Text 7 7 Why read this paper? Because it is relevant to my work? Because my colleagues/chief asked me to? Because I m curious about the topic? Because I want to increase my general knowledge? Because I m looking for some specific information? Because I want to confirm what I already know? Other reasons? BEFORE YOU READ Vocabulary practice Exercise 1. Match the English word with its translation. 1. acknowl- c a. in cieco edgement 2. address b. tra 3. award c. riconoscimento; ringraziamenti 4. between d. indirizzo 5. blinded e. premio 51
T H E D O C T O R I S I N Exercise 2. As above. 1. disclose a. redigere 2. draft b. probabilità 3. expertise c. competenza da esperto 4. likelihood d. finanziamento 5. grant e. dichiarare Exercise 3. As above. 1. major a. fonte 2. pooled b. raggruppati 3. reprint c. principale; grave 4. source d. sorveglianza 5. surveillance e. ristampa Exercise 4. As above. 1. thank a. diffusamente, comunemente 2. under b. entro 3. well c. ringraziare 4. widely d. sotto 5. within e. bene READ Exercise 1. Scan the text and find this information. 1. What journal published this paper? 2. When was it published? 3. What kind of text is this? (An Abstract? Editorial? Full text paper?) 4. What is a systematic review? (see Appendix) 5. Who are the authors of this paper? 6. What data sources did the authors use? 7. How were studies selected? 8. How many studies were reviewed? 9. What was the primary funding source? 10. Was there any potential conflict of interest? 11. Which author(s) were responsible for conception and design? 12. Which author(s) drafted this article? 13. Who provided administrative, technical, or logistic support? 14. Who collected and assembled the data? Exercise 5. How do you say these words in English? 1. morte d e a t h 2. valutare e e 3. esito o e 4. eseguire p m 5. chirurgia s y 52
T e x t 7 7 AFTER YOU READ Exercise 1. True, False, or Not Clear, based on this study? 1. This systematic review reports on the ability of RCRI to evaluate cardiac complications. 2. This systematic review examines the records of almost 800 thousand cardiac patients. 3. Major cardiac complications were defined as cardiac death, myocardial infarction, or nonfatal cardiac arrest. 4. The authors of this SR state that the studies they reviewed were not of very good quality. 5. The authors conclude that the RCRI is useful in predicting mortality after vascular noncardiac surgery. 53
T H E D O C T O R I S I N Exercise 2. Complete this chart with the data reported in the text. RCRI PREDICTION OF CARDIAC EVENTS After mixed noncardiac surgery high vs low risk pts. C.I. After vascular noncardiac surgery high vs low risk pts. C.I. AUC curve 0.65 0.46-0.81 Sensitivity Abstracts are subject to word limits (usually 250 words). The information they provide is therefore not necessarily complete or clear!......always consult the Results section of the full text paper for complete data information and interpretation. Specificity Positive likelihood ratio Negative likelihood ratio Exercise 3. Which is true for you? I understand the data provided in this Abstract. I don t understand the data provided in this Abstract and I need to consult the Tables in the full text paper. (Consult pp 173-175 of this textbook.) Exercise 4. Reflection What have I learned by reading this paper that I didn t already know? Is the information clear? Is the information complete? Can I take home any of the information in this paper? What is my opinion on this topic? Am I curious or interested enough to read the full text paper? 54
Text 8 8 Why read this paper? Because it is relevant to my work? Because my colleagues/chief asked me to? Because I m curious about the topic? Because I want to increase my general knowledge? Because I m looking for some specific information? Because I want to confirm what I already know? Other reasons? BEFORE YOU READ Vocabulary practice Exercise 1. Match the English word with its Italian translation. 1. closely c a. bambini 2. common b. avvenire 3. cough c. attentamente 4. children d. lieve 5. occur e. comparsa, inizio 6. length f. frequente 7. delay g. mediana 55
T H E D O C T O R I S I N Don t forget! adjective + adjective + adjective (etc.) + noun Take notes while you read! Underline, highlight, write comments this is an evidencebased best practice! 8. median h. durata 9. mild i. ritardo 10. onset j. tosse Exercise 2. How do you say the following in English? 1. entrambi b o t h 2. entro w n 3. età a e 4. febbre f r 5. gamma r e 6. malattia i s 7. maschio m e 8. patologia d e 9. premessa, b d contesto 10. scopo p e Exercise 3. Complete the chart. Noun Verb 1. confirmation confirm 2. detect 3. diagnose 4. document 5. duration 6. incubation 7. infection 8. observe 9. occur 10. treat Exercise 4. Look at the footnotes on p. 57 for new vocabulary. Syntax practice Translate the following noun phrases. 1. The clinical features of the disease Le caratteristiche cliniche della patologia 2. The most common symptoms 3. 2009 Pandemic Influenza A (H1N1) Virus Infection 4. Positive real-time RT-PCR test results 5. Beijing Institute of Respiratory Medicine 6. The Shanghai Public Health Clinical Center 7. Chinese Center for Disease Control and Prevention READ 1. Where was this article published? 2. When was it published? 3. Who are the authors of this paper? 4. What institution are they affiliated with? 5. What kind of text is this? (An Abstract? Editorial? Full text paper?) 6. Is the topic, as indicated in the title, relevant to your practice? 7. How many subjects were observed in this study? 8. What test was used to confirm infection? 9. What was the median incubation period of the virus? 10. How many independent risk factors did the authors identify? 56
Text 8 8 feature caratteristica; subsequently successivamente, in seguito; in whom nelle quali; port of entry luogo di prima assistenza (es. medico di famiglia, pronto soccorso o altro) shorten accorciare; rendere più breve; administer somministrare. 57
T H E D O C T O R I S I N AFTER YOU READ Exercise 1. Complete this chart based on the data provided in the text. Total n. patients observed Percentage females Average incubation period Percentage of pts with fever Percentage of pts with cough Incidence of nausea Percentage of pts with lymphopenia which resolved by day Percentage of adult pts with hypokalemia Duration of fever Exercise 2. True, False, or Not Clear, based on this study? 1. The pandemic influenza A (H1N1) was first seen in China in the spring of 2009. 2. Suspected cases of infection were admitted to hospital and put in quarantine. 3. This study observed patients admitted to hospitals located in 20 Northern provinces in China. 4. Over half of the patients in this study were treated with oseltamivir. 5. The average age of patients in this study was about 24 years. 6. Most of the patients in this study were female. 7. The least common symptom was nausea. 8. Most symptoms resolved by day 7. 9. Treatment with oseltamivir in the first two days of onset of symptoms was critical to reduced duration of infection. 10. Surveillance of the 2009 H1N1 flu resulted in fewer cases of infection. Exercise 3. Reflection What have I learned by reading this paper that I didn t already know? Is the information clear? Is the information complete? Can I take home any of the information in this paper? What is my opinion on this topic? Am I curious or interested enough to read the full text paper? Just for fun! Do you know these symptoms? 1. achy e a) sudato 2. dizzy b) con vertigini 3. faint c) debole, fiacco 4. sweaty d) sentirsi mancare 5. weak e) dolente 1. a chest cough a) mal di gola 2. a drippy nose b) mal d orecchio 3. a headache c) naso che cola 4. a sore throat d) mal di testa 5. earache e) tosse grassa 58
Text 9 9 Why read this paper? Because it is relevant to my work? Because my colleagues/chief asked me to? Because I m curious about the topic? Because I want to increase my general knowledge? Because I m looking for some specific information? Because I want to confirm what I already know? Other reasons? Think What do you know about telemedicine monitoring? Do you think it could reduce mortality and complications in the ICU? 59
T H E D O C T O R I S I N BEFORE YOU READ Vocabulary practice Exercise 1. Match the English word with its Italian translation. 1. monitor b a. diversi 2. length b. monitorare 3. stay c. sempre più 4. several d. durata 5. increasingly e. degenza 1. little a. contesto 2. assess b. grande, ampio 3. design c. poco 4. setting d. valutare 5. large e. disegno 1. illness a. principale 2. main b. parametro 3. outcome c. esito 4. measure d. solo 5. only e. malattia 1. threatening a. globale, complessivo 2. rate b. minaccioso 3. decrease c. tasso 4. overall d. miglioramento 5. improvement e. diminuire Exercise 2. True or false? 1. Between = tra due elementi True 2. Sick = cercare 3. Less = pochi 4. Worse = vocaboli 5. Full = il contrario di empty 6. Survivor = sopravvivenza Exercise 3. Complete the chart. XXX means there is no form. Noun Verb Adjective 1. length lengthen long 2. stay XXX 3. assess XXX 4. setting XXX 5. illness XXX 6. measure XXX 7. threatening 8. decrease XXX 9. improvement XXX Exercise 4. Look at the footnotes on p. 61 for new vocabulary. Syntax Exercise 1. Translate the following noun clauses. 1. Intensive care patients pazienti in terapia intensiva 2. Telemedicine technology 3. Large US health care system 4. Local physicians 5. Life-threatening events 6. Full treatment authority 7. Observed hospital mortality rates 60
Text 9 9 enable (v) rendere capace, mettere nelle condizioni di poter fare; intensivist (n) medico specialista nelle cure intensive; off-site location in un luogo esterno all ospedale, in un altro luogo; delegate (v) delegare, deputare; authority (n) autorità, potere, responsabilità; remainder (n) il restante. 61
T H E D O C T O R I S I N Knowing how a text is organized lets you find specific information quickly. Exercise 2. Identify the information blocks in the sentences below. The first sentence has been done for you. 1. Association of Telemedicine for Remote Monitoring of Intensive Care Patients With Mortality, Complications, and Length of Stay 2. Observational study conducted in 6 ICUs of 5 hospitals in a large US health care system to assess the use of tele- ICU. 3. Local physicians delegated full treatment authority to the tele-icu for 655 patients (31.1%) and authority to intervene only in life-threatening events for the remainder. 4. There were no significant differences between the preintervention and postintervention periods for hospital or ICU lenght of stay. Exercise 3. Translate the sentences in Exercise 2 above. 1. Associazione della telemedicina per il monitoraggio a distanza dei pazienti in terapia intensiva con mortalità, complicanze e durata di degenza. 2. 3. 4. READ 1. Where was this article published? 2. When was it published? 3. Who are the authors of this paper? 4. What institution are they affiliated with? 5. Where was the study conducted? 6. What kind of text is this? (An Abstract? Editorial? Full text paper?) 7. How many subjects were enrolled? 8. Why was the study conducted? 9. How long did the study last? 10. What were the outcome measures? AFTER YOU READ Exercise 1. True, False, or Not Clear, based on this study? 1. There is no evidence that telemedicine technology improves patient outcomes. 2. The aim of the study was to determine whether remote monitoring of ICU patients reduces mortality, complications, and LOS. 3. Local physicians were the patients family doctors. 4. Intensivists were fully responsible for all treatment decisions for about onehalf of patients. 5. Hospital mortality rates dropped. 6. Tele-ICU was significantly more useful in patients who were sicker. 7. Telemedicine had little effect on LOS. Exercise 2. Reflection What have I learned by reading this paper that I didn t already know? Is the information clear? Is the information complete? Can I take home any of the information in this paper? What is my opinion on this topic? Am I curious or interested enough to read the full text paper? 62