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PubMed2001

Critical reading of epidemiological papers. A guide.

Many clinicians, medical practitioners and decision makers have no formal training in epidemiology but need to understand and sometimes evaluate results in epidemiologic studies. This paper attempts to give guidance to non-epidemiologists on how to read and evaluate the quality of epidemiologic studies and their results critically. Different methodological issues for evaluating whether the results of a study are causal or by bias, chance or confounding are given. This includes criteria for the choice of an appropriate study design followed by problems of the definition of the study population and the sample selection. We will also point to potential sources of bias in the data collection procedure and list some principles for statistical analysis. Finally, we include comments on how the results should be presented and issues which are related to public health and ethical questions. Although it is not usually possible to perform a perfect study and the correct approach to study design and analysis is often highly dependent on specific features of the population and the surroundings, our paper should help to distinguish between weak and strong investigations and papers.

Bias↗
PubMedDate not supplied

Reexamination of the fate of Mendel's paper.

The usual account is that when Mendel gave his paper, no one understood what he said and there were no questions and no discussion. Examination of available evidence indicates that this is not true. Also, it is usually said that Mendel's paper was lost or ignored from 1866 to 1900. This is not true either. However, with the possible exception of one person, none of those citing the paper showed any interest in or understanding of Mendel's explanations of his results.

Austria↗
PubMed1998

The Scottish Green Paper: beyond a healthy mind in a healthy body.

The Green Paper Working together for a healthier Scotland is a landmark in the drive to improve health, with a vital emphasis on reducing inequalities. It paves the way for a considered approach to building a health promoting society, with a critical reappraisal of the traditional pre-eminence of disease and behavioural topics. Its three action levels--life circumstances, lifestyle topics and health topics--provide a framework for putting an end to unhelpful quarrels over approaches to health promotion and for doing what is best done at each of the three levels. Against the background of the Green Paper, this paper seeks to facilitate a common understanding among all concerned as a basis for the necessary united effort to promote health, calls for a wider recognition of the full scope of health--including well-being, and identifies implications and opportunities in the areas of research and evidence-based action.

Health Priorities↗
PubMed2006

Development of research paper writing skills of poultry science undergraduate students studying food microbiology.

Because food and poultry industries are demanding an improvement in written communication skills among graduates, research paper writing should be an integral part of a senior undergraduate class. However, scientific writing assignments are often treated as secondary to developing the technical skills of the students. Scientific research paper writing has been emphasized in an undergraduate course on advanced food microbiology taught in the Poultry Science Department at Texas A& M University (College Station, TX). Students' opinions suggest that research paper writing as part of a senior course in Poultry Science provides students with scientific communication skills and useful training for their career, but more emphasis on reading and understanding scientific literature may be required.

Agriculture↗
PubMed1996

The papers of Cicely Williams (1893-1992) in the Contemporary Medical Archives Centre at the Wellcome Institute.

The papers of Cicely Williams were given to the Contemporary Medical Archives Centre in 1993, and subsequently catalogued. They cover most aspects of her work in the field of maternal and child health, as practitioner, teacher and consultant, 1929-1989, especially in the developing world. The collection includes correspondence, reports, lectures, publications, photographs and sound recordings, and is of relevance to a wide range of issues related to maternal and child health and the development of appropriate local health care systems. In particular, it is of interest in relation to Williams' pioneering work on the identification of the childhood malnutrition disease kwashiorkor. The Cicely Williams papers complement many other collections held by the Contemporary Medical Archives Centre. This article focuses on two pre-war reports of her work in the Gold Coast and Singapore, which show the early development of ideas which are echoed throughout the rest of her papers.

Adolescent↗
PubMed1992

Primary Care Health Information System: a hybrid electronic-paper medical record system.

In summary, PCHIS is a hybrid electronic-paper medical record system that is clinically useful to health care providers. The paper chart still contains the bulk of information but the key facts about any given patient (diagnoses, surgeries, medications, allergies) and about the process of care (frequency of visits, referral patterns, test ordering, etc.) are readily available in electronic form. These key data are easily coded, are quickly and simultaneously accessible in multiple locations, serve as an excellent chart substitute whenever the paper chart is unavailable, and can be retrieved for in-depth analysis at any time, whether for clinical, administrative, research, or quality assurance purposes. The process of care can be studied and, to some extent, can also be modified by the system, as demonstrated by the physician response to the reminder system within PCHIS. The medical record chart summary, mandated by Joint Commission for ambulatory patient charts, is easily provided in hard copy as well as electronically. Whereas physician compliance in providing data to the system was initially sporadic, physician support has increased tremendously as the system has become more clinically useful to them. It is a system that exists and functions well within a patchwork of multiple different medical information systems. It is a system with sufficient intrinsic flexibility that it can and will continue to evolve in response to the needs of physicians and administrators.

Academic Medical Centers↗
PubMed1983

An analysis of the papers presented at the annual meetings of the American Academy of Optometry for the last twelve years.

The papers read at the annual meetings of the American Academy of Optometry by representatives from the schools of optometry for the last 12 years were analyzed. We tabulated the papers presented in the Sections and in the General Program. Topics were subdivided into binocular vision, ocular health, contact lenses, optics and refraction, etc. Some schools maintained a consistent level over the years whereas others varied in the number of papers read at the Academy meetings. The emphasis of some schools of optometry on certain fields of optometry became apparent.

Academies and Institutes↗
PubMed2006

Personal digital assistants change management more often than paper texts and foster patient confidence.

INTRODUCTION: Rapid retrieval of information, including drug treatment options, is critical to emergency department practice. OBJECTIVES: To assess feasibility and patient acceptance of personal digital assistants and to determine the scope of management changes. METHODS: Emergency medicine residents (EMRs, n = 18) and emergency medicine attending (EMAs, n = 12) used personal digital assistants with drug database and clinical references. Text versions were also available in the emergency department. We did a prospective, random, cross-over time-motion study, recording retrieval time, source, and changes to patient care for 16 and 8 h for EMRs and EMAs, respectively. We surveyed patients for confidence in EMRs and EMAs with personal digital assistants, and perceived efficiency. RESULTS: EMRs accessed paper (n = 131) or personal digital assistant (n = 181) information on 92.3% of patients (n = 17, both). They accessed personal digital assistant on 61.4% of patients vs. 44.5% with texts (odds ratio 1.99, 95% confidence interval 1.4-2.80). Mean access times were 9.3 and 9.4 s, respectively, +1.4 for both. Personal digital assistant access was 75%/25% between pharmacopeia and clinical resource. Personal digital assistants changed drug choice in 39/181 patients (21.5%), and other management (diagnosis, treatment or disposition) in 15/181 patients (8.3%). Odds ratio for change in management for personal digital assistant vs. paper was 2.00 (95% confidence interval 1.11-3.60). We surveyed patient perception for 198 of 295 patients (67.1%). Fifty percent reported more confidence in their EMRs and EMAs with a personal digital assistant, while 5% reported less confidence. Sixty percent agreed strongly that there is too much medical information to remember. CONCLUSIONS: Personal digital assistants are feasible in an academic emergency department and change management more often than texts. EMRs accessed personal digital assistants more often than paper texts. Patient perceptions of physicians who use personal digital assistants are neutral or favorable.

Attitude of Health Personnel↗
PubMed2001

Rock-scissors-paper and the survival of the weakest.

In the children's game of rock-scissors-paper, players each choose one of three strategies. A rock beats a pair of scissors, scissors beat a sheet of paper and paper beats a rock, so the strategies form a competitive cycle. Although cycles in competitive ability appear to be reasonably rare among terrestrial plants, they are common among marine sessile organisms and have been reported in other contexts. Here we consider a system with three species in a competitive loop and show that this simple ecology exhibits two counter-intuitive phenomena. First, the species that is least competitive is expected to have the largest population and, where there are oscillations in a finite population, to be the least likely to die out. As a consequence an apparent weakening of a species leads to an increase in its population. Second, evolution favours the most competitive individuals within a species, which leads to a decline in its population. This is analogous to the tragedy of the commons, but here, rather than leading to a collapse, the 'tragedy' acts to maintain diversity.

Animals↗
PubMed2006

Self-similar roughening of drying wet paper.

We studied the kinetic roughening dynamics of drying wet paper. The configurations of dry paper sheets are found to be self-similar, rater than self-affine. Accordingly, the paper roughening dynamics corresponds to the new class of anomalous kinetic roughening [J. J. Ramasco, J. M. López, and M. A. Rodríguez, Phys. Rev. Lett. 84, 2199 (2000)], characterized by the equal local and global roughness exponents zeta = alpha = 1 and the dynamic exponent z = 1.0+/-0.2, whereas the spectral roughness exponent alpha(s) > 1 is determined by the long-range correlations characterized by the fractal dimension of D crumpled sheet.

Journal Article↗
PubMed1994

Histochemical Demonstration and Localization of H2O2 in Organs of Higher Plants by Tissue Printing on Nitrocellulose Paper.

A sensitive tissue-print assay for the detection and histological localization of H2O2 in freshly cut organ sections was developed by impregnating nitrocellulose paper with a mixture of Kl and soluble starch. H2O2 transferred from the cut surface of the section to the dried paper forms I2, which can be visualized by the intensely colored I2-starch complex. The detection limit of the assay is in the range of 0.1 to 0.2 mmol L-1 H2O2. Due to the rapid immobilization of H2O2 in the paper, very clear prints of the tissue distribution of H2O2 can be obtained with a spatial resolution on the level of single cells. The application of this rapid and simple assay is explored in five experimental examples demonstrating that the in vivo level of H2O2 varies strikingly in different tissues and can be regulated by developmental factors such as hormones, light, and wounding. The results show that: (a) In the hypocotyl of soybean (Glycine max L.) seedlings the apoplastic H2O2 level increases strongly from top to base, accompanied by characteristic changes in its histological distribution. (b) In the epicotyl of pea (Pisum sativum L.) seedlings the induction of lateral expansion by ethylene is correlated with a depletion of H2O2 in the cell walls of the expanding tissues. (c) In the hypocotyl of bean (Phaseolus vulgaris L.) seedlings H2O2 is primarily localized in a ring of parenchymatic tissue between xylem and cortex next to lignifying cells but not in the lignifying cells themselves. (d) In the hypocotyl of sunflower (Helianthus annuus L.) and cucumber (Cucumis sativus L.) seedlings the light-mediated inhibition of elongation growth is correlated with a strong increase in H2O2 in the epidermis and in the vascular bundles. (e) Potato (Solanum tuberosum L.) tubers show high levels of H2O2 only in the outer cell layers but are able to accumulate H2O2 in the inner tissue upon wounding.

Journal Article↗
PubMed2005

National differences in publishing papers on adverse drug reactions.

AIMS: To examine how countries differ in attitudes to adverse drug reactions by examining published scientific papers. METHODS: We searched Ovid EMBASE for publications indexed by the category "therapeutic agents", and the subcategory "adverse effects", by country for 43 countries. RESULTS: We counted 1 810 202 papers world-wide regarding therapeutic agents during 14 years, of which 195 154 (10.8%) were included in the adverse effects subcategory. There were substantial differences between countries, not explained by population, economic variation, overall publication rate on therapeutic agents, or the presence of large indigenous pharmaceutical companies. CONCLUSIONS: Many local cultural factors influence the ratio of papers on adverse reactions to all drug effects, so it may be difficult to improve their recognition and reporting by international efforts.

Attitude to Health↗
PubMed1988

The profitability of 'guessing' in multiple choice question papers.

Candidates taking multiple choice question (MCQ) papers in which marks are deducted for wrong answers often omit many items for fear of losing marks. In an MCQ paper in 1985 candidates who omitted many items made relatively few errors; they were not necessarily much less able than those who omitted few items. Those who had omitted many items were interviewed and advised to answer more, including those about which they were uncertain but not totally ignorant; the same advice was given to the whole group before they took another MCQ paper in the same subject in 1987. In 1987 there were large changes in the numbers of items omitted and, in particular, those who had omitted many items in 1985 answered many more in 1987. They also made more errors; despite this they tended to improve their performance in relation to their colleagues. A clear relationship was shown, for the whole group, between an increase in the number of items attempted and a rise in the rank order. The effects on candidates' behaviour of deducting marks for wrong answers and of permitting them to omit items are reviewed and the nature of the advice which should be given to candidates taking such examinations is discussed.

Clinical Clerkship↗
PubMed2006

Presymptomatic and predictive genetic testing in minors: a systematic review of guidelines and position papers.

The objective of this study is to review ethical and clinical guidelines and position papers concerning the presymptomatic and predictive genetic testing of minors. The databases Medline, Philosopher's Index, Biological Abstracts, Web of Science and Google Scholar were searched using keywords relating to the presymptomatic and predictive testing of children. We also searched the websites of the national bioethics committees indexed on the websites of World Health Organization (WHO) and the German Reference Centre for Ethics in the Life Sciences, the websites of the Human Genetics Societies of various nations indexed on the website of the International Federation of Human Genetics Societies and related links and the national medical associations indexed on the website of the World Medical Association. We retrieved 27 different papers dealing with guidelines or position papers that fulfilled our search criteria. They encompassed the period 1991-2005 and originated from 31 different organizations. The main justification for presymptomatic and predictive genetic testing was the direct benefit to the minor through either medical intervention or preventive measures. If there were no urgent medical reasons, all guidelines recommend postponing testing until the child could consent to testing as a competent adolescent or as an adult. Ambiguity existed for childhood-onset disorders for which preventive or therapeutic measures are not available and for the timing of testing for childhood-onset disorders. Although the guidelines covering presymptomatic and predictive genetic testing of minors agree strongly that medical benefit is the main justification for testing, a lack of consensus remains in the case of childhood-onset disorders for which preventive or therapeutic measures are not available.

Age Factors↗
PubMed1996

Detection of human immunodeficiency virus-1 DNA, RNA and antibody, and occult blood in inactivated saliva: availability of the filter paper disk method.

Eighty three samples of saliva were collected from 60 subjects who were asymptomatic carriers of AIDS related complex (ARC) and AIDS. They included hemophiliacs, homosexuals and heterosexuals. Occult blood, human immunodeficiency virus-1 (HIV-1) antibody and DNA were assayed after heat treatment at 56 degrees C by strip method, particle agglutination and polymerase chain reaction (PCR), respectively. HIV-1 RNA was assayed by reverse transcription (RT)-PCR after heat treatment at 56 degrees C or 90 degrees C, or after application to filter paper disks with drying and heat treatment at 90 degrees C. Positive results were found in 53% (occult blood), 73% (HIV-1 antibody), 23% (HIV-1 DNA, 56 degrees C), 34% (HIV-1 RNA, 56 degrees C), 33% (HIV-1 RNA, 90 degrees C) and 25% (HIV-1 RNA, 90 degrees C, filter paper disk), respectively. The results did not depend on the stage of the disease or the route of infection. Other studies have reported the use of the filter paper disk method to detect antibodies against HIV and HIV genomes in blood samples. The present study demonstrated that it could also be used for the detection of HIV genomes in saliva samples.

AIDS Serodiagnosis↗
PubMed2006

Does presentation at the Registrars' Papers Day predict future publication?

There are research requirements for trainees to be eligible to present for their final examinations (Fellowship of Royal Australasian College of Surgeons, FRACS). One option is the presentation of a paper or poster at a meeting of which abstracts are subject to review and selection. This includes presentation at the annual Registrars' Papers Day (RPD) in New South Wales. There has been some debate surrounding whether research requirements are fulfilled by presentation at such meetings. Publication in a peer-reviewed journal should be the ultimate aim. A high publication rate will validate the quality of the meeting. All abstracts submitted to the RPD in 1998 and 1999 were analysed. A Medline search was performed in 2005 to identify publication of these presentations in a peer-reviewed journal. Variables of the study that were potentially predictive of subsequent publication were analysed. This included type of presentation, surgical specialty, clinical or laboratory-based study, study design (prospective or retrospective) and sample size. Chi-squared test with Yates' continuity correction was used to compare two independent proportions and significance was set at P < 0.05. The publication rates were: oral presentations 50% (17/34), poster presentations 39% (9/23) and rejected presentations 20% (2/10). The mean and median time to publication was 23.8 and 21.0 months. Prospective design was the only variable identified to have a statistically significant effect on the publication rate (P < 0.002). The most common publishing journal was the Australian and New Zealand Journal of Surgery (12 of 26). Overall consistency (author and study sample consistency) from presentation to publication was 32%. The overall 46% publication rate of this state-based trainees-organized meeting compares favourably with international meetings. The research requirement of the Royal Australasian College of Surgeons (RACS), which includes presentation at the RPD in New South Wales, produces good quality papers for publication.

Academic Dissertations as Topic↗
PubMed1999

Lack of consistency in research papers over the definition of pre-eclampsia.

The most common definition of pre-eclampsia involves hypertension and proteinuria. This has changed little in over a hundred years despite advances in understanding the underlying pathological process. However, a number of variations in definition exist, and this paper demonstrates a lack of consistency in research articles in defining pre-eclampsia. A quarter of papers omit description, and many authors choose their own interpretation of the standard classification. Editors and reviewers should ensure that papers include a clear description of the definition used and an adequate description of the population studied to allow meaningful interpretation of research findings.

Female↗
PubMed1993

Diagnosis of the carbohydrate-deficient glycoprotein syndrome by analysis of transferrin in filter paper blood spots.

Carbohydrate-deficient glycoprotein syndrome is a recently identified recessively inherited, multisystemic disease with severe nervous system involvement. It is characterized biochemically by carbohydrate-deficient serum glycoproteins, and can be diagnosed by analysis of abnormal isoforms of serum transferrin. Using stored, neonatally collected filter paper blood spots from such patients, it was shown that neonatal diagnosis was possible by immune-isoelectric focusing of transferrin eluted from up to 14-year-old samples. Freshly collected blood on filter paper was readily analyzed quantitatively for carbohydrate-deficient isotransferrins by a rapid microchromatographic assay, revealing highly elevated values in all patients. The presently described methods thus provide a means for early diagnosis of the carbohydrate-deficient glycoprotein syndrome in microliter volumes of capillary blood. Sampling on filter paper offers an important simplification in sample collection, storage and transport, and may make population studies possible.

Blood Specimen Collection↗