Publications by authors named "C Watling"

141 Publications

Associations of circulating insulin-like growth factor-I with intake of dietary proteins and other macronutrients.

Clin Nutr 2021 Jul 20;40(7):4685-4693. Epub 2021 Apr 20.

Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.

Background & Aims: Circulating insulin-like growth factor-I (IGF-I) is associated with the risk of several cancers. Dietary protein intake, particularly dairy protein, may increase circulating IGF-I; however, associations with different protein sources, other macronutrients, and fibre are inconclusive. To investigate the associations between intake of protein, macronutrients and their sources, fibre, and alcohol with serum IGF-I concentrations.

Methods: A total of 11,815 participants from UK Biobank who completed ≥4 24-h dietary assessments and had serum IGF-I concentrations measured at baseline were included. Multivariable linear regression was used to assess the cross-sectional associations of macronutrient and fibre intake with circulating IGF-I concentrations.

Results: Circulating IGF-I concentrations were positively associated with intake of total protein (per 2.5% higher energy intake: 0.56 nmol/L (95% confidence interval: 0.47, 0.66)), milk protein: 1.20 nmol/L (0.90, 1.51), and yogurt protein: 1.33 nmol/L (0.79, 1.86), but not with cheese protein: -0.07 nmol/L (-0.40, 0.25). IGF-I concentrations were also positively associated with intake of fibre (per 5 g/day higher intake: 0.46 nmol/L (0.35, 0.57)) and starch from wholegrains (Q5 vs. Q1: 1.08 nmol/L (0.77, 1.39)), and inversely associated with alcohol consumption (>40 g/day vs <1 g/day: -1.36 nmol/L (-1.00, -1.71)).

Conclusions: These results show differing associations with IGF-I concentrations depending on the source of dairy protein, with positive associations with milk and yogurt protein intake but no association with cheese protein. The positive association of fibre and starch from wholegrains with IGF-I warrants further investigation.
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http://dx.doi.org/10.1016/j.clnu.2021.04.021DOI Listing
July 2021

Numbers Encapsulate, Words Elaborate: Toward the Best Use of Comments for Assessment and Feedback on Entrustment Ratings.

Acad Med 2021 Jul;96(7S):S81-S86

R. Hatala is professor, Department of Medicine, and director, Clinical Educator Fellowship, Center for Health Education Scholarship, University of British Columbia, Vancouver, British Columbia, Canada; ORCID: https://orcid.org/0000-0003-0521-2590.

The adoption of entrustment ratings in medical education is based on a seemingly simple premise: to align workplace-based supervision with resident assessment. Yet it has been difficult to operationalize this concept. Entrustment rating forms combine numeric scales with comments and are embedded in a programmatic assessment framework, which encourages the collection of a large quantity of data. The implicit assumption that more is better has led to an untamable volume of data that competency committees must grapple with. In this article, the authors explore the roles of numbers and words on entrustment rating forms, focusing on the intended and optimal use(s) of each, with a focus on the words. They also unpack the problematic issue of dual-purposing words for both assessment and feedback. Words have enormous potential to elaborate, to contextualize, and to instruct; to realize this potential, educators must be crystal clear about their use. The authors set forth a number of possible ways to reconcile these tensions by more explicitly aligning words to purpose. For example, educators could focus written comments solely on assessment; create assessment encounters distinct from feedback encounters; or use different words collected from the same encounter to serve distinct feedback and assessment purposes. Finally, the authors address the tyranny of documentation created by programmatic assessment and urge caution in yielding to the temptation to reduce words to numbers to make them manageable. Instead, they encourage educators to preserve some educational encounters purely for feedback, and to consider that not all words need to become data.
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http://dx.doi.org/10.1097/ACM.0000000000004089DOI Listing
July 2021

Don't be reviewer 2! Reflections on writing effective peer review comments.

Perspect Med Educ 2021 Jun 11. Epub 2021 Jun 11.

Department of Medicine and Centre for Education Research and Innovation, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.

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http://dx.doi.org/10.1007/s40037-021-00670-zDOI Listing
June 2021

A pre-post evaluation of oncology healthcare providers' knowledge, attitudes, and practices following the implementation of a complementary medicine practice guideline.

Support Care Cancer 2021 Jun 7. Epub 2021 Jun 7.

College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, 89 Curry Place, Winnipeg, MB, R3T 2N2, Canada.

Purpose: Complementary medicine (CM) use is prevalent among cancer patients, yet it is often not assessed by oncology healthcare providers (HCPs). The purpose of this study was to evaluate oncology HCPs' knowledge, attitudes, and practices surrounding CM use before and after the implementation of a practice guideline focusing on standardizing assessment and documentation of CM.

Methods: Oncology HCPs across a provincial cancer agency were invited to participate in the study. The implementation strategy included an initial education session for HCPs and standardized CM assessment forms. Pre-post surveys assessing knowledge, attitudes, and practices related to CM were completed by HCPs prior to attending the education session and following the 4-month implementation period. Paired t-tests were conducted to determine differences between baseline and follow-up surveys.

Results: A total of 31 oncology HCPs completed both baseline and follow-up surveys, with over 3700 patient CM assessment forms being completed during the 4-month study period. At the end of the study, HCPs reported greater CM knowledge (p < 0.001), readiness to support cancer patients' CM decisions (p = 0.002), and willingness to consult with another HCP about CM (p = 0.004). No significant change in HCPs' reported attitudes towards CM, or other clinical practices related to CM were observed.

Conclusion: Implementing a practice guideline, including a CM education session and a standardized assessment form, was found to improve oncology HCPs' self-reported CM knowledge and readiness to answer cancer patients' questions about CM. The findings provide support for future knowledge translation research aimed at standardizing how CM is addressed within cancer care settings.
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http://dx.doi.org/10.1007/s00520-021-06318-2DOI Listing
June 2021

Improving the safety of distracted pedestrians with in-ground flashing lights. A railway crossing field study.

J Safety Res 2021 06 30;77:170-181. Epub 2021 Mar 30.

Queensland University of Technology (QUT), School of Optometry and Vision Science, Australia.

Introduction: Current signage at intersections is designed for attentive pedestrians who are looking ahead. Such signage may not be sufficient when distracted by smartphones. Illuminated in-ground LED lights at crossings are an innovative solution to alert distracted pedestrians.

Method: We conducted a field study at a railway crossing equipped with in-ground lights to assess whether distracted pedestrians (N = 34, Mean age 33.6 ± 8.6 years) could detect these lights and how this impacted on their visual scanning and crossing behaviour. This involved a 2 × 3 repeated measures design exploring the impact of the presence (treatment) or absence (control) of in-ground lights (treatment) at a crossing, and a distractor task presented through a mobile device (none, visual, and audio) on eye movements recorded using an eye tracker, and verbal reporting of when participants detected the lights.

Results: Participants engaged in the distraction tasks as evidenced by their accuracy and reaction times in all conditions. With both the audio and visual distraction tasks, participants looked at the in-ground LEDs and detected their activation as accurately as when not distracted (95%). While most participants detected the lights at their activation, visual distraction resulted in 10% of the detections occurring as participants entered the rail corridor, suggesting effectiveness in gaining pedestrians' attention. Further, participants were significantly less likely to check for trains when visually distracted (70%), a 10% reduction compared to the no or audio distractor conditions (80% and 78% respectively). The introduction of the in-ground lights resulted in appropriate scanning of the rail tracks (77% and 78% for the visual and auditory distractor tasks respectively) similar to that of non-distracted participants for the crossing without lights (80%).

Conclusions: Our findings indicate that illuminated in-ground lights could be useful in attracting the attention of distracted pedestrians at railway level crossings, and possibly at other road intersections. Practical Applications: Illuminated in-ground lights can be installed at rail and road intersections with known pedestrian distraction as a countermeasure. Further research is necessary to understand their long-term effects.
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http://dx.doi.org/10.1016/j.jsr.2021.02.014DOI Listing
June 2021
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