Understanding the Effect of Information Presentation Order and Orientation on Information Search and Treatment Evaluation

Background. Past research finds that treatment evaluations are more negative when risks are presented after benefits. This study investigates this order effect: manipulating tabular orientation and order of risk–benefit information, and examining information search order and gaze duration via eye-tracking. Design. 108 (Study 1) and 44 (Study 2) participants viewed information about treatment risks and benefits, in either a horizontal (left-right) or vertical (above-below) orientation, with the benefits or risks presented first (left side or at top). For 4 scenarios, participants answered 6 treatment evaluation questions (1–7 scales) that were combined into overall evaluation scores. In addition, Study 2 collected eye-tracking data during the benefit–risk presentation. Results. Participants tended to read one set of information (i.e., all risks or all benefits) before transitioning to the other. Analysis of order of fixations showed this tendency was stronger in the vertical (standardized mean rank difference further from 0, M = ±.88) than horizontal orientation (M = ± 0.71). Approximately 50% of the time was spent reading benefits when benefits were shown first, but this was reduced to ~40% when risks were presented first (regression coefficient: B = −4.52, p <.001). Eye-tracking measures did not strongly predict treatment evaluations, although time percentage reading benefits positively predicted evaluation when holding other variables constant (B = 0.02, p =.023). Conclusion. These results highlight the impact of seemingly arbitrary design choices on inspection order. For instance, presenting risks where they will be seen first leads to relatively less time spent considering treatment benefits. Other research suggests these changes to inspection order can influence multi-option and multi-attribute choices, and represent an area for future research

Histoplasmosis Cluster, Golf Course, Canada

We report a cluster of 4 cases of acute histoplasmosis (1 culture proven and 3 with positive serology, of which 2 were symptomatic) associated with exposure to soil during a golf course renovation. Patients in western Canada with compatible symptoms should be tested for histoplasmosis, regardless of their travel or exposure history

Influence of School Year on Seasonality of Norovirus Outbreaks in Developed Countries

Factors affecting the seasonal distribution of norovirus outbreaks are not well understood. This study examined whether grade school settings at the start of the school year may be a factor. We searched Ovid Medline from January 2002 to June 2014 for studies that provided all reported norovirus outbreaks in a developed country by month for a minimum of three years. Historical school years were obtained from verifiable sources. The start of the norovirus seasonal outbreak peak and peak outbreak month were determined for each study and compared to the start month of school. Northern hemisphere and southern hemisphere countries had a different norovirus seasonality and different school year structures (traditional compared to year round). In the two studies that provided outbreaks by age, outbreaks among children started several months before outbreaks in the adult population. The median number of months between school start and start of the seasonal outbreak peak was two months (interquartile range [IQR] = 2.0-3.0), while the median number of months between school start and peak outbreak month was four months (IQR = 3.0-4.0). These findings suggest the possibility the school setting at the start of the school year may be a factor in the seasonality of norovirus

Influence of School Year on Seasonality of Norovirus Outbreaks in Developed Countries

Factors affecting the seasonal distribution of norovirus outbreaks are not well understood. This study examined whether grade school settings at the start of the school year may be a factor. We searched Ovid Medline from January 2002 to June 2014 for studies that provided all reported norovirus outbreaks in a developed country by month for a minimum of three years. Historical school years were obtained from verifiable sources. The start of the norovirus seasonal outbreak peak and peak outbreak month were determined for each study and compared to the start month of school. Northern hemisphere and southern hemisphere countries had a different norovirus seasonality and different school year structures (traditional compared to year round). In the two studies that provided outbreaks by age, outbreaks among children started several months before outbreaks in the adult population. The median number of months between school start and start of the seasonal outbreak peak was two months (interquartile range [IQR] = 2.0–3.0), while the median number of months between school start and peak outbreak month was four months (IQR = 3.0–4.0). These findings suggest the possibility the school setting at the start of the school year may be a factor in the seasonality of norovirus