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PubMed1999

Automated collection of quality-of-life data: a comparison of paper and computer touch-screen questionnaires.

PURPOSE: To evaluate alternative automated methods of collecting data on quality of life (QOL) in cancer patients. After initial evaluation of a range of technologies, we compared computer touch-screen questionnaires with paper questionnaires scanned by optical reading systems in terms of patients' acceptance, data quality, and reliability. PATIENTS AND METHODS: In a randomized cross-over trial, 149 cancer patients completed the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30, version 2.0 (EORTC QLQ-C30), and the Hospital Anxiety and Depression Scale (HADS) on paper and on a touch screen. In a further test-retest study, 81 patients completed the electronic version of the questionnaires twice, with a time interval of 3 hours between questionnaires. RESULTS: Fifty-two percent of the patients preferred the touch screen to paper; 24% had no preference. The quality of the data collected with the touch-screen system was good, with no missed responses. At the group level, the differences between scores obtained with the two modes of administration of the instruments were small, suggesting equivalence for most of the QOL scales, with the possible exception of the emotional, fatigue, and nausea/vomiting scales and the appetite item, where patients tended to give more positive responses on the touch screen. At the individual patient level, the agreement was good, with a kappa coefficient from 0.57 to 0.77 and percent global agreement from 61% to 97%. The electronic questionnaire had good test-retest reliability, with correlation coefficients between the two administrations from 0.78 to 0.95, kappa coefficients of agreement from 0.55 to 0.90, and percent global agreement from 56% to 100%. CONCLUSION: Computer touch-screen QOL questionnaires were well accepted by cancer patients, with good data quality and reliability.

Adult↗

PubMed2001

'Taking the transference': some technical implications in three papers by Bion.

In this clinical paper, the author presents a coherent model for conceptualising the process of establishing a 'containing object' in the mind of the analysand throughout the course of analysis. The technical implications offered in this model derive mainly from concepts and notions put forward in three papers by Wilfred Bion and explicated by the present author: 'A theory of thinking' (1962/1988), in which Bion emphasises what he calls 'realistic projective identification', which functions as an unconscious form of communication to and calls for understanding on the part of the analyst that is aimed towards the development of thoughts and an apparatus with which to think thought; 'Notes on memory and desire' (1967/1988), in which he sets forth some 'rules' for the analytic work that is centred on the 'here and now' of the evolving therapeutic interaction; and his paper on 'Evidence' (1976/1987), wherein he focuses on the 'fact' of the individual analyst's emotional experience. The author also demonstrates, through the presentation of four detailed vignettes, some of the ways in which the analytic process may fail or succeed, highlighting the import of the analyst's capacity for 'reverie', 'transformation', and 'publication'--all aspects of the containing function. In addition, she further expands upon Bion's work with a discussion of the essentials of 'taking the transference' and differentiates between two main dimensions of interpretation, 'projective' and 'introjective'.

Humans↗

PubMed2006

Toddlers at risk for paper shredder injury in the home: easy access and severe injury.

A 2-year-old girl sustained severe injury to 2 fingers from a home paper shredder. This case illustrates the risk of injury from paper shredders, which are increasingly common household items. Toddlers are at risk of finger injury and amputation. The US Consumer Product Safety Commission performed an investigation of reported injuries and the characteristics of paper shredders that might have contributed to the injuries, and we summarize their findings.

Accidents, Home↗

PubMedDate not supplied

[Application of gender perspective in papers published between 2000 and 2003 from four National Institutes of Health journals].

OBJECTIVE: The objective of this study was to determine the application of gender perspective in public health papers in four journals published by the Mexican National Health Institutes. MATERIAL AND METHODS: A total of 999 papers published in the four journals between 2000 and 2003 was reviewed. Two levels of analysis were considered: (a) data presented by sex, providing description of differences between women and men, and (b) the analysis of these differences from gender perspective. RESULTS: One quarter (25.4%) of the articles described results by sex. The largest percentage was published in Salud Pública de México (48.8%) and the smallest in Revista de Investigación Clínica (16.1%). Gender perspective was used in only 4.2% of papers; of these, drug addictions, health behaviour and violence were the topics that occurred most frequently. CONCLUSIONS: This is the first study to assess the application of gender perspective in Mexican health articles. Similarly to other countries, a very small percentage of authors analyzed sex differences, and a smaller proportion applied gender perspective. Results demonstrate the importance of promoting interdisciplinary research that may promote the elucidation of health inequalities between men and women.

Cross-Sectional Studies↗

PubMed2004

Assessing negative priming by attended distractors in a paper-and-pencil task.

The paper-and-pencil digit-comparison task for assessing negative priming (NP) was introduced, using a referent-size-selection procedure that was demonstrated to enhance the effect. NP is indicated by slower responses to recently ignored items, and proposed within the clinical-experimental framework as a major cognitive index of active suppression of distracting information, critical to executive functioning. The digit-comparison task requires circling digits of a list with digit-asterisk pairs (a baseline measure for digit-selection), and the larger of two digits in each pair of the unrelated (with different digits in successive digit-pairs) and related lists (in which the smaller digit subsequently became a target). A total of 56 students (18-38 years) participated in two experiments that explored practice effects across lists and demonstrated reliable NP, i.e., slowing to complete the related list relative to the unrelated list, (F(2, 44) = 52.42, P < 0.0001). A 3rd experiment examined age-related effects. In the paper-and-pencil digit-comparison task, NP was reliable for the younger (N = 8, 18-24 years) and middle-aged adults (N = 8, 31-54 years), but absent for the older group (N = 8, 68-77 years). NP was also reduced with aging in a computer-implemented digit-comparison task, and preserved in a task typically used to test location-specific NP, accounting for the dissociation between identity- and spatial-based suppression of distractors (Rao R(3, 12) = 16.02, P < 0.0002). Since the paper-and-pencil digit-comparison task can be administered easily, it can be useful for neuropsychologists seeking practical measures of NP that do not require cumbersome technical equipment.

Adolescent↗

PubMed1977

Measurement of digital arterial blood pressure and its recording on usual electrocardiograph paper.

A simple method for measuring digital arterial pressure and its recording on usual EKG heat-writing paper was devised. The method enabled us to measure exactly the digital systolic as well as diastolic blood pressure without providing the calibrating scale of pressure, since the pressure scale is recorded on the paper automatically as pulse signals at the interval of 10mmHg. The pulse waves are also registered on the same paper by means of the finger plethysmograph. By use of a right-angled triangle transparent rule, we could estimate the value of digital systolic pressure at which the pulse wave began to appear when the cuff pressure for compressing the artery was gradually lowered. Estimated values of the digital arterial pressures were compared with those obtained by another method of Mendlowitz and his coworkers.

Adult↗

PubMed1991

A centennial review; the 1890 tetanus antitoxin paper of von Behring and Kitasato and the related developments.

The significance of the 1890 tetanus antitoxin paper by von Behring and Kitasato in the development of a new discipline, immunology, is reviewed. The possible reasons why Kitasato lost the first Nobel Prize for medicine to von Behring are presented. These are as follows: (1) The Nobel selection committee literally interpreted Alfred Nobel's will to award the prize to "the person who has made the most important discovery." (2) In the late 19th century, diphtheria was a serious contagious disease which claimed many thousands of lives in the Europe and America; and von Behring's solely authored paper on diphtheria antitoxin clinched the award for him. (3) The merit of tetanus antitoxin to humans, which was the focal point of the 1890 paper on tetanus antitoxin jointly authored by von Behring and Kitasato, was not recognized at the time of the award in 1901; it became apparent only during the First World War.

Allergy and Immunology↗

PubMed1990

Mail-in paper strip vs. microcolumn technique for measurement of glycosylated hemoglobin.

We compared glycosylated hemoglobin (GHb) determined from capillary blood samples on paper strips with a standard microcolumn technique in a cross-sectional observational study with laboratories blinded to duplicate samples. Both the standard and the filter strip laboratories were provided with 80 uniquely identified blood samples from 40 individuals. Each laboratory ran duplicate analyses on each sample, yielding 160 GHb values. The within-laboratory correlations between blinded duplicates were 0.98 for the standard (microcolumn technique) and 0.94 for the filter paper (affinity technique) laboratories. The between-laboratory correlations ranged from 0.69 to 0.77. When classifying patients by quartile of glycemic control, the laboratories agreed on 60% of the patients. In an effort to identify sources of between-laboratory variability, varying quantities of blood were applied to strips and reanalyzed. Five microliter drops always yielded inflated estimates of GHb. These data suggest that the estimates of GHb obtained from mail-in paper strips, although internally consistent, differ in important ways from standard laboratory values, reemphasizing the need for caution in the interpretation of interlaboratory and intermethod comparisons.

Blood Glucose Self-Monitoring↗

PubMed1983

A sensitive assay for creatine kinase in serum samples dried on paper: enhanced thermal stability of the dried enzyme.

A new bioluminescent creatine kinase (CK) assay using purified luciferase was used to analyse CK activity in serum samples dried on filter paper. Enzyme activity was preserved for over 1 wk on paper stored at room temperature. At 60 degrees C, CK activity in liquid serum samples was rapidly inactivated, but the activity of enzyme stored on paper was preserved for at least 2 days.

Clinical Enzyme Tests↗

PubMed2006

Comparing observational software with paper and pencil for time-sampled data: a field test of Interval Manager (INTMAN).

In this article, we describe the Interval Manager (INTMAN) software system for collecting time-sampled observational data and present a preliminary application comparing the program with a traditional paper-and-pencil method. INTMAN is a computer-assisted alternative to traditional paper-and-pencil methods for collecting fixed interval time-sampled observational data. The INTMAN data collection software runs on Pocket PC handheld computers and includes a desktop application for Microsoft Windows that is used for data analysis. Standard analysis options include modified frequencies, percent of intervals, conditional probabilities, and kappa agreement matrices and values. INTMAN and a standardized paper-and-pencil method were compared under identical conditions on five dimensions: setup time, duration of data entry, duration of interobserver agreement calculations, accuracy, and cost. Overall, the computer-assisted program was a more efficient and accurate data collection system for time-sampled data than the traditional method.

Behavioral Research↗

PubMed1977

Fluorescent treponemal antibody absorption (FTA-ABS) tests using blood samples collected on filter paper.

One hundred and eleven (111) blood specimens were collected from patients with known or suspected syphilis by venipuncture and on a small piece of No. 3 grade filter paper. Both specimens from each patient were tested by bluorescent treponemal antibody absorption (FTA-ABS) test. Of the 62 patients whose venipuncture sera were FTA-ABS positive, filter paper blood samples were also positive in 56 (90%) and negative in 6 (10%). Complete agreement was obtained on paired specimens from 49 patients who were FTA-ABS negative. These preliminary results suggest that finger stick blood samples, collected on filter paper, could be used for FTA-ABS testing of remote rural populations--such as in areas where yaws is endemic.

Blood Specimen Collection↗

PubMed1998

Application of the enzyme-linked immunoelectrotransfer blot to filter paper blood spots to estimate seroprevalence of cysticercosis in Bolivia.

An enzyme-linked immunoelectrotransfer blot (EITB) assay was used to study the prevalence of cysticercosis in rural Bolivia. Dried blood spots on filter paper from fingersticks were used as assay samples. Before the serosurvey, experiments were performed to show that samples eluted from dried whole blood on filter paper exhibited no decrease in sensitivity when compared with the more traditional serum samples used in the EITB. Fingerstick blood dried on filter paper is a convenient, economical way of transporting and storing field samples for epidemiologic surveys of cysticercosis in developing countries. This report shows the utility of this sample collection method in underdeveloped countries where refrigeration is not possible and where venipuncture is a problem. Blood was obtained from randomly selected residents in three rural regions of Bolivia: Chuquisaca (n = 1,859), Cochabamba (n = 1,516), and Tarija (n = 1,010). The estimated seroprevalence on 10% of the sample collected for the three regions were 9%, 4.5%, and 2%, respectively.

Animals↗

PubMed1999

Short report: Diagnosis of human fascioliasis: detection of anti-cathepsin L antibodies in blood samples collected on filter paper.

We have developed an ELISA for the diagnosis of human fascioliasis based on the detection of IgG4 antibodies to Fasciola hepatica cathepsin LI cysteine protease. Use of this assay in the Bolivian Altiplano, a region with a high prevalence of the disease, was hampered by the reluctance of the indigenous population to provide blood. To overcome this problem, we have investigated the method of collecting small quantities of blood from the finger onto filter paper, followed by the elution of antibodies for use in the diagnostic assay. Serum samples and blood samples collected onto filter paper were obtained from 57 individuals living in the village of Cutusuma in 1987 and from 11 individuals in Chijipata in 1996. Analysis of the IgG4-ELISA results revealed that there is highly significant linear relationship (P < 0.001) between the two methods of sampling. Most importantly, a reliable diagnosis was made with the blood-filter samples from Cutusuma, which had been stored for 10 years at 40 degrees C. While some deterioration of the blood-filter samples from Cutusuma had occurred over the 10-year storage period, no deterioration occurred with the Chijipata samples, which were stored for one year. Therefore, the method of collecting blood onto filter paper should prove useful for large-scale epidemiologic studies on human fascioliasis in the Bolivian Altiplano and in other regions where this disease is prevalent.

Animals↗

PubMed1983

Hypersensitivity angiitis caused by fumes from heat-activated photocopy paper.

A 53-year-old librarian had recurrent palpable purpura on her ankles and legs that was found to be caused by the fumes released from heat-activated photocopy paper at her place of employment. Behenic acid was identified as the responsible chemical component through a series of challenge studies that simulated her work exposure. Behenic acid, a fatty acid, is volatilized when heat-activated photocopy paper is developed. Absorption through the upper respiratory mucosa was the likely route of entry of this agent. The mechanism of this reaction is unclear. Skin biopsies, complement studies, and immune complex assays failed to confirm a type III immune response. Physicians should be aware that chemical fumes released from microfilm copying machines or other devices that use heat-activated photocopy paper may cause palpable purpura.

Fatty Acids↗

PubMed1990

Equal access to health care--patient dumping. NAHAM (National Association of Hospital Admitting Managers) position paper.

NAHAM's first position paper, "Equal Access to Health-Care-Patient Dumping," was prepared as part of the association's strategic planning process. This paper is the first in a series which will examine federal healthcare issues. This paper like the others to follow will increase membership awareness of healthcare issues, providing NAHAM with greater influence in the federal healthcare policy arena.

Admitting Department, Hospital↗

PubMed1993

Hospital pricing White Paper. Metropolitan Chicago Healthcare Council.

Hospital pricing issues are continuing to receive additional scrutiny on the part of government and the media. The hospital field has done a poor job of communicating their side of this issue. The Metropolitan Chicago Healthcare Council recently developed a Hospital Pricing White Paper to explain the complexities of hospital pricing. The purpose of the paper is to provide hospital staff with basic information that they could pass on to their key publics. A summary of the White Paper follows.

Economics, Hospital↗

PubMed1995

Will paper ever go away? Document imagers bet it won't.

Health care providers and payers alike would like to eliminate their paperwork, converting all information to digital form. Many provider organizations are attempting to implement computerized patient record systems designed to eventually eliminate the traditional file folders crammed with paper records. And a widespread movement to electronic data interchange for financial transactions holds out hope of eliminating paper claims and related financial transactions. But moving from a paper-intensive world to a computer world takes time, and the transition will never be complete.

Attitude to Computers↗

PubMedDate not supplied

Preparing manuscripts for submission to medical journals: the paper trail.

CONTEXT: Preparing a manuscript for publication in a medical journal is hard work. OBJECTIVE: To make it easier to prepare a readable manuscript. APPROACH: Start early--A substantial portion of the manuscript can be written before the project is completed. Even though you will revise it later, starting early will help document the methods and guide the analysis. Focus on high-visibility components--Pay attention to what readers are most likely to look at: the title, abstract, tables, and figures. Strive to develop a set of tables and figures that convey not only the major results but also the basic methods. Develop a systematic approach to the body of the paper--A standard framework can make it easier to write the introduction, methods, results, and discussion. An obvious organization with frequent subheadings and consistent labels makes the paper easier to read. Finish strong--Improve the paper by sharing it with others and by learning how to elicit and receive their feedback. Take the time to incorporate useful feedback by revising frequently.

Data Display↗