Autistic Women's Experience of Motherhood: A Qualitative Analysis of Reddit.

Autistic mothers remain under-represented in parental and autism research despite the associated physical and psychosocial challenges that accompany the transition to motherhood. Extant literature suggests autistic mothers experience sensory difficulties, communication challenges, stigma, and comorbidities as difficulties, but these studies have focused on autistic women in the perinatal period. The aim of this study was to examine reflections on motherhood from a Reddit community for autistic parents. Identified themes were Autistic Mothering is Different, Autistic Mothers Need Autistic Mothers, Autistic Mothers Experience Stigma, and Learnings from Lockdown. Findings extend existing research by offering insight into the ways autism impacts mothers beyond the perinatal period and have important implications for the future design and delivery of support services for autistic mothers.

Exploring Environmental Barriers and Facilitators to Inclusion on a University Campus for Autistic Students.

Background: Attending university allows individuals to build independence, develop social networks, and attain valuable qualifications, contributing to enhanced outcomes in adulthood. However, autistic people have poorer participation rates and outcomes in university than those with all other disabilities or without disabilities. Most research conducted with autistic young adults in the university environment focuses on their social and communicative challenges and supports rather than on how the physical environment impacts an autistic student's university experience. Therefore, there is a need for research into how the sensory aspects of the university environment can affect the well-being and outcomes of autistic students. Methods: This qualitative study explored the experiences of seven autistic university students in the physical spaces of an Australian university. Using a semi-structured interview guide, and photo-elicitation, we collected data in one-on-one interviews with seven autistic undergraduate students. Results: We found that sensory aspects of physical spaces on university campuses are both enabling and challenging for autistic students. These aspects not only impact how students navigate and utilize aspects of the campus, but they also influence how students engage and participate at university. Autistic students need the space and resources to manage sensory overload on campus, and universities that seek to support autistic students need to consider the physical and sensory needs of this cohort. Conclusions: Inclusive university education requires attention to the physical aspects of campuses that support the mental and physical well-being of autistic students.

Why was this study done?: Autistic people are less likely to enroll in and complete further education than those with all other disabilities or without disabilities. Most research conducted with autistic young adults in the university environment focuses on their social and communication challenges, rather than the enabling and disabling aspects of the physical university environment. What was the purpose of this study?: This study aimed to capture and understand autistic students' experiences in navigating and participating in the physical spaces in an Australian university. What did the researchers do?: We interviewed seven undergraduate university students about the places and spaces on the university campus that they found challenging and enabling. Participants took photographs of these spaces before the interview and brought the photographs with them for discussion. What were the results of the study?: We found that the participants readily identified places on the campus that were both enabling and challenging. Physical aspects that were challenging included noisy spaces, crowded areas, and spaces with bright artificial lights. These spaces impacted on their ability to participate and succeed in their studies. They also impacted on their ability to interact with other students, their enjoyment of university, and their physical and emotional well-being. Comfortable spaces that allowed them to recharge were those that were quiet, less busy, had lower levels of sensory input, and allowed them to unmask. What do these findings add to what was already known?: Previous research on the university experience of autistic students has focused primarily on social and educational supports. Research on sensory-friendly education settings has typically focused on primary and secondary education. This study provides evidence of the importance of physical and sensory environments in the educational experience of autistic students in a postsecondary environment. What are potential weaknesses in the study?: The main weakness of the study is the small number of participants (n = 7) and that they were all drawn from one university. While this limits the generalizability of the findings, this was an exploratory study and an important first step in developing our understanding of barriers and facilitators to inclusion on a university campus. How will these findings help autistic adults now or in the future?: While this is a small-scale exploratory study, and there is a need for more research in this area, there are some simple takeaways that could be implemented by universities at minimal cost to support the inclusion of autistic students. For example, sensory input could be reduced by lowering the volume of piped music or reducing the number or brightness of lights. Simple supports for students experiencing sensory overload could include quiet times in cafeterias and access to sensory retreat rooms. At a minimum, our findings could serve as a starting point for discussions between university administrators and autistic students about necessary environmental adjustments to create more inclusive campuses.

'Most people have no idea what autism is': Unpacking autism disclosure using social media analysis.

LAY ABSTRACT: Autism disclosure - that is sharing their autism diagnosis or identity with a person or people - is a difficult decision for many autistic people. While telling people they are autistic can be positive and helpful, it can also create a lot of problems. What we have learnt is that disclosure is really complicated. Rather than asking research participants questions about what might happen, we looked at what people were saying on public social media posts (Reddit and Twitter) about what did happen. We used three years of posts that were related to autism disclosure from a wide range of adults (autistic and non-autistic). Four main ideas were created from our data, with the key finding being that society does not understand autism. This lack of understanding creates problems for autistic people in work, dating, healthcare and mental health. The remaining ideas were that autistic people should have privacy and be treated with respect, that autistic representation can help society and that non-autistic people need to do more to help autistic people. Our findings support that society needs to do more through autism advocacy, better media representation and more public role models. Increasing the accuracy of understanding of autism across society will mean that autistic people can feel safer to disclose if they want to.

Consensus-based framework for evaluating data modernization initiatives: the case of cancer registration and electronic reporting.

As part of its data modernization initiative (DMI), the Centers for Disease Control and Prevention, Division of Cancer Prevention and Control is testing and implementing innovative solutions to improve cancer surveillance data quality and timeliness. We describe a consensus-based effort to create a framework to guide the evaluation of cancer surveillance modernization efforts by addressing specific context, processes, and costs related to cancer registration. We drew on prior theories, consulted with experts, and sought feedback from cancer registry staff. We developed the cancer surveillance systems, context, outcomes, and process evaluation (CS-SCOPE) framework to explain the ways in which cancer registry data quality, timeliness, and efficiency are impacted by external and internal contextual factors and interrelated process and content factors. The framework includes implementation measures to understand acceptability of process changes along with outcome measures to assess DMI initiation and ongoing sustainability. The framework's components and structures can be tailored for use in other DMI evaluations.

Perception of the Portrayal of Autism in Netflix's Atypical Within the Autism Community.

Background: Fictional portrayals of autism play a role in raising awareness, shaping knowledge, and influencing attitudes toward autism. However, the accuracy of these portrayals is a topic of debate. Limited research has been conducted with the autism community regarding their perceptions of fictional portrayals of autism. This study aimed to explore autistic people's perceptions of the accuracy, educational benefits, and impact of Atypical, a Netflix comedy drama series focused on the experiences of an autistic protagonist. Methods: Participants were 77 members of the autism community (autistic N = 65, parent/partner N = 12), recruited via social media. Participants completed a cross-sectional predominantly qualitative survey. We undertook descriptive statistical analyses on the quantitative data and used a reflexive thematic analysis approach to analyze the qualitative data. Results: The majority of participants described Sam's portrayal as accurate, emphasizing that it was accurate as one example of autism. Family members appeared more likely to perceive Atypical as having informative benefit and being likely to improve attitudes toward autism than were autistic people. The primary concerns identified were the stereotypical representation of a popular media image of autism, the lack of diversity, and the depiction of autism as a burden or challenge for the protagonist and his family. Conclusions: This study builds on previous research on the portrayal of autism in entertainment media by investigating the perception of the autism community regarding one such fictional portrayal. It identifies that for entertainment media to better represent the lived experience of autistic people and improve community understanding of autism, there is a need for increased diversity of portrayals and for the involvement of autistic people in the development and production process.

Why was this study done?: Portrayals of autism on television and in movies may increase autism awareness and knowledge and improve attitudes toward autistic people. However, they may also reinforce autism stereotypes and negative attitudes. Research shows that there are an increasing number of autistic characters in movies and television stories. Some studies find that these portrayals are largely accurate, others that they are misleading, and some that they are mixed. What has not been studied is what members of the autism community think about the accuracy, value, and likely impacts of these fictional portrayals. What was the purpose of this study?: The purpose of this study was to explore the perceptions of members of the autism community­autistic people and their families­about the Netflix television series Atypical and its autistic main character Sam Gardner. What did the researchers do?: The researchers recruited 77 people who had watched Atypical: 65 autistic people, 10 parents of autistic children, and 2 partners of autistic adults. Participants were recruited through social media and completed an anonymous online survey. Questions addressed their perceptions of the accuracy of the portrayal of Sam as an autistic person, and whether they thought the show would improve autism knowledge and attitudes. What were the results of the study?: The majority of participants thought that Sam's portrayal of autism within Atypical was accurate and that it would have some degree of educational benefit for non-autistic people. Family members appeared more likely than autistic people to think that Sam's portrayal was accurate, to believe that the show had educational benefit, and to agree that the show was likely to lead to more positive attitudes about autism. Participants expressed concern that Sam's portrayal was a stereotypical male representation of autism that was not representative of the broader autistic community and that the show presented a deficit-focused view of autism. What do these findings add to what was already known?: This study provides valuable information regarding the autism community's perceptions of the accuracy of the portrayals of autism, the potential educational benefit, and the likely influence on attitudes. It identifies that for entertainment media to better represent the lived experience of autistic people and improve community understanding of autism, there is a need for increased diversity of portrayals. What are potential weaknesses in the study?: The main weaknesses of the study are the overrepresentation of females (64%), the focus on a single television series with a male protagonist, and the limited detail on the participants' life experiences due to the anonymous nature of the study. How will these findings help autistic adults now or in the future?: This study should assist in advocacy with the producers of entertainment media, enabling them to hear the voices of the autism community and take on board their suggestions for more inclusive and representative portrayals of autism. Doing so has the potential to raise awareness, acceptance, and appreciation of autistic people in the broader community.

Advice for autistic people considering a career in academia.

LAY ABSTRACT: One of the recognised strengths of autistic people is their ability to absorb and retain large amounts of information; autistic children and adolescents are often described as 'little professors'. So, is the life of a university researcher or teacher the ideal career for an autistic person? In this study, 37 autistic people working in universities and colleges provide advice to young people considering a future career as an academic. They emphasise the importance of understanding the complexities and requirements of the role, understanding and valuing yourself and your strengths, and finding the right people to work with and learn from. They also discuss the importance of maintaining a balance between work and well-being, and between caution and passion. The life of an academic can be ideally suited to an autistic person, but it can also be very challenging.

Representation of autism in fictional media: A systematic review of media content and its impact on viewer knowledge and understanding of autism.

LAY ABSTRACT: The way autism is represented in fictional media can impact people's views of autistic people. For example, representations may contribute to negative views of autistic people as being unusual or dangerous, or they may challenge stereotypes and instead highlight the strengths of autistic people. This work aimed to review previous research to understand how autistic people have been represented in fictional media (Part A). It also sought to understand whether viewing fictional portrayals of autism has an impact on people's knowledge of autism and attitudes towards autistic people (Part B). Of 14 studies that were included in Part A, several unhelpful and stereotypical portrayals of autism emerged. Positive portrayals were those that highlighted the strengths of autistic people and reflected nuance. There is a need for greater diversity in representation of autism in fictional media. For example, not all autistic people are white heterosexual males. Across the five studies included in Part B, there were no improvements in people's knowledge of autism after watching or reading a short segment from a fictional TV series or novel that depicts an autistic person. Although there was a significant improvement in people's attitudes towards autistic people, these findings do not provide a complete picture given the short length of the media exposure and small number of studies. Future studies should investigate how multiple exposures to the representation of autistic people in both fictional and non-fictional sources can affect people's understanding of autism. There is also a need to develop more accurate and respectful ways of measuring people's knowledge of, and attitudes towards, autism.

Early Discharge of Adolescent and Young Adult Patients During Induction Chemotherapy for Newly Diagnosed Acute Lymphoblastic Leukemia: Is It Safe?

There is a lack of consensus for safely discharging adolescent and young adults (AYA) with newly diagnosed acute lymphoblastic leukemia. From 2017 to 2019 we evaluated predefined early discharge criteria for 41 AYA patients during induction chemotherapy. Only 17% (7/41) of patients met criteria for early discharge. Two (29%) patients who were discharged early were readmitted, but not to the pediatric intensive care unit (PICU). This outcome was compared to a historic cohort at our institution of 73 patients who were discharged without predefined discharge criteria. Twenty-seven (37%, p = 0.7) patients were readmitted, but 13 (48%) were readmitted to the PICU (p = 0.004).

Understanding the Experiences of Food Insecurity in Older Adult Households.

Food insecurity is a pressing multidimensional problem that negatively impacts the health and well-being of a significant number of the older population. Finding ways to better address nutritional issues among this vulnerable population is vital to their well-being. Using a mixed-methods approach, we conducted semi-structured phone interviews with a representative sample of 434 low-income older adult households in Tennessee. The aim of this study is to assess the prevalence of food insecurity, examine ongoing barriers, and, using qualitative data, to explore the diverse daily experiences older adults face when confronted with a food insecure lifestyle. Based on the USDA Adult 10-Item Household Screening Module, we found that 30% in our sample were designated as marginally, low or very low food secure. Many of those most vulnerable (older women, widowed or divorced, poor health and below the poverty line) constantly struggled with food insecurity. Being food insecure was attributed to limited financial resources, lack of transportation, health limitations, and a poor psychological state. Utilizing food stretching practicing, governmental agencies offering food supplements, family/friends, religious groups and personal resilience were common coping strategies. Implications and recommendations for service providers are offered.

Autistics working in academia: What are the barriers and facilitators?

LAY ABSTRACT: Academia appears to provide an ideal career option for autistic people: the opportunity to lock ourselves away in an ivory tower and utilise our extensive knowledge of a very specific topic. We know autistic people are underrepresented in postsecondary education, and there is a growing body of research on how to make universities more inclusive. What is missing from the literature is the voices of autistic people who have survived the university experience and gone on to become university teachers and researchers. Increasing the visibility of autistics in academia, and exploring the barriers and facilitators they experience in an academic career, is important to raise the aspirations of future university students and graduates. This study included 37 autistic academics from various disciplines and countries, exploring their perceptions of the positive and negative aspects of being an autistic in academia.

Epidemiology, Antimicrobial Resistance, and Virulence Determinants of Group B Streptococcus in an Australian Setting.

Streptococcus agalactiae [group B Streptococcus (GBS)] is a major neonatal pathogen and also causes invasive disease in non-pregnant adults. One hundred GBS isolates (n = 50 invasive disease and n = 50 colonizing pregnant women) were characterized using capsular serotyping by latex agglutination, antimicrobial susceptibility testing, and whole genome sequencing (WGS). All isolates were susceptible to penicillin, 32% were resistant to clindamycin. Of these, two isolates had reduced susceptibility to ceftriaxone (MIC 0.75 mg/L) and were found to have unique alleles at pbp2X and pbp1A. Capsular serotypes Ia (18%), III (18%), Ib (14%), V (12%), and VI (11%) were most common and comparison of latex agglutination and capsular genotyping by WGS showed 71% agreement. Less common capsular genotypes VI-VIII represented 15% of isolates, indicating that a significant proportion may not be targeted by the proposed pentavalent or hexavalent vaccines under development. WGS is a useful aid in GBS surveillance and shows correlation to phenotypic serotyping and antimicrobial susceptibility data.

Leukapheresis in Pediatric Acute Leukemia with Hyperleukocytosis: A Single-Center Experience.

Hyperleukocytosis in pediatric acute leukemia is associated with increased morbidity and mortality and at present there is no consensus on the use of leukapheresis (LPH) for its management. Our aim was to review characteristics and outcomes of newly diagnosed leukemia patients with hyperleukocytosis (HL) comparing those who received LPH and those who did not. An IRB approved retrospective case control study reviewed data from a single institution over a 10 year period. At our institution, LPH was used in 8 of 62 (13%) patients with hyperleukocytosis with minimal complications. Mean leukocyte count in patients who received LPH versus those who did not was 498 k cells/mm3 and 237 k cells/mm3, respectively. Patients who had symptoms of neurologic (63 vs. 17%) or pulmonary leukostasis (75 vs. 17%) were more likely to have undergone leukapheresis. The time from presentation to the initiation of chemotherapy was not different between those who received LPH and those who did not (mean of 35 h vs. 34 h). There was one death in the LPH group, that was the result of neurologic sequelae of hyperleukocytosis and not LPH itself. The use of LPH in patients with hyperleukocytosis is safe, well tolerated and does not alter time to chemotherapy at our institution.

Venous Thromboembolic Events in Adolescent and Young Adult Patients with Acute Lymphoblastic Leukemia.

Acute venous thromboembolisms (VTEs) are serious complications that occur during acute lymphoblastic leukemia (ALL) chemotherapy. The data elucidating risk factors for developing VTEs are limited in adolescent and young adult patients being treated per pediatric ALL protocols. In a cohort of 66 patients, 14 (21%) experienced VTEs. The majority of VTEs occurred during induction chemotherapy after the first dose of asparaginase, and in the upper extremities. Five-year relapse-free and overall survival were not impacted by VTEs. Contrary to VTEs in adults, hypoalbuminemia and increased body mass index were not associated with an elevated risk of VTE.

Pharmacy and Exercise as Complimentary Partners for Successful Cardiovascular Ageing.

Diseases of the cardiovascular system have been the biggest cause of mortality for the majority of the last century, currently contributing to almost a third of deaths every year globally. Ageing associates with changes to the structure and function of the heart and vascular system that progressively increase the incidence of abnormalities, morbidity, and cardiovascular disease. The burden of ageing and its relationship to cardiovascular disease risk highlights the need for more research into the underlying mechanisms involved and how they may be treated and/or prevented. Factors influencing adrenergic dysfunction may explain a significant part of the age-related deterioration in health and responsiveness of the cardiovascular system. Increased sympathetic activity in old age overstimulates adrenergic receptors and causes detrimental changes within the associated signalling mechanisms, including a reduction in receptor number and downstream effector efficiency. Pharmacological agents, such as metformin, resveratrol, beta-blockers, and angiotensin converting enzyme (ACE) inhibitors, have been identified as potential anti-ageing therapies with cardiovascular effects, which may be beneficial in treating the decline in cardiovascular function with old age. Regular exercise has also shown promise in the prevention and treatment of harmful age-related effects on the cardiovascular system. This review will investigate age-associated vascular and cardiac remodelling, and the link between adrenergic dysfunction and vascular and cardiac control. This review will also consider whether pharmacological or non-pharmacological therapies are most effective, or indeed complimentary to potentially optimised ageing of the cardiovascular system and improved quality of life in the elderly.

Measuring the Wrong Thing the Right Way? Time to Rethink Autism Research Tools.

Awareness and understanding of autism are increasing, sometimes in small incremental steps and sometimes through paradigm shifts. Much of this is driven by autistic advocates, whose voices are increasingly recognized as experts in their own lived experiences. The growing presence of autistic people in autism research-as participants, advisors, and (co)researchers-has brought about changes in the quality and relevance of autism research. We are seeing more studies by autistic autism researchers, more studies on issues of importance to autistic people, and more studies utilizing methodologies that resonate with autistic people. However, there remains a reliance on measures that are technically "valid" and "reliable" rather than relevant. As long as this is the case, we will continue to see studies published that "explain autism" in ways that do not reflect autistic experiences. Autism research is still making incremental changes and it is time for a paradigm shift.

"Why is this topic important?": Research into the experiences of autistic people is used to inform policy, practice, and community understanding. It is important that autism research respects and reflects autistic voices. Current research often uses scientific instruments that are not consistent with our lived experience of autism. "What is the purpose of this article?": This article explains why the current approach to research­encouraging the use of existing measures and incremental change­is harmful to autism research and to autistic people. It provides examples of commonly used tools and explains why they are problematic. The article aims at encouraging a discussion into why the findings of autism research are often inconsistent with the experiences of autistic people. "What personal or professional perspectives do the authors bring to this topic?": I am an autistic adult, the mother of two autistic adults and an autism advocate. I am also an autism researcher with a background in public health and communication. "What is already known about this topic?": Academic journals aim at publishing papers that present the best and most accurate research projects. Researchers are encouraged to use tools that have been developed and tested in previous studies, because these are considered to be "reliable" (consistent) and "valid" (accurate). Researchers are discouraged from developing new measures or making major changes to existing ones. So, it can be hard to publish community-driven research that uses tools developed by autistic people. "What do the authors recommend?": I recommend that autism researchers ensure that the tools they use to study autism actually measure the experiences of autistic people. I also recommend that we stop relying on existing measures that do not make sense to autistic people and work with autistic people to develop better tools. "How will these recommendations help autistic adults now or in the future?": These recommendations will help autistic adults by making autism research more relevant and useful. Research that reflects our actual experiences will improve community understanding of autism. It will also lead to better policies and practices that meet the needs and aspirations of autistic people.

Inclusion, Exclusion and Isolation of Autistic People: Community Attitudes and Autistic People's Experiences.

There is limited research examining the inclusion of autistic people in their local communities. This paper reports on two Australian studies which explored this gap, focusing on both autistic people's experiences and non-autistic people's attitudes towards autistic individuals. Study One was conducted with primarily non-autistic people (n = 2,383), and Study Two with primarily parents and carers of autistic people (n = 1,297 people). The majority of non-autistic adults perceived discrimination against autistic people in the community; consistent with the experiences of autistic people and their carers. Of particular concern was more negative attitudes towards, and experiences of, autistic adults. There is an urgent need to improve society's acceptance and inclusion of autistic people of all ages.

Predictors of chlamydia or gonorrhea among people with HIV in Miami-Dade County Ryan White Program in 2017.

The purpose of this study was to assess the prevalence of chlamydia or gonorrhea and factors associated with the diagnoses among people with HIV (PHIV) in the Ryan White Program Part A (RWP) in Miami-Dade County, Florida. We used 2017 calendar year data to identify factors associated with a chlamydia or gonorrhea diagnoses using logistic regression. About 50% of the 7110 PHIV who were ≥18 years old in active Ryan White care in 2017 reported being screened for chlamydia or gonorrhea. Of those screened, 2.3% reported diagnoses of chlamydia, gonorrhea or both. In the adjusted model, compared to PHIV ≥40 years-old, PHIV aged 18-24 and 25-39 years reported higher odds of diagnoses (adjusted odds ratio [aOR] 4.29; 95% confidence interval [CI]: 1.73-10.63 and aOR 4.58; 95% CI; 2.62-7.99 respectively). Those with multiple sexual partners in the last 12 months reported higher odds of diagnoses (aOR 1.67; (95% CI; 1.04-2.69)). Screening rates for chlamydia or gonorrhea are low, relative to CDC guidelines. Interventions are needed to increase rates of screening and targeted behavioral risk reduction techniques are highly recommended among those 18-39 years of age and those who have multiple sexual partners.

The Role of the Dopamine Transporter in the Effects of Amphetamine on Sleep and Sleep Architecture in Drosophila.

The dopamine transporter (DAT) mediates the inactivation of released dopamine (DA) through its reuptake, and thereby plays an important homeostatic role in dopaminergic neurotransmission. Amphetamines exert their stimulant effects by targeting DAT and inducing the reverse transport of DA, leading to a dramatic increase of extracellular DA. Animal models have proven critical to investigating the molecular and cellular mechanisms underlying transporter function and its modulation by psychostimulants such as amphetamine. Here we establish a behavioral model for amphetamine action using adult Drosophila melanogaster. We use it to characterize the effects of amphetamine on sleep and sleep architecture. Our data show that amphetamine induces hyperactivity and disrupts sleep in a DA-dependent manner. Flies that do not express a functional DAT (dDAT null mutants) have been shown to be hyperactive and to exhibit significantly reduced sleep at baseline. Our data show that, in contrast to its action in control flies, amphetamine decreases the locomotor activity of dDAT null mutants and restores their sleep by modulating distinct aspects of sleep structure. To begin to explore the circuitry involved in the actions of amphetamine on sleep, we also describe the localization of dDAT throughout the fly brain, particularly in neuropils known to regulate sleep. Together, our data establish Drosophila as a robust model for studying the regulatory mechanisms that govern DAT function and psychostimulant action.

Operational Characteristics of Central Cancer Registries that Support the Generation of High-Quality Surveillance Data.

Objectives: We aim to assess external and internal attributes and operations of the Centers for Disease Control and Prevention (CDC)'s National Program of Cancer Registries (NPCR) central cancer registries by their consistency in meeting national data quality standards. Methods: The NPCR 2017 Program Evaluation Instrument (PEI) data were used to assess registry operational attributes, including adoption of electronic reporting, compliance with reporting, staffing, and software used among 46 NPCR registries. These factors were stratified by (1) registries that met the NPCR 12-month standards for all years 2014-2017; (2) registries that met the NPCR 12-month standards at least once in 2014-2017 and met the NPCR 24-month standards for all years 2014-2017; and (3) registries that did not meet the NPCR 24-month standards for all years 2014-2017. Statistical tests helped identify significant differences among registries that consistently, sometimes, or seldom/never achieved data standards. Results: Registries that always met the standards had a higher level of electronic reporting and a higher compliance with reporting among hospitals than registries that sometimes or seldom/never met the standards. Although not a statistically significant finding, the same registries also had a higher proportion of staffing positions filled, a higher proportion of certified tumor registrars, and more quality assurance and information technology staff. Conclusions: This information may be used to understand the importance of various factors and characteristics, including the adoption of electronic reporting, that may be associated with a registry's ability to consistently meet NPCR standards. The findings may be helpful in identifying best practices for processing high-quality cancer data.

Regulation of sinus node pacemaking and atrioventricular node conduction by HCN channels in health and disease.

The funny current, If, was first recorded in the heart 40 or more years ago by Dario DiFrancesco and others. Since then, we have learnt that If plays an important role in pacemaking in the sinus node, the innate pacemaker of the heart, and more recently evidence has accumulated to show that If may play an important role in action potential conduction through the atrioventricular (AV) node. Evidence has also accumulated to show that regulation of the transcription and translation of the underlying Hcn genes plays an important role in the regulation of sinus node pacemaking and AV node conduction under normal physiological conditions - in athletes, during the circadian rhythm, in pregnancy, and during postnatal development - as well as pathological states - ageing, heart failure, pulmonary hypertension, diabetes and atrial fibrillation. There may be yet more pathological conditions involving changes in the expression of the Hcn genes. Here, we review the role of If and the underlying HCN channels in physiological and pathological changes of the sinus and AV nodes and we begin to explore the signalling pathways (microRNAs, transcription factors, GIRK4, the autonomic nervous system and inflammation) involved in this regulation. This review is dedicated to Dario DiFrancesco on his retirement.