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The psychometric properties of the paper-pencil and online versions of the Beliefs Toward Mental Illness Scale (BTMI) were examined in two studies with Latina/o individuals. In Study 1, 316 Latina/o participants completed the BTMI in a paper-pencil mode. The original three-factor model was found to be a poor fit model for the sample. Subsequent exploratory and confirmatory factor analyses identified a four-factor model as the best fitting model for the sample. The identified factors were Dangerousness, Social Dysfunction, Incurability, and Embarrassment. In Study 2, the identified best fit model was tested with 280 Latina/o participants who completed the BTMI online. The four-factor model had adequate fit. A series of measurement invariance tests on the fit model supported equal factor loadings, but rejected equivalent intercepts across paper-pencil and online administration methods, though partially equivalent intercepts and residuals were found. Consequently, modality-specific norms are recommended, depending on whether paper-pencil or online venues are utilized for administration.

Tablet computers have emerged as increasingly useful tools in medical education, particularly for assessment. However, it is not fully established whether tablet computers influence the quality and/or quantity of feedback provided in high stakes assessments. It is also unclear how electronically-recorded feedback relates to student performance. Our primary aim was to determine whether differences existed in feedback depending on the tool used to record it., Methods: We compared quantitative and qualitative feedback between paper-scoring sheets versus iPads™ across two consecutive years of a final year MBChB (UK medical degree) Objective Structured Clinical Examination. Quality of comments (using a validated five-point rating scale), number of examiner comments and number of words were compared across both methods of recording assessment performance using chi-squared analysis and independent t-test. We also explored relationships between student performance (checklist and global scoring) and feedback., Results: Data from 190 students (2850 paper scored interactions) in 2015 and 193 (2895 iPad™ scored interactions) in 2016 were analysed. Overall, a greater number of comments were given with iPad™ compared to written (42% versus 20%; p < 0.001) but the quality of feedback did not differ significantly. For both written and electronic feedback, students with low global scores were more likely to receive comments (p < 0.001)., Conclusion: The use of iPads™ in high stakes assessment increases the quantity of feedback compared to traditional paper scoring sheets. The quantity and quality of feedback for poorer performing candidates (by global score) were also better with iPad™ feedback., Competing Interests: No conflict of interests declared

Background: In our contemporary world, while part of the fibers used in the paper industry is obtained from primary fibers such as wood and agricultural plants, the rest is obtained from secondary fibers from waste papers. To manufacture paper with high optical quality from fibers of recycled waste papers, these papers require deinking and bleaching of fibers at desired levels. High efficiency in removal of ink from paper mass during recycling, and hence deinkability, are especially crucial for the optical and printability quality of the ultimate manufactured paper., Methods: In the present study, deinkability and printability performance of digitally printed paper with toner or inkjet ink were compared for the postrecycling product. To that end, opaque 80 g/m 2 office paper was digitally printed under standard printing conditions with laser toner or inkjet ink; then these sheets of paper were deinked by a deinking process based on the INGEDE method 11 p. After the deinking operation, the optical properties of the obtained recycled handsheets were compared with unprinted (reference) paper. Then the recycled paper was printed on once again under the same conditions as before with inkjet and laser printers, to monitor and measure printing color change before and after recycling, and differences in color universe., Results: Recycling and printing performances of water-based inkjet and toner-based laser printed paper were obtained. The outcomes for laser-printed recycled paper were better than those for inkjet-printed recycled paper., Conclusions: Compared for luminosity Y, brightness, CIE a* and CIE b* values, paper recycled from laser-printed paper exhibited higher value than paper recycled from inkjet-printed paper.

Background: Paper is one of the important inputs for the printing industry, and the most important leading parameter in the printing process is its brightness. Brightness can be brought to paper using coatings and sizing. Desired surface properties and, most importantly, surface roughness can be achieved by changing the contents of the coating and sizing of the materials it contains. The use of biomaterials is becoming more important in the paper industry, as they represent substances with a lower carbon footprint. Fish scales are already used as a filling material, cosmetic material and fish food, as well as for determining the age of fish., Methods: Fish scales were brought to different sizes by a milling process. Paper formulations including different amounts of fish scales were prepared with fish scales, and coatings on raw paper were subjected to test printings in IGT-C1, with formulations and physical characteristics of coatings such as brightness, lightfastness, strength, adhesion etc. being determined., Results: Regarding the value of yellowness, mixtures of 2.5%-10% can be used. The maximum value of brightness was obtained from a mixture of 10%. Aging visibly changed the colors., Conclusions: The coatings obtained were brighter than the initial coating compositions. The top quality formulation was the coating with 5% medium-sized fish scale particles.

In addition to the widespread availability of packaged cigarettes, the inhabitants of island nations of the Southwest Pacific frequently smoke commercially available loose tobacco using manufactured rolling papers, as well as locally grown tobacco rolled in manufactured rolling paper or wrapped in leaves, copybook paper, and newspaper. In this study, Vanuatu men who smoked local tobacco rolled in leaves, copybook paper, or newspaper showed significantly lower forced vital capacity (FVC), forced expiratory volume in 1 second (FEV 1 ), and FEV 1 /FVC ratios than men who smoked packaged cigarettes, store-bought tobacco rolled in manufactured rolling paper, or who smoked locally grown tobacco rolled in manufactured rolling papers. The addition of toxins from these unusual tobacco-wrapping media produces lung function deficits similar to the pattern noted among tobacco smokers who also inhale smoke from burning biomass. Thus, public health initiatives should consider including strategies addressing the use of wrapping media among smokers in South Pacific island societies.

Use of a smartphone as an optical detector for paper microfluidic devices has recently gained substantial attention due to its simplicity, ease of use, and handheld capability. Utilization of a UV light source enhances the optical signal intensities, especially for the particle immunoagglutination assay that has typically used visible or ambient light. Such enhancement is essential for true assimilation of assays to field deployable and point-of-care applications by greatly reducing the effects by independent environmental factors. This work is the first demonstration of using a UV LED (UVA) to enhance the Mie scatter signals from the particle immunoagglutination assay on the paper microfluidic devices and subsequent smartphone detection. Smartphone's CMOS camera can recognize the UVA scatter from the paper microfluidic channels efficiently in its green channel. For an Escherichia coli assay, the normalized signal intensities increased up to 50% from the negative signal with UV LED, compared with the 4% to 7% with ambient light. Detection limit was 10 colony-forming units/mL. Similar results were obtained in the presence of 10% human whole blood.

Background: Until now, environmental sustainability issues are almost entirely unsolved for packaging materials. With the final aim of finding materials with a single recycling channel, cellulose fiber/poly(vinyl)alcohol composites were investigated., Methods: After extrusion and injection molding, samples of composite with different cellulose fiber content (30%, 50% and 70% w/w) were tested., Results: Tensile mechanical tests exhibited an improvement in composite stiffness when the reinforcement content was increased together with a decrease in composite elongation. Solubility tests performed at room temperature and 45°C showed different behavior depending on the water-resistant film applied on the composite (50% cellulose fiber content). In particular, the uncoated composite showed complete solubility after 2 hours, whereas at the same time point, no solubility occurred when a non-water-soluble varnish was used., Conclusions: The proposed composites, named Poly-paper, appear to warrant further investigation as highly sustainable packaging.

Introduction: End-of-life surgical care is a major concern with a significant number of operations performed within the last year of life; surgery for hip fractures is a prime example. Unfortunately, no simple objective tool exists to assess life expectancy in the postoperative period. The goal of our study was to analyze 2 simple geriatric life expectancy calculators to compare with the current Veterans Affairs Surgical Quality Improvement Program (VASQIP) postoperative 30-day mortality calculator., Methods: This retrospective study assessed the utility of 3 validated calculators in 47 hip fracture repairs from July 2009 to May 2011. The tools included: 30-day VASQIP mortality calculator, 6-month Minimum Data Set Mortality Risk Index-Revised (MMRI-R), and Four-Year Mortality Index. The VASQIP calculator requires chart review, Current Procedural Terminology (CPT) codes, and laboratory analysis, whereas the mortality risk indices require simple patient questioning if prospective or simple chart review if retrospective. Scoring was performed and mortality risk was compared between survivors and nonsurvivors., Results: A total of 47 hip fractures were repaired during the study period with 37 survivors and 10 nonsurvivors. In all, 7 died within 30 days, 2 died within 6 months, and 1 died greater than 6 months after surgery. The mean age (standard deviation [SD]) of all patients undergoing hip fracture repair was 73.6 (13.3) years. The VASQIP calculator mean (SD) 30-day mortality risk was 10.4% (5.4) for nonsurvivors compared to survivors 4.3% (5.5), P < .003; the MMRI-R mean (SD) mortality risk was 35.8% (15.4) for nonsurvivors compared to survivors 14.7% (9.5), P < .001; the Four-Year Mortality Index mean (SD) mortality risk was 60.9% (16.9) for nonsurvivors compared to survivors 48.9% (24.4), P < .09., Conclusion: Overall, the VASQIP 30-day and MMRI-R 6-month mortality calculators showed significant differences in mortality risk between survivors versus nonsurvivors in a population with hip fracture. In contrast, the Four-Year Mortality calculator may not sufficiently discriminate operative risk. The easily obtained MMRI-R has the potential to provide information on short-term postoperative mortality risk.

Low health literacy is associated with poor health outcomes. Research is needed to understand the mechanisms and pathways of its effects. Computer-based assessment tools may improve efficiency and cost-effectiveness of health literacy research. The objective of this preliminary study was to assess if administration of the Short Test of Functional Health Literacy in Adults (STOFHLA) through a computer-based medium was comparable to the paper-based test in terms of accuracy and time to completion. A randomized, crossover design was used to compare computer versus paper format of the STOFHLA at a Midwestern family medicine residency program. Eighty participants were initially randomized to either computer (n = 42) or paper (n = 38) format of the STOFHLA. After a 30-day washout period, participants returned to complete the other version of the STOFHLA. Data analysis revealed no significant difference between paper- and computer-based surveys (p = .9401; N = 57). The majority of participants showed "adequate" health literacy via paper- and computer-based surveys (100% and 97% of participants, respectively). Electronic administration of STOFHLA results were equivalent to the paper administration results for evaluation of adult health literacy. Future investigations should focus on expanded populations in multiple health care settings and validation of other health literacy screening tools in a clinical setting.

Background: Questionnaires are often used to quantify the subjective aspects of illness such as disability, coping strategies, or symptoms of depression. Most questionnaires were validated in a paper-based format, but direct entry into a computer is becoming commonplace. The aim of this study was to assess differences in outcome of questionnaires pertinent to hand and upper extremity illness when they were administered in a computer or paper format., Methods: Ninety-nine patients completed both paper and web versions of the short forms of the Disabilities of Arm, Shoulder, and Hand; the Pain Catastrophizing Scale; the Short Health Anxiety Index (SHAI-6); the Patient Health Questionnaire Depression Scale; and a pain scale and the Pain Self-Efficacy Questionnaire sequentially during a single visit. We alternated starting with the paper or the web version after every five patients., Results: The cohort consisted of 46 females and 53 males with a mean age of 49 years. There were significant differences in SHAI-6 and the pain scale, but not in the other measures. The intraclass correlation was high., Conclusions: The use of these questionnaires in electronic format is valid provided that the small differences we observed are not important to the primary study question. In our opinion, for most studies, the advantages of using an electronic format outweigh the small additional variation that might be introduced in the measures in an electronic format.

This study examined the psychometric equivalence of paper-and-pencil and Internet formats of key questionnaires used in couple research. Self-report questionnaires assessing interpersonal constructs (relationship satisfaction, communication/conflict management, partner support, emotional intimacy) and intrapersonal constructs (individual traits, psychological symptoms, contextual influences) were administered to young adults in committed dating relationships. The same measures were administered twice via paper-and-pencil and/or Internet methods over a 2-week period. Method order was counterbalanced among participants, and temporal stability was controlled. Intrapersonal and interpersonal measures generally remained reliable when administered online and demonstrated quantitative and qualitative equivalence across methods. The implications of online administration of questionnaires are discussed, and specific recommendations are made for researchers who wish to transition to online data collection.

This study investigates the measurement equivalence of a five-factor measure of personality across two groups applying for jobs, who completed the same questionnaire using either a paper-and-pencil (n = 429) or a web online answer format (n = 651). The data were collected using the Big Five Questionnaire-2 (BFQ-2; which is a measure of the Five Factor Model) of personality traits. Multiple-group confirmatory factor analysis was used to test for the equivalence of factor covariance and mean structures of the BFQ-2. Findings suggested that the Five Factor Model scales have the same measurement unit and origin across applicants using different administration modes. However, latent means were slightly higher for applicants who responded in a web and unproctored condition than for applicants who completed a paper-and-pencil version of the same test. Practical implications for personality assessment are discussed.

The introduction of an electronic medical record (EMR) has been rapidly accelerating in South Korea. The EMR was expected to improve quality of care, readability, availability, and the quality of data. However, the reluctance of healthcare providers to use the EMR may have caused a reduction of information recorded in EMRs. The purpose of this study was to identify whether there was any loss of information following the introduction of a narrative text-based EMR in the recording of chief complaint and present illness in inpatient medical records. Inpatient medical records of a university hospital were retrospectively evaluated for one month before and one month after the introduction of the EMR in June 2006. The volume of information for chief complaint and present illness was measured by number of words in Korean and normalised bytes. Change in volume of information was measured by two-way ANOVA and multiple regression analyses, controlling for doctors' gender, age, and grade/year of residents, patients' readmission status, reasons for admission and service department to assess any effect of the introduction of an EMR. Total numbers of paper-based medical records (PMRs) and EMRs for analysis were 1,159 and 1,122, respectively. Forty-three doctors participated in the study. Thirty-one (72%) doctors were less than 30 years of age. Number of words proved a better outcome measure (R²=22 for CC, R²=36 for PI) than normalised bytes (R²=18 for CC, R²=35 for PI) for measuring volume of information. Results showed that the volume of information in the chief complaint and present illness was not decreased after the introduction of the EMR, except when the dependent variable was measured by number of words in the present illness. The study showed that the introduction of the EMR did not reduce the volume of information documented for chief complaint and present illness in inpatient medical records. However, further studies are needed to identify how to control the probable loss of information as showed in present illness measured by number of words.

Generally, handmade paper industries are considered as eco-friendly industries. These industries are known to use vegetable dyes which are thought to be safe and non-toxic. However, cardboard industries are considered as pollution-causing industries. The present study focuses on the genotoxic assessment of handmade paper and cardboard industry's effluent by Ames test using Salmonella typhimurium TA 98 and TA 100 strains. On mutagenicity analysis, effluents of both industries were found to be mutagenic with either one strain of Salmonella typhimurium or with both. Besides this, no significant difference was observed in effluent of both small-scale and large-scale handmade paper industries. Moreover, mutagenic compounds reach the nearby water body i.e. Amani Shah Drainage through connecting drain. Discharging of untreated effluent not only deteriorates the water quality but also reaches the food chain when used for irrigating nearby fields. Workers of these industries may suffer various health hazards when they are exposed to mutagenic effluent without having any information about it. Hence, discharging of effluents should thus be restricted or the workers while handling mutagenic substances should at least take proper precautions.

Although the use of computerized testing in psychopathology assessment has increased in recent years, limited research has examined the impact of this format in terms of potential differences in test validity rates. The current study explores potential differences in the rates of valid and invalid Minnesota Multiphasic Personality Inventory-2 (MMPI-2) protocols between computerized and paper-and-pencil administrations. Participants were 387 undergraduate students (157 men and 230 women) from a Midwestern university who completed either a computerized version or a paper-and-pencil version of the MMPI-2. Chi-square analyses revealed some important differences between administration modalities by gender. Overall, results indicated that although no differences existed in the computerized version, men were more likely to invalidate the paper-and-pencil version. Furthermore, although less likely overall to produce invalid MMPI-2 results, women were more likely to invalidate the paper-and-pencil version via random responding compared with the computerized version. Limitations and future directions are discussed.

Toxicity of dye containing effluent of tannery, textile, dyes and pulp-paper industries was evaluated in an acute toxicity test using Daphnia magna. The 48-hour EC(50) values were 4.33% and 19.5% for tannery effluents (Tn1 and Tn2). Textile effluents (Tx1-Tx7) had 48-hour EC(50) values; >100%, >100%, 62.9%, 63.0%, 40.3%, >100% and >100%, respectively. Dye industries (D1-D7) had 48-hour EC(50) values; 14.1%, 15.5%, 24.5%, 29.7%, 23.2%, >100% and >100%, respectively. Similarly pulp-paper effluents (P1-P5) showed acute toxicity as 100%, 77.87%, 46.44%, 69.55% and 82.84%, respectively. These results showed linear relationship with high degree of confidence (r(2) ≥ 0.84-0.99) between immobility and test concentrations. Toxicity classification criteria showed that out of five effluents from pulp-paper mill, four were minor acutely toxic having 48-hour EC(50) value in between >46%-100%. Out of seven textile effluents, four were not acutely toxic (48-hour EC(50) value >100%) and three were minor acutely toxic (48-hour EC( 50) value in the range of 40.3%-63.0%). Similarly, out of seven dye industrial effluents, two were not acutely toxic and five minor acutely toxic. One of the two tanneries was moderately acutely toxic and another one was minor acutely toxic. Classification based on toxic unit revealed that four out of five pulp-paper effluent, three out of seven textile effluents, five out of seven dye effluents and both the tannery effluents were toxic. Overall, 66.67% effluents were found toxic and 33.33% as non-toxic. In general, tannery and dyes effluents showed more toxicity than textile and paper mill effluents.

The psychometric properties of two paper-and-pencil versions of the Children's Attributional Style Interview (i.e., CASI-I and CASI-II) were evaluated in a sample of 166 third and fourth graders and a sample of 245 sixth and seventh graders. The results demonstrated strong internal consistency reliability, convergent validity, and a factor structure that was consistent with theory in both samples. Furthermore, analyses demonstrated adequate evidence of the reliability and validity of several dimensional subscale scores and the composite measures of attributional style for both positive and negative events. These results suggest the utility of the CASI in research testing specific attributional predictions of cognitive theories of depression with the dimensional subscale scores. They further add to the literature by demonstrating item-level factor analytic support for a children's attributional style measure and the feasibility of administration sizes larger than previously tested, which add to the utility of the CASI in large-scale research designs.

The authors examined whether paper-and-pencil and Web surveys administered in the school setting yield equivalent risk behavior prevalence estimates. Data were from a methods study conducted by the Centers for Disease Control and Prevention (CDC) in spring 2008. Intact classes of 9th- or 10th-grade students were assigned randomly to complete a survey via paper-and-pencil or Web. Data from 5,227 students were analyzed using logistic regression to identify associations of mode with reporting of 74 risk behaviors. Mode was associated with reporting of only 7 of the 74 risk behaviors. Results indicate prevalence estimates from paper-and-pencil and Web school-based surveys are generally equivalent.

Web-based surveys have become more prevalent in areas such as evaluation, research, and marketing research to name a few. The proliferation of these online surveys raises the question, how do response rates compare with traditional surveys and at what cost? This research explored response rates and costs for Web-based surveys, paper surveys, and mixed-mode surveys. The participants included evaluators from the American Evaluation Association (AEA). Results included that mixed-mode, while more expensive, had higher response rates.

Although the potential benefits of computer-based records have been identified in different areas of the healthcare environment, in many settings paper-based records and computer-based records are still used in parallel. In this article, emergency department (ED) staff perspectives about the use of paper- or computer-based records are presented. This was a qualitative study in which data were collected using in-depth semi-structured interviews with the ED staff. The interviews were transcribed verbatim and data were analysed using framework analysis. In total, 34 interviews were undertaken. The study identified a number of factors which might encourage or discourage the use of paper-based and computer-based records in the ED. Users also expressed their concerns and expectations. Although there is a tendency towards computerizing healthcare settings, user acceptance of technology should not be underestimated. To improve user acceptance, users' concerns should be investigated and addressed appropriately.

Organic dust exposure can influence the development and symptoms of immune-related diseases such as atopy and asthma, but has rarely been examined in relation to systemic autoimmunity. The present analyses explore the association of lifetime farm and occupational organic dust exposures with systemic lupus erythematosus (SLE) in recently diagnosed patients (n = 265) compared with controls (n = 355) frequency matched by age, sex and state. Questionnaire data included childhood farm residence, childhood and adult experience with specific crops, and adult work in textiles, hog or poultry processing and paper or furniture manufacture. Adjusted odds ratios (OR) and 95% confidence intervals (CI) were estimated by logistic regression models including age, sex, state, race, education and silica exposure. Overall childhood or adult farm contact and childhood farm residence were not associated with SLE. Farm contact with livestock was inversely associated with SLE (OR = 0.55, 95% CI 0.35, 0.88). This effect was most pronounced among those with childhood farm residence and both childhood and adult livestock exposure (OR = 0.19; 95% CI 0.06, 0.63), but was difficult to separate from adult exposure to grains or corn. Other adult occupational exposures were not associated with SLE risk overall, regardless of childhood farm residence or livestock exposure, although an inverse association was seen among non-smokers (OR = 0.59; 95% CI 0.33, 1.1), particularly for textile work (OR = 0.34; 95% CI 0.19, 0.64). These exploratory findings support the development of studies to specifically investigate the effects of organic dust exposure on SLE risk, with particular attention to exposure assessment and characterization of demographics, smoking and other occupational exposures.

This article describes rates of missing item responses in personal digital assistant (PDA) assessments as compared to paper assessments. Data come from the evaluation of a classroom-based leisure, life skills, and sexuality education program delivered to high school students in Cape Town, South Africa. Analyses show that the paper assessments had much higher rates of missing-ness than PDA assessments. This association is moderated by item order. Certain analyses also suggest that paper assessments have higher rates of missingness for items pertaining to participants' sexual behavior. Implications of these results for evaluation research will be discussed.

This qualitative study explored characteristics of a record-keeping log that students would find appealing and be receptive to using. A heterogeneous sample of undergraduate university students aged 18 to 25 years participated. An experienced moderator, using a semistructured interview guide, conducted 13 focus groups (N = 65). All focus groups were audio-recorded and transcribed verbatim. Inductive content analysis was conducted independently by two qualitative researchers. Measures were incorporated throughout the study to ensure data trustworthiness. Four themes illustrated students' suggestions for the log: layout, convenience, maximum distribution, and concerns. In particular, students discussed the use of a computer-based versus a paper-based log, hesitancies in using a log, and the need for: additional health information, multivenue distribution, and low to no cost. Students confirmed that a record-keeping log tailored to their needs and preferences would be attractive and appealing to students.

Background: The toes play an important stabilizing role in weightbearing activities. However, the factors that influence toe plantarflexion strength are poorly understood, and there are no validated measures for assessing toe weakness in the clinical setting. Therefore, the objectives of this study were to determine whether plantarflexion strength of the toes differs according to age and gender and to evaluate the validity of a clinical screening test for assessing toe plantarflexor weakness (the paper grip test)., Methods: Plantarflexion strength of the hallux and lesser toes was measured in 40 young participants (20 men and 20 women, mean age 20.8 +/- 2.2 years) and 40 older participants (20 men and 20 women, mean age 74.6 +/- 5.7 years) using a pressure platform in conjunction with clinical assessment using the paper grip test., Results: Older participants exhibited 32% less plantarflexion strength of the hallux and 27% less plantarflexion strength of the lesser toes compared to younger participants, and women exhibited 42% less hallux plantarflexor strength than men. Gender did not influence lesser toe plantarflexor strength. Participants who failed the paper grip test exhibited significantly reduced plantarflexion strength for both the hallux and lesser toes. The sensitivity and specificity of the paper grip test of the hallux to predict plantarflexor strength less than 2.6 kg was 80% and 79%, respectively, and the sensitivity and specificity of the paper grip test of the lesser toes to predict plantarflexor strength less than 2.2 kg was 75% and 74%, respectively., Conclusions: These findings indicate that aging is associated with reduced plantarflexion strength of the toes. The paper grip test may be a useful screening tool to detect toe weakness in the clinical setting.

Digital EEG technology has facilitated the recording of fast activity above 50 Hz, but previous work carried out in this field is, commonly, no longer referred to in the literature. This paper presents a summary of our experience in experimental epilepsy when frequencies above 100 Hz were recorded. It was shown that conventional recordings (1-70 Hz) do not correlate with the onset of clinical seizures and can actually lead to misleading neurophysiologic conclusions. Ultrafast activity (100-1500 Hz), on the other hand, showed excellent correlation with clinical behavior and pointed to the low brainstem for the origin of nonfocal tonic-clonic seizures. In the animal analogue of absence seizures the cortex, including cingulate gyrus, thalamus, and cerebellum, showed greater involvement than other brain structures. Ultrafast activity has a very limited electrical field, and evoked responses remain restricted to the corresponding sensory pathways. Focal penicillin administration led not only to spike generation but also to associated ultrafast frequency bursts in that area. It appears likely that ultrafast burst activity may be a better marker for focal cortical epileptogenesis than spikes or sharp waves, which can be transmitted from a distance.

Recent advances in handheld computer hardware and software may provide alternatives to paper-based data collection methods. The authors compared data collected with paper forms to data collected with handheld computer-based forms in a field observation study of alcohol purchase attempts at 47 community festivals in a large metropolitan area. Agreement between data collected with paper forms and data collected with handheld computers was greater than 95%. Computer-based forms handled branching patterns better and yielded data that were immediately available for analyses. Paper forms handled written comments better. Handheld computers are a feasible alternative to paper forms for field data collection.

Objective: To describe the authors' first year's experience with a picture archiving and communication system (PACS) for the management and storage of ultrasound images and to discuss the financial impact of the system in terms of costs of purchase, installation and operation., Materials and Methods: The Toronto Hospital, General Division, performs more than 30000 ultrasound studies each year. On June 27, 1994, an Ultra PACS (ALI Technology Incorporated, Richmond, BC) was introduced as the only method of image storage and archiving in the Ultrasound Division., Results: After structural renovations and a detailed work flow analysis, the Ultrasound Division converted from film to the PACS over a single weekend with no back-up. The advantages to date include consistently high-quality images; rapid image retrieval (images from the same day [online], 0 to 45 seconds; archived images [online], 3 to 5 minutes; images in storage [offline], 3 minutes); no loss of images; more efficient patient through-put, which allows the division to handle the same number of patients in 20% less operational time (change from a 10-hour day to an 8-hour day, over a 5-day week); less end-of-day overtime; and an improved work environment. There has been no change in the division's complement of full-time equivalent technologists, the number of film librarians has been reduced by 1, and physician service time has decreased by 20%. There has been no significant impact on overall operational financial status., Conclusion: The PACS has proved an efficient method for managing large numbers of ultrasound images in a cost-effective and technically sound manner. Its installation provides the basis for meeting the Ultrasound Division's next objective, to eliminate paper as the primary method of managing patient information and reports.

The reactivity of rabbit antisera to rat lung secretory proteins with other rodent species was evaluated by immunocytochemistry. Rabbit anti-rat surfactant apoprotein antiserum reacts with the cytoplasm of rat, mouse, and hamster type II pneumocytes and is specific for these cells. Rabbit antiserum to rat Clara cell secretory proteins stains rat, mouse, and hamster Clara cells. Rabbit antisera specific to the two antigenic types of rat Clara cell antigens were also both reactive with rat, mouse, and hamster Clara cells. An antiserum to the non-serum proteins of hamster lung lavage was also prepared and shown to be specifically reactive with hamster Clara cells. The availability of specific reagents for secretory proteins of rodent lungs is expected to facilitate studies of the respective cell types in various pathologic states.