Search

Importance: Few studies are available on informed consent (IC) among detained persons, even with ethics being a critical aspect of prison research. In IC research, audiovisual material seems to improve understanding and satisfaction compared with conventional paper-based material, but findings remain unclear., Objective: To compare audiovisual and paper-based materials for 1-time general IC for research in prisons., Design, Setting, and Participants: This cross-sectional randomized clinical trial was conducted in 2 corrections facilities in Switzerland (an adult prison and a juvenile detention center). The study was conducted from December 14, 2019, to December 2, 2020, in the adult prison and from January 15, 2020, to September 9, 2021, in the juvenile detention center. In the adult prison, study participation was offered to detained persons visiting the medical unit (response rate, 84.7%). In the juvenile detention center, all newly incarcerated adolescents were invited to participate (response rate, 98.0%)., Interventions: Participants were randomized to receive paper-based conventional material or to watch a 4-minute video. Materials included the same legal information, as required by the Swiss Federal Act on Research Involving Human Beings., Main Outcomes and Measures: The main outcome was acceptance to sign the IC form. Secondary outcomes included understanding, evaluation, and time to read or watch the IC material., Results: The study included 190 adults (mean [SD] age, 35.0 [11.8] years; 190 [100%] male) and 100 adolescents (mean [SD] age, 16.0 [1.1] years; 83 [83.0%] male). In the adult prison, no significant differences were found between groups in acceptance to sign the IC form (77 [81.1%] for paper-based material and 81 [85.3%] for audiovisual material; P = .39) and to evaluate it (mean [SD] correct responses, 5.09 [1.13] for paper-based material and 5.01 [1.07] for audiovisual material; P = .81). Understanding was significantly higher in the audiovisual material group (mean [SD] correct responses, 5.09 [1.84]) compared with the paper-based material group (mean [SD] correct responses, 4.61 [1.70]; P = .04). In the juvenile detention center, individuals in the audiovisual material group were more likely to sign the IC form (44 [89.8%]) than the paper-based material group (35 [68.6%], P = .006). No significant difference was found between groups for understanding and evaluation. Adults took a mean (SD) of 5 (2) minutes to read the paper material, and adolescents took 7 (3) minutes., Conclusions and Relevance: Given the small benefit of audiovisual material, these findings suggest that giving detained adults and prison health care staff a choice regarding IC material is best. For adolescents, audiovisual material should be provided. Future studies should focus on increasing understanding of the IC process., Trial Registration: ClinicalTrials.gov Identifier: NCT05505058.

Objective: To develop and evaluate a new filter paper method to determine capillary blood lead levels accurately in children., Design: Paired comparison of lead levels determined in capillary whole blood dried on filter paper with lead levels in venous whole blood samples determined by a reference method., Setting: Children's Hospital of Michigan clinics, Detroit., Patients: One hundred children aged 9 months to 6 years., Interventions: Lead concentrations determined in capillary whole blood samples dried on filter paper were compared with concentrations measured in paired venous whole blood samples by a reference method., Main Outcome Measures: Comparability of the two lead assay methods was assessed with the concordance coefficient. The sensitivity, specificity, and positive predictivity of the capillary filter paper method relative to the reference method were determined at three intervention decision concentrations of blood lead defined by the Centers for Disease Control and Prevention., Results: There was high agreement between the two assay methods, with a concordance coefficient of O.96. The capillary filter paper assay had a sensitivity of 90% and specificity of 90% for differentiating blood lead levels of 0.48 mumol/L (10 micrograms/dL) or more. Blood lead levels of 0.72 mumol/L (15 micrograms/dL) or more and 0.96 mumol/L (20 micrograms/dL) or more were identified with 98% and 94% sensitivity and 98% and 99% specificity, respectively. Positive predictivity was 93%, 98%, and 97%, respectively, at the three blood lead concentration decision points., Conclusion: The capillary filter paper method for blood lead analysis described herein provides a convenient, sensitive, accurate, and inexpensive method to examine children for elevated blood lead levels.

The article focuses on calling for papers on "Health and the 2024 Elections Globally," highlighting the significant influence of governments on health policies and inviting submissions to the periodical that address healthcare issues in national, regional or global contexts during election years.

Many reports of medical research do not discuss the varying opinions of the different authors and whether or not they agree with the final report of the research. In a survey of 36 co-authors of 10 papers published in The Lancet, the editor found that many of the contributing authors had interpretations and concerns that were not mentioned in the article., Context: To determine whether the views expressed in a research paper are accurate representations of contributors' opinions about the research being reported. Methods: Purposive sampling of 10 research articles published in The Lancet; qualitative analysis of answers to 6 questions about the meaning of the study put to contributors who were listed on the byline of these articles. Fifty-four contributors listed on the bylines of the 10 articles were evaluated, and answers to questions were compared between contributors within research groups and against the published research report. Results: A total of 36 (67%) of 54 contributors replied to this survey. Important weaknesses were often admitted on direct questioning but were not included in the published article. Contributors frequently disagreed about the importance of their findings, implications, and directions for future research. I could find no effort to study systematically past evidence relating to the investigators' own findings in either survey responses or the published article. Overall, the diversity of contributor opinion was commonly excluded from the published report. I found that discussion sections were haphazardly organized and did not deal systematically with important questions about the study. Conclusions: A research paper rarely represents the opinions of those scientists whose work it reports. The findings described herein reveal evidence of (self-)censored criticism, obscured meanings, confused assessment of implications, and failures to indicate directions for future research. There is now empirical support for the introduction of structured discussion sections in research papers. Editors might also explore ways to recover the plurality of contributors' opinions.

The article focuses on the bacterial aspects of dirty money and the historical concern regarding the transmission of infectious material through currency. While previous worries highlighted the potential danger of dirty paper money, bacteriological investigations failed to find significant microbial distribution on paper currency, suggesting that the composition of printed bills might inhibit bacterial growth.

Context: To compare family physicians' ability to retain information when reading a review article on paper vs on screen, and in their mother tongue vs in English., Methods: Randomized trial of 114 Scandinavian family physicians who read a review article in October or November 2000 from the Journal of Trauma for 10 minutes either on paper and in English, on screen and in English, on paper in their mother tongue, or on screen in their mother tongue. To assess comprehension, they immediately completed a questionnaire with 6 open questions about 13 key facts from the review article. Sum score was on a scale from 0 (no correct answers) to 13 points (all questions answered correctly)., Results: There was no significant difference between readers of paper vs screen versions, with a median (interquartile range [IQR]) of 4 (2-6) vs 4 (2-5), respectively (P =.97). Physicians who read in their mother tongue scored significantly higher than those who read in English, with a median (IQR) of 4 (3-6) vs 3 (2-4) (P =.01)., Conclusion: The medium (paper vs screen) did not influence the ability of family physicians to retain medical information. They best retained medical information when reading in their mother tongue.

Authors' contributions to medical articles cannot always be determined by the place of their names in a paper's author list. A total of 184 first authors of papers with four or more authors rated the contributions of the other authors to their scientific papers. The author listed first is traditionally considered to have conducted the majority of the research. The remaining authors are usually listed in descending order of contributions to the research. For example, the second author would theoretically have contributed more than the third. Among nonfirst authors there was wide inconsistency in their contributions to papers. Of the 184 authors who were reported to have contributed to only one substantial area of the research, 14% were second authors, 79% were middle authors and 7% were last authors. Twenty-six percent of all authors appeared to have made only a negligible contribution to the research. These authors appeared more frequently in papers with greater numbers of authors. Papers with many authors appear to reduce individual responsibility for research results.

The National Society of Genetic Counselors has issued guidelines for physicians who offer their patients genetic tests to see if the patient has a predisposition for a specific disease. Many genetic diseases do not produce symptoms until late in adulthood. Physicians should discuss the nature of the test as well as its risks, limitations and benefits. After the patient has been tested, the physician should explain the results and offer psychological support by a team of social workers, psychologists and genetic counselors. All tests should be done by laboratories certified by the federal government.

A 27-year-old woman experienced pruritus, eye and throat irritation, hoarseness, shortness of breath, and fatigue within half and hour of exposure to carbonless copy paper. On two separate occasions, she was purposely challenged in a controlled-blinded fashion with portions of the carbonless copy paper. This resulted on both occasions in contact urticaria of the hand that held the paper and changes in pulmonary function flow-volume loops characteristic of upper airway obstruction. To determine if alterations in prostaglandin (PG) metabolism might explain these findings, plasma PGF2 alpha and thromboxane B2 (both capable of causing these symptoms) were measured before and during the second exposure period. Both PGF2 alpha and thromboxane B2 increased substantially. We conclude that the cutaneous and respiratory symptoms induced by carbonless copy paper were probably related to PG release.

There appears to be little difference in scores given to medical manuscripts that are reviewed by blinded peer reviewers and those that are reviewed by non-blinded peer reviewers. Blinding in peer review means the reviewer does not know who wrote the article. Of 108 blinded peer reviewers assigned to evaluate 57 submitted manuscripts, almost half correctly guessed the identity of the authors. Blinded peer reviewers were slightly more inclined to give higher scores to authors who had previously published material, probably due to the higher quality of the writing than to their possible familiarity with the author. Non-blinded reviewers tended to score manuscripts from experienced authors no higher than manuscripts from less-experienced authors. This might indicate that non-blinded reviewers may be biased against certain authors., Objective.--To study whether reviewers aware of author identity are biased in favor of authors with more previous publications. Design.--Randomized controlled trial. Setting.--Editorial office of the Journal of Developmental and Behavioral Pediatrics. Participants.--Two "blinded" and two "nonblinded" reviewers assigned to 57 consecutive manuscripts submitted between September 1991 and March 1992. Outcome Measures.--Spearman rank correlation coefficients were used to compare the sum of rating scores of 1 to 5 (1, accept; 5, reject) given by the two blinded reviewers, the two nonblinded reviewers, and the editors to the number of articles published previously by the first and senior authors (as determined from requested curricula vitae). Blinded reviewers were sent a questionnaire asking whether they could determine the identity of the authors, how they knew, and whether they thought blinding changed the quality or difficulty of their review. Results.--The Wilcoxon Sign Rank Test disclosed no differences between blinded and nonblinded scores. The number of previous articles by the senior author was significantly correlated (P

The article focuses on concerns raised in response to a recent Viewpoint discussing the threats and opportunities associated with the rapid growth of mega-journals. It authors express concerns about issues not discussed in the original Viewpoint, such as the integrity of medical literature due to special issue manipulation, retraction rates, and paper-mill articles in mega-journals.

Researchers at Johns Hopkins University School of Medicine have begun a conference on the Internet to solicit advice and to upload electronic documents representing much of the scientific research of Johns Hopkins' psychobiologist Curt P. Richter. Richter worked at the University from 1919 until his death in 1988. His archives include 800 logbooks of scientific data, which can be scanned into electronic format. Most of the records are on acidic paper that is contaminated with lead and paint and could not be archived successfully.

JAMA: Journal of the American Medical Association has published a Special Communication titled "The Integration of Clinical Trials With the Practice of Medicine: Repairing a House Divided," which discusses the need to integrate clinical trials with clinical practice. The authors highlight the separate missions and infrastructures of clinical trialists and clinicians, leading to inefficiencies and limitations in trials. They propose solutions such as implementation science, novel statistical analysis approaches, and integration of trials with electronic health records. JAMA is launching a new series called "Integrating Clinical Trials and Practice" to explore innovations in trial design, funding, regulation, education, and application. The goal is to align clinical trials with clinical practice and improve patient care. [Extracted from the article]

Research papers that are submitted to medical and scientific journals for publication may be evaluated by the journals in various ways. Based on the review process, journal editors decide whether to accept the manuscript as is, require revisions, or reject the manuscript. One aspect of the editorial process that receives varying amounts of attention from the editorial boards at different journals is statistical assessment. The British Medical Journal has consistently recognized the need for careful evaluation of the statistical procedures reported in manuscripts. The editors screen articles and recommend which should be submitted for a thorough review by a statistician. A study was performed to monitor how well this system is working at the British Medical Journal. The percentage of papers judged to be statistically acceptable at the time of first submission was only 11 percent, but had improved substantially to 84 percent after publication. These results were encouraging, but also indicated that the system could be improved, since several articles had not been properly revised but were still published. The statistical areas that were most frequently found unacceptable were sample size calculations, confidence intervals, and the method of randomization. (Consumer Summary produced by Reliance Medical Information, Inc.)