects as reflecting God’s disapproval of both individual and collective sins, and the authors urged the populace to repent. The essay explores the concept of the ‘prodigious’ monster in Renaissance thought, especially as a reflection of the feminine imagination, and its use in religious propaganda as a visible expression of divine wrath. Noting several parallels between the twentieth-century depictions of monstrous femininity and the treatment of birth in 1970s ‘body horror’ films such as The Brood (Cronenberg, Montréal 1979), the essay argues that the focus on birth in these ballads is reflective of tensions between the strict gender roles in wider society and questions of Elizabeth’s succession in sixteenth-century England.

Inter-rater agreement for diagnoses of epilepsy in pregnant women

We report on inter-rater agreement in assessing the types of seizures exhibited by one hundred mothers ascertained in a study of the teratogenicity of maternal epilepsy and antiepileptic drugs. A summary of each woman's medical record and a one-page report of her responses to questions about her epilepsy were reviewed independently by six neurologists, three in pediatric neurology and three in adult neurology. Agreement was measured by the kappa statistic and log-linear modeling techniques. The adult neurologists agreed with each other 59% of the time, with the agreement higher when all three used information from the patients' records, such as an EEG, rather than when depending on the patients' responses to questions about their epilepsy. The pediatric neurologists agreed with each other 44% of the time and tended to rely more heavily on information in the patients' records, such as an EEG or a prior diagnosis, compared with the adult neurologists.

In search of solutions to grapevine trunk diseases through "crowd-sourced" science.

Trunk diseases create tremendous problems for the viticulture industry causing significant economical losses due to reduced yields, increased crop management costs for cultural and chemical preventive measures, and shortened life span of the vines (Munkvold et al., 1994; Bertsch et al., 2013). No cures are currently available and the diseased wood is typically removed to limit the spread of infection to other permanent structures of the vine. Knowledge of the mechanisms responsible for the development of these diseases is still limited. Recent advancements in genome sequencing technologies (so-called, Next Generation Sequencing) allow us to quickly catalog the entire repertoire of virulence functions of a plant pathogen, a rapid acquisition of a huge amount of information for organisms that were previously uncharacterized. We have recently released the draft genome sequences of pathogens associated with three major trunk diseases of grapevine: esca dieback (Phaeoacremonium aleophilum), botryosphaeria dieback (Neofusicoccum parvum), and eutypa dieback (Eutypa lata). All data, including the raw sequencing data, have been deposited in public databases (GenBank WGS and SRA archives) and are also hosted on the Cantu Lab website (http://cantulab.github.com). The data is freely available to anybody with no restrictions. Sequencing, assembly and preliminary genomic analyses are described in the journal Genome Announcements published by the American Society of Microbiology (Blanco-Ulate et al., 2013a,b,c). These one-page reports provide scientists that want to use the genomic information with details on the pathogen strains sequenced and how the sequencing and assembly were performed. With the exception of the genome of Botrytis cinerea (Amselem et al., 2011) the fungal agent of bunch rot, to our knowledge these are the first genomes of fungal grape pathogens publicly available. Updates to the current genome versions will be readily shared through the Cantu lab website hosted by GitHub (http://github.com), which will also provide a centralized repository for bioinformatic scripts and pipelines used in the genome analyses. The availability of newer versions will be communicated through Twitter (@CantuLab), or any social media that is widely used. By sharing these novel genomic sequences through rapid public release, we hope to stimulate research/scientific crowdsourcing to understand how these destructive pathogens cause disease, reducing grapevine yield and lifespan. This aggregation of talent and complementary expertise, with no need to initiate formal collaborations, will significantly reduce the time needed to solve these critical viticulture problems. We also hope that our openness will help promote the more collaborative model of scientific approach.