Patient preference: a comparison of electronic patient-completed questionnaires with paper among cancer patients.

In this study, we compared cancer patients preference for computerised (tablet/web-based) surveys versus paper. We also assessed whether the understanding of a cancer-related topic, pharmacogenomics is affected by the survey format, and examined differences in demographic and medical characteristics which may affect patient preference and understanding. Three hundred and four cancer patients completed a tablet-administered survey and another 153 patients completed a paper-based survey. Patients who participated in the tablet survey were questioned regarding their preference for survey format administration (paper, tablet and web-based). Understanding was assessed with a 'direct' method, by asking patients to assess their understanding of genetic testing, and with a 'composite' score. Patients preferred administration with tablet (71%) compared with web-based (12%) and paper (17%). Patients <65 years old, non-Caucasians and white-collar professionals significantly preferred the computerised format following multivariate analysis. There was no significant difference in understanding between the paper and tablet survey with direct questioning or composite score. Age (<65 years) and white-collar professionals were associated with increased understanding (both P = 0.03). There was no significant difference in understanding between the tablet and print survey in a multivariate analysis. Patients overwhelmingly preferred computerised surveys and understanding of pharmacogenomics was not affected by survey format.

Biomedical communications: collaborative research in scientific visualization, online learning, and knowledge translation.

Collaborative research in biomedical communications investigates the role of visual media in scientific discovery and in patient and health professional education. The spectrum of work is broad and includes the visualization of scientific knowledge and simulation of hypothetical models of health and disease, as well as the design of audience-centered interactive visual media. The work cited supports the notion that research-based visual media can contribute to the core missions of science: discovery, communication, collaboration, and education.

Increasing daily fruit and vegetable consumption: what changes do cardiac patients make?

BACKGROUND: Interventions targeting fruit and vegetable consumption report significant increases in consumption but do not detail how increases are achieved. This prospective study explored (i) the changes in daily fruit and daily vegetable consumption of cardiac patients participating in an intervention study and (ii) how participants made these changes. METHODS: A total of 120 cardiac patients were asked to increase their daily fruit and vegetable consumption by two portions and to maintain this over 3 months. They were telephoned at 7-, 28- and 90-day follow-up to record daily consumption using a dietary questionnaire; 94 participants completed all parts of the study. RESULTS: Mean reported daily fruit and daily vegetable consumption increased by 1.07 (SD = 1.26) and 0.34 (SD = 0.96) portions, respectively, over 3 months. These increases were statistically significant (P < 0.001) and greatest for participants who reported eating low levels of fruit and vegetables at recruitment. Eating fresh fruit as a snack and at mealtimes were preferred choices for participants. CONCLUSIONS: Providing information and telephone follow-up could be used by busy healthcare professionals instead of face-to-face contact. Interventions to increase total fruit and vegetable consumption could usefully focus on eating fruit. Interventions to increase vegetable consumption need further investigation.

The molecular biology of appressorium turgor generation by the rice blast fungus Magnaporthe grisea.

The rice blast fungus Magnaporthe grisea develops specialized infection structures known as appressoria, which develop enormous turgor pressure to bring about plant infection. Turgor is generated by accumulation of compatible solutes, including glycerol, which is synthesized in large quantities in the appressorium. Glycogen, trehalose and lipids represent the most abundant storage products in M. grisea conidia. Trehalose and glycogen are rapidly degraded during conidial germination and it is known that trehalose synthesis is required for virulence of the fungus. Lipid bodies are transported to the developing appressoria and degraded at the onset of turgor generation, in a process that is cAMP-dependent. A combined biochemical and genetic approach is being used to dissect the process of turgor generation in the rice blast fungus.

Factors affecting decision-making by young adults with intellectual disabilities.

Young adults with intellectual disabilities were placed into high and low learned helplessness groups based on their responses to a self-report questionnaire. Within each group participants were randomly allocated to one of three conditions for presentation of vignettes depicting decision-making situations: vignette only; vignette plus two options; and vignette plus the same two options, each with one positive and one negative consequence. Participants were asked to say what they would do in the situation and to give a reason. Responses were judged according to criteria based on theories of rational decision-making. Low learned helplessness participants obtained significantly higher decision-making scores. Additional information about options or options plus consequences was not beneficial for either group. Implications for providing training and experiences in decision-making are discussed.

Development of a hypermedia program designed to assist patients with localized prostate cancer in making treatment decisions.

The Prostate Centre, a hypermedia program integrating CD-ROM and Internet technology, was developed to help patients with localized prostate cancer access detailed and current information about available treatment options. Personal interviews with ten patients confirmed the need for more specific information examining the diagnosis and treatment of prostate cancer, as well as the suitability of computers for conveying this information. Sample screen designs effectively determined patients' visual preferences and were a useful springboard for conversation about a number of other relevant topics. Pilot testing of the resulting prototype elicited a positive response about the program from this sample audience. Patients regarded the program as useful, relevant to their needs, and navigable. Although the small sample size limited the study's generalizability, the method of involving patients in the design process successfully guided the program's development toward a greater fit with the users' needs.

Face facts: a history of physiognomy from ancient Mesopotamia to the end of the 19th century.

Inscribed on the face is a code, the translation of which has entertained and eluded humankind for many centuries. The practice of reading the face dates back as early as the paleobabylonian period in Mesopotamia. It wasn't until much later, however, that this ancient tradition was named.

CT-guided stereotactic antero-medial pulvinotomy and centromedian-parafascicular thalamotomy for intractable malignant pain.

A quick and safe CT image-guided stereotactic thalamotomy technique that has proved ideal for alleviating medically refractory intractable pain due to malignant disease is described. A simple method of deriving cartesian coordinates for target points that facilitates functional neurosurgery using CT images and the Brown-Roberts-Wells stereotactic system is also described.

Mcl-1, a member of the Bcl-2 family, delays apoptosis induced by c-Myc overexpression in Chinese hamster ovary cells.

Mcl-1, a protein increased early in the differentiation of human myeloblastic ML-1 cells, has sequence similarity to Bcl-2. In the present study, we determined whether Mcl-1 has functional similarity to Bcl-2 by testing its ability to inhibit apoptosis induced by c-Myc overexpression. This was carried out using Chinese hamster ovary 5AHSmyc cells which contain the human c-myc proto-oncogene under the control of a heat shock promoter. Heat treatment induces c-Myc overexpression and thus apoptosis as determined by internucleosomal DNA fragmentation. We transfected 5AHSmyc cells with mcl-1 and found that clones expressing the introduced Mcl-1 protein exhibited reduced DNA fragmentation. Mcl-1 was also capable of delaying the onset of cell death as judged by loss of membrane integrity, although it could not provide complete protection from c-Myc overexpression. Thus, Mcl-1 has functional homology to Bcl-2 in that Mcl-1 can enhance cell viability under conditions that otherwise cause apoptosis.

The cerebral function analysing monitor. Initial clinical experience, application and further development.

The cerebral function analysing monitor is a development of the cerebral function monitor. It produces a more detailed analysis of the electroencephalogram (EEG) amplitude and analyses the frequency of the waveforms into standard beta, alpha, theta and delta bands. It can analyse the EEG from two input channels, produce traces of the standard EEG, and compute visual, auditory, somato sensory and brain stem evoked potentials.

Correlates of sociometric status among TMR children in regular classrooms.

Nineteen trainable mentally retarded children integrated individually into regular primary school classes were rated by teachers and parents on checklists of problem behavior and by teachers on five areas of school competency. Nonretarded children in the same classes completed a sociometric questionnaire. The TMR children as a group were below average in sociometric status, but scores varied widely. Sociometric status was not associated with behavior ratings but was negatively correlated with all areas of school competency.

The value of electron microscope studies in diagnosing malignant change in ulcerative colitis.

Ultrastructural and histological appearances were studied in normal rectal and colonic mucosa, in the mucosa immediately adjacent to neoplasms (transitional mucosa), in neoplasms themselves, and in ulcerative colitis to try to determine whether any changes found in colitis might be recognized as premalignant. Two of the ulcerative colitis specimens showed histological evidence of premalignant change and these changes were reflected at the ultrastructural level. No electron microscopical premalignant changes were found which could not more easily be detected by simple histology, and it is concluded that attempts to detect premalignant changes in ulcerative colitis using electron microscopical techniques are likely to be unrewarding.