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Protocol for Writing a Summary for the TEACH Database

Revised November, 2005

Overview

The TEACH database includes summaries of research articles pertaining to children's exposures to toxic chemicals. A summary of an article for the TEACH database is targeted to the generalist scientist and the policy maker who want the take-home message and some basic facts about the study. Summaries are also intended for the general public, including parents, teachers, and other adults interested in the health of children.

The summary is not meant to be a regurgitation of the abstract. It is meant to provide an overview of the article, and highlight key findings in the study. For more detailed information about the study, the user of the database can pull the abstract or paper themselves.

Preparation of TEACH summaries should not rely exclusively upon the abstract, but rather draw details and perspectives from the text of the article. All text is to be original. Any phrases taken from the article must be in quotation marks.

These instructions are divided into four parts:

  1. Information Source
  2. Category Selections
  3. Study Description and Health Effects Section
  4. Exposure Information and Comments.

Some general punctuation rules:

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1. Information Source

There are four fields in this column: author, year, title, and journal information; each field separated by a period.

Author. Enter the last name of the first author followed by a comma. Then enter initials in capital letters, each followed by a period with no space between initials when there is more than one. After the final initial of the first author, place a period if only one author; otherwise place a comma.

When there are only two authors, write "and", then put the initials of the second author followed by the last name of the second author. Example: Solomon, S.R., and J.B. Finley.

When there are more than two authors, write "et al." Example: Casey, P.H., et al.

Year. The year of publication comes after the author(s) names, and ends in a period.

Article name. The journal article title is placed in quotes " "; each word is capitalized, regardless of capitalization in the original articles (besides prepositions and articles such as "and" and "to"). If there are quotes already in the title, use single hash quotes ' ' within the title. End the title with a period inside the close quote.

Journal. The full journal name is then given in italics and capitalized. Not all articles show the full journal name and may instead use an abbreviation, such as J Exp Med. You need to type it in full, such as Journal of Experimental Medicine. [Search full journal names at http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=journals] Exit Disclaimer. Do not put a period after the journal name.

To verify Information Source, go to: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi Exit Disclaimer and query the author.

Example: Patrizi, A., et al. 1999. "Sensitization to Thimerosal in Atopic Children." Contact Dermatitis 40(2):104-115.

After the journal name, in regular font (no longer italicized) put the volume first and any issue numbers in parentheses, then a colon (:), and then the first and last page numbers. Put a period after the page numbers, which is the last part of this column.

Book Chapters. Treat the name of the chapter as a journal article title followed by a comma and the word "in" and treat the book name as the journal name. After the journal name, put the Editor's name followed by a period. List the Publisher followed by a period. List the city and state, or city and country of publication followed by a period (e.g., New York, New York). After the period, space once and type: xx-xx (xx being page numbers). End with a period. See example below:

Lee, S.D., et al. 1983. "Assessment of Benzene Health Effects in Ambient Water," in Carcinogenicity and Toxicity of Benzene. Mehlman, M.A. (Editor). Princeton Scientific Publishers, Inc., Princeton, New Jersey. 91-119.

Web Sites and Government Documents. See two examples below.

U.S. EPA. 2002. "Arsenic Compounds--Statewide Estimates." 1996 Modeled Ambient Concentrations. <https://www.epa.gov/ttn/atw/nata/natsa2.html>.

U.S. EPA, Office of Prevention, Pesticides and Toxic Substances, Health Effects Division. 2002. "HED's Revised Risk Assessment for the Reregistration Legibility Decision." DP Barcodes D272009, D281936, D281917. PC Code: 080803. Case No. 0062.

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2. Category Selections

Selections need to be made for categories under chemical, source, medium, route, species, and ages when exposed and assessed.

Chemical
Select the chemical for which the summary is focused. For articles that studied more than one TEACH chemical, the summary is listed in duplicate and separately in the database under each chemical that was included in the study. Multiple listings of a single summary in the database are also appropriate for studies that looked at more than one form of mercury. Summaries are likely to be slightly different for each summary under the different chemicals, highlighting results for that particular chemical.

Source*
This part of the summary lists the actual source from which the chemical came. For most animal studies, investigators purchased a chemical somewhere and used it under experimental conditions — this would be an experimental source. If they used sludge from a contaminated industrial site, then source would be industrial.  Food is not considered a source. The chemical came from some source to get to the food, and food in the diet is considered a medium. Multiple sources for a single study may be appropriate. Review articles should have only "Review" selected in Source, Medium, and Route.

Medium*
Medium is the way the chemical got from the source to the exposed individuals. Examples include water, diet, indoor air, etc. For most animal studies, artificial means are used to get the chemical to the animal, and hence "experimental" is usually selected. Multiple media choices may be appropriate.

Route*
Route is the pathway that brings the chemical into contact with the body. Options include ingestion, inhalation, injection, etc. If injection, in the summary the site of injection should be mentioned. Gavage and intubation are experimental ways of getting chemicals into the stomach for ingestion. Intravenous feeding would be injection. Multiple route choices may be appropriate.

Species
Choose all species studied. For animal studies, list each specific species (i.e., mouse, rat) studied.

Ages When Exposed/Assessed
Boxes should be checked or filled in for ages when exposed or assessed. All ages that were exposed or assessed need to be identified. Definitions for each age range are listed on the TEACH Web site. Prenatal exposure should always have adult female and fetal boxes checked.

*"Multiple", "Not Specified", and "Multiple/Not Specified":
"Multiple/Not Specified" is used nearly every time that a Source, Medium, or Route is not specified in the article. It is most commonly used under Source alone, but also under Medium and/or Route.

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3. Study Description and Health Effects Endpoints

This section contains all information on effects, and also contains the study description when effects were measured in the study. In exposure only studies, the study description goes in the Exposure section, and an automatic statement – "Effects not evaluated in this study."– is inserted by the computer into blank Effect columns.
Note that for all sections of all entries, any text that is taken verbatim from the paper must be in quotes. Use of quotes should be minimal in all entries. In other words, the use of quotations is usually limited to one sentence per summary. Quotes are best used to reflect the author's interpretation of the study or the author's perspective on the study, and are taken from the text of the article as opposed to the abstract.
Effect studies include studies in which metabolite levels were measured; the generation of metabolites by the body is considered an effect. The body had to change the chemical to generate a metabolite, and is thus considered an effect. Adduct formation, most often seen in BaP studies, is not considered an effect unless the binding of metabolites to DNA was measured.
Redundancy in the summary is avoided. Details provided elsewhere in the summary, including information already provided in the boxes checked for categories, are generally not repeated in the Study Description or Exposure Information boxes. Some redundancy may be useful to highlight key points in the Study Description, but is used infrequently.
Study Description and Exposure Information text is written in the past tense (i.e., "Neurotransmitter levels were increased").
Any lists with multiple commas include a comma following the last item before the "and" (trailing comma): one, two, and three. The text of the Effects column text follows a general template as described here.

Sections of a Health Effects Summary:

The Health Effects Summary can be divided into four major sections. In most summaries, each section will be a separate paragraph, though this is not always the case.

Section 1: Framing Sentence/Study Description

Template:
"This study evaluated potential developmental effects following early childhood exposure to dichlorvos."

"(A) study of (B) effects in (C) following (D) exposure to (E)."

A= Large (if more than 500 people in the study), Case (if called a case study in the article), Follow-up study (if stated as such), or Review article (and not study). Use only if relevant.

B= neurological, neurobehavioral, behavioral, immunological, developmental, anatomical, neuromuscular, biochemical, etc.

C=study population (children, adults and children, neonates, fetuses, infants, toddlers, etc.); add brief detail about study population if relevant (e.g. children living near a gold-mining operation in Chile).

D=type of exposure if relevant (prenatal, early childhood most relevant; avoid repeating terms for which boxes are checked already, such as inhalation, ingestion, etc.). If not relevant, just use the word exposure.

E=name of chemical and information about source if relevant (e.g. PCBs in cooking oil that was contaminated in a poisoning incident in Iraq). Chemical abbreviations should be defined in this first sentence, then use the abbreviation for all instances following first use, except at the beginning of a sentence.

All five pieces of information may need to fit into two sentences. A critical detail of how the chemical of interest was measured may be appropriate here, but most often is placed in the exposure section.


Section 2: Critical Details of the Study

Critical details of results that are included in this section are details which highlight the authors' conclusions and other results that provide pertinent information to the TEACH audience. Too much detail is avoided. Although some details may be helpful, for additional details the reader may consult the original article; too many p values, numbers, or items measured can detract from the readability of the summary. Review the example below:

"Exposed boys scored significantly lower on CPM scores than controls (e.g., at 8 years, exposed boys, 24.1±0.9; control boys, 27.7±0.9, p=0.004), but exposed girls were not statistically different from their controls (e.g., at 8 years, exposed girls, 26.3±1.0; control girls, 27.4±0.9; p=0.22)." [Note that for this sentence, CPM was defined in the sentence above, with one sentence about what the CPM test measures. For this test there were no units to the numbers.] Generally, specific data values are included only rarely, in instances where a specific value is useful to the summary. More often, statistically significant results are summarized without specific data values, and with p values, odds ratios, or correlation coefficients provided in parentheses.

Note that there are no spaces before or after symbols such as "=". Also, put units after each set of numbers in a list. The format for numbers is to include appropriate commas for numbers greater than 999.

Section 3: Conclusions of the Study

In many summaries, it is possible to describe in one sentence the major finding of the study, which would be the bottom line or the take-home message. No excessive details or p values in this sentence. This sentence will vary in style, see examples below.

"Higher levels of PCBs in breast milk correlated with lower scores of psychomotor development at 3 and 7 months of age."

"Neither prenatal nor postnatal exposure to PCBs and dioxins was found to be related to neurological conditions at 42 months of age."

"Higher cord serum PCB level was associated with a greater number of errors on the Stenberg memory task in a dose-dependent fashion."

"Exposure to arsenic altered concentrations of several neurotransmitters in brains of prenatally-exposed children, while no behavioral effects were observed."

Section 4: Perspective Sentence

Of all the sections in the Health Effects Summary, this is the one area where a quote can be useful. Information used here puts the results in perspective and wraps it up. Any quote ideally is taken from the discussion or introduction of the paper. Any quotes that are conjecture, opinion, or hypothetical ideas should go in Exposure Information/Comments. To avoid confusion with users assigning responsibility to the summary writer for an author's finding or statement, identify that the "author(s) has concluded or stated or demonstrated or found."

Example:

"The authors stated that the microphthalmia effect seen by TCE has not been previously reported; however, the results for the rest of the chemicals were "generally consistent with previous reports.""

It is somewhat common that authors of articles do not provide information on the perspective of their findings. If the author doesn't provide such information, then leave the information out of the summary.

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4. Exposure Information and Comments/Notes

Line 1: Exposure Information

Open with study description as described above when an exposure-only study. For all studies, give doses administered, levels or concentrations measured, etc.

Any amount of chemicals measured as a concentration as amount per unit volume (e.g. mg/L, mg/cubic meter) should be called concentrations; concentrations are most often given for amounts of chemicals in blood, urine, air, etc. When the amount of the chemical is given as a total amount, then the quantity is considered a level; levels include examples such as mg/day, mg/kg body weight.

The summary should be clear without too much detail or too many numbers — only the most important or most relevant details are given. A statement that "more details were provided in the article" may be appropriate.

Line 2: Other Relevant Study Information Relating to Exposure

For human studies, give numbers of study subjects; for animal studies, give numbers only if unusually large (>20-25 per group) or unusually small (<10 per group). In some studies, exposure information was collected by questionnaire and should be stated so here. Also, defining groups for comparison often best fits here, because groups are usually defined by exposure levels.

"At 24 and 48 hours after impregnation, pregnant females were dosed with a range of 0.01-483 mg/kg body weight. This period of gestation is when embryos are traversing the pronuclear stages of development."

Line 3: Any Comments of Conjecture or Opinion

Any critical comments from the authors that are conjecture or opinion, and help to frame the perspective of the summary, would go at the end of the Exposure Information section. These types of comments are not common.

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