Effects of Acoustic Perception of Gender on Nonsampling Errors in Telephone Surveys

ERIC Educational Resources Information Center

Kenney McCulloch, Susan

2012-01-01

Many telephone surveys require interviewers to observe and record respondents' gender based solely on respondents' voice. Researchers may rely on these observations to: (1) screen for study eligibility; (2) determine skip patterns; (3) foster interviewer tailoring strategies; (4) contribute to nonresponse assessment and adjustments; (5)…

Survey nonresponse among ethnic minorities in a national health survey--a mixed-method study of participation, barriers, and potentials.

PubMed

Ahlmark, Nanna; Algren, Maria Holst; Holmberg, Teresa; Norredam, Marie Louise; Nielsen, Signe Smith; Blom, Astrid Benedikte; Bo, Anne; Juel, Knud

2015-01-01

The participation rate in the Danish National Health Survey (DNHS) 2010 was significantly lower among ethnic minorities than ethnic Danes. The purpose was to characterize nonresponse among ethnic minorities in DNHS, analyze variations in item nonresponse, and investigate barriers and incentives to participation. This was a mixed-method study. Logistic regression was used to analyze nonresponse using data from DNHS (N = 177,639 and chi-square tests in item nonresponse analyses. We explored barriers and incentives regarding participation through focus groups and cognitive interviews. Informants included immigrants and their descendants of both sexes, with and without higher education. The highest nonresponse rate was for non-Western descendants (80.0%) and immigrants 25 (72.3%) with basic education. Immigrants and descendants had higher odds ratios (OR = 3.07 and OR = 3.35, respectively) for nonresponse than ethnic Danes when adjusted for sex, age, marital status, and education. Non-Western immigrants had higher item nonresponse in several question categories. Barriers to non-participation related to the content, language, format, and layout of both the questionnaire and the cover letter. The sender and setting in which to receive the questionnaire also influenced answering incentives. We observed differences in barriers and incentives between immigrants and descendants. Nonresponse appears related to linguistic and/or educational limitations, to alienation generated by the questions' focus on disease and cultural assumptions, or mistrust regarding anonymity. Ethnic minorities seem particularly affected by such barriers. To increase survey participation, questions could be sensitized to reflect multicultural traditions, and the impact of sender and setting considered.

Questionnaire surveys of dentists on radiology

PubMed Central

Shelley, AM; Brunton, P; Horner, K

2012-01-01

Objectives Survey by questionnaire is a widely used research method in dental radiology. A major concern in reviews of questionnaires is non-response. The objectives of this study were to review questionnaire studies in dental radiology with regard to potential survey errors and to develop recommendations to assist future researchers. Methods A literature search with the software search package PubMed was used to obtain internet-based access to Medline through the website www.ncbi.nlm.nih.gov/pubmed. A search of the English language peer-reviewed literature was conducted of all published studies, with no restriction on date. The search strategy found articles with dates from 1983 to 2010. The medical subject heading terms used were “questionnaire”, “dental radiology” and “dental radiography”. The reference sections of articles retrieved by this method were hand-searched in order to identify further relevant papers. Reviews, commentaries and relevant studies from the wider literature were also included. Results 53 questionnaire studies were identified in the dental literature that concerned dental radiography and included a report of response rate. These were all published between 1983 and 2010. In total, 87 articles are referred to in this review, including the 53 dental radiology studies. Other cited articles include reviews, commentaries and examples of studies outside dental radiology where they are germane to the arguments presented. Conclusions Non-response is only one of four broad areas of error to which questionnaire surveys are subject. This review considers coverage, sampling and measurement, as well as non-response. Recommendations are made to assist future research that uses questionnaire surveys. PMID:22517994

Treatment non-response: Associations with smoking expectancies among treatment-seeking smokers.

PubMed

Garey, Lorra; Taha, Samar A; Kauffman, Brooke Y; Manning, Kara F; Neighbors, Clayton; Schmidt, Norman B; Zvolensky, Michael J

2017-10-01

Despite the high rate of smoking cessation treatment non-response, relatively little empirical work has examined predictors of treatment non-response. The present study sought to explore the effect of smoking outcome expectancies on treatment response in a sample of treatment-seeking adult daily smokers (N=182; 53.3% female; M age =40.67; SD=13.63). Results indicated that expectancies for smoking to reduce negative affect were related to an increased likelihood of treatment non-response (OR=0.73, CI: 0.54, 0.98). These findings remained significant after controlling for sex, presence of Axis I disorder, tobacco-related health problems, tobacco dependence, anxiety sensitivity, and condition assignment as well as other smoking expectancy dimensions. Post hoc analyses revealed that this relation was stronger for smokers in the integrated care condition vs. the standard care condition (Interaction: OR=1.69, CI: 1.05, 2.73). Additionally, expectancies for smoking to enhance positive affect and provide sensory satisfaction were associated with an increased likelihood of treatment response in the standard care condition. The current findings suggest expectancies that smoking will alleviate negative affect may be a risk factor of smoking cessation treatment non-response. Additionally, findings provide evidence that the relation between smoking expectancies and treatment non-response may differ by smoking cessation treatment. Copyright © 2017 Elsevier Ltd. All rights reserved.

[Psychosomatic aspects of stress].

PubMed

Okuse, S; Anzai, T

1992-03-01

We established the Bromocriptine test for the dopaminergic function of the hypothalamopituitary gland. The secretion patterns of plasma GH and PRL to 2.5 mg Bromocriptine, a dopamine receptor agonist, were classified into two types; a response type and a non-response type. The former showed an increase in plasma GH levels and suppression of PRL secretion; the latter showed no change in GH after Bromocriptine administration. The response type cases corresponded to psychosocial stress by neurotic and maladaptive behavior. The non-response type cases corresponded to psychosocial stress by alexithymic and over adaptive behaviors. Case Presentation 1. Essential Hypertension: a. 56-year old male, response type, blood pressure elevated by stress in daily life. Psychosomatic treatment: advice about blood pressure measurement at his home, brief psychotherapy and drug therapy. b. 53-year-old male, non-response type, type A behavior. Psychosomatic treatment: advice to increase awareness of body-mind relationships of his disorder, self-control training and drug therapy. 2. Gastric ulcers: a. 40-year-old male, response type, CMI IV region (Neurotic tendencies). Psychosomatic treatment: autogenic training and drug therapy. b. 28-year-old male, non-response type, high JAS scores(Over adaptative behavior). Psychosomatic treatment: advice to increase awareness of body-mind relationships of occurrence of his ulcers, to induce change in his perceptions of way of life, to encourage taking rest. 3. Technostress syndrome: a. 23-year-old female, response type, technoanxiety. Psychosomatic treatment: advice to make her take rest, and change in arrangements at her working place. b. 27-year-old male, non-response type, technodependent. Psychosomatic treatment: Fasting therapy. This therapy changed the non-response pattern to normal.

Power of Statistical Tests Used to Address Nonresponse Error in the "Journal of Agricultural Education"

ERIC Educational Resources Information Center

Johnson, Donald M.; Shoulders, Catherine W.

2017-01-01

As members of a profession committed to the dissemination of rigorous research pertaining to agricultural education, authors publishing in the Journal of Agricultural Education (JAE) must seek methods to evaluate and, when necessary, improve their research methods. The purpose of this study was to describe how authors of manuscripts published in…

Review of four publications on the Danish cohort study on mobile phone subscribers and risk of brain tumors.

PubMed

Söderqvist, Fredrik; Carlberg, Michael; Hardell, Lennart

2012-01-01

Since the International Agency for Research on Cancer recently classified radiofrequency electromagnetic fields, such as those emanating from mobile and cordless phones, as possibly carcinogenic to humans (group 2B), two additional reports relevant to the topic have been published. Both articles were new updates of a Danish cohort on mobile phone subscribers and concern the possible association between assumed use of mobile phones and risk of brain tumors. The aim of the present review is to reexamine all four publications on this cohort. In brief, publications were scrutinized, and in particular, if the authors made explicit claims to have either proved or disproved their hypothesis, such claims were reviewed in light of applied methods and study design, and in principle, the stronger the claims, the more careful our review. The nationwide Danish cohort study on mobile phone subscribers and risk of brain tumors, including at best 420,095 persons (58% of the initial cohort), is the only one of its kind. In comparison with previous investigations, i.e., case-control studies, its strength lies in the possibility to eliminate non-response, selection, and recall bias. Although at least non-response and recall bias can be excluded, the study has serious limitations related to exposure assessment. In fact, these limitations cloud the findings of the four reports to such an extent that render them uninformative at best. At worst, they may be used in a seemingly solid argument against an increased risk--as reassuring results from a large nationwide cohort study, which rules out not only non-response and recall bias but also an increased risk as indicated by tight confidence intervals. Although two of the most comprehensive case-control studies on the matter both have methodological limitations that need to be carefully considered, type I errors are not the only threats to the validity of studies on this topic--the Danish cohort study is a textbook example of that.

A comparison of data quality and practicality of online versus postal questionnaires in a sample of testicular cancer survivors.

PubMed

Smith, Allan Ben; King, Madeleine; Butow, Phyllis; Olver, Ian

2013-01-01

We aimed to compare data quality from online and postal questionnaires and to evaluate the practicality of these different questionnaire modes in a cancer sample. Participants in a study investigating the psychosocial sequelae of testicular cancer could choose to complete a postal or online version of the study questionnaire. Data quality was evaluated by assessing sources of nonobservational errors such as participant nonresponse, item nonresponse and sampling bias. Time taken and number of reminders required for questionnaire return were used as indicators of practicality. Participant nonresponse was significantly higher among participants who chose the postal questionnaire. The proportion of questionnaires with missing items and the mean number of missing items did not differ significantly by mode. A significantly larger proportion of tertiary-educated participants and managers/professionals completed the online questionnaire. There were no significant differences in age, relationship status, employment status, country of birth or language spoken by completion mode. Compared with postal questionnaires, online questionnaires were returned significantly more quickly and required significantly fewer reminders. These results demonstrate that online questionnaire completion can be offered in a cancer sample without compromising data quality. In fact, data quality from online questionnaires may be superior due to lower rates of participant nonresponse. Investigators should be aware of potential sampling bias created by more highly educated participants and managers/professionals choosing to complete online questionnaires. Besides this issue, online questionnaires offer an efficient method for collecting high-quality data, with faster return and fewer reminders. Copyright © 2011 John Wiley & Sons, Ltd.

Predictors of nonresponse in a questionnaire-based outcome study of vocational rehabilitation patients.

PubMed

Burrus, Cyrille; Ballabeni, Pierluigi; Deriaz, Olivier; Gobelet, Charles; Luthi, François

2009-09-01

To identify predictors of nonresponse to a self-report study of patients with orthopedic trauma hospitalized for vocational rehabilitation between November 15, 2003, and December 31, 2005. The role of biopsychosocial complexity, assessed using the INTERMED, was of particular interest. Cohort study. Questionnaires with quality of life, sociodemographic, and job-related questions were given to patients at hospitalization and 1 year after discharge. Sociodemographic data, biopsychosocial complexity, and presence of comorbidity were available at hospitalization (baseline) for all eligible patients. Logistic regression models were used to test a number of baseline variables as potential predictors of nonresponse to the questionnaires at each of the 2 time points. Rehabilitation clinic. Patients (N=990) hospitalized for vocational rehabilitation over a period of 2 years. Not applicable. Nonresponse to the questionnaires was the binary dependent variable. Patients with high biopsychosocial complexity, foreign native language, or low educational level were less likely to respond at both time points. Younger patients were less likely to respond at 1 year. Those living in a stable partnership were less likely than singles to respond at hospitalization. Sex, psychiatric, and somatic comorbidity and alcoholism were never associated with nonresponse. We stress the importance of assessing biopsychosocial complexity to predict nonresponse. Furthermore, the factors we found to be predictive of nonresponse are also known to influence treatment outcome and vocational rehabilitation. Therefore, it is important to increase the response rate of the groups of concern in order to reduce selection bias in epidemiologic investigations.

Estimation of population mean under systematic sampling

NASA Astrophysics Data System (ADS)

Noor-ul-amin, Muhammad; Javaid, Amjad

2017-11-01

In this study we propose a generalized ratio estimator under non-response for systematic random sampling. We also generate a class of estimators through special cases of generalized estimator using different combinations of coefficients of correlation, kurtosis and variation. The mean square errors and mathematical conditions are also derived to prove the efficiency of proposed estimators. Numerical illustration is included using three populations to support the results.

The socio-economic patterning of survey participation and non-response error in a multilevel study of food purchasing behaviour: area- and individual-level characteristics.

PubMed

Turrell, Gavin; Patterson, Carla; Oldenburg, Brian; Gould, Trish; Roy, Marie-Andree

2003-04-01

To undertake an assessment of survey participation and non-response error in a population-based study that examined the relationship between socio-economic position and food purchasing behaviour. The study was conducted in Brisbane City (Australia) in 2000. The sample was selected using a stratified two-stage cluster design. Respondents were recruited using a range of strategies that attempted to maximise the involvement of persons from disadvantaged backgrounds: respondents were contacted by personal visit and data were collected using home-based face-to-face interviews; multiple call-backs on different days and at different times were used; and a financial gratuity was provided. Non-institutionalised residents of private dwellings located in 50 small areas that differed in their socio-economic characteristics. Rates of survey participation - measured by non-contacts, exclusions, dropped cases, response rates and completions - were similar across areas, suggesting that residents of socio-economically advantaged and disadvantaged areas were equally likely to be recruited. Individual-level analysis, however, showed that respondents and non-respondents differed significantly in their sociodemographic and food purchasing characteristics: non-respondents were older, less educated and exhibited different purchasing behaviours. Misclassification bias probably accounted for the inconsistent pattern of association between the area- and individual-level results. Estimates of bias due to non-response indicated that although respondents and non-respondents were qualitatively different, the magnitude of error associated with this differential was minimal. Socio-economic position measured at the individual level is a strong and consistent predictor of survey non-participation. Future studies that set out to examine the relationship between socio-economic position and diet need to adopt sampling strategies and data collection methods that maximise the likelihood of recruiting participants from all points on the socio-economic spectrum, and particularly persons from disadvantaged backgrounds. Study designs that are not sensitive to the difficulties associated with recruiting a socio-economically representative sample are likely to produce biased estimates (underestimates) of socio-economic differences in the dietary outcome being investigated.

Clinical utility of C-reactive protein to predict treatment response during cystic fibrosis pulmonary exacerbations.

PubMed

Sharma, Ashutosh; Kirkpatrick, Gordon; Chen, Virginia; Skolnik, Kate; Hollander, Zsuzsanna; Wilcox, Pearce; Quon, Bradley S

2017-01-01

C-reactive protein (CRP) is a systemic marker of inflammation that correlates with disease status in cystic fibrosis (CF). The clinical utility of CRP measurement to guide pulmonary exacerbation (PEx) treatment decisions remains uncertain. To determine whether monitoring CRP during PEx treatment can be used to predict treatment response. We hypothesized that early changes in CRP can be used to predict treatment response. We reviewed all PEx events requiring hospitalization for intravenous (IV) antibiotics over 2 years at our institution. 83 PEx events met our eligibility criteria. CRP levels from admission to day 5 were evaluated to predict treatment non-response, using a modified version of a prior published composite definition. CRP was also evaluated to predict time until next exacerbation (TUNE). 53% of 83 PEx events were classified as treatment non-response. Paradoxically, 24% of PEx events were characterized by a ≥ 50% increase in CRP levels within the first five days of treatment. Absolute change in CRP from admission to day 5 was not associated with treatment non-response (p = 0.58). Adjusted for FEV1% predicted, admission log10 CRP was associated with treatment non-response (OR: 2.39; 95% CI: 1.14 to 5.91; p = 0.03) and shorter TUNE (HR: 1.60; 95% CI: 1.13 to 2.27; p = 0.008). The area under the receiver operating characteristics (ROC) curve of admission CRP to predict treatment non-response was 0.72 (95% CI 0.61-0.83; p<0.001). 23% of PEx events were characterized by an admission CRP of > 75 mg/L with a specificity of 90% for treatment non-response. Admission CRP predicts treatment non-response and time until next exacerbation. A very elevated admission CRP (>75mg/L) is highly specific for treatment non-response and might be used to target high-risk patients for future interventional studies aimed at improving exacerbation outcomes.

Stress and Sucrose Intake Modulate Neuronal Activity in the Anterior Hypothalamic Area in Rats

PubMed Central

Mitra, Arojit; Guèvremont, Geneviève; Timofeeva, Elena

2016-01-01

The anterior hypothalamic area (AHA) is an important integrative relay structure for a variety of autonomic, endocrine, and behavioral responses including feeding behavior and response to stress. However, changes in the activity of the AHA neurons during stress and feeding in freely moving rats are not clear. The present study investigated the firing rate and burst activity of neurons in the central nucleus of the AHA (cAHA) during sucrose intake in non-stressful conditions and after acute stress in freely behaving rats. Rats were implanted with micro-electrodes into the cAHA, and extracellular multi-unit activity was recorded during 1-h access to 10% sucrose in non-stressful conditions or after acute foot shock stress. Acute stress significantly reduced sucrose intake, total sucrose lick number, and lick frequency in licking clusters, and increased inter-lick intervals. At the cluster start (CS) of sucrose licking, the cAHA neurons increased (CS-excited, 20% of the recorded neurons), decreased (CS-inhibited, 42% of the neurons) or did not change (CS-nonresponsive, 38% of the neurons) their firing rate. Stress resulted in a significant increase in the firing rate of the CS-inhibited neurons by decreasing inter-spike intervals within the burst firing of these neurons. This increase in the stress-induced firing rate of the CS-inhibited neurons was accompanied by a disruption of the correlation between the firing rate of CS-inhibited and CS-nonresponsive neurons that was observed in non-stressful conditions. Stress did not affect the firing rate of the CS-excited and CS-nonresponsive neurons. However, stress changed the pattern of burst firing of the CS-excited and CS-nonresponsive neurons by decreasing and increasing the burst number in the CS-excited and CS-nonresponsive neurons, respectively. These results suggest that the cAHA neurons integrate the signals related to stress and intake of palatable food and play a role in the stress- and eating-related circuitry. PMID:27243579

Stress and Sucrose Intake Modulate Neuronal Activity in the Anterior Hypothalamic Area in Rats.

PubMed

Mitra, Arojit; Guèvremont, Geneviève; Timofeeva, Elena

2016-01-01

The anterior hypothalamic area (AHA) is an important integrative relay structure for a variety of autonomic, endocrine, and behavioral responses including feeding behavior and response to stress. However, changes in the activity of the AHA neurons during stress and feeding in freely moving rats are not clear. The present study investigated the firing rate and burst activity of neurons in the central nucleus of the AHA (cAHA) during sucrose intake in non-stressful conditions and after acute stress in freely behaving rats. Rats were implanted with micro-electrodes into the cAHA, and extracellular multi-unit activity was recorded during 1-h access to 10% sucrose in non-stressful conditions or after acute foot shock stress. Acute stress significantly reduced sucrose intake, total sucrose lick number, and lick frequency in licking clusters, and increased inter-lick intervals. At the cluster start (CS) of sucrose licking, the cAHA neurons increased (CS-excited, 20% of the recorded neurons), decreased (CS-inhibited, 42% of the neurons) or did not change (CS-nonresponsive, 38% of the neurons) their firing rate. Stress resulted in a significant increase in the firing rate of the CS-inhibited neurons by decreasing inter-spike intervals within the burst firing of these neurons. This increase in the stress-induced firing rate of the CS-inhibited neurons was accompanied by a disruption of the correlation between the firing rate of CS-inhibited and CS-nonresponsive neurons that was observed in non-stressful conditions. Stress did not affect the firing rate of the CS-excited and CS-nonresponsive neurons. However, stress changed the pattern of burst firing of the CS-excited and CS-nonresponsive neurons by decreasing and increasing the burst number in the CS-excited and CS-nonresponsive neurons, respectively. These results suggest that the cAHA neurons integrate the signals related to stress and intake of palatable food and play a role in the stress- and eating-related circuitry.

Measuring Substance Use and Misuse via Survey Research: Unfinished Business.

PubMed

Johnson, Timothy P

2015-01-01

This article reviews unfinished business regarding the assessment of substance use behaviors by using survey research methodologies, a practice that dates back to the earliest years of this journal's publication. Six classes of unfinished business are considered including errors of sampling, coverage, non-response, measurement, processing, and ethics. It may be that there is more now that we do not know than when this work began some 50 years ago.

Factors affecting study efficiency and item non-response in health surveys in developing countries: the Jamaica national healthy lifestyle survey.

PubMed

Wilks, Rainford; Younger, Novie; Mullings, Jasneth; Zohoori, Namvar; Figueroa, Peter; Tulloch-Reid, Marshall; Ferguson, Trevor; Walters, Christine; Bennett, Franklyn; Forrester, Terrence; Ward, Elizabeth; Ashley, Deanna

2007-02-28

Health surveys provide important information on the burden and secular trends of risk factors and disease. Several factors including survey and item non-response can affect data quality. There are few reports on efficiency, validity and the impact of item non-response, from developing countries. This report examines factors associated with item non-response and study efficiency in a national health survey in a developing Caribbean island. A national sample of participants aged 15-74 years was selected in a multi-stage sampling design accounting for 4 health regions and 14 parishes using enumeration districts as primary sampling units. Means and proportions of the variables of interest were compared between various categories. Non-response was defined as failure to provide an analyzable response. Linear and logistic regression models accounting for sample design and post-stratification weighting were used to identify independent correlates of recruitment efficiency and item non-response. We recruited 2012 15-74 year-olds (66.2% females) at a response rate of 87.6% with significant variation between regions (80.9% to 97.6%; p < 0.0001). Females outnumbered males in all parishes. The majority of subjects were recruited in a single visit, 39.1% required multiple visits varying significantly by region (27.0% to 49.8% [p < 0.0001]). Average interview time was 44.3 minutes with no variation between health regions, urban-rural residence, educational level, gender and SES; but increased significantly with older age category from 42.9 minutes in the youngest to 46.0 minutes in the oldest age category. Between 15.8% and 26.8% of persons did not provide responses for the number of sexual partners in the last year. Women and urban residents provided less data than their counterparts. Highest item non-response related to income at 30% with no gender difference but independently related to educational level, employment status, age group and health region. Characteristics of non-responders vary with types of questions. Informative health surveys are possible in developing countries. While survey response rates may be satisfactory, item non-response was high in respect of income and sexual practice. In contrast to developed countries, non-response to questions on income is higher and has different correlates. These findings can inform future surveys.

Reasons for nonresponse in a web-based survey of alcohol involvement among first-year college students.

PubMed

Cranford, James A; McCabe, Sean Esteban; Boyd, Carol J; Slayden, Janie; Reed, Mark B; Ketchie, Julie M; Lange, James E; Scott, Marcia S

2008-01-01

This study conducted a follow-up telephone survey of a probability sample of college students who did not respond to a Web survey to determine correlates of and reasons for nonresponse. A stratified random sample of 2502 full-time first-year undergraduate students was invited to participate in a Web-based survey. A random sample of 221 students who did not respond to the original Web survey completed an abbreviated version of the original survey by telephone. Nonresponse did not vary by gender, but nonresponse was higher among Blacks and Hispanics compared to Whites, and Blacks compared to Asians. Nonresponders reported lower frequency of past 28 days drinking, lower levels of past-year and past 28-days heavy episodic drinking, and more time spent preparing for classes than responders. The most common reasons for nonresponse were "too busy" (45.7%), "not interested" (18.1%), and "forgot to complete survey" (18.1%). Reasons for nonresponse to Web surveys among college students are similar to reasons for nonresponse to mail and telephone surveys, and some nonresponse reasons vary as a function of alcohol involvement.

Identification of non-response to treatment using narrative data in an electronic health record inflammatory bowel disease cohort

PubMed Central

Ananthakrishnan, Ashwin N.; Cagan, Andrew; Cai, Tianxi; Gainer, Vivian S.; Shaw, Stanley Y; Savova, Guergana; Churchill, Susanne; Karlson, Elizabeth W.; Murphy, Shawn N.; Liao, Katherine P.; Kohane, Isaac

2016-01-01

Introduction Electronic health records (EHR), increasingly a part of healthcare, provide a wealth of untapped narrative free text data that has the potential to accurately inform clinical outcomes. Methods From a validated cohort of patients with Crohn’s disease (CD) or ulcerative colitis (UC), we identified patients with ≥ 1 coded or narrative mention of monoclonal antibodies to tumor necrosis factor α (anti-TNF). Chart review by ascertained true use of therapy, time of initiation and cessation of treatment, as well as clinical response stratified as non-response, partial, or complete response at one year. Internal consistency was assessed in an independent validation cohort. Results A total of 3,087 patients had a mention of an anti-TNF. Actual therapy initiation was within 60 days of the first coded mention in 74% of patients. In the derivation cohort, 18% of anti-TNF starts were classified as non-response at 1 year, 21% as partial, and 56% as complete response. On multivariate analysis, the number of narrative mentions of diarrhea (OR 1.08, 95% CI 1.02 – 1.14) and fatigue (OR 1.16, 95% CI 1.02 – 1.32) were independently associated with non-response at 1 year (AUC 0.82). A likelihood of non-response score comprising a weighted sum of both demonstrated a good dose response relationship across non-responders (2.18), partial (1.20), and complete (0.50) responders (p < 0.0001) and correlated well with need for surgery or hospitalizations. Conclusions Narrative data in an EHR offers considerable potential to define temporally evolving disease outcomes such as non-response to treatment. PMID:26332313

Evaluating the Risk of Nonresponse Bias in Educational Large-Scale Assessments with School Nonresponse Questionnaires: A Theoretical Study

ERIC Educational Resources Information Center

Meinck, Sabine; Cortes, Diego; Tieck, Sabine

2017-01-01

Survey participation rates can have a direct impact on the validity of the data collected since nonresponse always holds the risk of bias. Therefore, the International Association for the Evaluation of Educational Achievement (IEA) has set very high standards for minimum survey participation rates. Nonresponse in IEA studies varies between studies…

Platelet response to increased aspirin dose in patients with persistent platelet aggregation while treated with aspirin 81 mg.

PubMed

Gengo, Fran; Westphal, Erica S; Rainka, Michelle M; Janda, Maria; Robson, Matthew J; Hourihane, J Maurice; Bates, Vernice

2016-04-01

This study demonstrates that patients who are taking 81 mg of aspirin and are nonresponsive benefit from a dose of 162 mg or greater vs a different antiplatelet therapy. We identified 100 patients who were nonresponsive to aspirin 81 mg via whole blood aggregometry and observed how many patients became responsive at a dose of 162 mg or greater. Platelet nonresponsiveness was defined as >10 Ω of resistance to collagen 1 µg/mL and/or an ohms ratio of collagen 1 µg/mL to collagen 5 µg/mL >0.5 and/or >6 Ω to arachidonate. Borderline response was defined as an improvement in 1 but not both of the above criteria. Of the initial 100 patients who were nonresponsive to an aspirin dose of 81 mg, 79% became responsive at a dose of 162 mg or >162 mg. Only 6% did not respond to any increase in dose. We believe that patients treated with low-dose aspirin who have significant risk for secondary vascular events should be individually assessed to determine their antiplatelet response. Those found to have persistent platelet aggregation despite treatment with 81 mg of aspirin have a higher likelihood of obtaining an adequate antiplatelet response at a higher aspirin dose. © 2015, The American College of Clinical Pharmacology.

What affects response rates in primary healthcare-based programmes? An analysis of individual and unit-related factors associated with increased odds of non-response based on HCV screening in the general population in Poland

PubMed Central

Parda, Natalia; Stępień, Małgorzata; Zakrzewska, Karolina; Madaliński, Kazimierz; Kołakowska, Agnieszka; Godzik, Paulina; Rosińska, Magdalena

2016-01-01

Objectives Response rate in public health programmes may be a limiting factor. It is important to first consider their delivery and acceptability for the target. This study aimed at determining individual and unit-related factors associated with increased odds of non-response based on hepatitis C virus screening in primary healthcare. Design Primary healthcare units (PHCUs) were extracted from the Register of Health Care Centres. Each of the PHCUs was to enrol adult patients selected on a random basis. Data on the recruitment of PHCUs and patients were analysed. Multilevel modelling was applied to investigate individual and unit-related factors associated with non-response. Multilevel logistic model was developed with fixed effects and only a random intercept for the unit. Preliminary analysis included a random effect for unit and each of the individual or PHCU covariates separately. For each of the PHCU covariates, we applied a two-level model with individual covariates, unit random effect and a single fixed effect of this unit covariate. Setting This study was conducted in primary care units in selected provinces in Poland. Participants A total of 242 PHCUs and 24 480 adults were invited. Of them, 44 PHCUs and 20 939 patients agreed to participate. Both PHCUs and patients were randomly selected. Results Data on 44 PHCUs and 24 480 patients were analysed. PHCU-level factors and recruitment strategies were important predictors of non-response. Unit random effect was significant in all models. Larger and private units reported higher non-response rates, while for those with a history of running public health programmes the odds of non-response was lower. Proactive recruitment, more working hours devoted to the project and patient resulted in higher acceptance of the project. Higher number of personnel had no such effect. Conclusions Prior to the implementation of public health programme, several factors that could hinder its execution should be addressed. PMID:27927665

What affects response rates in primary healthcare-based programmes? An analysis of individual and unit-related factors associated with increased odds of non-response based on HCV screening in the general population in Poland.

PubMed

Parda, Natalia; Stępień, Małgorzata; Zakrzewska, Karolina; Madaliński, Kazimierz; Kołakowska, Agnieszka; Godzik, Paulina; Rosińska, Magdalena

2016-12-07

Response rate in public health programmes may be a limiting factor. It is important to first consider their delivery and acceptability for the target. This study aimed at determining individual and unit-related factors associated with increased odds of non-response based on hepatitis C virus screening in primary healthcare. Primary healthcare units (PHCUs) were extracted from the Register of Health Care Centres. Each of the PHCUs was to enrol adult patients selected on a random basis. Data on the recruitment of PHCUs and patients were analysed. Multilevel modelling was applied to investigate individual and unit-related factors associated with non-response. Multilevel logistic model was developed with fixed effects and only a random intercept for the unit. Preliminary analysis included a random effect for unit and each of the individual or PHCU covariates separately. For each of the PHCU covariates, we applied a two-level model with individual covariates, unit random effect and a single fixed effect of this unit covariate. This study was conducted in primary care units in selected provinces in Poland. A total of 242 PHCUs and 24 480 adults were invited. Of them, 44 PHCUs and 20 939 patients agreed to participate. Both PHCUs and patients were randomly selected. Data on 44 PHCUs and 24 480 patients were analysed. PHCU-level factors and recruitment strategies were important predictors of non-response. Unit random effect was significant in all models. Larger and private units reported higher non-response rates, while for those with a history of running public health programmes the odds of non-response was lower. Proactive recruitment, more working hours devoted to the project and patient resulted in higher acceptance of the project. Higher number of personnel had no such effect. Prior to the implementation of public health programme, several factors that could hinder its execution should be addressed. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Binary variable multiple-model multiple imputation to address missing data mechanism uncertainty: Application to a smoking cessation trial

PubMed Central

Siddique, Juned; Harel, Ofer; Crespi, Catherine M.; Hedeker, Donald

2014-01-01

The true missing data mechanism is never known in practice. We present a method for generating multiple imputations for binary variables that formally incorporates missing data mechanism uncertainty. Imputations are generated from a distribution of imputation models rather than a single model, with the distribution reflecting subjective notions of missing data mechanism uncertainty. Parameter estimates and standard errors are obtained using rules for nested multiple imputation. Using simulation, we investigate the impact of missing data mechanism uncertainty on post-imputation inferences and show that incorporating this uncertainty can increase the coverage of parameter estimates. We apply our method to a longitudinal smoking cessation trial where nonignorably missing data were a concern. Our method provides a simple approach for formalizing subjective notions regarding nonresponse and can be implemented using existing imputation software. PMID:24634315

The Prevalence and Clinical Features of Non-responsive Gastroesophageal Reflux Disease to Practical Proton Pump Inhibitor Dose in Korea: A Multicenter Study.

PubMed

Park, Hong Jun; Park, Soo Heon; Shim, Ki Nam; Kim, Yong Sung; Kim, Hyun Jin; Han, Jae Pil; Kim, Yong Sik; Bang, Byoung Wook; Kim, Gwang Ha; Baik, Gwang Ho; Kim, Hyung Hun; Park, Seon Young; Kim, Sung Soo

2016-07-25

In Korea, there are no available multicenter data concerning the prevalence of or diagnostic approaches for non-responsive gastroesophageal reflux disease (GERD) which does not respond to practical dose of proton pump inhibitor (PPI) in Korea. The purpose of this study is to evaluate the prevalence and the symptom pattern of non-responsive GERD. A total of 12 hospitals who were members of a Korean GERD research group joined this study. We used the composite score (CS) as a reflux symptom scale which is a standardized questionnaire based on the frequency and severity of typical symptoms of GERD. We defined "non-responsive GERD" as follows: a subject with the erosive reflux disease (ERD) whose CS was not decreased by at least 50% after standard-dose PPIs for 8 weeks or a subject with non-erosive reflux disease (NERD) whose CS was not decreased by at least 50% after half-dose PPIs for 4 weeks. A total of 234 subjects were analyzed. Among them, 87 and 147 were confirmed to have ERD and NERD, respectively. The prevalence of non-responsive GERD was 26.9% (63/234). The rates of non-responsive GERD were not different between the ERD and NERD groups (25.3% vs. 27.9%, respectively, p=0.664). There were no differences between the non-responsive GERD and responsive GERD groups for sex (p=0.659), age (p=0.134), or BMI (p=0.209). However, the initial CS for epigastric pain and fullness were higher in the non-responsive GERD group (p=0.044, p=0.014, respectively). In conclusion, this multicenter Korean study showed that the rate of non-responsive GERD was substantially high up to 26%. In addition, the patients with the non-responsive GERD frequently showed dyspeptic symptoms such as epigastric pain and fullness.

Survey Page Length and Progress Indicators: What Are Their Relationships to Item Nonresponse?

ERIC Educational Resources Information Center

Bowman, Nicholas A.; Herzog, Serge; Sarraf, Shimon; Tukibayeva, Malika

2014-01-01

The popularity of online student surveys has been associated with greater item nonresponse. This chapter presents research aimed at exploring what factors might help minimize item nonresponse, such as altering online survey page length and using progress indicators.

Weighting or imputations? The example of nonresponses for daily trips in the French NPTS

DOT National Transportation Integrated Search

1998-10-01

This paper reports on methods used to correct nonresponse for daily mobility in the French National Personal Transportation Surveys. A two-stage technique was used for unit nonresponse: 1) post-stratification according to the households' characterist...

Non-alcoholic fatty liver disease and impaired proinsulin conversion as newly identified predictors of the long-term non-response to a lifestyle intervention for diabetes prevention: results from the TULIP study.

PubMed

Schmid, Vera; Wagner, Robert; Sailer, Corinna; Fritsche, Louise; Kantartzis, Konstantinos; Peter, Andreas; Heni, Martin; Häring, Hans-Ulrich; Stefan, Norbert; Fritsche, Andreas

2017-12-01

Lifestyle intervention is effective to prevent type 2 diabetes. However, a considerable long-term non-response occurs to a standard lifestyle intervention. We investigated which risk phenotypes at baseline and their changes during the lifestyle intervention predict long-term glycaemic non-response to the intervention. Of 300 participants at high risk for type 2 diabetes who participated in a 24 month lifestyle intervention with diet modification and increased physical activity, 190 participants could be re-examined after 8.7 ± 1.6 years. All individuals underwent a five-point 75 g OGTT and measurements of body fat compartments and liver fat content with MRI and spectroscopy at baseline, 9 and 24 months during the lifestyle intervention, and at long-term follow-up. Fasting proinsulin to insulin conversion (PI/I ratio) and insulin sensitivity and secretion were calculated from the OGTT. Non-response to lifestyle intervention was defined as no decrease in glycaemia, i.e. no decrease in AUC for glucose at 0-120 min during OGTT (AUCglucose 0-120 min ). Before the lifestyle intervention, 56% of participants had normal glucose regulation and 44% individuals had impaired fasting glucose and/or impaired glucose tolerance. At long-term follow-up, 11% had developed diabetes. Multivariable regression analysis with adjustment for age, sex, BMI and change in BMI during the lifestyle intervention revealed that baseline insulin secretion and insulin sensitivity, as well as change in insulin sensitivity during the lifestyle intervention, predicted long-term glycaemic control after 9 years. In addition, increased hepatic lipid content as well as impaired fasting proinsulin conversion at baseline were newly detected phenotypes that independently predicted long-term glycaemic control. Increased hepatic lipid content and impaired proinsulin conversion are new predictors, independent of change in body weight, for non-response to lifestyle intervention in addition to the confirmed factors, impaired insulin secretion and insulin sensitivity.

Atypical antipsychotics: recent research findings and applications to clinical practice: Proceedings of a symposium presented at the 29th Annual European College of Neuropsychopharmacology Congress, 19 September 2016, Vienna, Austria.

PubMed

Murray, Robin; Correll, Christoph U; Reynolds, Gavin P; Taylor, David

2017-03-01

Available evidence suggests that second-generation atypical antipsychotics are broadly similar to first-generation agents in terms of their efficacy, but may have a more favourable tolerability profile, primarily by being less likely to cause extrapyramidal symptoms. However, atypical antipsychotics are variably associated with disturbances in the cardiometabolic arena, including increased body weight and the development of metabolic syndrome, which may reflect differences in their receptor binding profiles. Effective management of schizophrenia must ensure that the physical health of patients is addressed together with their mental health. This should therefore involve consideration of the specific tolerability profiles of available agents and individualization of treatment to minimize the likelihood of adverse metabolic sequelae, thereby improving long-term adherence and optimizing overall treatment outcomes. Alongside this, modifiable risk factors (such as exercise, diet, obesity/body weight and smoking status) must be addressed, in order to optimize patients' overall health and quality of life (QoL). In addition to antipsychotic-induced side effects, the clinical management of early nonresponders and psychopharmacological approaches for patients with treatment-resistant schizophrenia remain important unmet needs. Evidence suggests that antipsychotic response starts early in the course of treatment and that early nonresponse accurately predicts nonresponse over the longer term. Early nonresponse therefore represents an important modifiable risk factor for poor efficacy and effectiveness outcomes, since switching or augmenting antipsychotic treatment in patients showing early nonresponse has been shown to improve the likelihood of subsequent treatment outcomes. Recent evidence has also demonstrated that patients showing early nonresponse to treatment with lurasidone at 2 weeks may benefit from an increase in dose at this timepoint without compromising tolerability/safety. However, further research is required to determine whether these findings are generalizable to other antipsychotic agents.

Evaluating Survey Quality in Health Services Research: A Decision Framework for Assessing Nonresponse Bias

PubMed Central

Halbesleben, Jonathon R B; Whitman, Marilyn V

2013-01-01

Objective To address the issue of nonresponse as problematic and offer appropriate strategies for assessing nonresponse bias. Study Design A review of current strategies used to assess the quality of survey data and the challenges associated with these strategies is provided along with appropriate post-data collection techniques that researchers should consider. Principal Findings Response rates are an incomplete assessment of survey data quality, and quick reactions to response rate should be avoided. Based on a five-question decision making framework, we offer potential ways to assess nonresponse bias, along with a description of the advantages and disadvantages to each. Conclusions It is important that the quality of survey data be considered to assess the relative contribution to the literature of a given study. Authors and funding agencies should consider the potential effects of nonresponse bias both before and after survey administration and report the results of assessments of nonresponse bias in addition to response rates. PMID:23046097

Missing data in FFQs: making assumptions about item non-response.

PubMed

Lamb, Karen E; Olstad, Dana Lee; Nguyen, Cattram; Milte, Catherine; McNaughton, Sarah A

2017-04-01

FFQs are a popular method of capturing dietary information in epidemiological studies and may be used to derive dietary exposures such as nutrient intake or overall dietary patterns and diet quality. As FFQs can involve large numbers of questions, participants may fail to respond to all questions, leaving researchers to decide how to deal with missing data when deriving intake measures. The aim of the present commentary is to discuss the current practice for dealing with item non-response in FFQs and to propose a research agenda for reporting and handling missing data in FFQs. Single imputation techniques, such as zero imputation (assuming no consumption of the item) or mean imputation, are commonly used to deal with item non-response in FFQs. However, single imputation methods make strong assumptions about the missing data mechanism and do not reflect the uncertainty created by the missing data. This can lead to incorrect inference about associations between diet and health outcomes. Although the use of multiple imputation methods in epidemiology has increased, these have seldom been used in the field of nutritional epidemiology to address missing data in FFQs. We discuss methods for dealing with item non-response in FFQs, highlighting the assumptions made under each approach. Researchers analysing FFQs should ensure that missing data are handled appropriately and clearly report how missing data were treated in analyses. Simulation studies are required to enable systematic evaluation of the utility of various methods for handling item non-response in FFQs under different assumptions about the missing data mechanism.

Analysis of Nonresponse Bias in Research for Business Education

ERIC Educational Resources Information Center

Bartlett, James E., II; Bartlett, Michelle E.; Reio, Thomas G., Jr.

2008-01-01

This research examined the issue of nonresponse bias and how it was reported in nonexperimental quantitative research published in the "Delta Pi Epsilon Journal" between 1995 and 2004. Through content analysis, 85 articles consisting of 91 separate samples were examined. In 72.5% of the cases, possible nonresponse bias was not examined in the…

What Incentives Can Teach Us about Missing Data in Longitudinal Assessment

ERIC Educational Resources Information Center

Martin, Georgianna L.; Loes, Chad N.

2010-01-01

In this chapter, the authors explore the effect of incentives on attrition and nonresponse in a multi-institutional longitudinal study. They organize this chapter into three sections. First, they review the literature regarding nonresponse among students and the effects of incentives on attrition and nonresponse in studies that employ…

A primer of nonresponse in the US Forest Inventory and Analysis program

Treesearch

Paul L. Patterson; John W. Coulston; Francis A. Roesch; James A. Westfall; Andrew D. Hill

2012-01-01

Nonresponse caused by denied access and hazardous conditions are a concern for the USDA Forest Service, Forest Inventory and Analysis (FIA) program, whose mission is to quantify status and trends in forest resources across the USA. Any appreciable amount of nonresponse can cause bias in FIA's estimates of population parameters. This paper will quantify the...

Electronic Health Records to Evaluate and Account for Non-response Bias: A Survey of Patients Using Chronic Opioid Therapy.

PubMed

Shortreed, Susan M; Von Korff, Michael; Thielke, Stephen; LeResche, Linda; Saunders, Kathleen; Rosenberg, Dori; Turner, Judith A

2016-01-01

In observational studies concerning drug use and misuse, persons misusing drugs may be less likely to respond to surveys. However, little is known about differences in drug use and drug misuse risk factors between survey respondents and nonrespondents. Using electronic health record (EHR) data, we compared respondents and non-respondents in a telephone survey of middle-aged and older chronic opioid therapy patients to assess predictors of interview nonresponse. We compared general patient characteristics, specific opioid misuse risk factors, and patterns of opioid use associated with increased risk of opioid misuse. Inverse probability weights were calculated to account for nonresponse bias by EHR-measured covariates. EHR-measured covariate distributions for the full sample (nonrespondents and respondents), the unweighted respondent sample, and the inverse probability weighted respondent sample are reported. We present weighted and unweighted prevalence of self-reported opioid misuse risk factors. Among 2489 potentially eligible patients, 1477 (59.3%) completed interviews. Response rates differed with age (45-54 years, 51.8%; 55-64 years, 58.7%; 65-74 years, 67.9%; and 75 years or older, 59.9%). Tobacco users had lower response rates than did nonusers (53.5% versus 60.9%). Charlson comorbidity score was also related to response rates. Individuals with a Charlson score of 2 had the highest response rate at 65.6%; response rates were lower amoung patients with the lowest (the patients with the fewest health conditions had response rates of 56.7-60.0%) and the highest Charlson scores (patients with the most health conditions had response rates of 52.2-56.0%). These bivariate relationships persisted in adjusted multivariable logistic regression models predicting survey response. Response rates of persons with and without specific opioid misuse risk factors were similar (e.g., 58.7% for persons with substance abuse diagnoses, 59.4% for those without). Opioid use patterns associated with opioid misuse did not predict response rates (e.g., 60.6% versus 59.2% for those receiving versus not receiving opioids from 3 or more physicians outside their primary care clinic). Very few patient characteristics predicted non-response; thus, inverse probability weights accounting for nonresponse had little impact on the distributions of EHR-measured covariates or self-reported measures related to opioid use and misuse. Response rates differed by characteristics that predict nonresponse in general health surveys (age, tobacco use), but did not appear to differ by specific patient or drug use risk factors for prescription opioid misuse among middle- and older-aged chronic opioid therapy patients. When observational studies are conducted in health plan populations, electronic health records may be used to evaluate nonresponse bias and to adjust for variables predicting interview nonresponse, complementing other research uses of EHR data in observational studies.

Botulinum Toxin in Secondarily Nonresponsive Patients with Spasmodic Dysphonia.

PubMed

Mor, Niv; Tang, Christopher; Blitzer, Andrew

2016-09-01

Chemodenervation with botulinum toxin (BoNT) has been effective and well tolerated for all types of dystonia for >30 years. We reviewed outcomes of our patients treated with BoNT serotype A (BoNT-A) for spasmodic dysphonia (SD) who became secondarily nonresponsive. We found that 8 of 1400 patients became nonresponsive to BoNT-A (0.57%), which is lower than the secondary nonresponse rate in other dystonias. After a cessation period, 4 of our patients resumed BoNT-A injections, and recurrence of immunoresistance was not seen in any of them. When compared with patients with other dystonias, patients with SD receive extremely low doses of BoNT. Small antigen challenge may explain the lower rate of immunoresistance and long-lasting efficacy after BoNT-A is restarted among secondary nonresponsive patients with SD. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

Survey Response-Related Biases in Contingent Valuation: Concepts, Remedies, and Empirical Application to Valuing Aquatic Plant Management

Treesearch

Mark L. Messonnier; John C. Bergstrom; Chrisopher M. Cornwell; R. Jeff Teasley; H. Ken Cordell

2000-01-01

Simple nonresponse and selection biases that may occur in survey research such as contingent valuation applications are discussed and tested. Correction mechanisms for these types of biases are demonstrated. Results indicate the importance of testing and correcting for unit and item nonresponse bias in contingent valuation survey data. When sample nonresponse and...

Method of calibrating an interferometer and reducing its systematic noise

NASA Technical Reports Server (NTRS)

Hammer, Philip D. (Inventor)

1997-01-01

Methods of operation and data analysis for an interferometer so as to eliminate the errors contributed by non-responsive or unstable pixels, interpixel gain variations that drift over time, and spurious noise that would otherwise degrade the operation of the interferometer are disclosed. The methods provide for either online or post-processing calibration. The methods apply prescribed reversible transformations that exploit the physical properties of interferograms obtained from said interferometer to derive a calibration reference signal for subsequent treatment of said interferograms for interpixel gain variations. A self-consistent approach for treating bad pixels is incorporated into the methods.

Nonresponse in the National Survey of Children's Health, 2007.

PubMed

Skalland, Benjamin J; Blumberg, Stephen J

2012-06-01

For random-digit-dial telephone surveys, the increasing difficulty in contacting eligible households and obtaining their cooperation raises concerns about the potential for nonresponse bias. This report presents an analysis of nonresponse bias in the 2007 National Survey of Children's Health, a module of the State and Local Area Integrated Telephone Survey conducted by the Centers for Disease Control and Prevention's National Center for Health Statistics. An attempt was made to measure bias in six key survey estimates using four different approaches: comparison of response rates for subgroups, use of sampling frame data, study of variation within the existing survey, and comparison of survey estimates with similar estimates from another source. Even when nonresponse-adjusted survey weights were used, the interviewed population was more likely to live in areas associated with higher levels of home ownership, lower home values, and greater proportions of non-Hispanic white persons when compared with the nonresponding population. Bias was found (although none greater than 3%) in national estimates of the proportion of children in excellent or very good health, those with consistent health insurance coverage, and those with a medical home. However, the level and direction of the bias depended on the approach used to measure it. There was no evidence of significant bias in the proportion of children with preventive medical care visits, those with families who ate daily meals together, or those living in safe neighborhoods.

Estimators used in the New Mexico inventory: practical implications of "truly" random nonresponse within each stratum

Treesearch

Paul L. Patterson; Sara A. Goeking

2012-01-01

The annual forest inventory of New Mexico began as an accelerated inventory, and 8 of the 10 Phase 2 panels were sampled between 2008 and 2011. The inventory includes a large proportion of nonresponse. FIA's estimation process uses post-stratification and assumes that nonresponse occurs at random within each stratum. We construct an estimator for the New Mexico...

Relationship between Future Time Orientation and Item Nonresponse on Subjective Probability Questions: A Cross-Cultural Analysis.

PubMed

Lee, Sunghee; Liu, Mingnan; Hu, Mengyao

2017-06-01

Time orientation is an unconscious yet fundamental cognitive process that provides a framework for organizing personal experiences in temporal categories of past, present and future, reflecting the relative emphasis given to these categories. Culture lies central to individuals' time orientation, leading to cultural variations in time orientation. For example, people from future-oriented cultures tend to emphasize the future and store information relevant for the future more than those from present- or past-oriented cultures. For survey questions that ask respondents to report expected probabilities of future events, this may translate into culture-specific question difficulties, manifested through systematically varying "I don't know" item nonresponse rates. This study drew on the time orientation theory and examined culture-specific nonresponse patterns on subjective probability questions using methodologically comparable population-based surveys from multiple countries. The results supported our hypothesis. Item nonresponse rates on these questions varied significantly in the way that future-orientation at the group as well as individual level was associated with lower nonresponse rates. This pattern did not apply to non-probability questions. Our study also suggested potential nonresponse bias. Examining culture-specific constructs, such as time orientation, as a framework for measurement mechanisms may contribute to improving cross-cultural research.

Relationship between Future Time Orientation and Item Nonresponse on Subjective Probability Questions: A Cross-Cultural Analysis

PubMed Central

Lee, Sunghee; Liu, Mingnan; Hu, Mengyao

2017-01-01

Time orientation is an unconscious yet fundamental cognitive process that provides a framework for organizing personal experiences in temporal categories of past, present and future, reflecting the relative emphasis given to these categories. Culture lies central to individuals’ time orientation, leading to cultural variations in time orientation. For example, people from future-oriented cultures tend to emphasize the future and store information relevant for the future more than those from present- or past-oriented cultures. For survey questions that ask respondents to report expected probabilities of future events, this may translate into culture-specific question difficulties, manifested through systematically varying “I don’t know” item nonresponse rates. This study drew on the time orientation theory and examined culture-specific nonresponse patterns on subjective probability questions using methodologically comparable population-based surveys from multiple countries. The results supported our hypothesis. Item nonresponse rates on these questions varied significantly in the way that future-orientation at the group as well as individual level was associated with lower nonresponse rates. This pattern did not apply to non-probability questions. Our study also suggested potential nonresponse bias. Examining culture-specific constructs, such as time orientation, as a framework for measurement mechanisms may contribute to improving cross-cultural research. PMID:28781381

Interactive effects of early and recent exposure to stressful contexts on cortisol reactivity in middle childhood.

PubMed

Jaffee, Sara R; McFarquhar, Tara; Stevens, Suzanne; Ouellet-Morin, Isabelle; Melhuish, Edward; Belsky, Jay

2015-02-01

Given mixed findings as to whether stressful experiences and relationships are associated with increases or decreases in children's cortisol reactivity, we tested whether a child's developmental history of risk exposure explained variation in cortisol reactivity to an experimentally induced task. We also tested whether the relationship between cortisol reactivity and children's internalizing and externalizing problems varied as a function of their developmental history of stressful experiences and relationships. Participants included 400 children (M = 9.99 years, SD = 0.74 years) from the Children's Experiences and Development Study. Early risk exposure was measured by children's experiences of harsh, nonresponsive parenting at 3 years. Recent risk exposure was measured by children's exposure to traumatic events in the past year. Children's cortisol reactivity was measured in response to a social provocation task and parents and teachers described children's internalizing and externalizing problems. The effect of recent exposure to traumatic events was partially dependent upon a child's early experiences of harsh, nonresponsive parenting: the more traumatic events children had recently experienced, the greater their cortisol reactivity if they had experienced lower (but not higher) levels of harsh, nonresponsive parenting at age 3. The lowest levels of cortisol reactivity were observed among children who had experienced the most traumatic events in the past year and higher (vs. lower) levels of harsh, nonresponsive parenting in early childhood. Among youth who experienced harsh, nonresponsive parent-child relationships in early childhood and later traumatic events, lower levels of cortisol reactivity were associated with higher levels of internalizing and externalizing problems. Hypothalamic-pituitary-adrenal (HPA) axis reactivity to psychological stressors and the relationship between HPA axis reactivity and children's internalizing and externalizing problems vary as a function of a child's developmental history of exposure to stressful relationships and experiences. © 2014 The Authors. Journal of Child Psychology and Psychiatry published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health.

Survey methods for assessing land cover map accuracy

USGS Publications Warehouse

Nusser, S.M.; Klaas, E.E.

2003-01-01

The increasing availability of digital photographic materials has fueled efforts by agencies and organizations to generate land cover maps for states, regions, and the United States as a whole. Regardless of the information sources and classification methods used, land cover maps are subject to numerous sources of error. In order to understand the quality of the information contained in these maps, it is desirable to generate statistically valid estimates of accuracy rates describing misclassification errors. We explored a full sample survey framework for creating accuracy assessment study designs that balance statistical and operational considerations in relation to study objectives for a regional assessment of GAP land cover maps. We focused not only on appropriate sample designs and estimation approaches, but on aspects of the data collection process, such as gaining cooperation of land owners and using pixel clusters as an observation unit. The approach was tested in a pilot study to assess the accuracy of Iowa GAP land cover maps. A stratified two-stage cluster sampling design addressed sample size requirements for land covers and the need for geographic spread while minimizing operational effort. Recruitment methods used for private land owners yielded high response rates, minimizing a source of nonresponse error. Collecting data for a 9-pixel cluster centered on the sampled pixel was simple to implement, and provided better information on rarer vegetation classes as well as substantial gains in precision relative to observing data at a single-pixel.

Growth condition dependency is the major cause of non-responsiveness upon genetic perturbation

PubMed Central

Amini, Saman; Holstege, Frank C. P.

2017-01-01

Investigating the role and interplay between individual proteins in biological processes is often performed by assessing the functional consequences of gene inactivation or removal. Depending on the sensitivity of the assay used for determining phenotype, between 66% (growth) and 53% (gene expression) of Saccharomyces cerevisiae gene deletion strains show no defect when analyzed under a single condition. Although it is well known that this non-responsive behavior is caused by different types of redundancy mechanisms or by growth condition/cell type dependency, it is not known what the relative contribution of these different causes is. Understanding the underlying causes of and their relative contribution to non-responsive behavior upon genetic perturbation is extremely important for designing efficient strategies aimed at elucidating gene function and unraveling complex cellular systems. Here, we provide a systematic classification of the underlying causes of and their relative contribution to non-responsive behavior upon gene deletion. The overall contribution of redundancy to non-responsive behavior is estimated at 29%, of which approximately 17% is due to homology-based redundancy and 12% is due to pathway-based redundancy. The major determinant of non-responsiveness is condition dependency (71%). For approximately 14% of protein complexes, just-in-time assembly can be put forward as a potential mechanistic explanation for how proteins can be regulated in a condition dependent manner. Taken together, the results underscore the large contribution of growth condition requirement to non-responsive behavior, which needs to be taken into account for strategies aimed at determining gene function. The classification provided here, can also be further harnessed in systematic analyses of complex cellular systems. PMID:28257504

Non-ignorable missingness in logistic regression.

PubMed

Wang, Joanna J J; Bartlett, Mark; Ryan, Louise

2017-08-30

Nonresponses and missing data are common in observational studies. Ignoring or inadequately handling missing data may lead to biased parameter estimation, incorrect standard errors and, as a consequence, incorrect statistical inference and conclusions. We present a strategy for modelling non-ignorable missingness where the probability of nonresponse depends on the outcome. Using a simple case of logistic regression, we quantify the bias in regression estimates and show the observed likelihood is non-identifiable under non-ignorable missing data mechanism. We then adopt a selection model factorisation of the joint distribution as the basis for a sensitivity analysis to study changes in estimated parameters and the robustness of study conclusions against different assumptions. A Bayesian framework for model estimation is used as it provides a flexible approach for incorporating different missing data assumptions and conducting sensitivity analysis. Using simulated data, we explore the performance of the Bayesian selection model in correcting for bias in a logistic regression. We then implement our strategy using survey data from the 45 and Up Study to investigate factors associated with worsening health from the baseline to follow-up survey. Our findings have practical implications for the use of the 45 and Up Study data to answer important research questions relating to health and quality-of-life. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

Mind the Mode: Differences in Paper vs. Web-Based Survey Modes Among Women With Cancer.

PubMed

Hagan, Teresa L; Belcher, Sarah M; Donovan, Heidi S

2017-09-01

Researchers administering surveys seek to balance data quality, sources of error, and practical concerns when selecting an administration mode. Rarely are decisions about survey administration based on the background of study participants, although socio-demographic characteristics like age, education, and race may contribute to participants' (non)responses. In this study, we describe differences in paper- and web-based surveys administered in a national cancer survivor study of women with a history of cancer to compare the ability of each survey administrative mode to provide quality, generalizable data. We compared paper- and web-based survey data by socio-demographic characteristics of respondents, missing data rates, scores on primary outcome measure, and administrative costs and time using descriptive statistics, tests of mean group differences, and linear regression. Our findings indicate that more potentially vulnerable patients preferred paper questionnaires and that data quality, responses, and costs significantly varied by mode and participants' demographic information. We provide targeted suggestions for researchers conducting survey research to reduce survey error and increase generalizability of study results to the patient population of interest. Researchers must carefully weigh the pros and cons of survey administration modes to ensure a representative sample and high-quality data. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Systematic review: predicting and optimising response to anti-TNF therapy in Crohn's disease - algorithm for practical management.

PubMed

Ding, N S; Hart, A; De Cruz, P

2016-01-01

Nonresponse and loss of response to anti-TNF therapies in Crohn's disease represent significant clinical problems for which clear management guidelines are lacking. To review the incidence, mechanisms and predictors of primary nonresponse and secondary loss of response to formulate practical clinical algorithms to guide management. Through a systematic literature review, 503 articles were identified which fit the inclusion criteria. Primary nonresponse to anti-TNF treatment affects 13-40% of patients. Secondary loss of response to anti-TNF occurs in 23-46% of patients when determined according to dose intensification, and 5-13% of patients when gauged by drug discontinuation rates. Recent evidence suggests that the mechanisms underlying primary nonresponse and secondary loss of response are multifactorial and include disease characteristics (phenotype, location, severity); drug (pharmacokinetic, pharmacodynamic or immunogenicity) and treatment strategy (dosing regimen) related factors. Clinical algorithms that employ therapeutic drug monitoring (using anti-TNF tough levels and anti-drug antibody levels) may be used to determine the underlying cause of primary nonresponse and secondary loss of response respectively and guide clinicians as to which patients are most likely to respond to anti-TNF therapy and help optimise drug therapy for those who are losing response to anti-TNF therapy. Nonresponse or loss of response to anti-TNF occurs commonly in Crohn's disease. Clinical algorithms utilising therapeutic drug monitoring may establish the mechanisms for treatment failure and help guide the subsequent therapeutic approach. © 2015 John Wiley & Sons Ltd.

A procedure for removing the effect of response bias errors from waterfowl hunter questionnaire responses

USGS Publications Warehouse

Atwood, E.L.

1958-01-01

Response bias errors are studied by comparing questionnaire responses from waterfowl hunters using four large public hunting areas with actual hunting data from these areas during two hunting seasons. To the extent that the data permit, the sources of the error in the responses were studied and the contribution of each type to the total error was measured. Response bias errors, including both prestige and memory bias, were found to be very large as compared to non-response and sampling errors. Good fits were obtained with the seasonal kill distribution of the actual hunting data and the negative binomial distribution and a good fit was obtained with the distribution of total season hunting activity and the semi-logarithmic curve. A comparison of the actual seasonal distributions with the questionnaire response distributions revealed that the prestige and memory bias errors are both positive. The comparisons also revealed the tendency for memory bias errors to occur at digit frequencies divisible by five and for prestige bias errors to occur at frequencies which are multiples of the legal daily bag limit. A graphical adjustment of the response distributions was carried out by developing a smooth curve from those frequency classes not included in the predictable biased frequency classes referred to above. Group averages were used in constructing the curve, as suggested by Ezekiel [1950]. The efficiency of the technique described for reducing response bias errors in hunter questionnaire responses on seasonal waterfowl kill is high in large samples. The graphical method is not as efficient in removing response bias errors in hunter questionnaire responses on seasonal hunting activity where an average of 60 percent was removed.

Nonresponse patterns in the Federal Waterfowl Hunter Questionnaire Survey

USGS Publications Warehouse

Pendleton, G.W.

1992-01-01

I analyzed data from the 1984 and 1986 Federal Waterfowl Hunter Questionnaire Survey (WHQS) to estimate the rate of return of name and address contact cards, to evaluate the efficiency of the Survey's stratification scheme, and to investigate potential sources of bias due to nonresponse at the contact card and questionnaire stages of the Survey. Median response at the contact card stage was 0.200 in 1984 and 0.208 in 1986, but was lower than 0.100 for many sample post offices. Large portions of the intended sample contributed little to the final estimates in the Survey. Differences in response characteristics between post office size strata were detected, but size strata were confounded with contact card return rates; differences among geographic zones within states were more pronounced. Large biases in harvest and hunter activity due to nonresponse were not found; however, consistent smaller magnitude biases were found. Bias in estimates of the proportion of active hunters was the most pronounced effect of nonresponse. All of the sources of bias detected would produce overestimates of harvest and activity. Redesigning the WHQS, including use of a complete list of waterfowl hunters and resampling nonrespondents, would be needed to reduce nonresponse bias.

The Stroop matching task presents conflict at both the response and nonresponse levels: an event-related potential and electromyography study.

PubMed

Caldas, A L; Machado-Pinheiro, W; Souza, L B; Motta-Ribeiro, G C; David, I A

2012-09-01

In the Stroop matching task, a Stroop word is compared to a colored bar. The origin of the conflict presented by this task is a topic of current debate. In an effort to disentangle nonresponse and response conflicts, we recorded electromyography (EMG) and event-related potentials (ERPs) while participants performed the task. The N450 component was sensitive to the relationship of color surfaces, regardless of the response, suggesting the participation of nonresponse conflict. Incompatible arrays (e.g., incongruent Stroop stimuli during "same" responses) presented a substantial amount of double EMG activation and slower EMG latencies, suggesting the participation of response conflict. We propose that both response and nonresponse conflicts are sources of these effects. The combined use of the EMG and ERP techniques played an important role in elucidating the conflicts immersed in the Stroop matching task. Copyright © 2012 Society for Psychophysiological Research.

Modeling motivated misreports to sensitive survey questions.

PubMed

Böckenholt, Ulf

2014-07-01

Asking sensitive or personal questions in surveys or experimental studies can both lower response rates and increase item non-response and misreports. Although non-response is easily diagnosed, misreports are not. However, misreports cannot be ignored because they give rise to systematic bias. The purpose of this paper is to present a modeling approach that identifies misreports and corrects for them. Misreports are conceptualized as a motivated process under which respondents edit their answers before they report them. For example, systematic bias introduced by overreports of socially desirable behaviors or underreports of less socially desirable ones can be modeled, leading to more-valid inferences. The proposed approach is applied to a large-scale experimental study and shows that respondents who feel powerful tend to overclaim their knowledge.

The Impact of Early Substance Use Disorder Treatment Response on Treatment Outcomes Among Pregnant Women With Primary Opioid Use.

PubMed

Tuten, Michelle; Fitzsimons, Heather; Hochheimer, Martin; Jones, Hendree E; Chisolm, Margaret S

2018-03-13

This study examined the impact of early patient response on treatment utilization and substance use among pregnant participants enrolled in substance use disorder (SUD) treatment. Treatment responders (TRs) and treatment nonresponders (TNRs) were compared on pretreatment and treatment measures. Regression models predicted treatment utilization and substance use. TR participants attended more treatment and had lower rates of substance use relative to TNR participants. Regression models for treatment utilization and substance use were significant. Maternal estimated gestational age (EGA) and baseline cocaine use were negatively associated with treatment attendance. Medication-assisted treatment, early treatment response, and baseline SUD treatment were positively associated with treatment attendance. Maternal EGA was negatively associated with counseling attendance; early treatment response was positively associated with counseling attendance. Predictors of any substance use at 1 month were maternal education, EGA, early treatment nonresponse, and baseline cocaine use. The single predictor of any substance use at 2 months was early treatment nonresponse. Predictors of opioid use at 1 month were maternal education, EGA, early treatment nonresponse, and baseline SUD treatment. Predictors of opioid use at 2 months were early treatment nonresponse, and baseline cocaine and marijuana use. Predictors of cocaine use at 1 month were early treatment nonresponse, baseline cocaine use, and baseline SUD treatment. Predictors of cocaine use at 2 months were early treatment nonresponse and baseline cocaine use. Early treatment response predicts more favorable maternal treatment utilization and substance use outcomes. Treatment providers should implement interventions to maximize patient early response to treatment.

Variability of non-response to aspirin in patients with peripheral arterial occlusive disease during long-term follow-up.

PubMed

Linnemann, Birgit; Prochnow, Stephanie; Mani, Helen; Schwonberg, Jan; Lindhoff-Last, Edelgard

2009-10-01

Non-responsiveness to aspirin as detected by laboratory tests may identify patients at high risk for future vascular events. The aim of this prospective study was to evaluate whether non-responsiveness to aspirin is stable over time. Ninety-eight patients with stable peripheral arterial occlusive disease (PAOD) treated with 100 mg/d aspirin were followed over a median timeframe of 17 months. Platelet function tests were performed initially and at follow-up using arachidonic acid-induced light transmittance aggregometry (LTA) in native platelet-rich plasma with the Behring Coagulation Timer and by measuring the collagen-epinephrine closure time (CT) on a Platelet Function Analyzer (PFA-100). When determining platelet function using LTA, four patients (4.1%) had residual platelet function (i.e., MaxAggr > or =78%) despite aspirin treatment, whereas, according to the PFA-100 results, 12 patients (12.2%) were identified as non-responders (i.e., CT <192 s). Fifty-seven patients who were still under treatment with 100 mg/d aspirin at the time of follow-up provided a second blood sample. Further platelet function tests with the PFA-100 system identified a persistent non-responsiveness to aspirin over time in three patients (5.3%) whereas four (7.0%) and 15 (26.3%) patients had changes in response status when platelet function was assessed by LTA and on the PFA-100(R), respectively. We conclude that true non-responsiveness to aspirin is a rare phenomenon in stable PAOD patients. Furthermore, we conclude that in a number of patients, aspirin non-responsiveness is not stable over time.

Associations Between Maternal Depressive Symptoms and Nonresponsive Feeding Styles and Practices in Mothers of Young Children: A Systematic Review

PubMed Central

2017-01-01

Background Childhood obesity is a significant global public health problem due to increasing rates worldwide. Growing evidence suggests that nonresponsive parental feeding styles and practices are important influences on children’s eating behaviors and weight status, especially during early childhood. Therefore, understanding parental factors that may influence nonresponsive parental feeding styles and practices is significant for the development of interventions to prevent childhood obesity. Objective The objectives of this systematic review were to (1) identify and review existing research examining the associations between maternal depressive symptoms and use of nonresponsive feeding styles and practices among mothers of young children (2-8 years of age), (2) highlight the limitations of reviewed studies, and (3) generate suggestions for future research. Methods Using the PRISMA (Preferred Reporting Items for Systematic review and Meta-Analysis Protocols) guidelines, six electronic academic databases were searched for peer-reviewed, full-text papers published in English between January 2000 and June 2016. Only studies with mothers 18+ years old of normally developing children between 2 and 8 years of age were included. Of the 297 citations identified, 35 full-text papers were retrieved and 8 were reviewed. Results The reviewed studies provided mixed evidence for associations between maternal depressive symptoms and nonresponsive feeding styles and practices. Two out of three studies reported positive associations with nonresponsive feeding styles, in that mothers with elevated depressive symptoms were more likely than mothers without those symptoms to exhibit uninvolved and permissive or indulgent feeding styles. Furthermore, results of reviewed studies provide good evidence for association between maternal depressive symptoms and instrumental feeding (3 of 3 reviewed studies) and nonresponsive family mealtime practices (3/3), but mixed evidence for pressuring children to eat (3/6) and emotional feeding (1/3). In addition, evidence for the association between maternal depressive symptoms and restricting child food intake was mixed: one study (1/6) found a positive association; two studies (2/6) found a negative association; whereas one study (1/6) found no association. Conclusions This review indicates that the results of studies examining the associations between maternal depressive symptoms and parental feeding styles and practices are mixed. Limitations of studies included in this review should be noted: (1) the use of a diverse set of self-report questionnaires to assess parental feeding practices is problematic due to potential misclassification and makes it difficult to compare these outcomes across studies, thus caution must be taken in drawing conclusions; and (2) the majority of included studies (6/8) were cross-sectional. There is a need for additional longitudinal studies to disentangle the influence of depression on parental feeding styles and practices. Nevertheless, given that depressive symptoms and feeding styles and practices are potentially modifiable, it is important to understand their relationship to inform obesity prevention interventions and programs. PMID:28550007

Gift card incentives and non-response bias in a survey of vaccine providers: the role of geographic and demographic factors.

PubMed

Van Otterloo, Joshua; Richards, Jennifer L; Seib, Katherine; Weiss, Paul; Omer, Saad B

2011-01-01

This study investigates the effects of non-response bias in a 2010 postal survey assessing experiences with H1N1 influenza vaccine administration among a diverse sample of providers (N = 765) in Washington state. Though we garnered a high response rate (80.9%) by using evidence-based survey design elements, including intensive follow-up and a gift card incentive from Target, non-response bias could exist if there were differences between respondents and non-respondents. We investigated differences between the two groups for seven variables: road distance to the nearest Target store, practice type, previous administration of vaccines, region, urbanicity, size of practice, and Vaccines for Children (VFC) program enrollment. We also examined the effect of non-response bias on survey estimates. Statistically significant differences between respondents and non-respondents were found for four variables: miles to the nearest Target store, type of medical practice, whether the practice routinely administered additional vaccines besides H1N1, and urbanicity. Practices were more likely to respond if they were from a small town or rural area (OR = 7.68, 95% CI = 1.44-40.88), were a non-traditional vaccine provider type (OR = 2.08, 95% CI = 1.06-4.08) or a pediatric provider type (OR = 4.03, 95% CI = 1.36-11.96), or administered additional vaccines besides H1N1 (OR = 1.80, 95% CI = 1.03-3.15). Of particular interest, for each ten mile increase in road distance from the nearest Target store, the likelihood of provider response decreased (OR = 0.73, 95% CI = 0.60-0.89). Of those variables associated with response, only small town or rural practice location was associated with a survey estimate of interest, suggesting that non-response bias had a minimal effect on survey estimates. These findings show that gift card incentives alongside survey design elements and follow-up can achieve high response rates. However, there is evidence that practices farther from the nearest place to redeem gift cards may be less likely to respond to the survey.

Responsibility/Nonresponsibility in Pyschosomatic Disorders.

ERIC Educational Resources Information Center

Greenwald, Deborah F.

1984-01-01

Interviewed 40 men to investigate the hypothesis that gastrointestinal and dermatological symptoms are associated with differing psychological styles and responses to the environment. Results suggested a responsive style is associated with gastrointestinal symptoms and a nonresponsive style is associated with dermatological symptoms. (JAC)

In an occupational health surveillance study, auxiliary data from administrative health and occupational databases effectively corrected for nonresponse.

PubMed

Santin, Gaëlle; Geoffroy, Béatrice; Bénézet, Laetitia; Delézire, Pauline; Chatelot, Juliette; Sitta, Rémi; Bouyer, Jean; Gueguen, Alice

2014-06-01

To show how reweighting can correct for unit nonresponse bias in an occupational health surveillance survey by using data from administrative databases in addition to classic sociodemographic data. In 2010, about 10,000 workers covered by a French health insurance fund were randomly selected and were sent a postal questionnaire. Simultaneously, auxiliary data from routine health insurance and occupational databases were collected for all these workers. To model the probability of response to the questionnaire, logistic regressions were performed with these auxiliary data to compute weights for correcting unit nonresponse. Corrected prevalences of questionnaire variables were estimated under several assumptions regarding the missing data process. The impact of reweighting was evaluated by a sensitivity analysis. Respondents had more reimbursement claims for medical services than nonrespondents but fewer reimbursements for medical prescriptions or hospitalizations. Salaried workers, workers in service companies, or who had held their job longer than 6 months were more likely to respond. Corrected prevalences after reweighting were slightly different from crude prevalences for some variables but meaningfully different for others. Linking health insurance and occupational data effectively corrects for nonresponse bias using reweighting techniques. Sociodemographic variables may be not sufficient to correct for nonresponse. Copyright © 2014 Elsevier Inc. All rights reserved.

Placebo non-response measure in sequential parallel comparison design studies.

PubMed

Rybin, Denis; Doros, Gheorghe; Pencina, Michael J; Fava, Maurizio

2015-07-10

The Sequential Parallel Comparison Design (SPCD) is one of the novel approaches addressing placebo response. The analysis of SPCD data typically classifies subjects as 'placebo responders' or 'placebo non-responders'. Most current methods employed for analysis of SPCD data utilize only a part of the data collected during the trial. A repeated measures model was proposed for analysis of continuous outcomes that permitted the inclusion of information from all subjects into the treatment effect estimation. We describe here a new approach using a weighted repeated measures model that further improves the utilization of data collected during the trial, allowing the incorporation of information that is relevant to the placebo response, and dealing with the problem of possible misclassification of subjects. Our simulations show that when compared to the unweighted repeated measures model method, our approach performs as well or, under certain conditions, better, in preserving the type I error, achieving adequate power and minimizing the mean squared error. Copyright © 2015 John Wiley & Sons, Ltd.

48 CFR 811.501 - Policy.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 811.501 Federal Acquisition Regulations System DEPARTMENT OF VETERANS AFFAIRS COMPETITION AND... increase in contract price is justified. The contracting officer must not use a liquidated damages provision for any of the following reasons: (a) As insurance against selection of a non-responsible bidder...

What we don't know can hurt us: Nonresponse bias assessment in birth defects research.

PubMed

Strassle, Paula D; Cassell, Cynthia H; Shapira, Stuart K; Tinker, Sarah C; Meyer, Robert E; Grosse, Scott D

2015-07-01

Nonresponse bias assessment is an important and underutilized tool in survey research to assess potential bias due to incomplete participation. This study illustrates a nonresponse bias sensitivity assessment using a survey on perceived barriers to care for children with orofacial clefts in North Carolina. Children born in North Carolina between 2001 and 2004 with an orofacial cleft were eligible for inclusion. Vital statistics data, including maternal and child characteristics, were available on all eligible subjects. Missing 'responses' from nonparticipants were imputed using assumptions based on the distribution of responses, survey method (mail or phone), and participant maternal demographics. Overall, 245 of 475 subjects (51.6%) responded to either a mail or phone survey. Cost as a barrier to care was reported by 25.0% of participants. When stratified by survey type, 28.3% of mail respondents and 17.2% of phone respondents reported cost as a barrier. Under various assumptions, the bias-adjusted estimated prevalence of cost as barrier to care ranged from 16.1% to 30.0%. Maternal age, education, race, and marital status at time of birth were not associated with subjects reporting cost as a barrier. As survey response rates continue to decline, the importance of assessing the potential impact of nonresponse bias has become more critical. Birth defects research is particularly conducive to nonresponse bias analysis, especially when birth defect registries and birth certificate records are used. Future birth defect studies which use population-based surveillance data and have incomplete participation could benefit from this type of nonresponse bias assessment. Birth Defects Research (Part A) 103:603-609, 2015. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

Multiple imputation to deal with missing EQ-5D-3L data: Should we impute individual domains or the actual index?

PubMed

Simons, Claire L; Rivero-Arias, Oliver; Yu, Ly-Mee; Simon, Judit

2015-04-01

Missing data are a well-known and widely documented problem in cost-effectiveness analyses alongside clinical trials using individual patient-level data. Current methodological research recommends multiple imputation (MI) to deal with missing health outcome data, but there is little guidance on whether MI for multi-attribute questionnaires, such as the EQ-5D-3L, should be carried out at domain or at summary score level. In this paper, we evaluated the impact of imputing individual domains versus imputing index values to deal with missing EQ-5D-3L data using a simulation study and developed recommendations for future practice. We simulated missing data in a patient-level dataset with complete EQ-5D-3L data at one point in time from a large multinational clinical trial (n = 1,814). Different proportions of missing data were generated using a missing at random (MAR) mechanism and three different scenarios were studied. The performance of using each method was evaluated using root mean squared error and mean absolute error of the actual versus predicted EQ-5D-3L indices. In large sample sizes (n > 500) and a missing data pattern that follows mainly unit non-response, imputing domains or the index produced similar results. However, domain imputation became more accurate than index imputation with pattern of missingness following an item non-response. For smaller sample sizes (n < 100), index imputation was more accurate. When MI models were misspecified, both domain and index imputations were inaccurate for any proportion of missing data. The decision between imputing the domains or the EQ-5D-3L index scores depends on the observed missing data pattern and the sample size available for analysis. Analysts conducting this type of exercises should also evaluate the sensitivity of the analysis to the MAR assumption and whether the imputation model is correctly specified.

Parental educational practices in relation to children's anxiety disorder-related behavior.

PubMed

Mellon, Robert C; Moutavelis, Adrianos G

2011-08-01

Schoolchildren reported their parents' use of aversive control and positive reinforcement contingencies in their educational interventions, as well as parental non-responsiveness to their requests for educational assistance. They also reported their own levels of six dimensions of anxiety disorder-related phenomena. Both parental use of aversive control and non-responsiveness were directly related to overall levels of child anxiety disorder-related behavior; these correlations were more robust than those observed in previous investigations of more diffuse dimensions of parenting style and trait anxiety. Panic disorder/agoraphobia and Generalized anxiety disorder were the dimensions most strongly correlated with both parental aversive control and non-responsiveness, while Compulsive behavior was uniquely uncorrelated with parental non-responsiveness and uniquely correlated with parental use of positive reinforcement contingencies. Differences in the magnitudes of correlations between anxiety disorder-related dimensions and parental educational practices are interpreted in terms of the probable differential effectiveness of their constituent behaviors in terminating parent-mediated negative reinforcers. Copyright © 2011 Elsevier Ltd. All rights reserved.

Estimating disease prevalence from two-phase surveys with non-response at the second phase

PubMed Central

Gao, Sujuan; Hui, Siu L.; Hall, Kathleen S.; Hendrie, Hugh C.

2010-01-01

SUMMARY In this paper we compare several methods for estimating population disease prevalence from data collected by two-phase sampling when there is non-response at the second phase. The traditional weighting type estimator requires the missing completely at random assumption and may yield biased estimates if the assumption does not hold. We review two approaches and propose one new approach to adjust for non-response assuming that the non-response depends on a set of covariates collected at the first phase: an adjusted weighting type estimator using estimated response probability from a response model; a modelling type estimator using predicted disease probability from a disease model; and a regression type estimator combining the adjusted weighting type estimator and the modelling type estimator. These estimators are illustrated using data from an Alzheimer’s disease study in two populations. Simulation results are presented to investigate the performances of the proposed estimators under various situations. PMID:10931514

Count me in: response to sexual orientation measures among older adults.

PubMed

Fredriksen-Goldsen, Karen I; Kim, Hyun-Jun

2015-07-01

Health disparities exist among sexual minority older adults. Yet, health and aging surveys rarely include sexual orientation measures and when they do, they often exclude older adults from being asked about sexual orientation. This is the first population-based study to assess item nonresponse to sexual orientation measures by age and change over time. We compare response rates and examine time trends in response patterns using adjusted logistic regressions. Among adults aged 65 and older, the nonresponse rate on sexual orientation is lower than income. While older adults show higher nonresponse rates on sexual orientation than younger adults, the nonresponse rates have significantly decreased over time. By 2010, only 1.23% of older adults responded don't know/not sure, with 1.55% refusing to answer sexual orientation questions. Decisions to not ask sexual orientation among older adults must be reconsidered, given documented health disparities and rapidly changing social trends in the understanding of diverse sexualities. © The Author(s) 2014.

Alternative Approaches to Assessing Nonresponse Bias in Longitudinal Survey Estimates: An Application to Substance-Use Outcomes Among Young Adults in the United States

PubMed Central

West, Brady Thomas; McCabe, Sean Esteban

2017-01-01

Abstract We evaluated alternative approaches to assessing and correcting for nonresponse bias in a longitudinal survey. We considered the changes in substance-use outcomes over a 3-year period among young adults aged 18–24 years (n = 5,199) in the United States, analyzing data from the National Epidemiologic Survey on Alcohol and Related Conditions. This survey collected a variety of substance-use information from a nationally representative sample of US adults in 2 waves: 2001–2002 and 2004–2005. We first considered nonresponse rates in the second wave as a function of key substance-use outcomes in wave 1. We then evaluated 5 alternative approaches designed to correct for nonresponse bias under different attrition mechanisms, including weighting adjustments, multiple imputation, selection models, and pattern-mixture models. Nonignorable attrition in a longitudinal survey can lead to bias in estimates of change in certain health behaviors over time, and only selected procedures enable analysts to assess the sensitivity of their inferences to different assumptions about the extent of nonignorability. We compared estimates based on these 5 approaches, and we suggest a road map for assessing the risk of nonresponse bias in longitudinal studies. We conclude with directions for future research in this area given the results of our evaluations. PMID:28338839

Interpreting Nonresponse in Survey Research: Methodological Heresy?

ERIC Educational Resources Information Center

Clark, Sheldon B.; Finn, Michael G.

A study is proposed that seeks to use the normally problematic factor of non-response to a survey in a positive way in order to estimate certain characteristics of a population subgroup. A longitudinal database, the Scientific and Technical Personnel Data System (STPDS) measures the educational, demographic, and employment characteristics of the…

Rasch Analysis for Binary Data with Nonignorable Nonresponses

ERIC Educational Resources Information Center

Bertoli-Barsotti, Lucio; Punzo, Antonio

2013-01-01

This paper introduces a two-dimensional Item Response Theory (IRT) model to deal with nonignorable nonresponses in tests with dichotomous items. One dimension provides information about the omitting behavior, while the other dimension is related to the person's "ability". The idea of embedding an IRT model for missingness into the measurement…

Nonresponse Bias in Student Evaluations of Teaching

ERIC Educational Resources Information Center

Bacon, Donald R.; Johnson, Carol J.; Stewart, Kim A.

2016-01-01

Response rates in student evaluations of teaching (SET) surveys are often low, especially when conducted online. These lower response rates raise the question of nonresponse bias. This article examines a data set comprising student evaluations of 6,754 business courses occurring over an 11-year period to investigate whether response rate is…

Nonresponse Bias to Mail Survey Questionnaires within a Professional Population.

ERIC Educational Resources Information Center

Hovland, Eric J.; And Others

1980-01-01

The possible bias resulting from excluding nonresponders in tabulating data from mail survey questionnaires in a dentist population was investigated. The differences between the responders and the nonresponders were analyzed with respect to the dentists' demographic data, attitudes, and knowledge. Nonresponse bias did not affect the results of…

Understanding Nonresponse to the 2007 Medicare CAHPS Survey

ERIC Educational Resources Information Center

Klein, David J.; Elliott, Marc N.; Haviland, Amelia M.; Saliba, Debra; Burkhart, Q.; Edwards, Carol; Zaslavsky, Alan M.

2011-01-01

Purpose: The Medicare Consumer Assessments of Healthcare Providers and Systems (MCAHPS) survey, a primarily English-language mail survey with English and Spanish telephone follow-up, is the primary means of assessing the health care experiences of American seniors. We examine unit (whole survey) and item nonresponse for this survey to explore…

Associations Between Maternal Depressive Symptoms and Nonresponsive Feeding Styles and Practices in Mothers of Young Children: A Systematic Review.

PubMed

Lindsay, Ana Cristina; Mesa, Tatiana; Greaney, Mary L; Wallington, Sherrie F; Wright, Julie A

2017-05-26

Childhood obesity is a significant global public health problem due to increasing rates worldwide. Growing evidence suggests that nonresponsive parental feeding styles and practices are important influences on children's eating behaviors and weight status, especially during early childhood. Therefore, understanding parental factors that may influence nonresponsive parental feeding styles and practices is significant for the development of interventions to prevent childhood obesity. The objectives of this systematic review were to (1) identify and review existing research examining the associations between maternal depressive symptoms and use of nonresponsive feeding styles and practices among mothers of young children (2-8 years of age), (2) highlight the limitations of reviewed studies, and (3) generate suggestions for future research. Using the PRISMA (Preferred Reporting Items for Systematic review and Meta-Analysis Protocols) guidelines, six electronic academic databases were searched for peer-reviewed, full-text papers published in English between January 2000 and June 2016. Only studies with mothers 18+ years old of normally developing children between 2 and 8 years of age were included. Of the 297 citations identified, 35 full-text papers were retrieved and 8 were reviewed. The reviewed studies provided mixed evidence for associations between maternal depressive symptoms and nonresponsive feeding styles and practices. Two out of three studies reported positive associations with nonresponsive feeding styles, in that mothers with elevated depressive symptoms were more likely than mothers without those symptoms to exhibit uninvolved and permissive or indulgent feeding styles. Furthermore, results of reviewed studies provide good evidence for association between maternal depressive symptoms and instrumental feeding (3 of 3 reviewed studies) and nonresponsive family mealtime practices (3/3), but mixed evidence for pressuring children to eat (3/6) and emotional feeding (1/3). In addition, evidence for the association between maternal depressive symptoms and restricting child food intake was mixed: one study (1/6) found a positive association; two studies (2/6) found a negative association; whereas one study (1/6) found no association. This review indicates that the results of studies examining the associations between maternal depressive symptoms and parental feeding styles and practices are mixed. Limitations of studies included in this review should be noted: (1) the use of a diverse set of self-report questionnaires to assess parental feeding practices is problematic due to potential misclassification and makes it difficult to compare these outcomes across studies, thus caution must be taken in drawing conclusions; and (2) the majority of included studies (6/8) were cross-sectional. There is a need for additional longitudinal studies to disentangle the influence of depression on parental feeding styles and practices. Nevertheless, given that depressive symptoms and feeding styles and practices are potentially modifiable, it is important to understand their relationship to inform obesity prevention interventions and programs. ©Ana Cristina Lindsay, Tatiana Mesa, Mary L. Greaney, Sherrie F. Wallington, Julie A. Wright. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 26.05.2017.

What Have We Learned about Treatment Failure in Empirically Supported Treatments? Some Suggestions for Practice

ERIC Educational Resources Information Center

Lambert, Michael J.

2011-01-01

The examination of treatment failure has substantial value in advancing psychological practice as illustrated by the articles in this special issue. Treatment failure is not well defined and includes at least two independent phenomena: nonresponse and deterioration. After discussing the important distinction between nonresponse to treatment and…

Pretreatment and Process Predictors of Outcome in Interpersonal and Cognitive Behavioral Psychotherapy for Binge Eating Disorder

ERIC Educational Resources Information Center

Hilbert, Anja; Saelens, Brian E.; Stein, Richard I.; Mockus, Danyte S.; Welch, R. Robinson; Matt, Georg E.; Wilfley, Denise E.

2007-01-01

The present study examined pretreatment and process predictors of individual nonresponse to psychological group treatment of binge eating disorder (BED). In a randomized trial, 162 overweight patients with BED were treated with either group cognitive-behavioral therapy or group interpersonal psychotherapy. Treatment nonresponse, which was defined…

Student Evaluation of Teaching: An Investigation of Nonresponse Bias in an Online Context

ERIC Educational Resources Information Center

Reisenwitz, Timothy H.

2016-01-01

The online administration of student evaluations has its shortcomings, including low participation, or low response rates, and bias. This study examines nonresponse bias in online student evaluations of instruction, that is, the differences between those students who complete online evaluations and those who decide not to complete them. It builds…

Improving Beta Test Evaluation Response Rates: A Meta-Evaluation

ERIC Educational Resources Information Center

Russ-Eft, Darlene; Preskill, Hallie

2005-01-01

This study presents a meta-evaluation of a beta-test of a customer service training program. The initial evaluation showed a low response rate. Therefore, the meta-evaluation focused on issues related to the conduct of the initial evaluation and reasons for nonresponse. The meta-evaluation identified solutions to the nonresponse problem as related…

Breastfeeding Duration and Authoritative Feeding Practices in First-Time Mothers.

PubMed

Jansen, Elena; Mallan, Kimberley M; Byrne, Rebecca; Daniels, Lynne A; Nicholson, Jan M

2016-08-01

Longer breastfeeding duration appears to have a protective effect against childhood obesity. This effect may be partially mediated by maternal feeding practices during the first years of life. However, the few studies that have examined links between breastfeeding duration and subsequent feeding practices have yielded conflicting results. Using a large sample of first-time mothers and a newly validated, comprehensive measure of maternal feeding (the Feeding Practices and Structure Questionnaire), this study examined associations between breastfeeding duration and maternal feeding practices at child age 24 months. Mothers (n = 458) enrolled in the NOURISH trial provided data on breastfeeding at child age 4, 14, and 24 months, and on feeding practices at 24 months. Structural equation modeling was used to examine associations between breastfeeding duration and 5 nonresponsive and 4 structure-related "authoritative" feeding practices, adjusting for a range of maternal and child characteristics. The model showed acceptable fit (χ(2)/df = 1.68; root mean square error of approximation = .04, comparative fit index = .91, and Tucker-Lewis index = .89) and longer breastfeeding duration was negatively associated with 4 out of 5 nonresponsive feeding practices and positively associated with 3 out of 4 structure-related feeding practices. Overall, these results suggest that mothers who breastfeed longer reported using more appropriate feeding practices. These data demonstrate an association between longer breastfeeding duration and authoritative feeding practices characterized by responsiveness and structure, which may partly account for the apparent protective effect of breastfeeding on childhood obesity. © The Author(s) 2015.

Absence of nonresponse bias in a study of sport-caught Great Lakes fish consumption and conception failure

DOE Office of Scientific and Technical Information (OSTI.GOV)

Stein, A.D.; Tay, E.; Courval, J.M.

1999-04-01

The authors have reported that men`s lifetime sport-caught Great Lakes fish consumption was associated with lifetime prevalence of conception delay or failure. Those cross-sectional data were based on responses to a postal questionnaire. The present study was conducted to evaluate whether nonresponse bias could explain the cross-sectional findings. The authors conducted telephone interviews with 230 men and 38 women who did not respond to the original responders with respect to key demographic, behavioral, and reproductive characteristics. Nonresponders were approximately 1.5 years older at interview, were more likely to be Caucasian, and reported higher incomes than responders. Among men, nonresponders hadmore » fished fewer days in the past year. Almost one half of nonresponders reported no fish consumption in the past year, compared to one quarter of responders. Nonresponders were more likely than responders to have ever conceived a live-born child, had more children, and were less likely to intend to have additional children in the next 5 years. Among both responders and nonresponders there was an increased prevalence of a period of conception failure among men who reported consuming greater quantities of sport-caught Great Lakes fish. The study provides support for the cross-sectional analyses presented previously, insofar as nonresponse bias is unlikely to have a major role in the observed association.« less

Extreme Nonresponse in Cognitive Therapy: Can Behavioral Activation Succeed where Cognitive Therapy Fails?

ERIC Educational Resources Information Center

Coffman, Sandra J.; Martell, Christopher R.; Dimidjian, Sona; Gallop, Robert; Hollon, Steven D.

2007-01-01

In a recent placebo-controlled comparison, behavioral activation was superior to cognitive therapy in the treatment of moderate to severely depressed adults. Moreover, a subset of patients exhibited a pattern of extreme nonresponse to cognitive therapy on self-reports of depression not evident on the clinician ratings. These patients were severely…

No Evidence of Substantive Nonresponse Bias for the 2011 Administration. SERU Project Technical Report

ERIC Educational Resources Information Center

Chatman, Steve

2011-01-01

This study of the 2011 administration focused on principal component scores based on the 2008 and 2009 SERU (Student Experience in the Research University) administrations. The first analysis is a traditional nonresponse examination where the response rates of various groups are compared to determine if the responding students represent the larger…

Dealing with Item Nonresponse in Large-Scale Cognitive Assessments: The Impact of Missing Data Methods on Estimated Explanatory Relationships

ERIC Educational Resources Information Center

Köhler, Carmen; Pohl, Steffi; Carstensen, Claus H.

2017-01-01

Competence data from low-stakes educational large-scale assessment studies allow for evaluating relationships between competencies and other variables. The impact of item-level nonresponse has not been investigated with regard to statistics that determine the size of these relationships (e.g., correlations, regression coefficients). Classical…

Non-Response in Student Surveys: The Role of Demographics, Engagement and Personality

ERIC Educational Resources Information Center

Porter, Stephen R.; Whitcomb, Michael E.

2005-01-01

What causes a student to participate in a survey? This paper looks at participation across multiple surveys to understand survey non-response; by using multiple surveys we minimize the impact of survey salience. Students at a selective liberal arts college were administered four different surveys throughout the 2002-2003 academic year, and we use…

Pain Sensitization Associated with Non-Response Following Physiotherapy in People with Knee Osteoarthritis.

PubMed

O'Leary, Helen; Smart, Keith M; Moloney, Niamh A; Blake, Catherine; Doody, Catherine M

2018-05-22

In knee osteoarthritis (OA) pain sensitization has been linked to a more severe symptomatology, but the prognostic implications of pain sensitivity in people undergoing conservative treatment such as physiotherapy are not established. This study aimed to prospectively investigate the association between features of pain sensitization and clinical outcome (non-response) following guideline-based physiotherapy in people with knee OA. Participants (n=156) with moderate/severe knee OA were recruited from secondary care. All participants completed self-administered questionnaires and underwent quantitative sensory testing (QST) at baseline, thereby establishing subjective and objective measures of pain sensitization. Participants (n=134) were later classified following a physiotherapy intervention, using treatment responder criteria (responder/non-responder). QST data was reduced to a core set of latent variables using principal component analysis. A hierarchical logistic regression model was constructed to investigate if features related to pain sensitization predicted non-response after controlling for other known predictors of poor outcome in knee OA. Higher temporal summation (TS) (OR 2.00, 95% CI 1.23 to 3.27) and lower pressure pain thresholds (PPT) (OR 0.48, 95% CI 0.29 to 0.81) emerged as robust predictors of non-response following physiotherapy, along with a higher comorbidity score. The model demonstrated high sensitivity (87.8%) but modest specificity (52.3%). The independent relationship between pain sensitization and non-response may indicate an underlying explanatory association between neuroplastic changes in nociceptive processing and the maintenance of on-going pain and disability in knee OA pain. These preliminary results suggest interventions targeting pain sensitization may warrant future investigation in this population.

The Noggin Factor in Survey Research: Developing New Techniques for Assessing Nonresponse Bias.

ERIC Educational Resources Information Center

Clark, Sheldon B.

The primary objective of this paper is to encourage survey researchers not to become overly reliant on the literature for generic solutions to non-response bias problems. In addition, the paper recounts an example of how a non-traditional approach was used to maximize the usefulness of data collected under unusual constraints and with an a priori…

Social Desirability, Non-Response Bias and Reliability in a Long Self-Report Measure: Illustrations from the MMPI-2 Administered to Brunei Student Teachers

ERIC Educational Resources Information Center

Mundia, Lawrence

2011-01-01

The survey investigated the problems of social desirability (SD), non-response bias (NRB) and reliability in the Minnesota Multiphasic Personality Inventory--Revised (MMPI-2) self-report inventory administered to Brunei student teachers. Bruneians scored higher on all the validity scales than the normative US sample, thereby threatening the…

Encouraging Survey Participation among Individuals Seeking HIV Prevention Services: Does a Community Identity Match Help or Hurt?

ERIC Educational Resources Information Center

Crowley, Jocelyn Elise; Roff, Brian H.; Lynch, Jeneve

2007-01-01

Understanding the behaviors and attitudes of at-risk populations is fundamental to controlling the spread of HIV, the virus that causes AIDS. The problem of nonresponse among these populations, however, plagues survey research designed to address these issues. Previous work undertaken to map out the dynamics of nonresponse--both noncontacts and…

An Analysis of Methods Used To Reduce Nonresponse Bias in Survey Research.

ERIC Educational Resources Information Center

Johnson, Victoria A.

The effectiveness of five methods used to estimate the population parameters of a variable of interest from a random sample in the presence of non-response to mail surveys was tested in conditions that vary the return rate and the relationship of the variable of interest to the likelihood of response. Data from 125,092 adult Alabama residents in…

Predicting Nonresponse Bias from Teacher Ratings of Mental Health Problems in Primary School Children

ERIC Educational Resources Information Center

Stormark, Kjell Morten; Heiervang, Einar; Heimann, Mikael; Lundervold, Astri; Gillberg, Christopher

2008-01-01

The impact of nonresponse on estimates of mental health problems was examined in a prospective teacher screen in a community survey of 9,155 7-9 year olds. For 6,611 of the children, parents consented to participation in the actual study (Responders), while for 2,544 children parental consent was not obtained (Nonresponders). The teacher screen…

Field trappping Bactrocera latifrons (Diptera: Tephritidae) with select eugenol analogs that have been found to attract other "nonresponsive" fruit fly species

USDA-ARS?s Scientific Manuscript database

Bactrocera latifrons (Hendel) (Diptera: Tephritidae) is a pest fruit fly species native to Oriental Asia which has invaded and established in Hawaii and Tanzania and has been recovered in detection trapping in California. It is largely non-responsive to the male lures cuelure and methyl eugenol. Alp...

No evidence of response bias in a population-based childhood cancer survivor questionnaire survey — Results from the Swiss Childhood Cancer Survivor Study

PubMed Central

Gianinazzi, Micòl E.; Michel, Gisela; Zwahlen, Marcel; von der Weid, Nicolas X.; Kuehni, Claudia E.

2017-01-01

Purpose This is the first study to quantify potential nonresponse bias in a childhood cancer survivor questionnaire survey. We describe early and late responders and nonresponders, and estimate nonresponse bias in a nationwide questionnaire survey of survivors. Methods In the Swiss Childhood Cancer Survivor Study, we compared characteristics of early responders (who answered an initial questionnaire), late responders (who answered after ≥1 reminder) and nonresponders. Sociodemographic and cancer-related information was available for the whole population from the Swiss Childhood Cancer Registry. We compared observed prevalence of typical outcomes in responders to the expected prevalence in a complete (100% response) representative population we constructed in order to estimate the effect of nonresponse bias. We constructed the complete population using inverse probability of participation weights. Results Of 2328 survivors, 930 returned the initial questionnaire (40%); 671 returned the questionnaire after ≥1reminder (29%). Compared to early and late responders, we found that the 727 nonresponders (31%) were more likely male, aged <20 years, French or Italian speaking, of foreign nationality, diagnosed with lymphoma or a CNS or germ cell tumor, and treated only with surgery. But observed prevalence of typical estimates (somatic health, medical care, mental health, health behaviors) was similar among the sample of early responders (40%), all responders (69%), and the complete representative population (100%). In this survey, nonresponse bias did not seem to influence observed prevalence estimates. Conclusion Nonresponse bias may play only a minor role in childhood cancer survivor studies, suggesting that results can be generalized to the whole population of such cancer survivors and applied in clinical practice. PMID:28463966

Corticosteroid therapy in ulcerative colitis: Clinical response and predictors

PubMed Central

Li, Jin; Wang, Fan; Zhang, Hong-Jie; Sheng, Jian-Qiu; Yan, Wen-Feng; Ma, Min-Xing; Fan, Ru-Ying; Gu, Fang; Li, Chuan-Feng; Chen, Da-Fan; Zheng, Ping; Gu, Yu-Pei; Cao, Qian; Yang, Hong; Qian, Jia-Ming; Hu, Pin-Jin; Xia, Bing

2015-01-01

AIM: To evaluate clinical response to initial corticosteroid (CS) treatment in Chinese ulcerative colitis patients (UC) and identify predictors of clinical response. METHODS: Four hundred and twenty-three UC patients who were initially treated with oral or intravenous CS from 2007 to 2011 were retrospectively reviewed at eight inflammatory bowel disease centers in China, and 101 consecutive cases with one-year follow-up were analyzed further for clinical response and predictors. Short-term outcomes within one month were classified as primary response and primary non-response. Long-term outcomes within one year were classified as prolonged CS response, CS dependence and secondary non-response. CS refractoriness included primary and secondary non-response. Multivariate analyses were performed to identify predictors associated with clinical response. RESULTS: Within one month, 95.0% and 5.0% of the cases were classified into primary response and non-response, respectively. Within one year, 41.6% of cases were assessed as prolonged CS response, while 49.5% as CS dependence and 4.0% as secondary non-response. The rate of CS refractoriness was 8.9%, while the cumulative rate of surgery was 6.9% within one year. After multivariate analysis of all the variables, tenesmus was found to be a negative predictor of CS dependence (OR = 0.336; 95%CI: 0.147-0.768; P = 0.013) and weight loss as a predictor of CS refractoriness (OR = 5.662; 95%CI: 1.111-28.857; P = 0.040). After one-month treatment, sustained high Sutherland score (≥ 6) also predicted CS dependence (OR = 2.347; 95%CI: 0.935-5.890; P = 0.014). CONCLUSION: Tenesmus was a negative predictor of CS dependence, while weight loss and sustained high Sutherland score were strongly associated with poor CS response. PMID:25780299

Health benefits offer rates: is there a nonresponse bias?

PubMed

Pickreign, Jeremy D; Gabel, Jon R

2005-04-01

To determine whether a nonresponse bias exists in the offer rate for health benefits in firms with fewer than 50 workers and to present a simple adjustment to correct for observed bias. The 2003 Employer Health Benefits Survey (EHBS) conducted by the Kaiser Family Foundation and Health Research and Educational Trust, and a follow-up survey of nonrespondents to the 2003 EHBS. We conducted a follow-up survey to the 2003 EHBS to collect health benefits offering data from firms with fewer than 50 workers. We used McNemar's test to verify that the follow-up survey provided results comparable to the EHBS, and t-tests were used to determine nonresponse bias. We applied a simple weighting adjustment to the EHBS. The data for both the EHBS and the follow-up survey were collected by the same survey research firm. The EHBS interviews the person most knowledgeable about the firm's health benefits, while the follow-up survey interviews the first person who answers the telephone whether they are the most knowledgeable or not. Principal Findings. Firms with 3-9 workers were more likely to exhibit a bias than were firms with 10-24 workers and 25-49 workers. Although the calculated bias for each size category was not significant, there is sufficient evidence to warrant caution when reporting offer rates. Survey nonresponse in the EHBS produces an upward bias on estimates for the offer rates of small firms. Although not significant, this upward bias is because of nonresponse by small firms that do not offer health benefits. Our research is limited in that we only control for differences in the size of the firm.

Contribution of whole platelet aggregometry to the endovascular management of unruptured aneurysms: an institutional experience.

PubMed

Aoun, S G; Welch, B G; Pride, L G; White, J; Novakovic, R; Hoes, K; Sarode, R

2017-10-01

Stent-assisted coiling of intracranial aneurysms is an efficient alternative treatment to surgical clipping but requires prolonged antiplatelet therapy. Some patients are non-responsive to aspirin and/or clopidogrel. To analyze the implications of this assessment using the 'whole blood aggregometry (WBA) by impedance' technique. The Southwestern Tertiary Aneurysm Registry was reviewed between 2002 and 2012 for patients with unruptured aneurysms treated with stent-assisted coiling. The study population was divided into patients who were tested preoperatively for platelet responsiveness to aspirin and clopidogrel ('tested' patients) and those who were not ('non-tested'). Where necessary, tested patients received additional doses of antiplatelet drugs to achieve adequate platelet inhibition. Endpoints included the incidence of non-responsiveness, the rates of thrombotic and hemorrhagic complications, and the rates of permanent morbidity and mortality. A total of 266 patients fulfilled our selection criteria: 114 non-tested patients who underwent 121 procedures, and 152 tested patients who underwent 171 procedures. The two groups did not vary significantly in patient age, gender, and aneurysms location. Aspirin non-responsiveness was detected in 3 patients (1.75%) and clopidogrel non-responsiveness in 21 patients (12.3%). Non-tested patients had an 11.6% rate of thrombotic complications with a 4.1% permanent morbidity or mortality rate versus 2.3% and 0.6% in tested patients (p=0.0013). The incidence of hemorrhagic complications was similar between the two groups. Preoperative platelet inhibition testing using WBA can be useful to assess and correct antiaggregant non-responsiveness, and may reduce postoperative mortality and permanent morbidity. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

The effect of participant nonresponse on HIV prevalence estimates in a population-based survey in two informal settlements in Nairobi city

PubMed Central

2010-01-01

Background Participant nonresponse in an HIV serosurvey can affect estimates of HIV prevalence. Nonresponse can arise from a participant's refusal to provide a blood sample or the failure to trace a sampled individual. In a serosurvey conducted by the African Population and Health Research Center and Kenya Medical Research Centre in the slums of Nairobi, 43% of sampled individuals did not provide a blood sample. This paper describes selective participation in the serosurvey and estimates bias in HIV prevalence figures. Methods The paper uses data derived from an HIV serosurvey nested in an on-going demographic surveillance system. Nonresponse was assessed using logistic regression and multiple imputation methods to impute missing data for HIV status using a set of common variables available for all sampled participants. Results Age, residence, high mobility, wealth, and ethnicity were independent predictors of a sampled individual not being contacted. Individuals aged 30-34 years, females, individuals from the Kikuyu and Kamba ethnicity, married participants, and residents of Viwandani were all less likely to accept HIV testing when contacted. Although men were less likely to be contacted, those found were more willing to be tested compared to females. The overall observed HIV prevalence was overestimated by 2%. The observed prevalence for male participants was underestimated by about 1% and that for females was overestimated by 3%. These differences were small and did not affect the overall estimate substantially as the observed estimates fell within the confidence limits of the corrected prevalence estimate. Conclusions Nonresponse in the HIV serosurvey in the two informal settlements was high, however, the effect on overall prevalence estimate was minimal. PMID:20649957

Accessory renal arteries: Prevalence in resistant hypertension and an important role in nonresponse to radiofrequency renal denervation.

PubMed

VonAchen, Paige; Hamann, Jason; Houghland, Thomas; Lesser, John R; Wang, Yale; Caye, David; Rosenthal, Kristi; Garberich, Ross F; Daniels, Mary; Schwartz, Robert S

The aim of this study was to understand the role of accessory renal arteries in resistant hypertension, and to establish their role in nonresponse to radiofrequency renal denervation (RDN) procedures. Prior studies suggest a role for accessory renal arteries in hypertensive syndromes, and recent clinical trials of renal denervation report that these anomalies are highly prevalent in resistant hypertension. This study evaluated the relationships among resistant hypertension, accessory renal arteries, and the response to radiofrequency (RF) renal denervation. Computed Tomography Angiography (CTA) and magnetic resonance imaging (MRI) scans from 58 patients with resistant hypertension undergoing RF renal denervation (RDN) were evaluated. Results were compared with CT scans in 57 healthy, normotensive subjects undergoing screening as possible renal transplant donors. All scans were carefully studied for accessory renal arteries, and were correlated with long term blood pressure reduction. Accessory renal arteries were markedly more prevalent in the hypertensive patients than normotensive renal donors (59% vs 32% respectively, p=0.004). RDN had an overall nonresponse rate of 29% (response rate 71%). Patients without accessory vessels had a borderline higher response rate to RDN than those with at least one accessory vessel (83% vs 62% respectively, p=0.076) and a higher RDN response than patients with untreated accessory arteries (83% vs 55%; p=0.040). For accessory renal arteries and nonresponse, the sensitivity was 76%, specificity 49%, with positive and negative predictive values 38% and 83% respectively. Accessory renal arteries were markedly over-represented in resistant hypertensives compared with healthy controls. While not all patients with accessory arteries were nonresponders, nonresponse was related to both the presence and non-treatment of accessory arteries. Addressing accessory renal arteries in future clinical trials may improve RDN therapeutic efficacy. Copyright © 2016 Elsevier Inc. All rights reserved.

Nonresponse bias in randomized controlled experiments in criminology: Putting the Queensland Community Engagement Trial (QCET) under a microscope.

PubMed

Antrobus, Emma; Elffers, Henk; White, Gentry; Mazerolle, Lorraine

2013-01-01

The goal of this article is to examine whether or not the results of the Queensland Community Engagement Trial (QCET)-a randomized controlled trial that tested the impact of procedural justice policing on citizen attitudes toward police-were affected by different types of nonresponse bias. We use two methods (Cochrane and Elffers methods) to explore nonresponse bias: First, we assess the impact of the low response rate by examining the effects of nonresponse group differences between the experimental and control conditions and pooled variance under different scenarios. Second, we assess the degree to which item response rates are influenced by the control and experimental conditions. Our analysis of the QCET data suggests that our substantive findings are not influenced by the low response rate in the trial. The results are robust even under extreme conditions, and statistical significance of the results would only be compromised in cases where the pooled variance was much larger for the nonresponse group and the difference between experimental and control conditions was greatly diminished. We also find that there were no biases in the item response rates across the experimental and control conditions. RCTs that involve field survey responses-like QCET-are potentially compromised by low response rates and how item response rates might be influenced by the control or experimental conditions. Our results show that the QCET results were not sensitive to the overall low response rate across the experimental and control conditions and the item response rates were not significantly different across the experimental and control groups. Overall, our analysis suggests that the results of QCET are robust and any biases in the survey responses do not significantly influence the main experimental findings.

Post-sampling mortality and non-response patterns in the English Cancer Patient Experience Survey: Implications for epidemiological studies based on surveys of cancer patients.

PubMed

Abel, Gary A; Saunders, Catherine L; Lyratzopoulos, Georgios

2016-04-01

Surveys of the experience of cancer patients are increasingly being introduced in different countries and used in cancer epidemiology research. Sampling processes, post-sampling mortality and survey non-response can influence the representativeness of cancer patient surveys. We examined predictors of post-sampling mortality and non-response among patients initially included in the sampling frame of the English Cancer Patient Experience Survey. We also compared the respondents' diagnostic case-mix to other relevant populations of cancer patients, including incident and prevalent cases. Of 109,477 initially sampled cancer patients, 6273 (5.7%) died between sampling and survey mail-out. Older age and diagnosis of brain, lung and pancreatic cancer were associated with higher risk of post-sampling mortality. The overall response rate was 67% (67,713 respondents), being >70% for the most affluent patients and those diagnosed with colon or breast cancer and <50% for Asian or Black patients, those under 35 and those diagnosed with brain cancer. The diagnostic case-mix of respondents varied substantially from incident or prevalent cancer cases. Respondents to the English Cancer Patient Experience Survey represent a population of recently treated cancer survivors. Although patient survey data can provide unique insights for improving cancer care quality, features of survey populations need to be acknowledged when analysing and interpreting findings from studies using such data. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Risk and prognostic factors of ventilator-associated pneumonia in trauma patients.

PubMed

Cavalcanti, Manuela; Ferrer, Miquel; Ferrer, Ricard; Morforte, Ramon; Garnacho, Angel; Torres, Antoni

2006-04-01

To assess the risk and prognostic factors of ventilator-associated pneumonia in trauma patients, with an emphasis on the inflammatory response. Case-control study. Trauma intensive care unit. Of 190 consecutive mechanically ventilated patients, those with microbiologically confirmed pneumonia (n = 62) were matched with 62 controls without pneumonia. None. Clinical, microbiological, and outcome variables were recorded. Cytokines were measured in serum and blind bronchoalveolar lavage specimens at onset of pneumonia. Multivariate analyses of risk and prognostic factors for ventilator-associated pneumonia were done. Increased severity of head and neck injury (odds ratio, 11.9; p < .001) was the only independent predictor of pneumonia. Among patients with pneumonia, serum levels of interleukin-6 (p = .019) and interleukin-8 (p = .036) at onset of pneumonia were higher in nonresponders to treatment. Moreover, serum levels of tumor necrosis factor-alpha (p = .028) and interleukin-6 (p = .007) at onset of pneumonia were higher in nonsurvivors. Mortality in the intensive care unit was 23% in cases and controls. Nonresponse to antimicrobial treatment (odds ratio, 22.2; p = .001) and the use of hyperventilation (p = .021) were independent predictors of mortality in the intensive care unit for patients with pneumonia. Severe head and neck trauma is strongly associated with ventilator-associated pneumonia. A higher inflammatory response is associated with nonresponse to treatment and mortality among patients with pneumonia. Although pneumonia did not influence mortality, nonresponse to treatment independently predicted mortality among these patients.

Evaluation of 143 Cases of Immune Thrombocytopenic Purpura With Regards to Clinical Course and Response to Treatment

PubMed Central

Albayrak, Murat; Balcik, Ozlem Sahin; Aki, Sahika Zeynep; Gokmen, Ayla; Ceran, Funda; Yokus, Osman; Dagdas, Simten; Ayli, Meltem; Ozet, Gulsum

2010-01-01

Objective: Immune thrombocytopenic purpura (ITP) is also known as idiopathic thrombocytopenic purpura. Increased platelet destruction and insufficient platelet production are both responsible for its etiopathogenesis. ITP can be diagnosed after excluding other possible causes of thrombocytopenia. Materials and Methods: One hundred forty-three cases of chronic ITP that were monitored in a hematology clinic were retrospectively evaluated. All cases received first line treatment of 1 mg/kg/day prednisolone. Corticosteroid nonresponsive (CN) cases and corticosteroid-dependent (CD) cases underwent splenectomies. Results: The rate of CN/CD cases was found to be 53% (n=76). Sixty-six percent of these cases (n=50) underwent splenectomies. The ratio of non-responsive cases to relapse cases after splenectomy (SN/SR) was 30% (n=15). The total number of cases was 41, including those without splenectomy (n=26) and with SY/SR (n=15). Helicobacter pylori (Hp) eradication, immunosuppressive agents and danazol treatments were administered to patients (n=10, n=14 and n=4, respectively). Currently, 13 patients are being monitored without treatment. Fifteen patients who were non-responsive to Hp eradication treatment, immunosuppressive treatment or danazol treatment are still being monitored without any treatment. Conclusion: Optimal treatment is not available for splenectomy-resistant cases of ITP. The response rates for Hp eradication treatment, immunosuppressive treatments and anabolic agents are low. Therefore, larger studies with more patients are required using new agents, such as thrombopoietin (TPO) receptor agonists and anti-CD20 monoclonal antibodies. PMID:25610140

Stratifying to reduce bias caused by high nonresponse rates: A case study from New Mexico’s forest inventory

Treesearch

Sara A. Goeking; Paul L. Patterson

2013-01-01

The USDA Forest Service’s Forest Inventory and Analysis (FIA) Program applies specific sampling and analysis procedures to estimate a variety of forest attributes. FIA’s Interior West region uses post-stratification, where strata consist of forest/nonforest polygons based on MODIS imagery, and assumes that nonresponse plots are distributed at random across each stratum...

An exploratory study of adolescent response to fluoxetine using psychological and biological predictors.

PubMed

Zohar, Ada H; Eilat, Tamar; Amitai, Maya; Taler, Michal; Bari, Romi; Chen, Alon; Apter, Alan; Weizman, Avraham; Fennig, Silvana

2018-01-01

Not enough is known about predicting therapeutic response to serotonin-specific reuptake inhibitors, and specifically to fluoxetine. This exploratory study used psychological and biological markers for (retrospective) prediction of treatment-response to fluoxetine in depressed and/or anxious adolescents. Forty-one consecutive adolescent outpatients with a primary diagnosis of severe affective and/or anxiety disorders were assessed and treated with an open-label 8-week trial of fluoxetine. Type D personality was assessed with the 14-item questionnaire, the DS14. In addition, TNFα, IL-6, and IL-1b were measured pre- and post-treatment. There was an elevation of Type D personality in patients, compared to the adolescent population rate. Post-treatment, 44% of patients were classified as non-responders; the relative risk of non-response for Type D personality patients was 2.8. Binary logistic regression predicting response vs. non-response showed a contribution of initial TNFα levels as well as Type D personality to non-response. In this exploratory study, the most significant contributor to non-response was Type D personality. However, the measurement of Type D was not prospective, and thus may be confounded with psychiatric morbidity. The measurement of personality in psychiatric settings may contribute to the understanding of treatment response and have clinical utility.

Measuring sexual orientation in adolescent health surveys: evaluation of eight school-based surveys.

PubMed

Saewyc, Elizabeth M; Bauer, Greta R; Skay, Carol L; Bearinger, Linda H; Resnick, Michael D; Reis, Elizabeth; Murphy, Aileen

2004-10-01

To examine the performance of various items measuring sexual orientation within 8 school-based adolescent health surveys in the United States and Canada from 1986 through 1999. Analyses examined nonresponse and unsure responses to sexual orientation items compared with other survey items, demographic differences in responses, tests for response set bias, and congruence of responses to multiple orientation items; analytical methods included frequencies, contingency tables with Chi-square, and ANOVA with least significant differences (LSD)post hoc tests; all analyses were conducted separately by gender. In all surveys, nonresponse rates for orientation questions were similar to other sexual questions, but not higher; younger students, immigrants, and students with learning disabilities were more likely to skip items or select "unsure." Sexual behavior items had the lowest nonresponse, but fewer than half of all students reported sexual behavior, limiting its usefulness for indicating orientation. Item placement in the survey, wording, and response set bias all appeared to influence nonresponse and unsure rates. Specific recommendations include standardizing wording across future surveys, and pilot testing items with diverse ages and ethnic groups of teens before use. All three dimensions of orientation should be assessed where possible; when limited to single items, sexual attraction may be the best choice. Specific wording suggestions are offered for future surveys.

MR enterography in nonresponsive adult celiac disease: Correlation with endoscopic, pathologic, serologic, and genetic features.

PubMed

Radmard, Amir Reza; Hashemi Taheri, Amir Pejman; Salehian Nik, Elham; Kooraki, Soheil; Kolahdoozan, Shadi; Mirminachi, Babak; Sotoudeh, Masoud; Ekhlasi, Golnaz; Malekzadeh, Reza; Shahbazkhani, Bijan

2017-10-01

To assess small bowel abnormalities on magnetic resonance enterography (MRE) in adult patients with nonresponsive celiac disease (CD) and investigate their associations with endoscopic, histopathologic, serologic, and genetic features. This prospective study was carried out between September 2012 and August 2013. After approval by the Ethics Committee of our institution, informed consent was acquired from all participants. Forty consecutive patients with nonresponsive CD, aged 17-76 years, underwent MRE using a 1.5T unit. Sequences included T 2 -HASTE, True-FISP, pre- and postcontrast VIBE to assess the quantitative (number of ileal and jejunal folds) and qualitative (fold pattern abnormalities, mural thickening, increased enhancement, bowel dilatation, or intussusception) measures. Endoscopic manifestations were categorized as normal/mild vs. severe. Histopathological results were divided into mild and severe. Genotyping of HLA-DQ2 and DQ8 was performed. Serum levels of tissue-transglutaminase, endomysial, and gliadin antibodies were also determined. Logistic regression analysis and receiver operating characteristic (ROC) curve were used. Twenty-nine (72.5%) cases showed abnormal MRE. Reversed jejunoileal fold pattern had significant association with severe endoscopic (odds ratio [OR] = 8.38, 95% confidence interval [CI] 1.73-40.5) and pathologic features (OR = 7.36, 95% CI 1.33-40.54). An increased number of ileal folds/inch was significantly associated with severe MARSH score and positive HLA-DQ8. (P < 0.001 and P = 0.026, respectively). Ileal fold number had the highest areas under the curve for prediction of severe endoscopic (AUC: 0.75, P = 0.009) and pathologic (AUC: 0.84, P < 0.001) findings and positive anti-transglutaminase antibody (AUC: 0.85, P = 0.027). Fold pattern reversal on MRE is highly associated with endoscopic and pathologic features of refractory celiac disease (RCD). Increased ileal folds showed higher correlation with endoscopic-pathologic features, HLA-DQ8, and anti-transglutaminase level. MRE might be more sensitive for detection of increased ileal folds in CD rather than reduction of duodenal and jejunal folds due to better distension of ileal loops. 2 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2017;46:1096-1106. © 2017 International Society for Magnetic Resonance in Medicine.

Implementing a mixed-mode design for collecting administrative records: striking a balance between quality and burden

EIA Publications

2012-01-01

RECS relies on actual records from energy suppliers to produce robust survey estimates of household energy consumption and expenditures. During the RECS Energy Supplier Survey (ESS), energy billing records are collected from the companies that supply electricity, natural gas, fuel oil/kerosene, and propane (LPG) to the interviewed households. As Federal agencies expand the use of administrative records to enhance, replace, or evaluate survey data, EIA has explored more flexible, reliable and efficient techniques to collect energy billing records. The ESS has historically been a mail-administered survey, but EIA introduced web data collection with the 2009 RECS ESS. In that survey, energy suppliers self-selected their reporting mode among several options: standardized paper form, on-line fillable form or spreadsheet, or failing all else, a nonstandard format of their choosing. In this paper, EIA describes where reporting mode appears to influence the data quality. We detail the reporting modes, the embedded and post-hoc quality control and consistency checks that were performed, the extent of detectable errors, and the methods used for correcting data errors. We explore by mode the levels of unit and item nonresponse, number of errors, and corrections made to the data. In summary, we find notable differences in data quality between modes and analyze where the benefits of offering these new modes outweigh the "costs".

Using Systematic Screening Procedures to Identify Students Who Are Nonresponsive to Primary Prevention Efforts: Integrating Academic and Behavioral Measures

ERIC Educational Resources Information Center

Kalberg, Jemma Robertson; Lane, Kathleen Lynne; Menzies, Holly Mariah

2010-01-01

Many school systems are adopting three-tiered models of prevention (e.g., Response to Intervention and Positive Behavior Support) to support an increasingly diverse student population (Sugai, Horner, & Gresham, 2002). A central feature of these models is that data are monitored to determine responsiveness. We offer this paper as a guide for…

Increasing the Precision of Estimates in Follow-Up Surveys: A Case Study. AIR 1983 Annual Forum Paper.

ERIC Educational Resources Information Center

Clark, Sheldon B.; Nichols, James O.

Survey data concerning teacher education program graduates were used to demonstrate the advantages of a stratified random sampling approach, with followup, relative to a one-shot mailing to an entire population. Sampling issues involved in such an approach are addressed, particularly with regard to quantifying the effects of nonresponse on the…

The Effect of Differential Incentives on Attrition Bias: Evidence from the PASS Wave 3 Incentive Experiment

ERIC Educational Resources Information Center

Felderer, Barbara; Müller, Gerrit; Kreuter, Frauke; Winter, Joachim

2018-01-01

Respondent incentives are widely used to increase response rates, but their effect on nonresponse bias has not been researched as much. To contribute to the research, we analyze an incentive experiment embedded within the third wave of the German household panel survey "Panel Labor Market and Social Security" conducted by the German…

The fading affect bias: Effects of social disclosure to an interactive versus non-responsive listener.

PubMed

Muir, Kate; Brown, Charity; Madill, Anna

2015-01-01

The intensity of negative emotions associated with event memories fades to a greater extent over time than positive emotions (fading affect bias or FAB). In this study, we examine how the presence and behaviour of a listener during social disclosure influences the FAB and the linguistic characteristics of event narratives. Participants recalled pleasant and unpleasant events and rated each event for its emotional intensity. Recalled events were then allocated to one of three experimental conditions: no disclosure, private verbal disclosure without a listener or social disclosure to another participant whose behaviour was experimentally manipulated. Participants again rated the emotional intensity of the events immediately after these manipulations and after a one-week delay. Verbal disclosure alone was not sufficient to enhance the FAB. However, social disclosure increased positive emotional intensity, regardless of the behaviour of the listener. Whilst talking to an interactive listener led unpleasant event memories to decrease in emotional intensity, talking to a non-responsive listener increased their negative emotional intensity. Further, listener behaviour influenced the extent of emotional expression in written event narratives. This study provides original evidence that listener behaviour during social disclosure is an important factor in the effects of social disclosure in the FAB.

Genetic analysis of Physcomitrella patens identifies ABSCISIC ACID NON-RESPONSIVE, a regulator of ABA responses unique to basal land plants and required for desiccation tolerance

DOE PAGES

Stevenson, Sean Ross; Kamisugi, Yasuko; Trinh, Chi H.; ...

2016-05-18

The anatomically simple plants that first colonized land must have acquired molecular and biochemical adaptations to drought stress. Abscisic acid (ABA) coordinates responses leading to desiccation tolerance in all land plants. We identified ABA nonresponsive mutants in the model bryophyte Physcomitrella patens and genotyped a segregating population to map and identify the ABA NON-RESPONSIVE (ANR) gene encoding a modular protein kinase comprising an N-terminal PAS domain, a central EDR domain, and a C-terminal MAPKKK-like domain. anr mutants fail to accumulate dehydration tolerance-associated gene products in response to drought, ABA, or osmotic stress and do not acquire ABA-dependent desiccation tolerance. Themore » crystal structure of the PAS domain, determined to 1.7-Å resolution, shows a conserved PAS-fold that dimerizes through a weak dimerization interface. Targeted mutagenesis of a conserved tryptophan residue within the PAS domain generates plants with ABA nonresponsive growth and strongly attenuated ABA-responsive gene expression, whereas deleting this domain retains a fully ABA-responsive phenotype. ANR orthologs are found in early-diverging land plant lineages and aquatic algae but are absent from more recently diverged vascular plants. Lastly, we propose that ANR genes represent an ancestral adaptation that enabled drought stress survival of the first terrestrial colonizers but were lost during land plant evolution.« less

Genetic analysis of Physcomitrella patens identifies ABSCISIC ACID NON-RESPONSIVE, a regulator of ABA responses unique to basal land plants and required for desiccation tolerance

DOE Office of Scientific and Technical Information (OSTI.GOV)

Stevenson, Sean Ross; Kamisugi, Yasuko; Trinh, Chi H.

The anatomically simple plants that first colonized land must have acquired molecular and biochemical adaptations to drought stress. Abscisic acid (ABA) coordinates responses leading to desiccation tolerance in all land plants. We identified ABA nonresponsive mutants in the model bryophyte Physcomitrella patens and genotyped a segregating population to map and identify the ABA NON-RESPONSIVE (ANR) gene encoding a modular protein kinase comprising an N-terminal PAS domain, a central EDR domain, and a C-terminal MAPKKK-like domain. anr mutants fail to accumulate dehydration tolerance-associated gene products in response to drought, ABA, or osmotic stress and do not acquire ABA-dependent desiccation tolerance. Themore » crystal structure of the PAS domain, determined to 1.7-Å resolution, shows a conserved PAS-fold that dimerizes through a weak dimerization interface. Targeted mutagenesis of a conserved tryptophan residue within the PAS domain generates plants with ABA nonresponsive growth and strongly attenuated ABA-responsive gene expression, whereas deleting this domain retains a fully ABA-responsive phenotype. ANR orthologs are found in early-diverging land plant lineages and aquatic algae but are absent from more recently diverged vascular plants. Lastly, we propose that ANR genes represent an ancestral adaptation that enabled drought stress survival of the first terrestrial colonizers but were lost during land plant evolution.« less

Defective distal regulatory element at the 5' upstream of rat prolactin gene of steroid-nonresponsive GH-subclone.

PubMed

Kumar, V; Wong, D T; Pasion, S G; Biswas, D K

1987-12-08

The prolactin-nonproducing (PRL-) GH cell strains (rat pituitary tumor cells in culture). GH12C1 and F1BGH12C1, do not respond to steroid hormones estradiol or hydrocortisone (HC). However, the stimulatory effect of estradiol and the inhibitory effect of hydrocortisone on prolactin synthesis can be demonstrated in the prolactin-producing GH cell strain, GH4C1. In this investigation we have examined the 5' end flanking region of rat prolactin (rat PRL) gene of steroid-responsive, GH4C1 cells to identify the positive and negative regulatory elements and to verify the status of these elements in steroid-nonresponsive F1BGH12C1 cells. Results presented in this report demonstrate that the basel level expression of the co-transferred Neo gene (neomycin phosphoribosyl transferase) is modulated by the distal upstream regulatory elements of rat PRL gene in response to steroid hormones. The expression of adjacent Neo gene is inhibited by dexamethasone and is stimulated by estradiol in transfectants carrying distal regulatory elements (SRE) of steroid-responsive cells. These responses are not observed in transfectants with the rat PRL upstream sequences derived from steroid-nonresponsive cells. The basal level expression of the host cell alpha-2 tubulin gene is not affected by dexamethasone. We report here the identification of the distal steroid regulatory element (SRE) located between 3.8 and 7.8 kb upstream of the transcription initiation site of rat PRL gene. Both the positive and the negative effects of steroid hormones can be identified within this upstream sequence. This distal SRE appears to be nonfunctional in steroid-nonresponsive cells. Though the proximal SRE is functional, the defect in the distal SRE makes the GH substrain nonresponsive to steroid hormones. These results suggest that both the proximal and the distal SREs are essential for the mediation of action of steroid hormones in GH cells.

Spatial heterogeneity in soil microbes alters outcomes of plant competition.

PubMed

Abbott, Karen C; Karst, Justine; Biederman, Lori A; Borrett, Stuart R; Hastings, Alan; Walsh, Vonda; Bever, James D

2015-01-01

Plant species vary greatly in their responsiveness to nutritional soil mutualists, such as mycorrhizal fungi and rhizobia, and this responsiveness is associated with a trade-off in allocation to root structures for resource uptake. As a result, the outcome of plant competition can change with the density of mutualists, with microbe-responsive plant species having high competitive ability when mutualists are abundant and non-responsive plants having high competitive ability with low densities of mutualists. When responsive plant species also allow mutualists to grow to greater densities, changes in mutualist density can generate a positive feedback, reinforcing an initial advantage to either plant type. We study a model of mutualist-mediated competition to understand outcomes of plant-plant interactions within a patchy environment. We find that a microbe-responsive plant can exclude a non-responsive plant from some initial conditions, but it must do so across the landscape including in the microbe-free areas where it is a poorer competitor. Otherwise, the non-responsive plant will persist in both mutualist-free and mutualist-rich regions. We apply our general findings to two different biological scenarios: invasion of a non-responsive plant into an established microbe-responsive native population, and successional replacement of non-responders by microbe-responsive species. We find that resistance to invasion is greatest when seed dispersal by the native plant is modest and dispersal by the invader is greater. Nonetheless, a native plant that relies on microbial mutualists for competitive dominance may be particularly vulnerable to invasion because any disturbance that temporarily reduces its density or that of the mutualist creates a window for a non-responsive invader to establish dominance. We further find that the positive feedbacks from associations with beneficial soil microbes create resistance to successional turnover. Our theoretical results constitute an important first step toward developing a general understanding of the interplay between mutualism and competition in patchy landscapes, and generate qualitative predictions that may be tested in future empirical studies.

Spatial Heterogeneity in Soil Microbes Alters Outcomes of Plant Competition

PubMed Central

Abbott, Karen C.; Karst, Justine; Biederman, Lori A.; Borrett, Stuart R.; Hastings, Alan; Walsh, Vonda; Bever, James D.

2015-01-01

Plant species vary greatly in their responsiveness to nutritional soil mutualists, such as mycorrhizal fungi and rhizobia, and this responsiveness is associated with a trade-off in allocation to root structures for resource uptake. As a result, the outcome of plant competition can change with the density of mutualists, with microbe-responsive plant species having high competitive ability when mutualists are abundant and non-responsive plants having high competitive ability with low densities of mutualists. When responsive plant species also allow mutualists to grow to greater densities, changes in mutualist density can generate a positive feedback, reinforcing an initial advantage to either plant type. We study a model of mutualist-mediated competition to understand outcomes of plant-plant interactions within a patchy environment. We find that a microbe-responsive plant can exclude a non-responsive plant from some initial conditions, but it must do so across the landscape including in the microbe-free areas where it is a poorer competitor. Otherwise, the non-responsive plant will persist in both mutualist-free and mutualist-rich regions. We apply our general findings to two different biological scenarios: invasion of a non-responsive plant into an established microbe-responsive native population, and successional replacement of non-responders by microbe-responsive species. We find that resistance to invasion is greatest when seed dispersal by the native plant is modest and dispersal by the invader is greater. Nonetheless, a native plant that relies on microbial mutualists for competitive dominance may be particularly vulnerable to invasion because any disturbance that temporarily reduces its density or that of the mutualist creates a window for a non-responsive invader to establish dominance. We further find that the positive feedbacks from associations with beneficial soil microbes create resistance to successional turnover. Our theoretical results constitute an important first step toward developing a general understanding of the interplay between mutualism and competition in patchy landscapes, and generate qualitative predictions that may be tested in future empirical studies. PMID:25946068

Predicting and managing primary and secondary non-response to rituximab using B-cell biomarkers in systemic lupus erythematosus

PubMed Central

Md Yusof, Md Yuzaiful; Shaw, Daniel; El-Sherbiny, Yasser M; Dunn, Emma; Rawstron, Andy C; Emery, Paul; Vital, Edward M

2017-01-01

Objective To assess factors associated with primary and secondary non-response to rituximab in systemic lupus erythematosus (SLE) and evaluate management of secondary non-depletion non-response (2NDNR). Methods 125 patients with SLE treated with rituximab over 12 years were studied prospectively. A major clinical response was defined as improvement of all active British Isles Lupus Assessment Group (BILAG)-2004 domains to grade C/better and no A/B flare. Partial responders were defined by one persistent BILAG B. B-cell subsets were measured using highly sensitive flow cytometry. Patients with 2NDNR, defined by infusion reaction and defective depletion, were treated with ocrelizumab or ofatumumab. Results 117 patients had evaluable data. In cycle 1 (C1), 96/117 (82%) achieved BILAG response (major=50%, partial=32%). In multivariable analysis, younger age (OR 0.97, 95% CI 0.94 to 1.00) and B-cell depletion at 6 weeks (OR 3.22, 95% CI 1.24 to 8.33) increased the odds of major response. Complete depletion was predicted by normal complement and lower pre-rituximab plasmablasts and was not associated with increased serious infection post-rituximab. Seventy-seven (with data on 72) C1 responders were retreated on clinical relapse. Of these, 61/72 (85%) responded in cycle 2 (C2). Of the 11 C2 non-responders, nine met 2NDNR criteria (incidence=12%) and tested positive for anti-rituximab antibodies. Lack of concomitant immunosuppressant and higher pre-rituximab plasmablasts predicted 2NDNR. Five were switched to ocrelizumab/ofatumumab, and all depleted and responded. Conclusion Treatment with anti-CD20 agents can be guided by B-cell monitoring and should aim to achieve complete depletion. 2NDNR is associated with anti-rituximab antibodies, and switching to humanised agents restores depletion and response. In SLE, alternative anti-CD20 antibodies may be more consistently effective. PMID:28684557

Analysis of five-year trends in self-reported language preference and issues of item non-response among Hispanic persons in a large cross-sectional health survey: implications for the measurement of an ethnic minority population

PubMed Central

2010-01-01

Background Significant differences in health outcomes have been documented among Hispanic persons, the fastest-growing demographic segment of the United States. The objective of this study was to examine trends in population growth and the collection of health data among Hispanic persons, including issues of language preference and survey completion using a national health survey to highlight issues of measurement of an increasingly important demographic segment of the United States. Design Data from the 2003-2007 United States Census and the Behavioral Risk Factor Surveillance System were used to compare trends in population growth and survey sample size as well as differences in survey response based on language preference among a Hispanic population. Percentages of item non-response on selected survey questions were compared for Hispanic respondents choosing to complete the survey in Spanish and those choosing to complete the survey in English. The mean number of attempts to complete the survey was also compared based on language preference among Hispanic respondents. Results The sample size of Hispanic persons in the Behavioral Risk Factor Surveillance System saw little growth compared to the actual growth of the Hispanic population in the United States. Significant differences in survey item non-response for nine of 15 survey questions were seen based on language preference. Hispanic respondents choosing to complete the survey in Spanish had a significantly fewer number of call attempts for survey completion compared to their Hispanic counterparts choosing to communicate in English. Conclusions Including additional measures of acculturation and increasing the sample size of Hispanic persons in a national health survey such as the Behavioral Risk Factor Surveillance System may result in more precise findings that could be used to better target prevention and health care needs for an ethnic minority population. PMID:20412575

Prediction of treatment outcomes to exercise in patients with nonremitted major depressive disorder.

PubMed

Rethorst, Chad D; South, Charles C; Rush, A John; Greer, Tracy L; Trivedi, Madhukar H

2017-12-01

Only one-third of patients with major depressive disorder (MDD) achieve remission with initial treatment. Consequently, current clinical practice relies on a "trial-and-error" approach to identify an effective treatment for each patient. The purpose of this report was to determine whether we could identify a set of clinical and biological parameters with potential clinical utility for prescription of exercise for treatment of MDD in a secondary analysis of the Treatment with Exercise Augmentation in Depression (TREAD) trial. Participants with nonremitted MDD were randomized to one of two exercise doses for 12 weeks. Participants were categorized as "remitters" (≤12 on the IDS-C), nonresponders (<30% drop in IDS-C), or neither. The least absolute shrinkage and selection operator (LASSO) and random forests were used to evaluate 30 variables as predictors of both remission and nonresponse. Predictors were used to model treatment outcomes using logistic regression. Of the 122 participants, 36 were categorized as remitters (29.5%), 56 as nonresponders (45.9%), and 30 as neither (24.6%). Predictors of remission were higher levels of brain-derived neurotrophic factor (BDNF) and IL-1B, greater depressive symptom severity, and higher postexercise positive affect. Predictors of treatment nonresponse were low cardiorespiratory fitness, lower levels of IL-6 and BDNF, and lower postexercise positive affect. Models including these predictors resulted in predictive values greater than 70% (true predicted remitters/all predicted remitters) with specificities greater than 25% (true predicted remitters/all remitters). Results indicate feasibility in identifying patients who will either remit or not respond to exercise as a treatment for MDD utilizing a clinical decision model that incorporates multiple patient characteristics. © 2017 Wiley Periodicals, Inc.

Design and Weighting Methods for a Nationally Representative Sample of HIV-infected Adults Receiving Medical Care in the United States-Medical Monitoring Project

PubMed Central

Iachan, Ronaldo; H. Johnson, Christopher; L. Harding, Richard; Kyle, Tonja; Saavedra, Pedro; L. Frazier, Emma; Beer, Linda; L. Mattson, Christine; Skarbinski, Jacek

2016-01-01

Background: Health surveys of the general US population are inadequate for monitoring human immunodeficiency virus (HIV) infection because the relatively low prevalence of the disease (<0.5%) leads to small subpopulation sample sizes. Objective: To collect a nationally and locally representative probability sample of HIV-infected adults receiving medical care to monitor clinical and behavioral outcomes, supplementing the data in the National HIV Surveillance System. This paper describes the sample design and weighting methods for the Medical Monitoring Project (MMP) and provides estimates of the size and characteristics of this population. Methods: To develop a method for obtaining valid, representative estimates of the in-care population, we implemented a cross-sectional, three-stage design that sampled 23 jurisdictions, then 691 facilities, then 9,344 HIV patients receiving medical care, using probability-proportional-to-size methods. The data weighting process followed standard methods, accounting for the probabilities of selection at each stage and adjusting for nonresponse and multiplicity. Nonresponse adjustments accounted for differing response at both facility and patient levels. Multiplicity adjustments accounted for visits to more than one HIV care facility. Results: MMP used a multistage stratified probability sampling design that was approximately self-weighting in each of the 23 project areas and nationally. The probability sample represents the estimated 421,186 HIV-infected adults receiving medical care during January through April 2009. Methods were efficient (i.e., induced small, unequal weighting effects and small standard errors for a range of weighted estimates). Conclusion: The information collected through MMP allows monitoring trends in clinical and behavioral outcomes and informs resource allocation for treatment and prevention activities. PMID:27651851

Sexual orientation in the 2013 national health interview survey: a quality assessment.

PubMed

Dahlhamer, James M; Galinsky, Adena M; Joestl, Sarah S; Ward, Brian W

2014-12-01

Objective-This report presents a set of quality analyses of sexual orientation data collected in the 2013 National Health Interview Survey (NHIS). NHIS sexual orientation estimates are compared with those from the National Survey of Family Growth (NSFG) and the National Health and Nutrition Examination Survey (NHANES). Selected health outcomes by sexual orientation are compared between NHIS and NSFG. Assessments of item nonresponse, item response times, and responses to follow-up questions to the sexual orientation question are also presented. Methods-NHIS is a multipurpose health survey conducted continuously throughout the year by the Centers for Disease Control and Prevention's National Center for Health Statistics. Analyses in this report were based on NHIS data collected in 2013 from 34,557 adults aged 18 and over. Sampling weights were used to produce national estimates that are representative of the civilian noninstitutionalized U.S. adult population. Data from the 2006-2010 NSFG and 2009-2012 NHANES were used for the comparisons. Results-Based on the 2013 NHIS data, 96.6% of adults identified as straight, 1.6% identified as gay/lesbian, and 0.7% identified as bisexual. The remaining 1.1% of adults identified as ''something else,'' stated ''I don't know the answer,'' or refused to answer. Responses to follow-up questions suggest that the sexual orientation question is producing little classification error. In addition, largely similar patterns of association between sexual orientation and health were observed for NHIS and NSFG. Analyses of item nonresponse rates revealed few data quality issues, although item response times suggest possible shortcutting of the question and comprehension problems for select respondents. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

Sexual Assault and Sexual Harassment in the U.S. Military. Volume 1. Design of the 2014 RAND Military Workplace Study

DTIC Science & Technology

2014-01-01

studies need to examine whether nonresponse bias remains in survey estimates. Even a comparatively small nonresponse rate could, in theory , lead to...gathering and maintaining the data needed , and completing and reviewing the collection of information. Send comments regarding this burden estimate or any...crimes in Article 120 need not be associated with sexual gratification if they are designed to humiliate or debase the person who is assaulted. Instead

Neuropsychiatric manifestations in late-onset urea cycle disorder patients.

PubMed

Serrano, Mercedes; Martins, Cecilia; Pérez-Dueñas, Belén; Gómez-López, Lilian; Murgui, Empar; Fons, Carmen; García-Cazorla, Angels; Artuch, Rafael; Jara, Fernando; Arranz, José A; Häberle, Johannes; Briones, Paz; Campistol, Jaume; Pineda, Mercedes; Vilaseca, Maria A

2010-03-01

Inherited urea cycle disorders represent one of the most common groups of inborn errors of metabolism. Late-onset urea cycle disorders caused by partial enzyme deficiencies may present with unexpected clinical phenotypes. We report 9 patients followed up in our hospital presenting late-onset urea cycle disorders who initially manifested neuropsychiatric/neurodevelopmental symptoms (the most prevalent neuropsychiatric/neurodevelopmental diagnoses were mental retardation, attention-deficit hyperactivity disorder [ADHD], language disorder, and delirium). Generally, these clinical pictures did not benefit from pharmacological treatment. Conversely, dietary treatment improved the symptoms. Regarding biochemical data, 2 patients showed normal ammonium but high glutamine levels. This study highlights the fact that neuropsychiatric/neurodevelopmental findings are common among the initial symptomatology of late-onset urea cycle disorders. The authors recommend that unexplained or nonresponsive neuropsychiatric/neurodevelopmental symptoms appearing during childhood or adolescence be followed by a study of ammonia and amino acid plasmatic levels to rule out a urea cycle disorder.

Initial nonresponse and survey response mode biases in survey research.

PubMed

Chi, Donald L; Chen, Chao Ying

2015-01-01

We evaluated survey response factors (particularly initial nonresponse and survey mode) that may be associated with bias in survey research. We examined prevention-related beliefs and outcomes for initial mail survey responders (n=209), follow-up mail survey responders (n=78), and follow-up telephone survey responders (n=74). The Pearson chi-square test and analysis of variance identified beliefs and behavioral outcomes associated with survey response mode. Follow-up options to the initial mail survey improved response rates (22.0-38.0 percent). Initial mail survey responders more strongly believed topical fluoride protects teeth from cavities than others (P=0.04). A significantly larger proportion of parents completing a follow-up telephone survey (30.8 percent) refused topical fluoride for their child than those completing mail surveys (10.3-10.4 percent) (P<0.0001). Multiple mode surveys with follow-up improve response rates. Initial nonresponse and survey response mode may be associated with biases in survey research. © 2015 American Association of Public Health Dentistry.

P44/WDR77 restricts the sensitivity of proliferating cells to TGFβ signaling

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yi, Pengfei; Department of Cancer Biology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030; Gao, Shen

2014-07-18

Highlights: • P44/WDR77 causes proliferating cells to become non-responsive to TGFβ signaling. • P44/WDR77 down-regulates TβRII and TβR2 expression. • P44/WDR77 down-regulated TGFβ signaling correlates with lung tumorigenesis. - Abstract: We previously reported that a novel WD-40 domain-containing protein, p44/WDR77, drives quiescent epithelial cells to re-enter the cell cycle and plays an essential role for growth of lung and prostate cancer cells. Transforming growth factor beta (TGFβ) signaling is important in the maintenance of non-transformed cells in the quiescent or slowly cycling stage. However, both non-transformed proliferating cells and human cancer cells are non-responsive to endogenous TGFβ signaling. The mechanismmore » by which proliferating cells become refractory to TGFβ inhibition is not well established. Here, we found that silencing p44/WDR77 increased cellular sensitivity to TGFβ signaling and that this was inversely correlated with decreased cell proliferation. Smad2 or 3 phosphorylation, TGFβ-mediated transcription, and TGFβ2 and TGFβ receptor type II (TβRII) expression were dramatically induced by silencing of p44/WDR77. These data support the hypothesis that p44/WDR77 down-regulates the expression of the TGFβ ligand and its receptor, thereby leading to a cellular non-response to TGFβ signaling. Finally, we found that p44/WDR77 expression was correlated with cell proliferation and decreased TGFβ signaling during lung tumorigenesis. Together, these results suggest that p44/WDR77 expression causes the non-sensitivity of proliferating cells to TGFβ signaling, thereby contributing to cellular proliferation during lung tumorigenesis.« less

Role of Key TYMS Polymorphisms on Methotrexate Therapeutic Outcome in Portuguese Rheumatoid Arthritis Patients

PubMed Central

Lima, Aurea; Seabra, Vítor; Bernardes, Miguel; Azevedo, Rita; Sousa, Hugo; Medeiros, Rui

2014-01-01

Background Therapeutic outcome of rheumatoid arthritis (RA) patients treated with methotrexate (MTX) can be modulated by thymidylate synthase (TS) levels, which may be altered by genetic polymorphisms in TS gene (TYMS). This study aims to elucidate the influence of TYMS polymorphisms in MTX therapeutic outcome (regarding both clinical response and toxicity) in Portuguese RA patients. Methods Clinicopathological data from 233 Caucasian RA patients treated with MTX were collected, outcomes were defined and patients were genotyped for the following TYMS polymorphisms: 1) 28 base pairs (bp) variable number tandem repeat (rs34743033); 2) single nucleotide polymorphism C>G (rs2853542); and 3) 6 bp sequence deletion (1494del6, rs34489327). Chi-square and binary logistic regression analyses were performed, using genotype and haplotype-based approaches. Results Considering TYMS genotypes, 3R3R (p = 0.005, OR = 2.34), 3RC3RG (p = 0.016, OR = 3.52) and 6bp− carriers (p = 0.011, OR = 1.96) were associated with non-response to MTX. Multivariate analysis confirmed the increased risk for non-response to MTX in 6bp− carriers (p = 0.016, OR = 2.74). Data demonstrated that TYMS polymorphisms were in linkage disequilibrium (p<0.00001). Haplotype multivariate analysis revealed that haplotypes harboring both 3R and 6bp− alleles were associated with non-response to MTX. Regarding MTX-related toxicity, no statistically significant differences were observed in relation to TYMS genotypes and haplotypes. Conclusion Our study reveals that TYMS polymorphisms could be important to help predicting clinical response to MTX in RA patients. Despite the potential of these findings, translation into clinical practice needs larger studies to confirm these evidences. PMID:25279663

Getting physicians to open the survey: little evidence that an envelope teaser increases response rates.

PubMed

Ziegenfuss, Jeanette Y; Burmeister, Kelly; James, Katherine M; Haas, Lindsey; Tilburt, Jon C; Beebe, Timothy J

2012-03-31

Physician surveys are an important tool to assess attitudes, beliefs and self-reported behaviors of this policy relevant group. In order for a physician to respond to a mailed survey, they must first open the envelope. While there is some evidence that package elements can impact physician response rates, the impact of an envelope teaser is unknown. Here we assess this by testing the impact of adding a brightly colored "$25 incentive" sticker to the outside of an envelope on response rates and nonresponse bias in a survey of physicians. In the second mailing of a survey assessing physicians' moral beliefs and views on controversial health care topics, initial nonrespondents were randomly assigned to receive a survey in an envelope with a colored "$25 incentive" sticker (teaser group) or an envelope without a sticker (control group). Response rates were compared between the teaser and control groups overall and by age, gender, region of the United States, specialty and years in practice. Nonresponse bias was assessed by comparing the demographic composition of the respondents to the nonrespondents in the experimental and control condition. No significant differences in response rates were observed between the experimental and control conditions overall (p = 0.38) or after stratifying by age, gender, region, or practice type. Within the teaser condition, there was some variation in response rate by years since graduation. There was no independent effect of the teaser on response when simultaneously controlling for demographic characteristics (OR = 0.875, p = 0.4112). Neither response rates nor nonresponse bias were impacted by the use of an envelope teaser in a survey of physicians in the United States.

Evaluating a Modular Design Approach to Collecting Survey Data Using Text Messages

PubMed Central

West, Brady T.; Ghimire, Dirgha; Axinn, William G.

2015-01-01

This article presents analyses of data from a pilot study in Nepal that was designed to provide an initial examination of the errors and costs associated with an innovative methodology for survey data collection. We embedded a randomized experiment within a long-standing panel survey, collecting data on a small number of items with varying sensitivity from a probability sample of 450 young Nepalese adults. Survey items ranged from simple demographics to indicators of substance abuse and mental health problems. Sampled adults were randomly assigned to one of three different modes of data collection: 1) a standard one-time telephone interview, 2) a “single sitting” back-and-forth interview with an interviewer using text messaging, and 3) an interview using text messages within a modular design framework (which generally involves breaking the survey response task into distinct parts over a short period of time). Respondents in the modular group were asked to respond (via text message exchanges with an interviewer) to only one question on a given day, rather than complete the entire survey. Both bivariate and multivariate analyses demonstrate that the two text messaging modes increased the probability of disclosing sensitive information relative to the telephone mode, and that respondents in the modular design group, while responding less frequently, found the survey to be significantly easier. Further, those who responded in the modular group were not unique in terms of available covariates, suggesting that the reduced item response rates only introduced limited nonresponse bias. Future research should consider enhancing this methodology, applying it with other modes of data collection (e. g., web surveys), and continuously evaluating its effectiveness from a total survey error perspective. PMID:26322137

Interviewer effects on non-response propensity in longitudinal surveys: a multilevel modelling approach

PubMed Central

Vassallo, Rebecca; Durrant, Gabriele B; Smith, Peter W F; Goldstein, Harvey

2015-01-01

The paper investigates two different multilevel approaches, the multilevel cross-classified and the multiple-membership models, for the analysis of interviewer effects on wave non-response in longitudinal surveys. The models proposed incorporate both interviewer and area effects to account for the non-hierarchical structure, the influence of potentially more than one interviewer across waves and possible confounding of area and interviewer effects arising from the non-random allocation of interviewers across areas. The methods are compared by using a data set: the UK Family and Children Survey. PMID:25598587

Long non-coding RNA GAS5 sensitizes renal cell carcinoma to sorafenib via miR-21/SOX5 pathway.

PubMed

Liu, Lei; Pang, Xinlu; Shang, Wenjin; Xie, Hongchang; Feng, Yonghua; Feng, Guiwen

2018-06-12

Although the use of sorafenib appears to increase the survival rate of renal cell carcinoma (RCC) patients, there is also a proportion of patients who exhibit a poor primary response to sorafenib treatment. Therefore, it is critical to elucidate the mechanisms underlying sorafenib resistance and find representative biomarkers for sorafenib treatment in RCC patients. Herein, we identified that a long noncoding RNA GAS5 was downregulated in sorafenib nonresponsive RCCs. GAS5 overexpression conferred sorafenib sensitive to nonresponsive RCC cells, whereas knockdown of GAS5 promoted responsive RCC cells resistant to sorafenib treatment in vitro and in vivo. Mechanistically, GAS5 functioned as competing endogenous RNA to repress miR-21, which controlled its down-stream target SOX5. We proposed that GAS5 was responsible for sorafenib resistance in RCC cells and GAS5 exerted its function through the miR-21/ SOX5 axis. Our findings suggested that GAS5 downregulation may be a new marker of poor response to sorafenib and GAS5 could be a potential therapeutic target for sorafenib treatment in RCC.

Non-response to sad mood induction: implications for emotion research.

PubMed

Rottenberg, Jonathan; Kovacs, Maria; Yaroslavsky, Ilya

2018-05-01

Experimental induction of sad mood states is a mainstay of laboratory research on affect and cognition, mood regulation, and mood disorders. Typically, the success of such mood manipulations is reported as a statistically significant pre- to post-induction change in the self-rated intensity of the target affect. The present commentary was motivated by an unexpected finding in one of our studies concerning the response rate to a well-validated sad mood induction. Using the customary statistical approach, we found a significant mean increase in self-rated sadness intensity with a moderate effect size, verifying the "success" of the mood induction. However, that "success" masked that, between one-fifth and about one-third of our samples (adolescents who had histories of childhood-onset major depressive disorder and healthy controls) reported absolutely no sadness in response to the mood induction procedure. We consider implications of our experience for emotion research by (1) commenting upon the typically overlooked phenomenon of nonresponse, (2) suggesting changes in reporting practices regarding mood induction success, and (3) outlining future directions to help scientists determine why some subjects do not respond to experimental mood induction.

Enteric Coating and Aspirin Nonresponsiveness in Patients With Type 2 Diabetes Mellitus.

PubMed

Bhatt, Deepak L; Grosser, Tilo; Dong, Jing-Fei; Logan, Douglas; Jeske, Walter; Angiolillo, Dominick J; Frelinger, Andrew L; Lei, Lanyu; Liang, Juan; Moore, Jason E; Cryer, Byron; Marathi, Upendra

2017-02-14

A limitation of aspirin is that some patients, particularly those with diabetes, may not have an optimal antiplatelet effect. The goal of this study was to determine if oral bioavailability mediates nonresponsiveness. The rate and extent of serum thromboxane generation and aspirin pharmacokinetics were measured in 40 patients with diabetes in a randomized, single-blind, triple-crossover study. Patients were exposed to three 325-mg aspirin formulations: plain aspirin, PL2200 (a modified-release lipid-based aspirin), and a delayed-release enteric-coated (EC) aspirin. Onset of antiplatelet activity was determined by the rate and extent of inhibition of serum thromboxane B 2 (TXB 2 ) generation. Aspirin nonresponsiveness was defined as a level of residual serum TXB 2 associated with elevated thrombotic risk (<99.0% inhibition or TXB 2 >3.1 ng/ml) within 72 h after 3 daily aspirin doses. The rate of aspirin nonresponsiveness was 15.8%, 8.1%, and 52.8% for plain aspirin, PL2200, and EC aspirin, respectively (p < 0.001 for both comparisons vs. EC aspirin; p = 0.30 for comparison between plain aspirin and PL2200). Similarly, 56% of EC aspirin-treated subjects had serum TXB 2 levels >3.1 ng/ml, compared with 18% and 11% of subjects after administration of plain aspirin and PL2200 (p < 0.0001). Compared with findings for plain aspirin and PL2200, this high rate of nonresponsiveness with EC aspirin was associated with lower exposure to acetylsalicylic acid (63% and 70% lower geometric mean maximum plasma concentration [C max ] and 77% and 82% lower AUC 0-t [area under the curve from time 0 to the last time measured]) and 66% and 72% lower maximum decrease of TXB 2 , with marked interindividual variability. A high proportion of patients treated with EC aspirin failed to achieve complete inhibition of TXB 2 generation due to incomplete absorption. Reduced bioavailability may contribute to "aspirin resistance" in patients with diabetes. (Pharmacodynamic Evaluation of PL2200 Versus Enteric-Coated and Immediate Release Aspirin in Diabetic Patients; NCT01515657). Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Surveys of Health Professions Trainees: Prevalence, Response Rates, and Predictive Factors to Guide Researchers.

PubMed

Phillips, Andrew W; Friedman, Benjamin T; Utrankar, Amol; Ta, Andrew Q; Reddy, Shalini T; Durning, Steven J

2017-02-01

To establish a baseline overall response rate for surveys of health professions trainees, determine strategies associated with improved response rates, and evaluate for the presence of nonresponse bias. The authors performed a comprehensive analysis of all articles published in Academic Medicine, Medical Education, and Advances in Health Sciences Education in 2013, recording response rates. Additionally, they reviewed nonresponse bias analyses and factors suggested in other fields to affect response rate including survey delivery method, prenotification, and incentives. The search yielded 732 total articles; of these, 356 were research articles, and of these, 185 (52.0%) used at least one survey. Of these, 66 articles (35.6%) met inclusion criteria and yielded 73 unique surveys. Of the 73 surveys used, investigators reported a response rate for 63.0% of them; response rates ranged from 26.6% to 100%, mean (standard deviation) 71.3% (19.5%). Investigators reported using incentives for only 16.4% of the 73 surveys. The only survey methodology factor significantly associated with response rate was single- vs. multi-institutional surveys (respectively, 74.6% [21.2%] vs. 62.0% [12.8%], P = .022). Notably, statistical power for all analyses was limited. No articles evaluated for nonresponse bias. Approximately half of the articles evaluated used a survey as part of their methods. Limited data are available to establish a baseline response rate among health professions trainees and inform researchers which strategies are associated with higher response rates. Journals publishing survey-based health professions education research should improve reporting of response rate, nonresponse bias, and other survey factors.

Trial type mixing substantially reduces the response set effect in the Stroop task.

PubMed

Hasshim, Nabil; Parris, Benjamin A

2017-03-20

The response set effect refers to the finding that an irrelevant incongruent colour-word produces greater interference when it is one of the response options (referred to as a response set trial), compared to when it is not (a non-response set trial). Despite being a key effect for models of selective attention, the magnitude of the effect varies considerably across studies. We report two within-subjects experiments that tested the hypothesis that presentation format modulates the magnitude of the response set effect. Trial types (e.g. response set, non-response set, neutral) were either presented in separate blocks (pure) or in blocks containing trials from all conditions presented randomly (mixed). In the first experiment we show that the response set effect is substantially reduced in the mixed block context as a result of a decrease in RTs to response set trials. By demonstrating the modulation of the response set effect under conditions of trial type mixing we present evidence that is difficult for models of the effect based on strategic, top-down biasing of attention to explain. In a second experiment we tested a stimulus-driven account of the response set effect by manipulating the number of colour-words that make up the non-response set of distractors. The results show that the greater the number of non-response set colour concepts, the smaller the response set effect. Alternative accounts of the data and its implications for research debating the automaticity of reading are discussed. Copyright © 2017 Elsevier B.V. All rights reserved.

Data quality assurance: an analysis of patient non-response.

PubMed

Derby, Dustin C; Haan, Andrea; Wood, Kurt

2011-01-01

Patient satisfaction is paramount to maintaining high clinical quality assurance. This study seeks to compare response rates, response bias, and the completeness of data between paper and electronic collection modes of a chiropractic patient satisfaction survey. A convenience sample of 206 patients presenting to a chiropractic college clinic were surveyed concerning satisfaction with their chiropractic care. Paper (in-clinic and postal) and electronic modes of survey administration were compared for response rates and non-response bias. The online data collection mode resulted in fewer non-responses and a higher response rate, and did not evince response bias when compared to paper modes. The postal paper mode predicted non-response rates over the in-clinic paper and online modalities and exhibited a gender bias. This current study was a single clinic study; future studies should consider multi-clinic data collections. Busy clinic operations and available staff resources restricted the ability to conduct a random sampling of patients or to invite all eligible patients, therefore limiting the generalizability of collected survey data. Results of this study will provide data to aid development of survey protocols that efficiently, account for available human resources, and are convenient for patients while allowing for the most complete and accurate data collection possible in an educational clinic setting. Understanding patient responses across survey modes is critical for the cultivation of quality business intelligence within college teaching clinic settings. This study bridges measurement evidence from three popular data collection modalities and offers support for higher levels of quality for web-based data collection.

Increased plasma levels of competing amino acids, rather than lowered plasma tryptophan levels, are associated with a non-response to treatment in major depression.

PubMed

Ormstad, Heidi; Dahl, Johan; Verkerk, Robert; Andreassen, Ole A; Maes, Michael

2016-08-01

Lowered plasma tryptophan (TRP) and TRP/competing amino acid (CAA) ratio may be involved in the pathophysiology of major depression (MDD). Increased cortisol and immune-inflammatory mediators in MDD may affect the availability of TRP to the brain. We investigated whether baseline or post-treatment TRP, CAAs and TRP/CAA ratio are associated with a treatment response in MDD and whether these effects may be mediated by cortisol or immune biomarkers. We included 50 medication-free MDD patients with a depressive episode (DSM diagnosis) and assessed symptom severity with the Inventory of Depressive Symptomatology (IDS) before and after treatment as usual for 12 weeks (endpoint). Plasma levels of TRP, CAAs, the ratio, cortisol, CRP and 6 selected cytokines were assayed. The primary outcome was a 50% reduction in the IDS, while the secondary was a remission of the depressive episode. In IDS non-responders, CAAs increased and the TRP/CAA ratio decreased, while in IDS responders CAAs decreased and the TRP/CAA ratio increased from baseline to endpoint. In patients who were still depressed at endpoint TRP and CAAs levels had increased from baseline, while in remitted patients no such effects were found. Increases in CAAs were inversely correlated with changes in interleukin-1 receptor antagonist levels. The results show that increased CAA levels from baseline to endpoint are associated with a non-response to treatment in MDD patients. This suggests that the mechanism underpinning the CAA-related treatment resistance may be related to changes in immune pathways. CAA levels and amino acid metabolism may be new drug targets in depression. Copyright © 2016 Elsevier B.V. and ECNP. All rights reserved.

Participation rates, response bias and response behaviours in the community survey of the Swiss Spinal Cord Injury Cohort Study (SwiSCI).

PubMed

Fekete, Christine; Segerer, Wolfgang; Gemperli, Armin; Brinkhof, Martin W G

2015-10-08

Surveying persons with disabilities is challenging, as targeted subjects may experience specific barriers to survey participation. Here we report on participation rates and response behaviour in a community survey of people with spinal cord injury (SCI) in Switzerland. The cross-sectional survey was implemented as part of the Swiss Spinal Cord Injury Cohort Study (SwiSCI) and represents the largest population-based SCI survey in Europe including nearly 2000 persons. Design features to enhance participation rates included the division of the questionnaire volume over three successive modules; recurrent and mixed-mode reminding of non-responders; and mixed-mode options for response. We describe participation rates of the SwiSCI community survey (absolute and cumulative cooperation, contact, response, and attrition rates) and report on response rates in relation to recruitment efforts. Potential non-response bias and the association between responders' characteristics and response behaviour (response speed: reminding until participation; response mode: paper-pencil vs. online completion) were assessed using regression modelling. Over the successive modules, absolute response rates were 61.1, 80.6 and 87.3% which resulted in cumulative response rates of 49.3 and 42.6% for the second and third modules. Written reminders effectively increased response rates, with the first reminder showing the largest impact. Telephone reminders, partly with direct telephone interviewing, enhanced response rate to the first module, but were essentially redundant in subsequent modules. Non-response to the main module was related to current age, membership of Swiss Paraplegic Association (SPA) and time since injury, but not to gender, lesion level and preferred language of response. Response speed increased with household income, but was not associated to other sociodemographic factors, lesion characteristics or health indicators. We found significant associations between online completion and male gender, younger age, higher education, higher income, SPA membership, tetraplegia, longer time since injury, higher quality of life, and more participation restrictions. In this sample with little non-response bias, recurrent and mixed-mode reminding and mixed-mode options for response were key features of optimizing survey design.

Understanding flucloxacillin prescribing trends and treatment non-response in UK primary care: a Clinical Practice Research Datalink (CPRD) study

PubMed Central

Francis, Nick A.; Hood, Kerenza; Lyons, Ronan; Butler, Christopher C.

2016-01-01

Objectives The volume of prescribed antibiotics is associated with antimicrobial resistance and, unlike most other antibiotic classes, flucloxacillin prescribing has increased. We aimed to describe UK primary care flucloxacillin prescribing and factors associated with subsequent antibiotic prescribing as a proxy for non-response. Patients and methods Clinical Practice Research Datalink patients with acute prescriptions for oral flucloxacillin between January 2004 and December 2013, prescription details, associated Read codes and patient demographics were identified. Monthly prescribing rates were plotted and logistic regression identified factors associated with having a subsequent antibiotic prescription within 28 days. Results 3 031 179 acute prescriptions for 1 667 431 patients were included. Average monthly prescription rates increased from 4.74 prescriptions per 1000 patient-months in 2004 to 5.74 (increase of 21.1%) in 2013. The highest prescribing rates and the largest increases in rates were seen in older adults (70+ years), but the overall increase in prescribing was not accounted for by an ageing population. Prescribing 500 mg tablets/capsules rather than 250 mg became more common. Children were frequently prescribed low doses and small volumes (5 day course) and prescribing declined for children, including for impetigo. Only 4.2% of new prescriptions involved co-prescription of another antibiotic. Age (<5 and ≥60 years), diagnosis of ‘cellulitis or abscess’ or no associated code, and 500 mg dose were associated with a subsequent antibiotic prescription, which occurred after 17.6% of first prescriptions. Conclusions There is a need to understand better the reasons for increased prescribing of flucloxacillin in primary care, optimal dosing (and the need to co-prescribe other antibiotics) and the reasons why one in five patients are prescribed a further antibiotic within 4 weeks. PMID:27090629

Effect of survey mode on response patterns: comparison of face-to-face and self-administered modes in health surveys.

PubMed

Christensen, Anne Illemann; Ekholm, Ola; Glümer, Charlotte; Juel, Knud

2014-04-01

While face-to-face interviews are considered the gold standard of survey modes, self-administered questionnaires are often preferred for cost and convenience. This article examines response patterns in two general population health surveys carried out by face-to-face interview and self-administered questionnaire, respectively. Data derives from a health interview survey in the Region of Southern Denmark (face-to-face interview) and The Danish Health and Morbidity Survey 2010 (self-administered questionnaire). Identical questions were used in both surveys. Data on all individuals were obtained from administrative registers and linked to survey data at individual level. Multiple logistic regression analyses were used to examine the effect of survey mode on response patterns. The non-response rate was higher in the self-administered survey (37.9%) than in the face-to-face interview survey (23.7%). Marital status, ethnic background and highest completed education were associated with non-response in both modes. Furthermore, sex and age were associated with non-response in the self-administered mode. No significant mode effects were observed for indicators related to use of health services, but significant mode effects were observed for indicators related to self-reported health-related quality of life, health behaviour, social relations and morbidity (long-standing illness). The same factors were generally associated with non-response in both modes. Indicators based on factual questions with simple answers categories were overall more comparable according to mode than indicators based on questions that involved more subjective assessments. Other measures such as efficiency and cost-effectiveness of the mode should also be considered when determining the most appropriate form of data collection.

C1 Inhibitor in Acute Antibody-Mediated Rejection Nonresponsive to Conventional Therapy in Kidney Transplant Recipients: A Pilot Study.

PubMed

Viglietti, D; Gosset, C; Loupy, A; Deville, L; Verine, J; Zeevi, A; Glotz, D; Lefaucheur, C

2016-05-01

Complement inhibitors have not been thoroughly evaluated in the treatment of acute antibody-mediated rejection (ABMR). We performed a prospective, single-arm pilot study to investigate the potential effects and safety of C1 inhibitor (C1-INH) Berinert added to high-dose intravenous immunoglobulin (IVIG) for the treatment of acute ABMR that is nonresponsive to conventional therapy. Kidney recipients with nonresponsive active ABMR and acute allograft dysfunction were enrolled between April 2013 and July 2014 and received C1-INH and IVIG for 6 months (six patients). The primary end point was the change in eGFR at 6 months after inclusion (M+6). Secondary end points included the changes in histology and DSA characteristics and adverse events as evaluated at M+6. All patients showed an improvement in eGFR between inclusion and M+6: from 38.7 ± 17.9 to 45.2 ± 21.3 mL/min/1.73 m(2) (p = 0.0277). There was no change in histological features, except a decrease in the C4d deposition rate from 5/6 to 1/6 (p = 0.0455). There was a change in DSA C1q status from 6/6 to 1/6 positive (p = 0.0253). One deep venous thrombosis was observed. In a secondary analysis, C1-INH patients were compared with a similar historical control group (21 patients). C1-INH added to IVIG is safe and may improve allograft function in kidney recipients with nonresponsive acute ABMR. © Copyright 2015 The American Society of Transplantation and the American Society of Transplant Surgeons.

Effects of aircraft noise on human sleep.

NASA Technical Reports Server (NTRS)

Lukas, J. S.

1972-01-01

Under controlled conditions in two test rooms, studies were made of the response of sleeping subjects to the stimuli of simulated sonic booms and subsonic jet aircraft noise. Children were relatively nonresponsive to the stimuli. In general, the older the subject, the more likely is behavioral awakening. The response rates to the two types of stimuli were essentially the same. The stimulus intensity had little, if any, effect on frequency of arousal, although other degrees of response did increase.

Guidelines for the Management of Wet Age-Related Macular Degeneration: Recommendations from a Panel of Greek Experts.

PubMed

Androudi, Sofia; Dastiridou, Anna; Pharmakakis, Nikolaos; Stefaniotou, Maria; Kalogeropoulos, Christos; Symeonidis, Chrysanthos; Charonis, Alexandros; Tsilimbaris, Miltiadis

2016-05-01

To propose guidelines for the management of patients with wet age-related macular degeneration (wAMD), taking into account the results of large multicenter studies and clinical experience of retina experts. A team of retina experts developed a consensus paper after three consecutive meetings. The group was focused on guidelines to help clinical decision-making around the definition of successful treatment and the definition of non-response to therapy. Parameters suggestive of a successful response to treatments included: any gain in best corrected visual acuity (BCVA) or vision loss that is less than 5-10 Early Treatment Diabetic Retinopathy Study (ETDRS) letters, reduction of central retinal thickness, partial or complete absorption of subretinal fluid (SRF), reduction of intraretinal fluid, reduction of pigment epithelial detachment or restoration of the anatomy of outer retinal layers. Non-response to current treatment was considered in the case of loss of BCVA greater than 10 ETDRS letters, increased retinal edema or increase of SRF as evidenced by optical coherence tomography or new bleeding in biomicroscopy. The introduction of anti-VEGF agents revolutionized the treatment of wAMD. Given the complexity of the disease, the emerging new agents and the difference of cases recruited in clinical trials compared to those appearing in every-day practice, it is essential to individualize treatment options taking into account the results of clinical trials.

Brain-computer interfaces in the continuum of consciousness.

PubMed

Kübler, Andrea; Kotchoubey, Boris

2007-12-01

To summarize recent developments and look at important future aspects of brain-computer interfaces. Recent brain-computer interface studies are largely targeted at helping severely or even completely paralysed patients. The former are only able to communicate yes or no via a single muscle twitch, and the latter are totally nonresponsive. Such patients can control brain-computer interfaces and use them to select letters, words or items on a computer screen, for neuroprosthesis control or for surfing the Internet. This condition of motor paralysis, in which cognition and consciousness appear to be unaffected, is traditionally opposed to nonresponsiveness due to disorders of consciousness. Although these groups of patients may appear to be very alike, numerous transition states between them are demonstrated by recent studies. All nonresponsive patients can be regarded on a continuum of consciousness which may vary even within short time periods. As overt behaviour is lacking, cognitive functions in such patients can only be investigated using neurophysiological methods. We suggest that brain-computer interfaces may provide a new tool to investigate cognition in disorders of consciousness, and propose a hierarchical procedure entailing passive stimulation, active instructions, volitional paradigms, and brain-computer interface operation.

Impaired functioning of immune defenses to infection in premature and term infants and their implications for vaccination.

PubMed

Baxter, David

2010-06-01

Newborn infants, particularly those born prematurely are at increased risk of infections, including vaccine preventable ones, resulting in an increased morbidity and mortality risk. Defects associated with higher mortality may involve external barriers and the innate and adaptive systems. The available evidence suggests a complex situation that ranges from pathogen/immunogen non-responsiveness to fully mature adult-equivalent functionality depending on both host and vaccine characteristics. This review considers potential qualitative and quantitative differences with respect to immune defences between premature/term infants and adults and evaluates implications of such differences for immunization outcomes.

Spectrophotometric Determination of Phenolic Antioxidants in the Presence of Thiols and Proteins.

PubMed

Avan, Aslı Neslihan; Demirci Çekiç, Sema; Uzunboy, Seda; Apak, Reşat

2016-08-12

Development of easy, practical, and low-cost spectrophotometric methods is required for the selective determination of phenolic antioxidants in the presence of other similar substances. As electron transfer (ET)-based total antioxidant capacity (TAC) assays generally measure the reducing ability of antioxidant compounds, thiols and phenols cannot be differentiated since they are both responsive to the probe reagent. In this study, three of the most common TAC determination methods, namely cupric ion reducing antioxidant capacity (CUPRAC), 2,2'-azinobis(3-ethylbenzothiazoline-6-sulfonic acid) diammonium salt/trolox equivalent antioxidant capacity (ABTS/TEAC), and ferric reducing antioxidant power (FRAP), were tested for the assay of phenolics in the presence of selected thiol and protein compounds. Although the FRAP method is almost non-responsive to thiol compounds individually, surprising overoxidations with large positive deviations from additivity were observed when using this method for (phenols + thiols) mixtures. Among the tested TAC methods, CUPRAC gave the most additive results for all studied (phenol + thiol) and (phenol + protein) mixtures with minimal relative error. As ABTS/TEAC and FRAP methods gave small and large deviations, respectively, from additivity of absorbances arising from these components in mixtures, mercury(II) compounds were added to stabilize the thiol components in the form of Hg(II)-thiol complexes so as to enable selective spectrophotometric determination of phenolic components. This error compensation was most efficient for the FRAP method in testing (thiols + phenols) mixtures.

Back to the basics: Identifying and addressing underlying challenges in achieving high quality and relevant health statistics for indigenous populations in Canada

PubMed Central

Smylie, Janet; Firestone, Michelle

2015-01-01

Canada is known internationally for excellence in both the quality and public policy relevance of its health and social statistics. There is a double standard however with respect to the relevance and quality of statistics for Indigenous populations in Canada. Indigenous specific health and social statistics gathering is informed by unique ethical, rights-based, policy and practice imperatives regarding the need for Indigenous participation and leadership in Indigenous data processes throughout the spectrum of indicator development, data collection, management, analysis and use. We demonstrate how current Indigenous data quality challenges including misclassification errors and non-response bias systematically contribute to a significant underestimate of inequities in health determinants, health status, and health care access between Indigenous and non-Indigenous people in Canada. The major quality challenge underlying these errors and biases is the lack of Indigenous specific identifiers that are consistent and relevant in major health and social data sources. The recent removal of an Indigenous identity question from the Canadian census has resulted in further deterioration of an already suboptimal system. A revision of core health data sources to include relevant, consistent, and inclusive Indigenous self-identification is urgently required. These changes need to be carried out in partnership with Indigenous peoples and their representative and governing organizations. PMID:26793283

Impact of Pilot Delay and Non-Responsiveness on the Safety Performance of Airborne Separation

NASA Technical Reports Server (NTRS)

Consiglio, Maria; Hoadley, Sherwood; Wing, David; Baxley, Brian; Allen, Bonnie Danette

2008-01-01

Assessing the safety effects of prediction errors and uncertainty on automationsupported functions in the Next Generation Air Transportation System concept of operations is of foremost importance, particularly safety critical functions such as separation that involve human decision-making. Both ground-based and airborne, the automation of separation functions must be designed to account for, and mitigate the impact of, information uncertainty and varying human response. This paper describes an experiment that addresses the potential impact of operator delay when interacting with separation support systems. In this study, we evaluated an airborne separation capability operated by a simulated pilot. The experimental runs are part of the Safety Performance of Airborne Separation (SPAS) experiment suite that examines the safety implications of prediction errors and system uncertainties on airborne separation assistance systems. Pilot actions required by the airborne separation automation to resolve traffic conflicts were delayed within a wide range, varying from five to 240 seconds while a percentage of randomly selected pilots were programmed to completely miss the conflict alerts and therefore take no action. Results indicate that the strategicAirborne Separation Assistance System (ASAS) functions exercised in the experiment can sustain pilot response delays of up to 90 seconds and more, depending on the traffic density. However, when pilots or operators fail to respond to conflict alerts the safety effects are substantial, particularly at higher traffic densities.

Obsessive–Compulsive Disorder Comorbidity: Clinical Assessment and Therapeutic Implications

PubMed Central

Pallanti, Stefano; Grassi, Giacomo; Sarrecchia, Elisa Dinah; Cantisani, Andrea; Pellegrini, Matteo

2011-01-01

Obsessive–compulsive disorder (OCD) is a neuropsychiatric disorder affecting approximately 1–3% of the population. OCD is probably an etiologically heterogeneous condition. Individuals with OCD frequently have additional psychiatric disorders concomitantly or at some time during their lifetime. Recently, some authors proposed an OCD sub-classification based on comorbidity. An important issue in assessing comorbidity is the fact that the non-response to treatment often involves the presence of comorbid conditions. Non-responsive patients are more likely to meet criteria for comorbid axis I or axis II disorders and the presence of a specific comorbid condition could be a distinguishing feature in OCD, with influence on the treatment adequacy and outcome. PMID:22203806

Using a site-specific technical error to establish training responsiveness: a preliminary explorative study.

PubMed

Weatherwax, Ryan M; Harris, Nigel K; Kilding, Andrew E; Dalleck, Lance C

2018-01-01

Even though cardiorespiratory fitness (CRF) training elicits numerous health benefits, not all individuals have positive training responses following a structured CRF intervention. It has been suggested that the technical error (TE), a combination of biological variability and measurement error, should be used to establish specific training responsiveness criteria to gain further insight on the effectiveness of the training program. To date, most training interventions use an absolute change or a TE from previous findings, which do not take into consideration the training site and equipment used to establish training outcomes or the specific cohort being evaluated. The purpose of this investigation was to retrospectively analyze training responsiveness of two CRF training interventions using two common criteria and a site-specific TE. Sixteen men and women completed two maximal graded exercise tests and verification bouts to identify maximal oxygen consumption (VO 2 max) and establish a site-specific TE. The TE was then used to retrospectively analyze training responsiveness in comparison to commonly used criteria: percent change of >0% and >+5.6% in VO 2 max. The TE was found to be 7.7% for relative VO 2 max. χ 2 testing showed significant differences in all training criteria for each intervention and pooled data from both interventions, except between %Δ >0 and %Δ >+7.7% in one of the investigations. Training nonresponsiveness ranged from 11.5% to 34.6%. Findings from the present study support the utility of site-specific TE criterion to quantify training responsiveness. A similar methodology of establishing a site-specific and even cohort specific TE should be considered to establish when true cardiorespiratory training adaptations occur.

Neurobiological correlates of illness progression in the recurrent affective disorders.

PubMed

Post, Robert M; Fleming, Jaclyn; Kapczinski, Flavio

2012-05-01

Some clinical aspects of affective illness progression, such as episode-, stress-, and substance-induced sensitization, have been well documented in the literature, but others have received less attention. These include cognitive deficits, treatment-refractoriness, and neurobiological correlates of illness progression, which are the primary focus of this paper. We review the evidence that cognitive dysfunction, treatment resistance, medical comorbidities, and neurobiological abnormalities increase as a function of the number of prior episodes or duration of illness in the recurrent unipolar and bipolar disorders. Substantial evidence supports the view that cognitive dysfunction and vulnerability to a diagnosis of dementia in old age increases as a function of number of prior mood episodes as does non-response to many therapeutic interventions as well as naturalistic treatment. Neurobiological abnormalities that correlate with the number of mood episodes or duration of illness include: anatomical, functional, and biochemical deficits in the prefrontal cortex and hippocampus, as well as amygdala hyperactivity and cortisol hyper-secretion. Some neurotrophic factors and inflammatory markers may also change with greater illness burden. Causality cannot be inferred from these correlative relationships. Nonetheless, given the potentially grave consequences of episode recurrence and progression for morbidity and treatment non-responsiveness, it is clinically wise to assume episodes are causing some of the progressive cognitive and neurobiological abnormalities. As such, earlier and more sustained long-term prophylaxis to attempt to reduce these adverse outcomes is indicated. Copyright © 2012 Elsevier Ltd. All rights reserved.

The pyrimidin analogue cyclopentenyl cytosine induces alloantigen-specific non-responsiveness of human T lymphocytes

PubMed Central

Nikolaeva, N; Bemelman, F J; Yong, S-L; Verschuur, A; van Lier, R A W; ten Berge, I J M

2008-01-01

Cyclopentenyl cytosine (CPEC) has been shown to induce apoptosis in human T lymphoblastic cell lines and T cells from leukaemia patients. In this study we have addressed the question of whether CPEC is able to decrease proliferation and effector functions of human alloresponsive T lymphocytes and induce T cell anergy. The proliferative capacity of human peripheral blood mononuclear cells in response to allogeneic stimulation was measured by 5,6-carboxy-succinimidyl-diacetate-fluorescein-ester staining. Flow cytometric analysis was performed using surface CD4, CD8, CD25, CD103 and intracellular perforin, granzyme A, granzyme B, caspase-3 and forkhead box P3 (FoxP3) markers. The in vivo immunosuppressive capacity was tested in a murine skin graft model. Addition of CPEC at a concentration of 20 nM strongly decreased the expansion and cytotoxicity of alloreactive T cells. Specific restimulation in the absence of CPEC showed that the cells became anergic. The drug induced caspase-dependent apoptosis of alloreactive T lymphocytes. Finally, CPEC increased the percentage of CD25high FoxP3+ CD4+ and CD103+ CD8+ T cells, and potentiated the effect of rapamycin in increasing the numbers of alloreactive regulatory T cells. Treatment with CPEC of CBA/CA mice transplanted with B10/Br skin grafts significantly prolonged graft survival. We conclude that CPEC inhibits proliferation and cytotoxicity of human alloreactive T cells and induces alloantigen non-responsiveness in vitro. PMID:18062797

Use of monetary and nonmonetary incentives to increase response rates among African Americans in the Wisconsin Pregnancy Risk Assessment Monitoring System.

PubMed

Dykema, Jennifer; Stevenson, John; Kniss, Chad; Kvale, Katherine; González, Kim; Cautley, Eleanor

2012-05-01

From 2009 to 2010, an experiment was conducted to increase response rates among African American mothers in the Wisconsin Pregnancy Risk Assessment Monitoring System (PRAMS). Sample members were randomly assigned to groups that received a prepaid, cash incentive of $5 (n = 219); a coupon for diapers valued at $6 (n = 210); or no incentive (n = 209). Incentives were included with the questionnaire, which was mailed to respondents. We examined the effects of the incentives on several outcomes, including response rates, cost effectiveness, survey response distributions, and item nonresponse. Response rates were significantly higher for the cash group than for the coupon (42.5 vs. 32.4%, P < .05) or no incentive group (42.5 vs. 30.1%, P < .01); the coupon and no incentive groups performed similarly. While absolute costs were the highest for the cash group, the cost per completed survey was the lowest. The incentives had limited effects on response distributions for specific survey questions. Although respondents completing the survey by mail in the cash and coupon groups exhibited a trend toward being less likely to have missing data, the effect was not significant. Compared to a coupon or no incentive, a small cash incentive significantly improved response rates and was cost effective among African American respondents in Wisconsin PRAMS. Incentives had only limited effects, however, on survey response distributions, and no significant effects on item nonresponse.

Growth Patterns in the Irish Pyridoxine Nonresponsive Homocystinuria Population and the Influence of Metabolic Control and Protein Intake

PubMed Central

Coughlan, Aoife; Grant, Tim; McNulty, Jenny; Clark, Anne; Deverell, Deirdre; Mayne, Philip; Hughes, Joanne; Monavari, Ahmad; Knerr, Ina; Crushell, Ellen

2017-01-01

A low methionine diet is the mainstay of treatment for pyridoxine nonresponsive homocystinuria (HCU). There are various guidelines for recommended protein intakes for HCU and clinical practice varies. Poor growth has been associated with low cystine levels. This retrospective review of 48 Irish pyridoxine nonresponsive HCU patients assessed weight, height, body mass index (BMI), protein intake, and metabolic control up to 18 years at nine set time points. Patients diagnosed through newborn screening (NBS) were compared to late diagnosed (LD) patients. At 18 years the LD group (n = 12, mean age at diagnosis 5.09 years) were heavier (estimated effect +4.97 Kg, P = 0.0058) and taller (estimated effect +7.97 cm P = 0.0204) than the NBS group (n = 36). There was no difference in growth rate between the groups after 10 years of age. The HCU population were heavier and taller than the general population by one standard deviation with no difference in BMI. There was no association between intermittently low cystine levels and height. Three protein intake guidelines were compared; there was no difference in adult height between those who met the lowest of the guidelines (Genetic Metabolic Dietitians International) and those with a higher protein intake. PMID:29270317

It's all about balance: propensity score matching in the context of complex survey data.

PubMed

Lenis, David; Nguyen, Trang Quynh; Dong, Nianbo; Stuart, Elizabeth A

2017-12-27

Many research studies aim to draw causal inferences using data from large, nationally representative survey samples, and many of these studies use propensity score matching to make those causal inferences as rigorous as possible given the non-experimental nature of the data. However, very few applied studies are careful about incorporating the survey design with the propensity score analysis, which may mean that the results do not generate population inferences. This may be because few methodological studies examine how to best combine these methods. Furthermore, even fewer of them investigate different non-response mechanisms. This study examines methods for handling survey weights in propensity score matching analyses of survey data under different non-response mechanisms. Our main conclusions are: (i) whether the survey weights are incorporated in the estimation of the propensity score does not impact estimation of the population treatment effect, as long as good population treated-comparison balance is achieved on confounders, (ii) survey weights must be used in the outcome analysis, and (iii) the transferring of survey weights (i.e., assigning the weights of the treated units to the comparison units matched to them) can be beneficial under certain non-response mechanisms. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Field Trapping Bactrocera latifrons (Diptera: Tephritidae) with Select Eugenol Analogs That Have Been Found to Attract Other 'Non-Responsive' Fruit Fly Species.

PubMed

McQuate, Grant T; Royer, Jane E; Sylva, Charmaine D

2018-05-01

Bactrocera latifrons (Hendel) (Diptera: Tephritidae) is a pest fruit fly species native to Oriental Asia which has invaded and established in Hawaii and Tanzania and has been recovered in detection trapping in California. It is largely non-responsive to the male lures cuelure and methyl eugenol. Alpha-ionol + cade oil is a moderately effective male B. latifrons attractant, but is not as attractive as cuelure or methyl eugenol are to other fruit fly species. An improved attractant is therefore desired. With the recent success in finding other non-responsive fruit fly species attracted to isoeugenol, methyl-isoeugenol, or dihydroeugenol in Australia and other countries, we wanted to assess whether B. latifrons might also respond to these “eugenol analogs.” Working with wild B. latifrons populations in Hawaii, we assessed the relative catch of B. latifrons in traps baited with the eugenol analogs with catch in traps baited with alpha-ionol, alpha-ionol + cade oil, or alpha-ionol + eugenol. Catch was significantly higher in traps baited with alpha-ionol + cade oil relative to traps with any of the other baits. There was, though, some male B. latifrons catch in traps baited with dihydroeugenol or isoeugenol but none in traps baited with methyl-isoeugenol.

Late response to patient-reported outcome questionnaires after surgery was associated with worse outcome.

PubMed

Hutchings, Andrew; Grosse Frie, Kirstin; Neuburger, Jenny; van der Meulen, Jan; Black, Nick

2013-02-01

Nonresponse to patient-reported outcome (PRO) questionnaires after surgery might bias the results. Our aim was to gauge the potential impact of nonresponse bias by comparing the outcomes of early and late responders. This study compares 59,565 early and 20,735 late responders who underwent a hip or knee replacement, hernia repair, or varicose vein (VV) surgery. The association between timeliness of response and three outcomes (the mean postoperative disease-specific PRO and generic PRO scores and the proportion reporting a fair or poor result) was examined by regression analysis. Late responders were slightly more likely to be young, nonwhite, deprived, and have a more severe preoperative condition with poorer quality of life. Late response was associated with a slightly poorer outcome in all four procedures although not statistically significant (P < 0.05) for VV surgery. Adjusting for preoperative characteristics reduced the strength of the associations, but they remained statistically significant. As nonresponse to PRO questionnaires introduces slight bias, differences in response rates between hospitals should be taken into account when making comparisons so as to avoid overestimating the performance of those with lower response rates and failing to detect poor performing hospitals. Copyright © 2013 Elsevier Inc. All rights reserved.

Swiss national community survey on functioning after spinal cord injury: Protocol, characteristics of participants and determinants of non-response.

PubMed

Brinkhof, Martin W G; Fekete, Christine; Chamberlain, Jonviea D; Post, Marcel W M; Gemperli, Armin

2016-02-01

To detail the protocol, recruitment, study population, response, and data quality of the first population-based community survey of the Swiss Spinal Cord Injury (SwiSCI) Cohort Study. The survey consisted of 3 successive modules administered between September 2011 and March 2013. The first two modules queried demographics, lesion characteristics and key domains of functioning. The third module collected information on psychological personal factors and health behaviour; work integration; or health services and aging. Community-dwelling persons with chronic spinal cord injury in Switzerland. Descriptive analyses of the recruitment process, participant characteristics, and correspondence between self-reported and clinical data. Determinants for participation and the impact of non-response on survey results were assessed. Out of 3,144 eligible persons 1,549 participated in the first two modules (cumulative response rate 49.3%). Approximately three-quarters of participants were male, with a median age of 53 years, and 78% had traumatic spinal cord injury. Record-linkage with medical records demonstrated substantial agreement with self-reported demographic and lesion characteristics. A minimal non-response bias was found. The community survey was effective in recruiting an unbiased sample, thus providing valuable information to study functioning, health maintenance, and quality of life in the Swiss SCI community.

A comparison of survey techniques on sensitive sexual behavior in Italy.

PubMed

Caltabiano, Marcantonio; Dalla-Zuanna, Gianpiero

2013-01-01

This article compares two national surveys carried out through the most commonly used procedures in Italy: CATI (computer-assisted telephone interviews) and SAQ-FI (self-answered questionnaires following interviews). Both surveys ask two identical questions concerning sensitive sexual behavior: early age at first intercourse and same-sex attraction. The SAQ-FI survey had both unit non-response and item non-response rates much lower than the CATI survey. Moreover, in the CATI survey, the groups with highest item non-response rates were also the groups with the lowest proportions of early intercourse and homosexual attraction. In addition, a differential analysis of the respondents produced diverse results for the two surveys. This is especially true of results by gender for same-sex attraction: Such behavior is more common among men (3.1%) than women (2.9%), according to the CATI survey, whereas the opposite is true of the SAQ-FI survey (6.1% of men vs. 7.7% women). In Italy at the beginning of the 21st century, CATI surveys reveal a lower level of early intercourse and same-sex attraction than SAQ-FI surveys. This article argues that the CATI survey underestimates the true level of these sensitive sexual behaviors in the Italian population.

Assessment of clopidogrel non-response by the PFA-100 system using the new test cartridge INNOVANCE PFA P2Y.

PubMed

Linnemann, Birgit; Schwonberg, Jan; Rechner, Andreas R; Mani, Helen; Lindhoff-Last, Edelgard

2010-06-01

Until now, the PFA-100 system has been considered unsuitable for monitoring clopidogrel efficacy. The authors evaluated platelet function in peripheral arterial occlusive disease (PAOD) patients using a new PFA-100(R) test cartridge (product name: INNOVANCE PFA P2Y*) specifically designed for this purpose. Twenty-two stable PAOD patients on antithrombotic therapy with clopidogrel alone (n = 22) and 18 patients undergoing a peripheral catheter intervention, preliminarily treated with 100 mg/day of aspirin followed by co-administration of clopidogrel (loading dose 300 mg, maintenance dose 75 mg/day), were enrolled in this study. Defining non-responsiveness to clopidogrel as an aggregation response within the reference range (90% central interval), four (18.2%) non-responders using light transmittance aggregometry (LTA) induced by 5 microM adenosine diphosphate (ADP) and six (27.3%) non-responders using LTA induced by 2 microM ADP (LateAggr >72.1% and >42.9%, respectively) were identified. INNOVANCE PFA P2Y* determined six (27.3%) non-responders (CT < 87 s). Agreement between the two aggregometry assays and INNOVANCE PFA P2Y* on the definition of clopidogrel response and non-response exceeded 70%. Only three patients were uniformly identified as clopidogrel non-responders by all three assays. When clopidogrel was co-administered with aspirin, two (11.1%) non-responders to clopidogrel were detected with INNOVANCE PFA P2Y*, whereas ADP-induced LTA found all patients to be responsive. INNOVANCE PFA P2Y* appears to be suitable for monitoring the effect of clopidogrel on platelet function. Its sensitivity in detecting responsiveness or non-responsiveness to clopidogrel is comparable to ADP-induced LTA. Additional prospective studies are needed to clarify the clinical relevance of the test results and classification obtained with INNOVANCE PFA P2Y*.

Maternal Feeding Practices among Children with Feeding Difficulties-Cross-sectional Study in a Brazilian Reference Center.

PubMed

Machado, Rachel H V; Tosatti, Abykeyla M; Malzyner, Gabriela; Maximino, Priscilla; Ramos, Cláudia C; Bozzini, Ana Beatriz; Ribeiro, Letícia; Fisberg, Mauro

2017-01-01

Given the positive influence of responsive caregiving on dietary habits in childhood, to raise awareness of caregivers regarding their behavior is crucial in multidisciplinary care on infant feeding. To identify the most common responsive and non-responsive feeding practices in mothers of children with feeding complaints, as well as to seek associations between practices and caregivers' profile. Cross-sectional study with 77 children under 18 years old, with complaints of feeding difficulties. Data were collected during interviews with mothers: child age, gender, duration of exclusive breastfeeding, presence of organic disease, dynamics of bottle use, self-feeding practices and posture at meals, use of appropriate feeding equipment; basic information about the mothers (parity and level of education), caregiver feeding style, presence of coercive feeding, frequency and characteristics of family meals. Statistical analysis considered significance level at 5%. The non-responsive profile predominated among mothers (76.2%, with the Authoritarian style being the most prevalent-39.7%). The responsive profile was characterized by absence of coercive feeding, stimulation of self-feeding practices, use of appropriate feeding equipment and meal environment, with interaction at meals. Non-responsive profile consisted of both inadequate environment and posture at meals, use of distraction and coercive feeding, lack of shared meals, and disregard for children's hunger signals. Only the habit of sharing meals with children was associated with mothers' profile, and considered a protection factor against non-responsive care (OR 0.23; 95% CI 0.06-0.88). Both Authoritarian ( p  = 0.000) and indulgent mothers ( p  = 0.007) breastfed exclusively for longer time than negligent ones. There was a higher level of interaction with children in "responsive" parental style (OR 0.056; p  = 0.01) compared to other feeding styles. Results highlight the need for educational interventions focused on caregivers' behaviors.

[Effect of neoadjuvant chemotherapy on nutritional status of locally advanced gastric cancer].

PubMed

Deng, Guopeng; Qu, Jianjun; Zhai, Shengyong; Shi, Yiran; Wang, Xinbo

2018-03-25

To study the effect of neoadjuvant chemotherapy on nutritional status in patients with locally advanced gastric cancer. Cases inclusion criteria: (1)18-65 years old; (2) Gastric cancer confirmed by gastroscopic biopsy; (3) Preoperative TNM stage III( according to the AJCC stage 2000 standard; (4) Kamosfsky functional status score> 60 points; (5)Receiving neoadjuvant chemotherapy voluntarily and signing the informed consent form. Case exclusion criteria: (1)Having contraindications of chemotherapy and surgery; (2) Suffering from heart, liver and kidney and other underlying diseases; (3) Concurrent with malignant diseases, wasting disease or other digestive diseases. According to the above criteria, clinical data of 73 patients of stage III( gastric cancer receiving neoadjuvant chemotherapy at Weifang People's Hospital from May 2015 to March 2017 were prospectively collected. The cohort study was adopted. After removing 3 patients who did not complete the chemotherapy, a total of 70 patients who completed the chemotherapy were included in the study. All the patients received SOX chemotherapy without nutritional support during chemotherapy. Changes of body composition and nutritional indicators were analyzed before and after chemotherapy, and according to the tumor regression after chemotherapy, patients were divided into response group (complete or sub-total tumor regression) and non-response group (tumor part, with or without a small amount of retreat) for stratified analysis. Of 70 gastric cancer patients, 40 were male and 30 were female with a age of (53.8±6.4) (28 to 64) years. There were 26 cases (37.1%) of stage III(a, 35 cases (50.0%) of stage III(b and 9 cases (12.9%) of stage III(c. There were 41 cases in response group and 29 cases in non-response group. Three patients (4.3%) were complete remission (CR) and 38 patients (54.3%) were partial remission (PR) in response group, while 23 cases (32.9%) were stable disease (SD) and 6 cases (8.6%) were progressive disease (PD). After neoadjuvant chemotherapy, the extracellular fluid of the whole patients increased from (13.3±1.7) L to (13.5±1.6) L (t=-2.044, P=0.045); the intracellular fluid decreased from (21.4±2.5) L to (21.1±2.4) L (t=2.369, P=0.021); the lymphocyte count decreased from (0.31±0.10)×10 9 /L to (0.29±0.10)×10 9 /L (t=1.706, P=0.009); the other indexes were not significantly different (all P>0.05). Stratified analysis showed that after neoadjuvant chemotherapy in response group, body mass increased from (60.1±8.8) kg to (61.0±8.3) kg (t=-2.773, P=0.008); body mass index increased from (21.9±2.4) kg/m 2 to (22.3±1.9) kg/m 2 (t=-3.479, P=0.001), while above two parameters did not differ significantly in non-response group. No significant differences in body mass, body mass index, skeletal muscle, inorganic salt, extracellular fluid, body fat, protein, upper arm circumference and intracellular fluid were found between two groups before and after neoadjuvant chemotherapy(all P>0.05). Except slight decrease in hemoglobin and lymphocyte, the other nutritional indicators were slightly elevated in response group, while the differences were not statistically significant(all P>0.05). All nutritional indicators in non-response group were slightly decreased without significant differences as well (all P>0.05). Neoadjuvant chemotherapy does not aggravate malnutrition in patients with locally advanced gastric cancer.

The cycle characteristics of clomiphene with clomiphene and menotropins in polycystic ovary syndrome and non polycystic ovary syndrome infertile patients.

PubMed

Ghasemi, M; Ashraf, H; Koushyar, H; Mousavifar, N

2013-06-01

This study compares the cycle characteristics of clomiphene (CC) with CC+HMG (Human Menopausal Gonadotropin or Menotropins) in Polycystic Ovary Syndrome (PCOS) and non-PCOS infertile patients. Patients were treated by CC + minimal HMg protocol. The cancellation rate, the mean number of different follicle sizes and endometrial thickness and pattern were compared. The cancelled cycles due to non-responsiveness were significantly higher in CC compared to CC+ minimal HMg protocol. PCOS patients are significantly nonresponsive in CC cycle and hyperresponsive in CC+ minimal HMg cycles. The mean number of different sizes of follicles and the endometrial thickness were significantly higher in CC+ minimal HMg. PCOS patients were significantly different from non-PCOS regarding the number of mature follicle and endometrial thickness. The pregnancy rate was 11% (10.2% in non-PCOS and 12.2% in PCOS). CC+ minimal HMg is a viable alternative to HMg /FSH only protocol in CC failure or resistant patients, and its efficacy can be mostly attributed to improvement of endometrial quality and increase in follicle number. Moreover, due to high cancellation of PCOS patients treated by this protocol, seemingly other alternatives should be found; perhaps sequential letrozole+HMg/FSH that have been shown to improve the ovarian response in this group of patients.

The importance of post hoc approaches for overcoming non-response and attrition bias in population-sampled studies.

PubMed

Gray, Linsay

2016-01-01

Population-based health studies are critical resources for monitoring population health and related factors such as substance use, but reliable inference can be compromised in various ways. Non-response and attrition are major methodological problems which reduce power and can hamper the generalizability of findings if individuals who participate and who remain in a study differ systematically from those who do not. In this issue of SPPE, McCabe et al. studied participants of the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions, comparing attrition in Wave 2 across participants with different patterns of substance use at Wave 1. The implications of differential follow-up and further possibilities for addressing selective participation are discussed.

P53 Immune Responses in Breast Cancer Patients: Assessment of CTL Recognizing the HLA-A2.1 Restricted, Wild-type Sequence p53 (264-272) Epitope; Frequencies of Tetramer+ T Cells Specific for the Wild-Type Sequence P53 (264-272) Peptide in the Circulation of Patients with Head and Neck Cancer; The Ability of Variant Peptides to Reverse the Nonresponsiveness of T Lymphocytes to the Wild-Type Sequence P53 (264-272) Epitope

DTIC Science & Technology

2002-10-01

This document contains three papers focusing on the analysis of anti-p53 cellular immune responses of breast, head, neck, and oral cancer patients...variants were generated by amino acid exchanges at positions 6 (6T) and 7 (7W) of the peptide. The 7W variant peptide has potential for immunotherapy of nonresponsive oral cancer patients.

41 CFR 60-2.2 - Agency action.

Code of Federal Regulations, 2013 CFR

2013-07-01

... of conciliation, mediation, and persuasion to develop an acceptable affirmative action program... persuasion to resolve the deficiencies which led to the determination of nonresponsibility. If satisfactory...

41 CFR 60-2.2 - Agency action.

Code of Federal Regulations, 2012 CFR

2012-07-01

... of conciliation, mediation, and persuasion to develop an acceptable affirmative action program... persuasion to resolve the deficiencies which led to the determination of nonresponsibility. If satisfactory...

41 CFR 60-2.2 - Agency action.

Code of Federal Regulations, 2014 CFR

2014-07-01

... of conciliation, mediation, and persuasion to develop an acceptable affirmative action program... persuasion to resolve the deficiencies which led to the determination of nonresponsibility. If satisfactory...

Spectrophotometric Determination of Phenolic Antioxidants in the Presence of Thiols and Proteins

PubMed Central

Avan, Aslı Neslihan; Demirci Çekiç, Sema; Uzunboy, Seda; Apak, Reşat

2016-01-01

Development of easy, practical, and low-cost spectrophotometric methods is required for the selective determination of phenolic antioxidants in the presence of other similar substances. As electron transfer (ET)-based total antioxidant capacity (TAC) assays generally measure the reducing ability of antioxidant compounds, thiols and phenols cannot be differentiated since they are both responsive to the probe reagent. In this study, three of the most common TAC determination methods, namely cupric ion reducing antioxidant capacity (CUPRAC), 2,2′-azinobis(3-ethylbenzothiazoline-6-sulfonic acid) diammonium salt/trolox equivalent antioxidant capacity (ABTS/TEAC), and ferric reducing antioxidant power (FRAP), were tested for the assay of phenolics in the presence of selected thiol and protein compounds. Although the FRAP method is almost non-responsive to thiol compounds individually, surprising overoxidations with large positive deviations from additivity were observed when using this method for (phenols + thiols) mixtures. Among the tested TAC methods, CUPRAC gave the most additive results for all studied (phenol + thiol) and (phenol + protein) mixtures with minimal relative error. As ABTS/TEAC and FRAP methods gave small and large deviations, respectively, from additivity of absorbances arising from these components in mixtures, mercury(II) compounds were added to stabilize the thiol components in the form of Hg(II)-thiol complexes so as to enable selective spectrophotometric determination of phenolic components. This error compensation was most efficient for the FRAP method in testing (thiols + phenols) mixtures. PMID:27529232

Official statistics and claims data records indicate non-response and recall bias within survey-based estimates of health care utilization in the older population

PubMed Central

2013-01-01

Background The validity of survey-based health care utilization estimates in the older population has been poorly researched. Owing to data protection legislation and a great number of different health care insurance providers, the assessment of recall and non-response bias is challenging to impossible in many countries. The objective of our study was to compare estimates from a population-based study in older German adults with external secondary data. Methods We used data from the German KORA-Age study, which included 4,127 people aged 65–94 years. Self-report questions covered the utilization of long-term care services, inpatient services, outpatient services, and pharmaceuticals. We calculated age- and sex-standardized mean utilization rates in each domain and compared them with the corresponding estimates derived from official statistics and independent statutory health insurance data. Results The KORA-Age study underestimated the use of long-term care services (−52%), in-hospital days (−21%) and physician visits (−70%). In contrast, the assessment of drug consumption by postal self-report questionnaires yielded similar estimates to the analysis of insurance claims data (−9%). Conclusion Survey estimates based on self-report tend to underestimate true health care utilization in the older population. Direct validation studies are needed to disentangle the impact of recall and non-response bias. PMID:23286781

Gene expression changes in uterine myomas in response to ulipristal acetate treatment.

PubMed

Courtoy, Guillaume E; Donnez, Jacques; Ambroise, Jérôme; Arriagada, Pablo; Luyckx, Mathieu; Marbaix, Etienne; Dolmans, Marie-Madeleine

2018-05-07

Does ulipristal acetate (UPA) modify the expression of genes related to apoptosis or the extracellular matrix in uterine myomas and are any modifications associated with a clinical response? Targeted analysis of 176 apoptosis- or extracellular-matrix-related genes was conducted using polymerase chain reaction (PCR) arrays. Relevant results were validated by quantitative PCR. Four groups were established: responsive short-term (one course, n = 9), responsive long-term (two to four courses, n = 9), non-responsive (n = 9), and the control group who was not given any hormone therapy (n = 9). The clinical response was monitored by medical imagery and considered significant when volume reduction was greater than 25%. Compared with untreated myomas, significant changes in expression of four genes were found in UPA-treated myomas. Gene expression of integrin subunit beta 4 was repressed by UPA treatment (fold change [FC] = -12.50, P < 0.001, q < 0.001), tenascin-C expression was downregulated in UPA-responsive patients (FC = -2.50, P = 0.010, q = 0.090), survivin was repressed in short-term UPA-responsive tumours (FC = -7.69, P < 0.001, q = 0.010), and catenin delta 2 gene expression was upregulated in non-responsive myomas (FC = +7.36, P < 0.001, q = 0.010). This characterization provides the first molecular distinction between myomas responsive or non-responsive to UPA treatment. Copyright © 2018 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

Differences in baseline and process variables between non-responders and responders in Internet-based cognitive behavior therapy for chronic tinnitus.

PubMed

Probst, Thomas; Weise, Cornelia; Andersson, Gerhard; Kleinstäuber, Maria

2018-06-06

Although Internet-based cognitive behavior therapy (iCBT) is an effective treatment for chronic tinnitus, several patients do not improve. In the current study, baseline and process variables were compared between non-responders and responders. Data from patients participating in two randomized controlled trials on iCBT for chronic tinnitus were re-analyzed. Based on the literature, a pre-post difference on the "Tinnitus Handicap Inventory" (THI) of less than seven points improvement was used to operationalize non-response. Associations between non-response and baseline variables (age, gender, and questionnaire scores), patient progress (THI), the process of the therapeutic alliance ("Working Alliance Inventory-Short Revised"; WAI-SR), as well as other process variables (number of logins, amount of messages sent from therapists to patients) were investigated. The results showed that non-responders had a less favorable change on the THI than responders already at mid-treatment (p < .05). The alliance (WAI-SR) during iCBT was not associated with non-response. Non-responders showed more severe sleep disturbances, logged in less in the iCBT platform, and received fewer messages from the therapists than responders, but these differences were mostly not significant anymore when correcting for multiple testing. To conclude, no symptom change in the first half of iCBT for chronic tinnitus patients is a risk factor of not benefiting from iCBT.

Using facial electromyography to detect preserved emotional processing in disorders of consciousness: A proof-of-principle study.

PubMed

Fiacconi, Chris M; Owen, Adrian M

2016-09-01

To examine whether emotional functioning can be observed in patients who are behaviourally non-responsive using peripheral markers of emotional functioning. We tested two patients, both diagnosed as being in a vegetative state (VS) following hypoxia secondary to cardiac arrest. Thirty-seven healthy participants with no history of neurological illness served as a control group. The activity of two facial muscles (zygomaticus major, corrugator supercilii) was measured using facial electromyography (EMG) to probe for patterned responses that differentiate between auditorily presented joke and non-joke stimuli in VS patients. One of the two VS patients we tested demonstrated greater zygomatic and reduced corrugator activity in response to jokes compared with non-jokes. Critically, these responses followed the pattern and temporal profile of muscle activity observed in our healthy control sample. Despite their behaviorally non-responsive profile, some patients diagnosed as VS appear to retain some aspects of emotional experience. Our findings represent, to our knowledge, the first demonstration that a patient diagnosed as VS can exhibit intact emotional responses to humor as assessed by facial EMG. Therefore, our approach may constitute a feasible bedside tool capable of providing novel insight into the mental and emotional lives of patients who are behaviourally non-responsive. Copyright © 2016 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

Acute graft-versus-host disease biomarkers measured during therapy can predict treatment outcomes: a Blood and Marrow Transplant Clinical Trials Network study

PubMed Central

Logan, Brent R.; Wu, Juan; Alousi, Amin M.; Bolaños-Meade, Javier; Ferrara, James L. M.; Ho, Vincent T.; Weisdorf, Daniel J.

2012-01-01

Acute graft-versus-host disease (GVHD) is the primary limitation of allogeneic hematopoietic cell transplantation, and once it develops, there are no reliable diagnostic tests to predict treatment outcomes. We hypothesized that 6 previously validated diagnostic biomarkers of GVHD (IL-2 receptor-α; tumor necrosis factor receptor-1; hepatocyte growth factor; IL-8; elafin, a skin-specific marker; and regenerating islet–derived 3-α, a gastrointestinal tract–specific marker) could discriminate between therapy responsive and nonresponsive patients and predict survival in patients receiving GVHD therapy. We measured GVHD biomarker concentrations from samples prospectively obtained at the initiation of treatment, day 14, and day 28, on a multicenter, randomized, 4-arm phase 2 clinical trial for newly diagnosed acute GVHD. We found that at each of 3 time points, GVHD onset, 2 weeks into treatment, and 4 weeks into treatment, a 6-protein biomarker panel predicted for the important clinical outcomes of day 28 posttherapy nonresponse and mortality at day 180 from onset. GVHD biomarker panels can be used for early identification of patients at high or low risk for treatment nonresponsiveness or death, and they may provide opportunities for early intervention and improved survival after hematopoietic cell transplantation. The study was registered in clinicaltrials.gov as NCT00224874. PMID:22383800

Assessing the Representativeness of Population-Sampled Health Surveys Through Linkage to Administrative Data on Alcohol-Related Outcomes

PubMed Central

Gorman, Emma; Leyland, Alastair H.; McCartney, Gerry; White, Ian R.; Katikireddi, Srinivasa Vittal; Rutherford, Lisa; Graham, Lesley; Gray, Linsay

2014-01-01

Health surveys are an important resource for monitoring population health, but selective nonresponse may impede valid inference. This study aimed to assess nonresponse bias in a population-sampled health survey in Scotland, with a focus on alcohol-related outcomes. Nonresponse bias was assessed by examining whether rates of alcohol-related harm (i.e., hospitalization or death) and all-cause mortality among respondents to the Scottish Health Surveys (from 1995 to 2010) were equivalent to those in the general population, and whether the extent of any bias varied according to sociodemographic attributes or over time. Data from consenting respondents (aged 20–64 years) to 6 Scottish Health Surveys were confidentially linked to death and hospitalization records and compared with general population counterparts. Directly age-standardized incidence rates of alcohol-related harm and all-cause mortality were lower among Scottish Health Survey respondents compared with the general population. For all years combined, the survey-to-population rate ratios were 0.69 (95% confidence interval: 0.61, 0.76) for the incidence of alcohol-related harm and 0.89 (95% confidence interval: 0.83, 0.96) for all-cause mortality. Bias was more pronounced among persons residing in more deprived areas; limited evidence was found for regional or temporal variation. This suggests that corresponding underestimation of population rates of alcohol consumption is likely to be socially patterned. PMID:25227767

Eating, feeding, and feeling: emotional responsiveness mediates longitudinal associations between maternal binge eating, feeding practices, and child weight.

PubMed

Saltzman, Jaclyn A; Pineros-Leano, Maria; Liechty, Janet M; Bost, Kelly K; Fiese, Barbara H

2016-08-02

Although it is known that maternal disordered eating is related to restrictive feeding practices, there is little research exploring mechanisms for this association or its effects on other feeding practices. The purpose of this study was to assess whether maternal emotion responses mediate the association between maternal binge eating (BE) and child feeding practices, in order to identify potential risk factors for feeding practices that influence child weight. This longitudinal observational study included (n = 260) mothers and children from the STRONG Kids Panel Survey. At Wave 1, children were an average of 37 months old (SD = 6.9), and at Wave 2 children were an average of 57 months old (SD = 8.3). Mothers self-reported their frequency of binge eating behavior (Wave 1), responses to children's negative emotions (Wave 1), feeding practices (Wave 1 and Wave 2), and child height and weight were measured at both time points. Using bias-corrected bootstrapping procedures, we tested the hypothesis that longitudinal associations between maternal BE and nonresponsive parent feeding practices would be mediated by parents' unsupportive responses to children's negative emotion. We also tested a serial mediation model positing that maternal BE predicts child body mass index (BMI) percentile change 18-24 months later, indirectly through unsupportive responses to negative emotion and nonresponsive feeding practices. Maternal BE predicted use of more nonresponsive feeding practices (e.g. Emotion Regulation, Restriction for Health, Pressure to Eat, and Food as Reward), indirectly through more Distress responses to children's negative emotions. In the serial mediation model, maternal BE was associated with greater use of Distress responses, which indirectly predicted higher child BMI percentile through Food as Reward feeding practices. These results suggest that maternal eating and emotion responsiveness are important for understanding the interpersonal context of feeding behaviors, and child weight outcomes. Distress responses may serve as a risk factor for use of unhealthful feeding practices among mothers with BE and these responses may increase children's risk for weight gain. This study used an observational prospective design. Therefore, it has not been registered as a clinical intervention trial.

Functional MR imaging assessment of a non-responsive brain injured patient.

PubMed

Moritz, C H; Rowley, H A; Haughton, V M; Swartz, K R; Jones, J; Badie, B

2001-10-01

Functional magnetic resonance imaging (fMRI) was requested to assist in the evaluation of a comatose 38-year-old woman who had sustained multiple cerebral contusions from a motor vehicle accident. Previous electrophysiologic studies suggested absence of thalamocortical processing in response to median nerve stimulation. Whole-brain fMRI was performed utilizing visual, somatosensory, and auditory stimulation paradigms. Results demonstrated intact task-correlated sensory and cognitive blood oxygen level dependent (BOLD) hemodynamic response to stimuli. Electrodiagnostic studies were repeated and evoked potentials indicated supratentorial recovery in the cerebrum. At 3-months post trauma the patient had recovered many cognitive & sensorimotor functions, accurately reflecting the prognostic fMRI evaluation. These results indicate that fMRI examinations may provide a useful evaluation for brain function in non-responsive brain trauma patients.

A randomised trial and economic evaluation of the effect of response mode on response rate, response bias, and item non-response in a survey of doctors.

PubMed

Scott, Anthony; Jeon, Sung-Hee; Joyce, Catherine M; Humphreys, John S; Kalb, Guyonne; Witt, Julia; Leahy, Anne

2011-09-05

Surveys of doctors are an important data collection method in health services research. Ways to improve response rates, minimise survey response bias and item non-response, within a given budget, have not previously been addressed in the same study. The aim of this paper is to compare the effects and costs of three different modes of survey administration in a national survey of doctors. A stratified random sample of 4.9% (2,702/54,160) of doctors undertaking clinical practice was drawn from a national directory of all doctors in Australia. Stratification was by four doctor types: general practitioners, specialists, specialists-in-training, and hospital non-specialists, and by six rural/remote categories. A three-arm parallel trial design with equal randomisation across arms was used. Doctors were randomly allocated to: online questionnaire (902); simultaneous mixed mode (a paper questionnaire and login details sent together) (900); or, sequential mixed mode (online followed by a paper questionnaire with the reminder) (900). Analysis was by intention to treat, as within each primary mode, doctors could choose either paper or online. Primary outcome measures were response rate, survey response bias, item non-response, and cost. The online mode had a response rate 12.95%, followed by the simultaneous mixed mode with 19.7%, and the sequential mixed mode with 20.7%. After adjusting for observed differences between the groups, the online mode had a 7 percentage point lower response rate compared to the simultaneous mixed mode, and a 7.7 percentage point lower response rate compared to sequential mixed mode. The difference in response rate between the sequential and simultaneous modes was not statistically significant. Both mixed modes showed evidence of response bias, whilst the characteristics of online respondents were similar to the population. However, the online mode had a higher rate of item non-response compared to both mixed modes. The total cost of the online survey was 38% lower than simultaneous mixed mode and 22% lower than sequential mixed mode. The cost of the sequential mixed mode was 14% lower than simultaneous mixed mode. Compared to the online mode, the sequential mixed mode was the most cost-effective, although exhibiting some evidence of response bias. Decisions on which survey mode to use depend on response rates, response bias, item non-response and costs. The sequential mixed mode appears to be the most cost-effective mode of survey administration for surveys of the population of doctors, if one is prepared to accept a degree of response bias. Online surveys are not yet suitable to be used exclusively for surveys of the doctor population.

A randomised trial and economic evaluation of the effect of response mode on response rate, response bias, and item non-response in a survey of doctors

PubMed Central

2011-01-01

Background Surveys of doctors are an important data collection method in health services research. Ways to improve response rates, minimise survey response bias and item non-response, within a given budget, have not previously been addressed in the same study. The aim of this paper is to compare the effects and costs of three different modes of survey administration in a national survey of doctors. Methods A stratified random sample of 4.9% (2,702/54,160) of doctors undertaking clinical practice was drawn from a national directory of all doctors in Australia. Stratification was by four doctor types: general practitioners, specialists, specialists-in-training, and hospital non-specialists, and by six rural/remote categories. A three-arm parallel trial design with equal randomisation across arms was used. Doctors were randomly allocated to: online questionnaire (902); simultaneous mixed mode (a paper questionnaire and login details sent together) (900); or, sequential mixed mode (online followed by a paper questionnaire with the reminder) (900). Analysis was by intention to treat, as within each primary mode, doctors could choose either paper or online. Primary outcome measures were response rate, survey response bias, item non-response, and cost. Results The online mode had a response rate 12.95%, followed by the simultaneous mixed mode with 19.7%, and the sequential mixed mode with 20.7%. After adjusting for observed differences between the groups, the online mode had a 7 percentage point lower response rate compared to the simultaneous mixed mode, and a 7.7 percentage point lower response rate compared to sequential mixed mode. The difference in response rate between the sequential and simultaneous modes was not statistically significant. Both mixed modes showed evidence of response bias, whilst the characteristics of online respondents were similar to the population. However, the online mode had a higher rate of item non-response compared to both mixed modes. The total cost of the online survey was 38% lower than simultaneous mixed mode and 22% lower than sequential mixed mode. The cost of the sequential mixed mode was 14% lower than simultaneous mixed mode. Compared to the online mode, the sequential mixed mode was the most cost-effective, although exhibiting some evidence of response bias. Conclusions Decisions on which survey mode to use depend on response rates, response bias, item non-response and costs. The sequential mixed mode appears to be the most cost-effective mode of survey administration for surveys of the population of doctors, if one is prepared to accept a degree of response bias. Online surveys are not yet suitable to be used exclusively for surveys of the doctor population. PMID:21888678

Competence imagery: a case study treating emetophobia.

PubMed

Moran, Daniel J; O'Brien, Richard M

2005-06-01

An emetophobic child is nonresponsive to conventional systematic desensitization and has her anxiety responses counterconditioned by using Competence Imagery instead of physical relaxation responses while progressing through her fear hierarchy.

Pharmacogenomics of Methotrexate Membrane Transport Pathway: Can Clinical Response to Methotrexate in Rheumatoid Arthritis Be Predicted?

PubMed Central

Lima, Aurea; Bernardes, Miguel; Azevedo, Rita; Medeiros, Rui; Seabra, Vitor

2015-01-01

Background: Methotrexate (MTX) is widely used for rheumatoid arthritis (RA) treatment. Single nucleotide polymorphisms (SNPs) could be used as predictors of patients’ therapeutic outcome variability. Therefore, this study aims to evaluate the influence of SNPs in genes encoding for MTX membrane transport proteins in order to predict clinical response to MTX. Methods: Clinicopathological data from 233 RA patients treated with MTX were collected, clinical response defined, and patients genotyped for 23 SNPs. Genotype and haplotype analyses were performed using multivariate methods and a genetic risk index (GRI) for non-response was created. Results: Increased risk for non-response was associated to SLC22A11 rs11231809 T carriers; ABCC1 rs246240 G carriers; ABCC1 rs3784864 G carriers; CGG haplotype for ABCC1 rs35592, rs2074087 and rs3784864; and CGG haplotype for ABCC1 rs35592, rs246240 and rs3784864. GRI demonstrated that patients with Index 3 were 16-fold more likely to be non-responders than those with Index 1. Conclusions: This study revealed that SLC22A11 and ABCC1 may be important to identify those patients who will not benefit from MTX treatment, highlighting the relevance in translating these results to clinical practice. However, further validation by independent studies is needed to develop the field of personalized medicine to predict clinical response to MTX treatment. PMID:26086825

Pharmacogenomics of Methotrexate Membrane Transport Pathway: Can Clinical Response to Methotrexate in Rheumatoid Arthritis Be Predicted?

PubMed

Lima, Aurea; Bernardes, Miguel; Azevedo, Rita; Medeiros, Rui; Seabra, Vítor

2015-06-16

Methotrexate (MTX) is widely used for rheumatoid arthritis (RA) treatment. Single nucleotide polymorphisms (SNPs) could be used as predictors of patients' therapeutic outcome variability. Therefore, this study aims to evaluate the influence of SNPs in genes encoding for MTX membrane transport proteins in order to predict clinical response to MTX. Clinicopathological data from 233 RA patients treated with MTX were collected, clinical response defined, and patients genotyped for 23 SNPs. Genotype and haplotype analyses were performed using multivariate methods and a genetic risk index (GRI) for non-response was created. Increased risk for non-response was associated to SLC22A11 rs11231809 T carriers; ABCC1 rs246240 G carriers; ABCC1 rs3784864 G carriers; CGG haplotype for ABCC1 rs35592, rs2074087 and rs3784864; and CGG haplotype for ABCC1 rs35592, rs246240 and rs3784864. GRI demonstrated that patients with Index 3 were 16-fold more likely to be non-responders than those with Index 1. This study revealed that SLC22A11 and ABCC1 may be important to identify those patients who will not benefit from MTX treatment, highlighting the relevance in translating these results to clinical practice. However, further validation by independent studies is needed to develop the field of personalized medicine to predict clinical response to MTX treatment.

Assessment of Bleeding and Thrombosis Based on Aspirin Responsiveness after Continuous-Flow Left Ventricular Assist Device Placement.

PubMed

Floroff, Catherine K; Rieger, Krista L; Veasey, Tara M; Strout, Sara E; DeNino, Walter F; Meadows, Holly B; Stroud, Martha R; Toole, John M; Heyward, Dawn P; Brisco-Bacik, Meredith A; Cook, Jennifer L; Lazarchick, John; Uber, Walter E

Pump thrombosis (PT) is a severe complication of left ventricular assist device (LVAD) support. This study evaluated PT and bleeding after LVAD placement in patients responsive to a standard aspirin dose of 81 mg using platelet inhibition monitoring compared with initial nonresponders who were then titrated upward to achieve therapeutic response. Patients ≥ 18 years of age with initial placement of HeartMate II LVAD at our institution and at least one VerifyNow Aspirin test performed during initial hospitalization were included. The primary endpoints were bleeding and PT compared between initial aspirin responders and nonresponders. Of 85 patients, 19 (22%) were nonresponsive to initial aspirin therapy. Responders and nonresponders showed similar survival (p = 0.082), freedom from suspected/confirmed PT (p = 0.941), confirmed PT (p = 0.273), bleeding (p = 0.401), and incidence rates in PT and bleeding. Among the initial responders (<500 vs. 500-549 aspirin reaction units), there were no significant differences in survival (p = 0.177), freedom from suspected/confirmed PT (p = 0.542), confirmed PT (p = 0.159), bleeding (p = 0.879), and incidence of PT and bleeding. Platelet function testing may detect resistance to standard aspirin regimens used in LVAD patients. Dose escalation in initially nonresponsive patients to achieve responsiveness may confer a similar PT risk to patients initially responsive to standard aspirin dosing without increased bleeding risk.

Non-Responsive Feeding Practices, Unhealthy Eating Behaviors, and Risk of Child Overweight and Obesity in Southeast Asia: A Systematic Review

PubMed Central

Cristina Lindsay, Ana; Sitthisongkram, Somporn; Greaney, Mary L.; Wallington, Sherrie F.; Ruengdej, Praewrapee

2017-01-01

Childhood obesity is increasing dramatically in many Southeast Asian countries, and becoming a significant public health concern. This review summarizes the evidence on associations between parental feeding practices, child eating behaviors, and the risk of overweight and obesity in Southeast Asian children 2–12 years old. We systematically searched five electronic academic/research (PubMed, PsycINFO, ProQuest Nursing, Medline, and CINAHL) databases using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement for peer-reviewed studies published in English between January 2000 and December 2016. Fourteen observational studies met the inclusion criteria and were reviewed. Reviewed studies were examined separately for preschool- and school-aged children and revealed that non-responsive parental feeding practices and unhealthy child eating behaviors were associated with a risk of child overweight and obesity in several Southeast Asian countries. Nonetheless, due to the small number of identified studies (n = 14) and because only about half of the Southeast Asian countries (Thailand, Vietnam, Singapore, the Philippines, and Malaysia) were represented (5/11) in the examined studies, additional research is needed to further understand the factors associated with childhood obesity among children in Southeast Asia to develop interventions that are tailored to the specific needs of Southeast Asian countries and designed to address practices and behaviors that may promote childhood obesity. PMID:28422081

Non-Responsive Feeding Practices, Unhealthy Eating Behaviors, and Risk of Child Overweight and Obesity in Southeast Asia: A Systematic Review.

PubMed

Lindsay, Ana Cristina; Sitthisongkram, Somporn; Greaney, Mary L; Wallington, Sherrie F; Ruengdej, Praewrapee

2017-04-19

Childhood obesity is increasing dramatically in many Southeast Asian countries, and becoming a significant public health concern. This review summarizes the evidence on associations between parental feeding practices, child eating behaviors, and the risk of overweight and obesity in Southeast Asian children 2-12 years old. We systematically searched five electronic academic/research (PubMed, PsycINFO, ProQuest Nursing, Medline, and CINAHL) databases using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement for peer-reviewed studies published in English between January 2000 and December 2016. Fourteen observational studies met the inclusion criteria and were reviewed. Reviewed studies were examined separately for preschool- and school-aged children and revealed that non-responsive parental feeding practices and unhealthy child eating behaviors were associated with a risk of child overweight and obesity in several Southeast Asian countries. Nonetheless, due to the small number of identified studies ( n = 14) and because only about half of the Southeast Asian countries (Thailand, Vietnam, Singapore, the Philippines, and Malaysia) were represented (5/11) in the examined studies, additional research is needed to further understand the factors associated with childhood obesity among children in Southeast Asia to develop interventions that are tailored to the specific needs of Southeast Asian countries and designed to address practices and behaviors that may promote childhood obesity.

Transportation technology and methodology reports

DOT National Transportation Integrated Search

1999-12-22

This Internet site sponsored by the Office of Highway Policy Information provides links to a compilation of PDF reports on transportation technology and methodology. Reports include "FHWA Statistical Programs;" "Nonresponse in Household Travel Survey...

FcγRIIIa Expression on Monocytes in Rheumatoid Arthritis: Role in Immune-Complex Stimulated TNF Production and Non-Response to Methotrexate Therapy

PubMed Central

Cooper, Dawn L.; Martin, Stephen G.; Robinson, James I.; Mackie, Sarah L.; Charles, Christopher J.; Nam, Jackie; Consortium, YEAR; Isaacs, John D.; Emery, Paul; Morgan, Ann W.

2012-01-01

Objective The expression of FcγRIIIa/CD16 may render monocytes targets for activation by IgG-containing immune complexes (IC). We investigated whether FcγRIIIa/CD16 was upregulated in rheumatoid arthritis (RA), associated with TNF production in response to IC-stimulation, and if this predicted response to methotrexate therapy. Methods FcγRIIIa/CD16 expression on CD14low and CD14++ monocytes was measured by flow cytometry in healthy controls and RA patients (early and long-standing disease). Intracellular TNF-staining was carried out after in vitro LPS or heat-aggregated immunoglobulin (HAG) activation. FcγRIIIa/CD16 expression pre- and post-steroid/methotrexate treatment was examined. Results Increased FcγRIIIa/CD16 expression on CD14++ monocytes in long-standing RA patients compared to controls was demonstrated (p = 0.002) with intermediate levels in early-RA patients. HAG-induced TNF-production in RA patients was correlated with the percentage of CD14++ monocytes expressing FcγRIIIa/CD16 (p<0.001). The percentage of CD14++ monocytes expressing FcγRIIIa/CD16 at baseline in early DMARD-naïve RA patients was negatively correlated with DAS28-ESR improvement 14-weeks post-methotrexate therapy (p = 0.003) and was significantly increased in EULAR non-responders compared to moderate (p = 0.01) or good responders (p = 0.003). FcγRIIIa/CD16 expression was not correlated with age, presence of systemic inflammation or autoantibody titers. Conclusion Increased FcγRIIIa/CD16 expression on CD14++ monocytes in RA may result in a cell that has increased responsiveness to IC-stimulation. This monocyte subset may contribute to non-response to methotrexate therapy. PMID:22235253

Frequency and Cause of Persistent Symptoms in Celiac Disease Patients on a Long-term Gluten-free Diet.

PubMed

Stasi, Elisa; Marafini, Irene; Caruso, Roberta; Soderino, Federica; Angelucci, Erika; Del Vecchio Blanco, Giovanna; Paoluzi, Omero A; Calabrese, Emma; Sedda, Silvia; Zorzi, Francesca; Pallone, Francesco; Monteleone, Giovanni

2016-03-01

To estimate the frequency and cause of nonresponsive celiac disease (CD). Treatment of CD is based on life-long adherence to a gluten-free diet (GFD). Some celiac patients experience persistence of symptoms despite a GFD. This condition is defined as nonresponsive CD. Celiac patients on a GFD for at least 12 months underwent diet compliance assessment, laboratory tests, breath tests, endoscopic, and histologic evaluations according to the symptoms/signs reported. Seventy of 321 (21.8%) patients had persistent or recurrent symptoms/signs. The cause of symptom persistence was evaluated in 56 of 70 patients. Thirteen of 56 (23%) patients were antiendomysial antibody positive. Among the patients with negative serology, 1 had fibromyalgia, and 3 had evidence that disproved the diagnosis of CD. The remaining 39 patients with negative serology underwent duodenal biopsy sampling, which evidenced histologic alterations in 24 patients. Among the 15 patients with normal histology 3 were lactose intolerant, 9 had irritable bowel syndrome, 2 had gastroesophageal reflux disease, and in 1 patient a cause for the persistent symptom was not identified. In patients with confirmed diagnosis of CD, exposure to dietary gluten was the main cause of persistence of symptoms/signs, and consistently after dietary modification, symptoms resolved in 63% of the patients at later time points during follow-up. Nonresponsive CD occurs in nearly one fifth of celiac patients on GFD and its occurrence suggests further investigations to optimize the management of celiac patients.

75 FR 42438 - Agency Information Collection Activities; Proposed Collection; Comment Request; Willingness To...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-21

... Facilities Cooling Water Intake Structures: Instrument, Pre-test, and Implementation (New). ICR numbers: EPA... test for and ameliorate survey non-response bias. EPA will follow standard practice in stated...

[Participation and representation of the immigrant population in the Spanish National Health Survey 2011-2012].

PubMed

González-Rábago, Yolanda; La Parra, Daniel; Martín, Unai; Malmusi, Davide

2014-01-01

Population health surveys have been the main data source for analysis of immigrants' health status in Spain. The aim of this study was to analyze the representation of this population in the Spanish National Health Survey (SNHS) 2011-2012. We analyzed methodological publications and data from the SNHS 2011-2012 and the population registry. Differences in the participation rate between the national and foreign populations and the causes for these differences were analyzed, as well as the representation of 11 countries of birth in the survey with respect to the general population, with and without weighting. Households with any foreign person had a lower participation rate, either due to a higher error in the sampling frame or to a higher non-response rate. In each country of birth, the sample was smaller than would be expected according to the population registry, especially among the Chinese population. When we applied the sample weights to the 11 countries of birth, the estimated population volume was closer to the estimated volume of the population registry for all the countries considered, although globally both the underrepresentation and the intranational bias remained. The lower participation of the immigrant population and differences in participation depending on the country of origin suggest the existence of a potential bias in the SNHS, which should be taken into account in studies analyzing the health of this population. The lower participation rate should be studied in greater depth in order to take appropriate measures to increase the representativeness of health surveys. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

Indications and Use of the Gluten Contamination Elimination Diet for Patients with Non-Responsive Celiac Disease

PubMed Central

Leonard, Maureen M.; Cureton, Pamela; Fasano, Alessio

2017-01-01

For the majority of patients diagnosed with celiac disease, once a gluten-free diet is initiated, symptoms improve within weeks and may completely resolve in months. However, up to 30% of patients may show signs, symptoms or persistent small intestinal damage after one year on a gluten-free diet. These patients require evaluation for other common GI etiologies and assessment of their celiac disease status in order to make a diagnosis and suggest treatment. Here, we propose an approach to evaluating patients with celiac disease with persistent symptoms, persistently elevated serology, and or persistent villous atrophy despite a gluten-free diet. We detail how to diagnose and distinguish between non-responsive and refractory celiac disease. Finally, we introduce the indications for use of the gluten contamination elimination diet and provide information for practitioners to implement the diet when necessary in their practice. PMID:29057833

Indications and Use of the Gluten Contamination Elimination Diet for Patients with Non-Responsive Celiac Disease.

PubMed

Leonard, Maureen M; Cureton, Pamela; Fasano, Alessio

2017-10-18

For the majority of patients diagnosed with celiac disease, once a gluten-free diet is initiated, symptoms improve within weeks and may completely resolve in months. However, up to 30% of patients may show signs, symptoms or persistent small intestinal damage after one year on a gluten-free diet. These patients require evaluation for other common GI etiologies and assessment of their celiac disease status in order to make a diagnosis and suggest treatment. Here, we propose an approach to evaluating patients with celiac disease with persistent symptoms, persistently elevated serology, and or persistent villous atrophy despite a gluten-free diet. We detail how to diagnose and distinguish between non-responsive and refractory celiac disease. Finally, we introduce the indications for use of the gluten contamination elimination diet and provide information for practitioners to implement the diet when necessary in their practice.

A Test of Web and Mail Mode Effects in a Financially Sensitive Survey of Older Americans

PubMed Central

Hsu, Joanne W.

2018-01-01

This study leverages a randomized experimental design of a mixed-mode mail- and web-based survey to examine mode effects separately from sample selectivity issues. Using data from the Cognitive Economics Study, which contains some sensitive financial questions, we analyze two sets of questions: fixed-choice questions posed nearly identically across mode, and dollar-value questions that exploit features available only on web mode. Focusing on differences in item nonresponse and response distributions, our results indicate that, in contrast to mail mode, web mode surveys display lower item nonresponse for all questions. While respondents appear to prefer providing financial information in ranges, use of reminder screens on the web version yields greater use of exact values without large sacrifices in item response. Still, response distributions for all questions are similar across mode, suggesting that data on sensitive financial questions collected from the two modes can be pooled.

The proteome of methylmalonic acidemia (MMA): the elucidation of altered pathways in patient livers.

PubMed

Caterino, Marianna; Chandler, Randy J; Sloan, Jennifer L; Dorko, Kenneth; Cusmano-Ozog, Kristina; Ingenito, Laura; Strom, Stephen C; Imperlini, Esther; Scolamiero, Emanuela; Venditti, Charles P; Ruoppolo, Margherita

2016-02-01

Methylmalonic acidemia (MMA) is a heterogeneous and severe autosomal recessive inborn error of metabolism most commonly caused by the deficient activity of the vitamin B12 dependent enzyme, methylmalonyl-CoA mutase (MUT). The main treatment for MMA patients is the dietary restriction of propiogenic amino acids and carnitine supplementation. Despite treatment, the prognosis for vitamin B12 non-responsive patients remains poor and is associated with neonatal lethality, persistent morbidity and decreased life expectancy. While multi-organ pathology is a feature of MMA, the liver is severely impacted by mitochondrial dysfunction which likely underlies the metabolic instability experienced by the patients. Liver and/or combined liver/kidney transplantation is therefore sometimes performed in severely affected patients. Using liver specimens from donors and MMA patients undergoing elective liver transplantation collected under a dedicated natural history protocol (clinicaltrials.gov: NCT00078078), we employed proteomics to characterize the liver pathology and impaired hepatic metabolism observed in the patients. Pathway analysis revealed perturbations of enzymes involved in energy metabolism, gluconeogenesis and Krebs cycle anaplerosis. Our findings identify new pathophysiologic and therapeutic targets that could be valuable for designing alternative therapies to alleviate clinical manifestations seen in this disorder.

Electronic messaging and communication with living kidney donors.

PubMed

Ruck, Jessica M; Zhou, Sheng; Thomas, Alvin G; Cramm, Shannon L; Massie, Allan B; Montgomery, John R; Berger, Jonathan C; Henderson, Macey L; Segev, Dorry L

2018-02-01

New regulations require living kidney donor (LKD) follow-up for 2 years, but donor retention remains poor. Electronic communication (eg, text messaging and e-mail) might improve donor retention. To explore the possible impact of electronic communication, we recruited LKDs to participate in an exploratory study of communication via telephone, e-mail, or text messaging postdonation; communication through this study was purely optional and did not replace standard follow-up. Of 69 LKDs recruited, 3% requested telephone call, 52% e-mail, and 45% text messaging. Telephone response rate was 0%; these LKDs were subsequently excluded from analysis. Overall response rates with e-mail or text messaging at 1 week, 1 month, 6 months, 1 year, and 2 years were 94%, 87%, 81%, 72%, and 72%. Lower response rates were seen in African Americans, even after adjusting for age, sex, and contact method (incidence rate ratio (IRR) nonresponse 2.07 5.81 16.36 , P = .001). Text messaging had higher response rates than e-mail (IRR nonresponse 0.11 0.28 0.71 , P = .007). Rates of nonresponse were similar by sex (IRR 0.68, P = .4) and age (IRR 1.00, P > .9). In summary, LKDs strongly preferred electronic messaging over telephone and were highly responsive 2 years postdonation, even in this nonrequired, nonincentivized exploratory research study. These electronic communication tools can be automated and may improve regulatory compliance and postdonation care. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Long-term follow-up study of patients with serotonin reuptake inhibitor-nonresponsive obsessive-compulsive disorder.

PubMed

Reddy, Y C Janardhan; Alur, Adarsha M; Manjunath, Smitha; Kandavel, Thennarasu; Math, Suresh Bada

2010-06-01

There is a paucity of data on the long-term outcome of serotonin reuptake inhibitor (SRI)-nonresponsive obsessive-compulsive disorder (OCD). We report long-term outcome of OCD in subjects who had not responded to at least 2 adequate trials of SRIs. This is a naturalistic follow-up of 36 (72%) of 50 SRI nonresponders with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition OCD, after about 4.5 years. Two had committed suicide (4%), and 12 (24%) could not be traced or refused consent. The study has a catch-up longitudinal design. The primary outcome measure was "remission," measured using the Psychiatric Status Rating Scale. Multiple logistic backward (Wald) regression analysis was used to identify predictors of remission. Of the 36 subjects, 14 were in remission (39%): 4 were in full remission (11%) and 10 were in partial remission (28%). Those who remitted were considered to have good outcome. Not having received cognitive behavior therapy (CBT) in the interval period, poorer quality of life at baseline, shorter duration of follow-up, and later age at onset predicted poor outcome. Study findings suggest that a substantial proportion of OCD patients with proven SRI nonresponse improve over a period, possibly because of continued efforts to treat them. The prognosis of SRI nonresponders need not be viewed pessimistically, and if treated aggressively with both medications and CBT, they may continue to show improvement. There is an urgent need to systematically examine the efficacy of various treatment options, particularly CBT in treating SRI nonresponders.

Comparative effectiveness of infliximab and adalimumab in Crohn’s disease and ulcerative colitis

PubMed Central

Ananthakrishnan, Ashwin N.; Cagan, Andrew; Cai, Tianxi; Gainer, Vivian S.; Shaw, Stanley Y; Savova, Guergana; Churchill, Susanne; Karlson, Elizabeth W.; Kohane, Isaac; Liao, Katherine P.; Murphy, Shawn N.

2016-01-01

Introduction The availability of monoclonal antibodies to tumor necrosis factor α (anti-TNF) has revolutionized management of Crohn’s disease (CD) and ulcerative colitis (UC). However, limited data exists regarding comparative effectiveness of these agents to inform clinical practice. Methods This study consisted of patients with CD or UC initiation either infliximab (IFX) or adalimumab (ADA) between 1998 and 2010. A validated likelihood of non-response classification score utilizing frequency of narrative mentions of relevant symptoms in the electronic health record (EHR) was applied to assess comparative effectiveness at 1 year. IBD-related surgery, hospitalization, and use of steroids was determined during this period. Results Our final cohort included 1,060 new initiations of IFX (68% for CD) and 391 of ADA (79% for CD). In CD, the likelihood of non-response was higher in ADA than IFX (OR 1.62, 95% CI 1.21 – 2.17). Similar differences favoring efficacy of IFX was observed for the individual symptoms of diarrhea, pain, bleeding, and fatigue. However, there was no difference in IBD-related surgery, hospitalizations or prednisone use within 1 year after initiation of IFX or ADA in CD. There was no difference in narrative or codified outcomes between the two agents in UC. Conclusion We identified a modestly higher likelihood of symptomatic non-response at 1 year for ADA compared to IFX in patients with CD. However, there were no differences in IBD-related surgery or hospitalizations suggesting these treatments are broadly comparable in effectiveness in routine clinical practice. PMID:26933751

The Sampling Design of the China Family Panel Studies (CFPS)

PubMed Central

Xie, Yu; Lu, Ping

2018-01-01

The China Family Panel Studies (CFPS) is an on-going, nearly nationwide, comprehensive, longitudinal social survey that is intended to serve research needs on a large variety of social phenomena in contemporary China. In this paper, we describe the sampling design of the CFPS sample for its 2010 baseline survey and methods for constructing weights to adjust for sampling design and survey nonresponses. Specifically, the CFPS used a multi-stage probability strategy to reduce operation costs and implicit stratification to increase efficiency. Respondents were oversampled in five provinces or administrative equivalents for regional comparisons. We provide operation details for both sampling and weights construction. PMID:29854418

Compressor surge counter

DOEpatents

Castleberry, Kimberly N.

1983-01-01

A surge counter for a rotating compressor is provided which detects surging by monitoring the vibration signal from an accelerometer mounted on the shaft bearing of the compressor. The circuit detects a rapid increase in the amplitude envelope of the vibration signal, e.g., 4 dB or greater in less than one second, which is associated with a surge onset and increments a counter. The circuit is rendered non-responsive for a period of about 5 seconds following the detection which corresponds to the duration of the surge condition. This prevents multiple registration of counts during the surge period due to rapid swings in vibration amplitude during the period.

76 FR 81133 - Hours of Service of Drivers

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-27

... be off for an extended period of time, a practice that naturally imposes a non-regulatory restorative... Other 25 2 27 Total 21,106 2,806 23,912 Note: Totals do not include 546 non-germane, non-responsive, or...

Long-term Observations of Ecohydrology, Climate, Energy Fluxes, and Eddy Covariance Error in a Large, Semiarid Floodplain

NASA Astrophysics Data System (ADS)

Cleverly, J. R.; Thibault, J. R.; Dahm, C. N.; Allred Coonrod, J. E.; Slusher, M.; Teet, S.; Schuetz, J.

2008-12-01

Some of the highest rates of water and energy fluxes between terrestrial ecosystems and the atmosphere occur over large floodplains in arid and semiarid areas. Often located in high-pressure zones near 35 degrees latitude, abundant radiation and easily accessible groundwater contribute few limitations on growth and production in desert phreatophytes. Desert regions typically undergo cycles of drought and floods, and phreatophytic communities wax or wane in cover, density, and structure with cumulative species responses to timing and severity in these regional weather cycles. The Rio-ET Laboratory at the University of New Mexico has been collecting long-term data from a flux network of riparian monitoring stations, mounted on towers along the Middle Rio Grande. Ongoing measurements of energy, water and carbon dioxide fluxes, groundwater dynamics, meteorology, leaf area index, and community dynamics began at some locations in 1999. Recent reanalysis of the flux dataset was performed in which error correction procedures were compared to each and other and in relation to an irrigated crop under advection. Most riparian sites exhibited stable atmospheric stratification and an energy balance consistent with evaporative cooling. Evaporative cooling was more prominent in the late afternoon and evening, during wet conditions. Reduced latent heat fluxes were observed in a cottonwood forest following restoration and fire, but only in years when the forest floor was not re-vegetated by opportunistic annuals or target removal species. Water use by riparian phreatophytes was 1) non-responsive to drought during the monsoon season (non-native Russian olive and monospecific saltcedar communities), 2) responded negatively to monsoon-season drought (xeroriparian saltcedar and saltgrass mosaic community), or 3) responded positively to monsoon-season drought (cottonwood forests). Water salvage related to ecological restoration is dependent upon restoration strategy, emphasizing the importance of due diligent followup to prevent unintentional re-vegetation of the site. Restoration of monospecific saltcedar provides the greatest opportunity for water salvage although restoration of cottonwood forests through removal of densely-packed non-native understory results in marginal water salvage. Benefits of ecosystem restoration increase with drought and during the period of explosive growth following a period of prolonged drought.

The impact of non-response bias due to sampling in public health studies: A comparison of voluntary versus mandatory recruitment in a Dutch national survey on adolescent health.

PubMed

Cheung, Kei Long; Ten Klooster, Peter M; Smit, Cees; de Vries, Hein; Pieterse, Marcel E

2017-03-23

In public health monitoring of young people it is critical to understand the effects of selective non-response, in particular when a controversial topic is involved like substance abuse or sexual behaviour. Research that is dependent upon voluntary subject participation is particularly vulnerable to sampling bias. As respondents whose participation is hardest to elicit on a voluntary basis are also more likely to report risk behaviour, this potentially leads to underestimation of risk factor prevalence. Inviting adolescents to participate in a home-sent postal survey is a typical voluntary recruitment strategy with high non-response, as opposed to mandatory participation during school time. This study examines the extent to which prevalence estimates of adolescent health-related characteristics are biased due to different sampling methods, and whether this also biases within-subject analyses. Cross-sectional datasets collected in 2011 in Twente and IJsselland, two similar and adjacent regions in the Netherlands, were used. In total, 9360 youngsters in a mandatory sample (Twente) and 1952 youngsters in a voluntary sample (IJsselland) participated in the study. To test whether the samples differed on health-related variables, we conducted both univariate and multivariable logistic regression analyses controlling for any demographic difference between the samples. Additional multivariable logistic regressions were conducted to examine moderating effects of sampling method on associations between health-related variables. As expected, females, older individuals, as well as individuals with higher education levels, were over-represented in the voluntary sample, compared to the mandatory sample. Respondents in the voluntary sample tended to smoke less, consume less alcohol (ever, lifetime, and past four weeks), have better mental health, have better subjective health status, have more positive school experiences and have less sexual intercourse than respondents in the mandatory sample. No moderating effects were found for sampling method on associations between variables. This is one of first studies to provide strong evidence that voluntary recruitment may lead to a strong non-response bias in health-related prevalence estimates in adolescents, as compared to mandatory recruitment. The resulting underestimation in prevalence of health behaviours and well-being measures appeared large, up to a four-fold lower proportion for self-reported alcohol consumption. Correlations between variables, though, appeared to be insensitive to sampling bias.

Nonresponse to 17-alpha hydroxyprogesterone caproate for recurrent spontaneous preterm birth prevention: clinical prediction and generation of a risk scoring system.

PubMed

Manuck, Tracy A; Stoddard, Gregory J; Fry, Rebecca C; Esplin, M Sean; Varner, Michael W

2016-11-01

Spontaneous preterm birth remains a leading cause of neonatal morbidity and mortality among nonanomalous neonates in the United States. Spontaneous preterm birth tends to recur at similar gestational ages. Intramuscular 17-alpha hydroxyprogesterone caproate reduces the risk of recurrent spontaneous preterm birth. Unfortunately, one-third of high-risk women will have a recurrent spontaneous preterm birth despite 17-alpha hydroxyprogesterone caproate therapy; the reasons for this variability in response are unknown. We hypothesized that clinical factors among women treated with 17-alpha hydroxyprogesterone caproate who suffer recurrent spontaneous preterm birth at a similar gestational age differ from women who deliver later, and that these associations could be used to generate a clinical scoring system to predict 17-alpha hydroxyprogesterone caproate response. Secondary analysis of a prospective, multicenter, randomized controlled trial enrolling women with ≥1 previous singleton spontaneous preterm birth <37 weeks' gestation. Participants received daily omega-3 supplementation or placebo for the prevention of recurrent preterm birth; all were provided 17-alpha hydroxyprogesterone caproate. Women were classified as a 17-alpha hydroxyprogesterone caproate responder or nonresponder by calculating the difference in delivery gestational age between the 17-alpha hydroxyprogesterone caproate-treated pregnancy and her earliest previous spontaneous preterm birth. Responders were women with pregnancy extending ≥3 weeks later compared with the delivery gestational age of their earliest previous preterm birth; nonresponders delivered earlier or within 3 weeks of the gestational age of their earliest previous preterm birth. A risk score for nonresponse to 17-alpha hydroxyprogesterone caproate was generated from regression models via the use of clinical predictors and was validated in an independent population. Data were analyzed with multivariable logistic regression. A total of 754 women met inclusion criteria; 159 (21%) were nonresponders. Responders delivered later on average (37.7±2.5 weeks) than nonresponders (31.5±5.3 weeks), P<.001. Among responders, 27% had a recurrent spontaneous preterm birth (vs 100% of nonresponders). Demographic characteristics were similar between responders and nonresponders. In a multivariable logistic regression model, independent risk factors for nonresponse to 17-alpha hydroxyprogesterone caproate were each additional week of gestation of the earliest previous preterm birth (odds ratio, 1.23; 95% confidence interval, 1.17-1.30, P<.001), placental abruption or significant vaginal bleeding (odds ratio, 5.60; 95% confidence interval, 2.46-12.71, P<.001), gonorrhea and/or chlamydia in the current pregnancy (odds ratio, 3.59; 95% confidence interval, 1.36-9.48, P=.010), carriage of a male fetus (odds ratio, 1.51; 95% confidence interval, 1.02-2.24, P=.040), and a penultimate preterm birth (odds ratio, 2.10; 95% confidence interval, 1.03-4.25, P=.041). These clinical factors were used to generate a risk score for nonresponse to 17-alpha hydroxyprogesterone caproate as follows: black +1, male fetus +1, penultimate preterm birth +2, gonorrhea/chlamydia +4, placental abruption +5, earliest previous preterm birth was 32-36 weeks +5. A total risk score >6 was 78% sensitive and 60% specific for predicting nonresponse to 17-alpha hydroxyprogesterone caproate (area under the curve=0.69). This scoring system was validated in an independent population of 287 women; in the validation set, a total risk score >6 performed similarly with a 65% sensitivity, 67% specificity and area under the curve of 0.66. Several clinical characteristics define women at risk for recurrent preterm birth at a similar gestational age despite 17-alpha hydroxyprogesterone caproate therapy and can be used to generate a clinical risk predictor score. These data should be refined and confirmed in other cohorts, and women at high risk for nonresponse should be targets for novel therapeutic intervention studies. Copyright © 2016 Elsevier Inc. All rights reserved.

Income non-reporting: implications for health inequalities research.

PubMed

Turrell, G

2000-03-01

To determine whether, in the context of a face to face interview, socioeconomic groups differ in their propensity to provide details about the amount of their personal income, and to discuss the likely consequences of any differences for studies that use income based measures of socioeconomic position. The study used data from the 1995 Australian Health Survey. The sample was selected using a stratified multi-stage area design that covered urban and rural areas across all States and Territories and included non-institutionalised residents of private and non-private dwellings. The response rate was 91.5% for selected dwellings and 97.0% for persons within dwellings. Data were collected using face to face interviews. Income response, the dependent measure, was binary coded (0 if income was reported and 1 for refusals, "don't knows" and insufficient information). Socioeconomic position was measured using employment status, occupation, education and main income source. The socioeconomic characteristics of income non-reporters were initially examined using sex specific age adjusted proportions with 95% confidence intervals. Multivariate analysis was performed using logistic regression. Persons aged 15-64 (n = 33,434) who were reportedly in receipt of an income from one or more sources during the data collection reference period. The overall rate of income non-response was 9.8%. Propensity to not report income increased with age (15-29 years 5.8%, 30-49 10.6%, 50-64 13.8%). No gender differences were found (men 10.2%, women 9.3%). Income non-response was not strongly nor consistently related to education or occupation for men, although there was a suggested association among these variables for women, with highly educated women and those in professional occupations being less likely to report their income. Strong associations were evident between income non-response, labour force status and main income source. Rates were highest among the employed and those in receipt of an income from their own business or partnership, and lowest among the unemployed and those in receipt of a government pension or benefit (which excluded the unemployed). Given that differences in income non-reporting were small to moderate across levels of the education and occupation variables, and that propensity to not report income was greater among higher socioeconomic groups, estimates of the relation between income and health are unlikely to be affected by socioeconomic variability in income non-response. Probability estimates from a logistic regression suggested that higher rates of income non-reporting among employed persons who received their income from a business or partnership were not attributable to socio-economic factors. Rather, it is proposed that these higher rates were attributable to recall effects, or concerns about having one's income information disclosed to taxation authorities. Future studies need to replicate this analysis to determine whether the results can be inferred to other survey and data collection contexts. The analysis should also be extended to include an examination of the relation between socio-economic position and accuracy of income reporting. Little is known about this issue, yet it represents a potential source of bias that may have important implications for studies that investigate the association between income and health.

40 CFR 35.2105 - Debarment and suspension.

Code of Federal Regulations, 2010 CFR

2010-07-01

... unit of government for facilities planning or design work whose name appears on the master list of... applicant should be found non-responsible under part 30 of this subchapter or be the subject of possible debarment or suspension under part 32 of this subchapter. ...

Genetic Markers Predict Primary Non-Response and Durable Response To Anti-TNF Biologic Therapies in Crohn's Disease.

PubMed

Barber, Grant E; Yajnik, Vijay; Khalili, Hamed; Giallourakis, Cosmas; Garber, John; Xavier, Ramnik; Ananthakrishnan, Ashwin N

2016-12-01

One-fifth of patients with Crohn's disease (CD) are primary non-responders to anti-tumor necrosis factor (anti-TNF) therapy, and an estimated 10-15% will fail therapy annually. Little is known about the genetics of response to anti-TNF therapy. The aim of our study was to identify genetic factors associated with primary non-response (PNR) and loss of response to anti-TNFs in CD. From a prospective registry, we characterized the response of 427 CD patients to their first anti-TNF therapy. Patients were designated as achieving primary response, durable response, and non-durable response based on clinical, endoscopic, and radiologic criteria. Genotyping was performed on the Illumina Immunochip. Separate genetic scores based on presence of predictive genetic alleles were calculated for PNR and durable response and performance of clinical and genetics models were compared. From 359 patients, 36 were adjudged to have PNR (10%), 200 had durable response, and 74 had non-durable response. PNRs had longer disease duration and were more likely to be smokers. Fifteen risk alleles were associated with PNR. Patients with PNR had a significantly higher genetic risk score (GRS) (P =8 × 10 -12 ). A combined clinical-genetic model more accurately predicted PNR when compared with a clinical only model (0.93 vs. 0.70, P <0.001). Sixteen distinct single nucleotide polymorphisms predicted durable response with a higher GRS (P =7 × 10 -13 ). The GRSs for PNR and durable response were not mutually correlated, suggesting distinct mechanisms. Genetic risk alleles can predict primary non-response and durable response to anti-TNF therapy in CD.

Is a Health Interview Survey an appropriate tool to assess domestic violence?

PubMed

Drieskens, Sabine; Demarest, Stefaan; D'Hoker, Nicola; Ortiz, Barbara; Tafforeau, Jean

2017-10-01

The aim of this study is to assess if a Health Interview Survey (HIS) targeting the general population is an appropriate tool to collect valid data on domestic violence. Studying item non-response on the question on domestic violence and its association with socio-demographic and health characteristics compared with victims of domestic violence can contribute to this. Cross-sectional data from the Belgian HIS 2013 were analysed. A question whether the perpetrator of a violent event was a member of the respondents' household was embedded in a general topic on violence in the self-administered questionnaire. This study is limited to people aged 15+ that at least completed the first question of this topic. Socio-demographic characteristics of item non-respondents and of victims of domestic violence were explored and the association with health status was assessed through ORs calculated via logistic regression. The year prevalence of domestic violence is 1.1%. Although the question on domestic violence yields a high level of non-response (62%), this does not hinder the further completion of the questionnaire. When compared with victims of domestic violence, those not responding on the question on the perpetrator have better (mental) health. When compared with those not being victim of domestic violence, victims report poorer physical and mental health. An HIS can be an appropriate tool to assess domestic violence in the general population and its association with health. However, a solution should be found for the high item non-response on the question on the perpetrator of the violent event. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Ketamine and Imipramine Reverse Transcriptional Signatures of Susceptibility and Induce Resilience-Specific Gene Expression Profiles.

PubMed

Bagot, Rosemary C; Cates, Hannah M; Purushothaman, Immanuel; Vialou, Vincent; Heller, Elizabeth A; Yieh, Lynn; LaBonté, Benoit; Peña, Catherine J; Shen, Li; Wittenberg, Gayle M; Nestler, Eric J

2017-02-15

Examining transcriptional regulation by antidepressants in key neural circuits implicated in depression and understanding the relation to transcriptional mechanisms of susceptibility and natural resilience may help in the search for new therapeutic agents. Given the heterogeneity of treatment response in human populations, examining both treatment response and nonresponse is critical. We compared the effects of a conventional monoamine-based tricyclic antidepressant, imipramine, and a rapidly acting, non-monoamine-based antidepressant, ketamine, in mice subjected to chronic social defeat stress, a validated depression model, and used RNA sequencing to analyze transcriptional profiles associated with susceptibility, resilience, and antidepressant response and nonresponse in the prefrontal cortex (PFC), nucleus accumbens, hippocampus, and amygdala. We identified similar numbers of responders and nonresponders after ketamine or imipramine treatment. Ketamine induced more expression changes in the hippocampus; imipramine induced more expression changes in the nucleus accumbens and amygdala. Transcriptional profiles in treatment responders were most similar in the PFC. Nonresponse reflected both the lack of response-associated gene expression changes and unique gene regulation. In responders, both drugs reversed susceptibility-associated transcriptional changes and induced resilience-associated transcription in the PFC. We generated a uniquely large resource of gene expression data in four interconnected limbic brain regions implicated in depression and its treatment with imipramine or ketamine. Our analyses highlight the PFC as a key site of common transcriptional regulation by antidepressant drugs and in both reversing susceptibility- and inducing resilience-associated molecular adaptations. In addition, we found region-specific effects of each drug, suggesting both common and unique effects of imipramine versus ketamine. Copyright © 2016 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

HIV testing in national population-based surveys: experience from the Demographic and Health Surveys.

PubMed Central

Mishra, Vinod; Vaessen, Martin; Boerma, J. Ties; Arnold, Fred; Way, Ann; Barrere, Bernard; Cross, Anne; Hong, Rathavuth; Sangha, Jasbir

2006-01-01

OBJECTIVES: To describe the methods used in the Demographic and Health Surveys (DHS) to collect nationally representative data on the prevalence of human immunodeficiency virus (HIV) and assess the value of such data to country HIV surveillance systems. METHODS: During 2001-04, national samples of adult women and men in Burkina Faso, Cameroon, Dominican Republic, Ghana, Mali, Kenya, United Republic of Tanzania and Zambia were tested for HIV. Dried blood spot samples were collected for HIV testing, following internationally accepted ethical standards. The results for each country are presented by age, sex, and urban versus rural residence. To estimate the effects of non-response, HIV prevalence among non-responding males and females was predicted using multivariate statistical models for those who were tested, with a common set of predictor variables. RESULTS: Rates of HIV testing varied from 70% among Kenyan men to 92% among women in Burkina Faso and Cameroon. Despite large differences in HIV prevalence between the surveys (1-16%), fairly consistent patterns of HIV infection were observed by age, sex and urban versus rural residence, with considerably higher rates in urban areas and in women, especially at younger ages. Analysis of non-response bias indicates that although predicted HIV prevalence tended to be higher in non-tested males and females than in those tested, the overall effects of non-response on the observed national estimates of HIV prevalence are insignificant. CONCLUSIONS: Population-based surveys can provide reliable, direct estimates of national and regional HIV seroprevalence among men and women irrespective of pregnancy status. Survey data greatly enhance surveillance systems and the accuracy of national estimates in generalized epidemics. PMID:16878227

[Evaluation, correction and impact of non-response in studies of childhood obesity].

PubMed

Santiago-Pérez, María Isolina; Pérez-Ríos, Mónica; Malvar, Alberto; Suanzes, Jorge; Hervada, Xurxo

2017-09-25

To evaluate and correct the impact of non-response in the prevalence of underweight, overweight and obesity in children aged 6 to 15 years old using silhouette scales. Cross-sectional study carried out in 2013 among 8,145 Galician schoolchildren aged 6-15 years old. The students who agreed to participate were weighed and measured and, based on body mass index, the prevalence of underweight, overweight and obesity was estimated. Teachers rated all students using silhouette scales. The valuations were used to estimate the prevalence corrected by non-response. Using the Bayes theorem, participation rates were estimated according to weight status. The participation rate was 92.3% in the 6 -to 11-year-old group, and 90% in the 12- to 15-year old age group. In both groups, the prevalence of underweight and overweight were similar between participants and non-participants. However, obesity was higher among non-participants, especially at 12 to 15 years of age (6.3% vs. 12.2% ; p < 0.05). The prevalence did not change when corrected by the teacher's valuation. The participation rate of obese students was lower than the overall rate (82% vs. 90% at 12 to 15 years old; p < 0.05). The presence of participation bias, which was greater at 12-15 years old, was confirmed. However, the impact of the bias on prevalence was negligible due to the high participation rate. In obesity studies with objective measures, it is essential to quantify non-participation, as well as to assess its impact and correct it. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Riboflavin-Responsive and -Non-responsive Mutations in FAD Synthase Cause Multiple Acyl-CoA Dehydrogenase and Combined Respiratory-Chain Deficiency.

PubMed

Olsen, Rikke K J; Koňaříková, Eliška; Giancaspero, Teresa A; Mosegaard, Signe; Boczonadi, Veronika; Mataković, Lavinija; Veauville-Merllié, Alice; Terrile, Caterina; Schwarzmayr, Thomas; Haack, Tobias B; Auranen, Mari; Leone, Piero; Galluccio, Michele; Imbard, Apolline; Gutierrez-Rios, Purificacion; Palmfeldt, Johan; Graf, Elisabeth; Vianey-Saban, Christine; Oppenheim, Marcus; Schiff, Manuel; Pichard, Samia; Rigal, Odile; Pyle, Angela; Chinnery, Patrick F; Konstantopoulou, Vassiliki; Möslinger, Dorothea; Feichtinger, René G; Talim, Beril; Topaloglu, Haluk; Coskun, Turgay; Gucer, Safak; Botta, Annalisa; Pegoraro, Elena; Malena, Adriana; Vergani, Lodovica; Mazzà, Daniela; Zollino, Marcella; Ghezzi, Daniele; Acquaviva, Cecile; Tyni, Tiina; Boneh, Avihu; Meitinger, Thomas; Strom, Tim M; Gregersen, Niels; Mayr, Johannes A; Horvath, Rita; Barile, Maria; Prokisch, Holger

2016-06-02

Multiple acyl-CoA dehydrogenase deficiencies (MADDs) are a heterogeneous group of metabolic disorders with combined respiratory-chain deficiency and a neuromuscular phenotype. Despite recent advances in understanding the genetic basis of MADD, a number of cases remain unexplained. Here, we report clinically relevant variants in FLAD1, which encodes FAD synthase (FADS), as the cause of MADD and respiratory-chain dysfunction in nine individuals recruited from metabolic centers in six countries. In most individuals, we identified biallelic frameshift variants in the molybdopterin binding (MPTb) domain, located upstream of the FADS domain. Inasmuch as FADS is essential for cellular supply of FAD cofactors, the finding of biallelic frameshift variants was unexpected. Using RNA sequencing analysis combined with protein mass spectrometry, we discovered FLAD1 isoforms, which only encode the FADS domain. The existence of these isoforms might explain why affected individuals with biallelic FLAD1 frameshift variants still harbor substantial FADS activity. Another group of individuals with a milder phenotype responsive to riboflavin were shown to have single amino acid changes in the FADS domain. When produced in E. coli, these mutant FADS proteins resulted in impaired but detectable FADS activity; for one of the variant proteins, the addition of FAD significantly improved protein stability, arguing for a chaperone-like action similar to what has been reported in other riboflavin-responsive inborn errors of metabolism. In conclusion, our studies identify FLAD1 variants as a cause of potentially treatable inborn errors of metabolism manifesting with MADD and shed light on the mechanisms by which FADS ensures cellular FAD homeostasis. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Hemispheric Specialization for Emotional Word Processing Is a Function of SSRI Responsiveness

ERIC Educational Resources Information Center

Walsh, Amy; McDowall, John; Grimshaw, Gina M.

2010-01-01

Vulnerability to depression and non-response to Selective Serotonin Reuptake Inhibitors (SSRIs) are associated with specific neurophysiological characteristics including greater right hemisphere (RH) relative to left hemisphere (LH) activity. The present study investigated the relationship between hemispheric specialization and processing of…

New Mathematical Strategy Using Branch and Bound Method

NASA Astrophysics Data System (ADS)

Tarray, Tanveer Ahmad; Bhat, Muzafar Rasool

In this paper, the problem of optimal allocation in stratified random sampling is used in the presence of nonresponse. The problem is formulated as a nonlinear programming problem (NLPP) and is solved using Branch and Bound method. Also the results are formulated through LINGO.

Epigenetic Reprogramming of the Type III Interferon Response Potentiates Antiviral Activity and Suppresses Tumor Growth

PubMed Central

Ding, Siyuan; Khoury-Hanold, William; Iwasaki, Akiko; Robek, Michael D.

2014-01-01

Type III interferon (IFN-λ) exhibits potent antiviral activity similar to IFN-α/β, but in contrast to the ubiquitous expression of the IFN-α/β receptor, the IFN-λ receptor is restricted to cells of epithelial origin. Despite the importance of IFN-λ in tissue-specific antiviral immunity, the molecular mechanisms responsible for this confined receptor expression remain elusive. Here, we demonstrate that the histone deacetylase (HDAC) repression machinery mediates transcriptional silencing of the unique IFN-λ receptor subunit (IFNLR1) in a cell-type-specific manner. Importantly, HDAC inhibitors elevate receptor expression and restore sensitivity to IFN-λ in previously nonresponsive cells, thereby enhancing protection against viral pathogens. In addition, blocking HDAC activity renders nonresponsive cell types susceptible to the pro-apoptotic activity of IFN-λ, revealing the combination of HDAC inhibitors and IFN-λ to be a potential antitumor strategy. These results demonstrate that the type III IFN response may be therapeutically harnessed by epigenetic rewiring of the IFN-λ receptor expression program. PMID:24409098

Role of pharmacogenetics on deferasirox AUC and efficacy.

PubMed

Cusato, Jessica; Allegra, Sarah; De Francia, Silvia; Massano, Davide; Piga, Antonio; D'Avolio, Antonio

2016-04-01

We evaluated deferasirox pharmacokinetic according to SNPs in genes involved in its metabolism and elimination. Moreover, we defined a plasma area under the curve cut-off value predicting therapy response. Allelic discrimination was performed by real-time PCR. Drug plasma concentrations were measured by a high performance liquid chromatography system coupled with an ultraviolet method. Pharmacokinetic parameters were significantly influenced by UGT1A1 rs887829C>T, UGT1A3 rs1983023C>T and rs3806596A>G SNPs. Area under the curve cut-off values of 360 μg/ml/h for efficacy were here defined and 250 μg/ml/h for nonresponse was reported. UGT1A3 rs3806596GG and ABCG2 rs13120400CC genotypes were factors able to predict efficacy, whereas UGT1A3 rs3806596GG was a nonresponse predictor. These data show how screening patient's genetic profile may help clinicians to optimize iron chelation therapy with deferasirox.

Social isolation, survey nonresponse, and nonresponse bias: An empirical evaluation using social network data within an organization.

PubMed

Watanabe, Megumi; Olson, Kristen; Falci, Christina

2017-03-01

Survey researchers have long hypothesized that social isolation negatively affects the probability of survey participation and biases survey estimates. Previous research, however, has relied on proxy measures of isolation, such as being a marginalized group member within a population. We re-examine the relationship between social isolation and survey participation using direct measures of social isolation derived from social network data; specifically, instrumental research and expressive friendship connections among faculty within academic departments. Using a reconceptualization of social isolation, we find that social network isolation is negatively associated with unit response. Among women (a numerical minority group within the organization), we further find that social group isolation (i.e., lacking instrumental network connections to men, the majority group in the organization) is negatively associated with survey participation. Finally, we show that some survey estimates are systematically biased due to nonparticipation from socially isolated people. Copyright © 2016 Elsevier Inc. All rights reserved.

Characterizing pathways by which gravitropic effectors could move from the root cap to the root of primary roots of Zea mays

NASA Technical Reports Server (NTRS)

Moore, R.; McClelen, C. E.

1989-01-01

Plasmodesmata linking the root cap and root in primary roots Zea mays are restricted to approx. 400 protodermal cells bordering approx. 110000 microns2 of the calyptrogen of the root cap. This area is less than 10% of the cross-sectional area of the root-tip at the cap junction. Therefore, gravitropic effectors moving from the root cap to the root can move symplastically only through a relatively small area in the centre of the root. Decapped roots are non-responsive to gravity. However, decapped roots whose caps are replaced immediately after decapping are strongly graviresponsive. Thus, gravicurvature occurs only when the root cap contacts the root, and symplastic continuity between the cap and root is not required for gravicurvature. Completely removing mucilage from the root tip renders the root non-responsive to gravity. Taken together, these data suggest that gravitropic effectors move apoplastically through mucilage from the cap to the root.

First reported association of chronic lymphocytic leukaemia and interstitial granulomatous dermatitis.

PubMed

Riaz, Irbaz Bin; Kamal, Muhammad Umar; Segal, Robert J; Anwer, Faiz

2016-05-18

Interstitial granulomatous dermatitis (IGD), a rare disease, is well known to be associated with connective tissue disorders, malignancies and several drugs. We describe this first case of IGD in association with chronic lymphocytic leukaemia/small lymphocytic lymphoma (CLL/SLL). A 66-year-old woman with a 6-year history of untreated CLL/SLL, presented with a 2-month history of progressively worsening eruption of the left thigh, along with fatigue, lymphadenopathy and night sweats. Skin biopsy showed findings consistent with IGD and infiltration of CLL. The eruption was non-responsive to treatment with antibiotics and local steroids. There was a significant improvement in the rash after an initial cycle of chemotherapy (combination therapy with bendamustine and rituximab) and complete resolution by the third cycle, for the treatment of her CLL. We suggest that the possibility of an underlying haematological malignancy should be investigated in patients with a skin rash non-responsive to conventional therapy. 2016 BMJ Publishing Group Ltd.

The incontinence impact questionnaire: results in an Italian female population stratified by educational status.

PubMed

Costantini, Elisabetta; Lazzeri, Massimo; Bini, Vittorio; Del Zingaro, Michele; Kocjiancic, Ervin; Porena, Massimo

2009-01-01

To determine the response rate to the self-administered Incontinence Impact Questionnaire (IIQ) in an Italian female population. 172 consecutive patients referred to the urogynecological department of an urban university teaching hospital were invited to answer the self-administered IIQ. Correlations were investigated between answer rate, age, educational status and urogenital pathology. Only 41.6% of patients with low educational status answered all questions compared with 47.6 and 58% of medium and high educational status (p = 0.038 and p = 0.011 respectively). Mean patient age correlated inversely with educational status (rho = -0.443; p < 0.0001) and directly with non-response rate (rho = 0.207; p = 0.007). The non-response rate was correlated significantly and inversely with educational status only in continent patients (rho = -0.254; p = 0.037) and in patients with pelvic organ prolapse (rho = -0.256; p = 0.017). The IIQ answer rate correlated directly with educational status in an Italian female population. Copyright (c) 2009 S. Karger AG, Basel.

Overcoming cetuximab resistance in HNSCC: the role of AURKB and DUSP proteins.

PubMed

Boeckx, Carolien; Op de Beeck, Ken; Wouters, An; Deschoolmeester, Vanessa; Limame, Ridha; Zwaenepoel, Karen; Specenier, Pol; Pauwels, Patrick; Vermorken, Jan B; Peeters, Marc; Van Camp, Guy; Baay, Marc; Lardon, Filip

2014-11-28

Unraveling the underlying mechanisms of cetuximab resistance in head and neck squamous cell carcinoma (HNSCC) is of major importance as many tumors remain non-responsive or become resistant. Our microarray results suggest that "resistant" cells still exhibit RAS-MAPK pathway signaling contributing to drug resistance, as witnessed by low expression of DUSP5 and DUSP6, negative regulators of ERK1/2, and increased expression of AURKB, a key regulator of mitosis. Therefore, interrupting the RAS-MAPK pathway by an ERK1/2 inhibitor (apigenin) or an AURKB inhibitor (barasertib) might be a new strategy for overcoming cetuximab resistance in HNSCC. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Donepezil improves episodic memory in young individuals vulnerable to the effects of sleep deprivation.

PubMed

Chuah, Lisa Y M; Chong, Delise L; Chen, Annette K; Rekshan, William R; Tan, Jiat-Chow; Zheng, Hui; Chee, Michael W L

2009-08-01

We investigated if donepezil, a long-acting orally administered cholinesterase inhibitor, would reduce episodic memory deficits associated with 24 h of sleep deprivation. Double-blind, placebo-controlled, crossover study involving 7 laboratory visits over 2 months. Participants underwent 4 functional MRI scans; 2 sessions (donepezil or placebo) followed a normal night's sleep, and 2 sessions followed a night of sleep deprivation. The study took place in a research laboratory. 26 young, healthy volunteers with no history of any sleep, psychiatric, or neurologic disorders. 5 mg of donepezil was taken once daily for approximately 17 days. Subjects were scanned while performing a semantic judgment task and tested for word recognition outside the scanner 45 minutes later. Sleep deprivation increased the frequency of non-responses at encoding and impaired delayed recognition. No benefit of donepezil was evident when participants were well rested. When sleep deprived, individuals who showed greater performance decline improved with donepezil, whereas more resistant individuals did not benefit. Accompanying these behavioral effects, there was corresponding modulation of task-related activation in functionally relevant brain regions. Brain regions identified in relation to donepezil-induced alteration in non-response rates could be distinguished from regions relating to improved recognition memory. This suggests that donepezil can improve delayed recognition in sleep-deprived persons by improving attention as well as enhancing memory encoding. Donepezil reduced decline in recognition performance in individuals vulnerable to the effects of sleep deprivation. Additionally, our findings demonstrate the utility of combined fMRI-behavior evaluation in psychopharmacological studies.

Selective decrease in central nervous system serotonin turnover in children with dopa-nonresponsive dystonia.

PubMed

Assmann, Birgit; Köhler, Martin; Hoffmann, Georg F; Heales, Simon; Surtees, Robert

2002-07-01

Childhood dystonia that does not respond to treatment with levodopa (dopa-nonresponsive dystonia, DND) has an unclear pathogenesis and is notoriously difficult to treat. To test the hypothesis that there may be abnormalities in serotonin turnover in DND we measured cerebrospinal fluid (CSF) concentrations of homovanillic (HVA) and 5-hydroxyindoleacetic (HIAA) acids, metabolites of dopamine and serotonin, respectively, in 18 children with dystonia not responsive to levodopa. These were combined with a reference population of 85 children with neurologic or metabolic disease known not to affect dopamine or serotonin metabolism. Because of the known natural age-related decrement in HVA and HIAA concentrations, the results were analyzed using multiple regression using age and DND as predictors of CSF HIAA and HVA concentrations. DND was a highly significant predictor of CSF HIAA concentration (p < 0.001) but not of CSF HVA concentration (p = 0.59). After fitting a regression model, the geometric mean ratio of CSF HIAA in DND compared with the reference range was 0.53 whereas that for CSF HVA was 0.95. We also analyzed CSF HIAA/HVA ratios. After fitting a regression model, we found no dependence on age, and the mean of CSF HIAA/HVA in DND was 0.28 whereas that for the reference range was 0.49 (p < 0.001). We conclude that a significant number of children with DND have reduced CNS serotonin turnover. Treatment with drugs that increase serotonin concentration in the synaptic cleft should be considered in this group of patients.

Prediction of Methotrexate Clinical Response in Portuguese Rheumatoid Arthritis Patients: Implication of MTHFR rs1801133 and ATIC rs4673993 Polymorphisms

PubMed Central

Lima, Aurea; Monteiro, Joaquim; Bernardes, Miguel; Sousa, Hugo; Azevedo, Rita; Seabra, Vitor; Medeiros, Rui

2014-01-01

Objective. Methotrexate (MTX), the most used drug in rheumatoid arthritis (RA) treatment, showing variability in clinical response, is often associated with genetic polymorphisms. This study aimed to elucidate the role of methylenetetrahydrofolate reductase (MTHFR) C677T and aminoimidazole carboxamide adenosine ribonucleotide transformylase (ATIC) T675C polymorphisms and clinicopathological variables in clinical response to MTX in Portuguese RA patients. Methods. Study included 233 RA patients treated with MTX for at least six months. MTHFR C677T and ATIC T675C polymorphisms were genotyped and clinicopathological variables were collected. Statistical analyses were performed and binary logistic regression method adjusted to possible confounding variables. Results. Multivariate analyses demonstrated that MTHFR 677TT (OR = 4.63; P = 0.013) and ATIC 675T carriers (OR = 5.16; P = 0.013) were associated with over 4-fold increased risk for nonresponse. For clinicopathological variables, noncurrent smokers (OR = 7.98; P = 0.001), patients positive to anti-cyclic citrullinated peptide (OR = 3.53; P = 0.004) and antinuclear antibodies (OR = 2.28; P = 0.045), with higher health assessment questionnaire score (OR = 2.42; P = 0.007), and nonsteroidal anti-inflammatory drug users (OR = 2.77; P = 0.018) were also associated with nonresponse. Contrarily, subcutaneous administration route (OR = 0.11; P < 0.001) was associated with response. Conclusion. Our study suggests that MTHFR C677T and ATIC T675C genotyping combined with clinicopathological data may help to identify patients whom will not benefit from MTX treatment and, therefore, assist clinicians in personalizing RA treatment. PMID:24967362

Adjusting for non-response in National Aquatic Resource Surveys

EPA Science Inventory

The National Rivers and Streams Assessment (NRSA) is a national-scale probabilistic survey. As part of the survey design, each site is associated with a weight reflecting the number of stream kilometers in the target population represented by that site. During each round of the s...

76 FR 41280 - Agency Information Collection Activities: Proposed Collection; Comment Request; Generic Clearance...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-13

... proposed sample size, the expected response rate, methods for assessing potential non-response bias, the... Activities: Proposed Collection; Comment Request; Generic Clearance for the Collection of Qualitative...): ``Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery '' to OMB for...

Physician Responses to Multiple Questionnaire Mailings.

ERIC Educational Resources Information Center

Sobal, Jeffery; And Others

1990-01-01

Three questionnaire mailings to 1,535 physicians that produced 977 responses were analyzed. The only variable significantly different across the mailings was medical specialty. This finding indicates that the more homogeneous the group the greater the response rate. Issues of nonresponse bias and insufficient sample size are discussed. (TJH)

Bayesian hierarchical modeling for subject-level response classification in peptide microarray immunoassays

PubMed Central

Imholte, Gregory; Gottardo, Raphael

2017-01-01

Summary The peptide microarray immunoassay simultaneously screens sample serum against thousands of peptides, determining the presence of antibodies bound to array probes. Peptide microarrays tiling immunogenic regions of pathogens (e.g. envelope proteins of a virus) are an important high throughput tool for querying and mapping antibody binding. Because of the assay’s many steps, from probe synthesis to incubation, peptide microarray data can be noisy with extreme outliers. In addition, subjects may produce different antibody profiles in response to an identical vaccine stimulus or infection, due to variability among subjects’ immune systems. We present a robust Bayesian hierarchical model for peptide microarray experiments, pepBayes, to estimate the probability of antibody response for each subject/peptide combination. Heavy-tailed error distributions accommodate outliers and extreme responses, and tailored random effect terms automatically incorporate technical effects prevalent in the assay. We apply our model to two vaccine trial datasets to demonstrate model performance. Our approach enjoys high sensitivity and specificity when detecting vaccine induced antibody responses. A simulation study shows an adaptive thresholding classification method has appropriate false discovery rate control with high sensitivity, and receiver operating characteristics generated on vaccine trial data suggest that pepBayes clearly separates responses from non-responses. PMID:27061097

23 CFR 1340.9 - Computation of estimates.

Code of Federal Regulations, 2014 CFR

2014-04-01

... OBSERVATIONAL SURVEYS OF SEAT BELT USE Survey Design Requirements § 1340.9 Computation of estimates. (a) Data... design and any subsequent adjustments. (e) Sampling weight adjustments for observation sites with no... section, the nonresponse rate for the entire survey shall not exceed 10 percent for the ratio of the total...

23 CFR 1340.9 - Computation of estimates.

Code of Federal Regulations, 2012 CFR

2012-04-01

... OBSERVATIONAL SURVEYS OF SEAT BELT USE Survey Design Requirements § 1340.9 Computation of estimates. (a) Data... design and any subsequent adjustments. (e) Sampling weight adjustments for observation sites with no... section, the nonresponse rate for the entire survey shall not exceed 10 percent for the ratio of the total...

23 CFR 1340.3 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-04-01

... OBSERVATIONAL SURVEYS OF SEAT BELT USE General § 1340.3 Definitions. As used in this part— Access ramp means the... general public are not allowed to drive motor vehicles. Nonresponse rate means, for any survey variable... location where survey data are collected. Passenger motor vehicle means a motor vehicle with a gross...

23 CFR 1340.3 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-04-01

... OBSERVATIONAL SURVEYS OF SEAT BELT USE General § 1340.3 Definitions. As used in this part— Access ramp means the... general public are not allowed to drive motor vehicles. Nonresponse rate means, for any survey variable... location where survey data are collected. Passenger motor vehicle means a motor vehicle with a gross...

23 CFR 1340.3 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-04-01

... OBSERVATIONAL SURVEYS OF SEAT BELT USE General § 1340.3 Definitions. As used in this part— Access ramp means the... general public are not allowed to drive motor vehicles. Nonresponse rate means, for any survey variable... location where survey data are collected. Passenger motor vehicle means a motor vehicle with a gross...

23 CFR 1340.9 - Computation of estimates.

Code of Federal Regulations, 2013 CFR

2013-04-01

... OBSERVATIONAL SURVEYS OF SEAT BELT USE Survey Design Requirements § 1340.9 Computation of estimates. (a) Data... design and any subsequent adjustments. (e) Sampling weight adjustments for observation sites with no... section, the nonresponse rate for the entire survey shall not exceed 10 percent for the ratio of the total...

78 FR 23755 - Agency Information Collection Activities: Proposed Collection; Comment Request; Generic Clearance...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-22

... justify the proposed sample size, the expected response rate, methods for assessing potential non-response... Collection; Comment Request; Generic Clearance for the Collection of Qualitative Feedback on Agency Service... Qualitative Feedback on Agency Service Delivery '' for approval under the Paperwork Reduction Act (PRA) (44 U...

Understanding Low Survey Response Rates Among Young U.S. Military Personnel

DTIC Science & Technology

2015-01-01

and Training; Resource Management; and Strategy and Doctrine. The research reported here was prepared under contract FA7014-06-C-0001. Additional...Sampling Strategy ........................................................................................................................ 3   Response...27   Strategies to Reduce Nonresponse in the 2012 RAND Information and Communication Technology and Well-Being Survey

31 CFR 370.21 - Are there any requirements related to a prenotification entry?

Code of Federal Regulations, 2010 CFR

2010-07-01

... specified time period, we may interpret the nonresponsiveness as the financial institution's agreement to.... In our discretion, we may initiate a prenotification entry to a financial institution prior to... there might be problems with sending a subsequent debit entry. (b) Requirements placed upon financial...

Intensive Outpatient Behavioral Treatment of Primary Urinary Incontinence of Children With Autism

ERIC Educational Resources Information Center

LeBlanc, Linda A.; Carr, James E.; Crossett, Sarah E.; Bennett, Christine M.; Detweiler, Dawn D.

2005-01-01

Three children with autism who were previously nonresponsive to low-intensity toilet training interventions were toilet trained using a modified Azrin and Foxx (1971) intensive toilet training procedure. Effects were demonstrated using a nonconcurrent multiple baseline design across participants. The training was conducted across home and school…

A Multi-State Study of Off-Farm Employment.

ERIC Educational Resources Information Center

Wozniak, Patricia J.; And Others

1988-01-01

The scope, development, and implementation of a seven-state study on the impact of farm wives' employment on family functioning and economic productivity are described. The procedures used in questionnaire development, sampling, and data collection are reported, along with information on item and unit nonresponse. All the articles in this special…

Rural Housing--Need and Non-Response.

ERIC Educational Resources Information Center

Rural Housing Alliance, Washington, DC.

Rural areas contain 25 percent of the nation's population and 60 percent of its substandard housing, a fact primarily attributable to maldistribution of income, geographic distribution, and racial discrimination. Federal intervention in housing has been largely indirect and to the benefit of upper income groups, with tax subsidies accounting for…

48 CFR 814.404-2 - Rejection of individual bids.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Rejection of individual... Rejection of individual bids. (a) When a contracting officer finds a bid that is being considered for an... nonresponsive an individual bid that is not in compliance with the Government's bid acceptance time, since...

13 CFR 125.5 - Certificate of Competency Program.

Code of Federal Regulations, 2010 CFR

2010-01-01

... the type of product being procured or the specific contract at issue. (iv) A non-manufacturer making... application. (1) The COC review process is not limited to the areas of nonresponsibility cited by the contracting officer. SBA may, at its discretion, independently evaluate the COC applicant for all elements of...

Cognitive-Behavioral Therapy for Rapid Cycling Bipolar Disorder

ERIC Educational Resources Information Center

Reilly-Harrington, Noreen A.; Knauz, Robert O.

2005-01-01

This article describes the application of cognitive-behavioral therapy (CBT) to the treatment of rapid cycling bipolar disorder. Between 10% and 24% of bipolar patients experience a rapid cycling course, with 4 or more mood episodes occurring per year. Characterized by nonresponse to standard mood-stabilizing medications, rapid cyclers are…

Linking Returning Veterans in Rural Community Colleges to Mental Health Care

DTIC Science & Technology

2015-01-01

limitation was mitigated somewhat by the use of non-response weights developed using the characteristics (age category, gender, race/ethnicity minority...Journal of Psychiatry. 1998; 155:1092-1096. 7 Aud S, Wilkinson- Flicker S, Kristapovich P, Rathbun A, Wang X, Zhang J. The Condition of Education 2013

2011 Montana Youth Risk Behavior Survey: Nonpublic Accredited Schools

ERIC Educational Resources Information Center

Montana Office of Public Instruction, 2011

2011-01-01

This report presents the 2011 Montana Youth Risk Behavior Survey high school student frequency distributions for nonpublic accredited schools. These frequency distributions are based upon surveys with 349 high school students in Nonpublic Region during February of 2011. Frequency distributions may not total 349 due to nonresponse and percents may…

2011 Montana Youth Risk Behavior Survey: Alternative Schools

ERIC Educational Resources Information Center

Montana Office of Public Instruction, 2011

2011-01-01

This report presents the 2011 Montana Youth Risk Behavior alternative school student frequency distributions. These frequency distributions are based upon surveys with 274 alternative school students in Montana during February of 2011. Frequency distributions may not total 274 due to nonresponse and percents may not total 100 percent due to…

78 FR 70015 - Proposed Information Collection; Comment Request; Large Pelagic Fishing Survey

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-22

...) target sample size from 10,780 to 15,900 interviews for Northeast and Southeast combined. Add up to five questions to the LPTS questionnaire. Add a non-response follow-up survey to the LPTS in the Southeast region... from 1,500 to 1,000 interviews. [[Page 70016

Parenthood and Childhood in the Scandinavian Countries: Challenges of Responsibility.

ERIC Educational Resources Information Center

Jensen, An-Magritt

1998-01-01

Examines the impact of fertility, family changes, and employment trends on parenthood in Scandinavia. Maintains that the most vulnerable aspect of responsible parenthood is the privatization of the family and feminization of childhood. Parenthood as private choice may encourage societal nonresponsibility for children. The high risk of parental…

The TRacking Adolescents' Individual Lives Survey (TRAILS): Design, Current Status, and Selected Findings

ERIC Educational Resources Information Center

Ormel, Johan; Oldehinkel, Albertine J.; Sijtsema, Jelle; van Oort, Floor; Raven, Dennis; Veenstra, Rene; Vollebergh, Wilma A. M.; Verhulst, Frank C.

2012-01-01

Objectives: The objectives of this study were as follows: to present a concise overview of the sample, outcomes, determinants, non-response and attrition of the ongoing TRacking Adolescents' Individual Lives Survey (TRAILS), which started in 2001; to summarize a selection of recent findings on continuity, discontinuity, risk, and protective…

2016 Workplace and Gender Relations Survey of Active Duty Members: Frequently Asked Questions

DTIC Science & Technology

2017-05-01

active duty population both at the sample design stage as well as during the statistical weighting process to account for survey non-response and post...used the OPA sampling design , won the 2011 Policy Impact Award from The American Association for Public Opinion Research (AAPOR), which “recognizes

Statistical properties of alternative national forest inventory area estimators

Treesearch

Francis Roesch; John Coulston; Andrew D. Hill

2012-01-01

The statistical properties of potential estimators of forest area for the USDA Forest Service's Forest Inventory and Analysis (FIA) program are presented and discussed. The current FIA area estimator is compared and contrasted with a weighted mean estimator and an estimator based on the Polya posterior, in the presence of nonresponse. Estimator optimality is...

77 FR 2066 - Proposed Data Collections Submitted for Public Comment and Recommendations

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-13

... dataset, which is used to assess non-response bias, for quality control, to improve the ability of MMP to... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention [60Day-12-0740... on proposed data collection projects, the Centers for Disease Control and Prevention (CDC) will...

Multiple Imputation of Multilevel Missing Data-Rigor versus Simplicity

ERIC Educational Resources Information Center

Drechsler, Jörg

2015-01-01

Multiple imputation is widely accepted as the method of choice to address item-nonresponse in surveys. However, research on imputation strategies for the hierarchical structures that are typically found in the data in educational contexts is still limited. While a multilevel imputation model should be preferred from a theoretical point of view if…

Power Analysis for Anticipated Non-Response in Randomized Block Designs

ERIC Educational Resources Information Center

Pustejovsky, James E.

2011-01-01

Recent guidance on the treatment of missing data in experiments advocates the use of sensitivity analysis and worst-case bounds analysis for addressing non-ignorable missing data mechanisms; moreover, plans for the analysis of missing data should be specified prior to data collection (Puma et al., 2009). While these authors recommend only that…

What Response Rates Are Needed to Make Reliable Inferences from Student Evaluations of Teaching?

ERIC Educational Resources Information Center

Zumrawi, Abdel Azim; Bates, Simon P.; Schroeder, Marianne

2014-01-01

This paper addresses the determination of statistically desirable response rates in students' surveys, with emphasis on assessing the effect of underlying variability in the student evaluation of teaching (SET). We discuss factors affecting the determination of adequate response rates and highlight challenges caused by non-response and lack of…

19 CFR 181.72 - Verification scope and method.

Code of Federal Regulations, 2010 CFR

2010-04-01

... written questionnaire sent to an exporter or a producer, including a producer of a material, in Canada or Mexico. The questionnaire: (A) May be sent by certified or registered mail, or by any other method that... treatment on the good. (d) Failure to respond to letter or questionnaire—(1) Nonresponse to initial letter...

Organizations and Survey Research: Implementing Response Enhancing Strategies and Conducting Nonresponse Analyses

ERIC Educational Resources Information Center

Fulton, Brad R.

2018-01-01

Surveys provide a critical source of data for scholars, yet declining response rates are threatening the quality of data being collected. This threat is particularly acute among organizational studies that use key informants--the mean response rate for published studies is 34 percent. This article describes several response enhancing strategies…

Presidential Address: How to Improve Poverty Measurement in the United States

ERIC Educational Resources Information Center

Blank, Rebecca M.

2008-01-01

This paper discusses the reasons why the current official U.S. poverty measure is outdated and nonresponsive to many anti-poverty initiatives. A variety of efforts to update and improve the statistic have failed, for political, technical, and institutional reasons. Meanwhile, the European Union is taking a very different approach to poverty…

A Statistical Model for Misreported Binary Outcomes in Clustered RCTs of Education Interventions

ERIC Educational Resources Information Center

Schochet, Peter Z.

2013-01-01

In randomized control trials (RCTs) of educational interventions, there is a growing literature on impact estimation methods to adjust for missing student outcome data using such methods as multiple imputation, the construction of nonresponse weights, casewise deletion, and maximum likelihood methods (see, for example, Allison, 2002; Graham, 2009;…

2011 Montana Youth Risk Behavior Survey: Students with Disabilities

ERIC Educational Resources Information Center

Montana Office of Public Instruction, 2011

2011-01-01

This report presents the 2011 Montana Youth Risk Behavior Survey high school student frequency distributions for students with disabilities. These frequency distributions are based upon surveys with 1,672 high school students with disabilities in Montana during February of 2011. Frequency distributions may not total 1,672 due to nonresponse and…

Intolerance of Uncertainty Predicts Anxiety Outcomes Following CBT in Youth with ASD

ERIC Educational Resources Information Center

Keefer, Amy; Kreiser, Nicole L.; Singh, Vini; Blakeley-Smith, Audrey; Duncan, Amie; Johnson, Catherine; Klinger, Laura; Meyer, Allison; Reaven, Judy; Vasa, Roma A.

2017-01-01

Modified cognitive-behavioral therapy (MCBT) has been demonstrated to reduce anxiety in youth with autism spectrum disorder (ASD). However, non-response rates are fairly high. Few studies have investigated factors associated with response. Intolerance of uncertainty (IU) is a treatment target for anxiety and worry in neurotypical populations and…

Language, Cognition, and the Right Hemisphere: A Response to Gazzaniga.

ERIC Educational Resources Information Center

Levy, Jerre

1983-01-01

Disputes several assumptions made by Gazzaniga in the preceding article, namely: (l) that any capacity to extract meaning from spoken or written words indicates linguistic competence; and (2) that the right hemisphere is passive and nonresponsive and that the limits of its cognitive abilities are manifested in simple matching-to-sample tasks. (GC)

The Wikipedia Gender Gap Revisited: Characterizing Survey Response Bias with Propensity Score Estimation.

PubMed

Hill, Benjamin Mako; Shaw, Aaron

2013-01-01

Opt-in surveys are the most widespread method used to study participation in online communities, but produce biased results in the absence of adjustments for non-response. A 2008 survey conducted by the Wikimedia Foundation and United Nations University at Maastricht is the source of a frequently cited statistic that less than 13% of Wikipedia contributors are female. However, the same study suggested that only 39.9% of Wikipedia readers in the US were female - a finding contradicted by a representative survey of American adults by the Pew Research Center conducted less than two months later. Combining these two datasets through an application and extension of a propensity score estimation technique used to model survey non-response bias, we construct revised estimates, contingent on explicit assumptions, for several of the Wikimedia Foundation and United Nations University at Maastricht claims about Wikipedia editors. We estimate that the proportion of female US adult editors was 27.5% higher than the original study reported (22.7%, versus 17.8%), and that the total proportion of female editors was 26.8% higher (16.1%, versus 12.7%).

The Wikipedia Gender Gap Revisited: Characterizing Survey Response Bias with Propensity Score Estimation

PubMed Central

2013-01-01

Opt-in surveys are the most widespread method used to study participation in online communities, but produce biased results in the absence of adjustments for non-response. A 2008 survey conducted by the Wikimedia Foundation and United Nations University at Maastricht is the source of a frequently cited statistic that less than 13% of Wikipedia contributors are female. However, the same study suggested that only 39.9% of Wikipedia readers in the US were female – a finding contradicted by a representative survey of American adults by the Pew Research Center conducted less than two months later. Combining these two datasets through an application and extension of a propensity score estimation technique used to model survey non-response bias, we construct revised estimates, contingent on explicit assumptions, for several of the Wikimedia Foundation and United Nations University at Maastricht claims about Wikipedia editors. We estimate that the proportion of female US adult editors was 27.5% higher than the original study reported (22.7%, versus 17.8%), and that the total proportion of female editors was 26.8% higher (16.1%, versus 12.7%). PMID:23840366

Sources of nonresponse to the Federal Waterfowl Hunter Questionnaire Survey

USGS Publications Warehouse

Barker, R.J.; Geissler, P.H.; Hoover, B.A.

1992-01-01

Response rates to the Federal Waterfowl Hunter Questionnaire Survey (WHQS) have declined since the 1950's, suggesting that harvest estimates may be biased. Consequently, we investigated reasons for WHQS nonresponse using surveys of waterfowl hunters in Arkansas, California, Louisiana, Minnesota, New Jersey, and Texas [USA]. Sampling frames were constructed using lists of buyers of state hunting licenses or state duck stamps. We mailed questionnaires to 16,452 randomly selected hunters, with 2 follow-up mailings at 3-week intervals. Questionnaires were completed by 8,812 respondents, and a further 587 interviews were conducted by telephone. Post offices accounted for between 53.7% (Minn.) and 92.8% (N.J.) of federal waterfowl duck stamp sales, and stores accounted for most other sales. Of hunters who bought a federal waterfowl stamp from sample post offices, between 16.7% (Minn.) and 40.0% (Ark.) reported receiving a WHQS contact card. Of those receiving contact cards, between 30.0% (N.J.) and 64.3% (La. and Tex.) reported returning them. Because survey coverage of the target population is poor, we recommend that a new sampling frame be developed for the WHQS.

The Public Health Challenge of Consumer Non-Compliance to Toy Product Recalls and Proposed Solutions

PubMed Central

Yu, Xiayang

2018-01-01

This paper addresses the public health issue of toy product recalls in the United States, an under-addressed topic in scholarly literature, yet highly relevant to the prevention of pediatric injuries. Toy-related injuries led to 274,000 emergency room visits and seven fatalities in 2016 in the United States, and toy-related injury rates have remained stable over the last five years despite declining incidences of recalls. While dangerous toys not being recalled and the misuse of “safe” products are possible contributing factors, consumer non-response to recall notices also contributes to unintentional child injury from dangerous toys. We discuss the process of recalling toys, and the role of the U.S. Consumer Product Safety Commission in that process. We also review potential factors behind significant consumer non-response to recall notifications, citing economic and psychological theories as explanations for the actions of multiple stakeholders in the recall process. We close by proposing reforms at the regulatory, consumer, and retailer levels that might boost compliance with recall notifications and ultimately reduce injury morbidity and mortality. PMID:29562602

Donepezil Improves Episodic Memory in Young Individuals Vulnerable to the Effects of Sleep Deprivation

PubMed Central

Chuah, Lisa Y.M.; Chong, Delise L.; Chen, Annette K.; Rekshan, William R.; Tan, Jiat-Chow; Zheng, Hui; Chee, Michael W.L.

2009-01-01

Study Objectives: We investigated if donepezil, a long-acting orally administered cholinesterase inhibitor, would reduce episodic memory deficits associated with 24 h of sleep deprivation. Design: Double-blind, placebo-controlled, crossover study involving 7 laboratory visits over 2 months. Participants underwent 4 functional MRI scans; 2 sessions (donepezil or placebo) followed a normal night's sleep, and 2 sessions followed a night of sleep deprivation. Setting: The study took place in a research laboratory. Participants: 26 young, healthy volunteers with no history of any sleep, psychiatric, or neurologic disorders. Interventions: 5 mg of donepezil was taken once daily for approximately 17 days. Measurements and Results: Subjects were scanned while performing a semantic judgment task and tested for word recognition outside the scanner 45 minutes later. Sleep deprivation increased the frequency of non-responses at encoding and impaired delayed recognition. No benefit of donepezil was evident when participants were well rested. When sleep deprived, individuals who showed greater performance decline improved with donepezil, whereas more resistant individuals did not benefit. Accompanying these behavioral effects, there was corresponding modulation of task-related activation in functionally relevant brain regions. Brain regions identified in relation to donepezil-induced alteration in non-response rates could be distinguished from regions relating to improved recognition memory. This suggests that donepezil can improve delayed recognition in sleep-deprived persons by improving attention as well as enhancing memory encoding. Conclusions: Donepezil reduced decline in recognition performance in individuals vulnerable to the effects of sleep deprivation. Additionally, our findings demonstrate the utility of combined fMRI–behavior evaluation in psychopharmacological studies. Citation: Chuah LYM; Chong DL; Chen AK; Rekshan WR; Tan JC; Zheng H; Chee MWL. Donepezil improves episodic memory in young individuals vulnerable to the effects of sleep deprivation. SLEEP 2009;32(8):999-1010. PMID:19725251

Response to ticagrelor in clopidogrel nonresponders and responders and effect of switching therapies: the RESPOND study.

PubMed

Gurbel, Paul A; Bliden, Kevin P; Butler, Kathleen; Antonino, Mark J; Wei, Cheryl; Teng, Renli; Rasmussen, Lars; Storey, Robert F; Nielsen, Tonny; Eikelboom, John W; Sabe-Affaki, Georges; Husted, Steen; Kereiakes, Dean J; Henderson, David; Patel, Dharmendra V; Tantry, Udaya S

2010-03-16

The antiplatelet effects of the Platelet Inhibition and Patient Outcomes (PLATO) trial dose of ticagrelor in patients nonresponsive to clopidogrel and after they switch agents are unknown. Patients with stable coronary artery disease on aspirin therapy received a 300-mg clopidogrel load; nonresponders were identified by light transmittance aggregometry. In a 2-way crossover design, nonresponders (n=41) and responders (n=57) randomly received clopidogrel (600 mg/75 mg once daily) or ticagrelor (180 mg/90 mg twice daily) for 14 days during period 1. In period 2, all nonresponders switched treatment; half of the responders continued the same treatment, whereas the others switched treatment. Inhibition of platelet aggregation was higher in nonresponders treated with ticagrelor compared with clopidogrel (P<0.05). Treatment with ticagrelor among nonresponders resulted in a >10%, >30%, and >50% decrease in platelet aggregation from baseline in 100%, 75%, and 13% of patients, respectively. Platelet aggregation fell from 59+/-9% to 35+/-11% in patients switched from clopidogrel to ticagrelor and increased from 36+/-14% to 56+/-9% in patients switched from ticagrelor to clopidogrel (P<0.0001 for both). Platelet reactivity was below the cut points previously associated with ischemic risk measured by light transmittance aggregometry, VerifyNow P2Y(12) assay, and vasodilator-stimulated phosphoprotein phosphorylation in 98% to 100% of patients after ticagrelor therapy versus 44% to 76% of patients after clopidogrel therapy. Ticagrelor therapy overcomes nonresponsiveness to clopidogrel, and its antiplatelet effect is the same in responders and nonresponders. Nearly all clopidogrel nonresponders and responders treated with ticagrelor will have platelet reactivity below the cut points associated with ischemic risk. Clinical Trial Registration- http://www.clinicaltrials.gov. Unique Identifier: NCT00642811.

Predictors of response to cardiac resynchronization therapy: A prospective cohort study.

PubMed

Abreu, Ana; Oliveira, Mário; Silva Cunha, Pedro; Santa Clara, Helena; Santos, Vanessa; Portugal, Guilherme; Rio, Pedro; Soares, Rui; Moura Branco, Luísa; Alves, Marta; Papoila, Ana Luísa; Ferreira, Rui; Mota Carmo, Miguel

2017-06-01

Cardiac resynchronization therapy (CRT) has modified the prognosis of chronic heart failure (HF) with left ventricular systolic dysfunction. However, 30% of patients do not have a favorable response. The big question is how to determine predictors of response. To identify baseline characteristics that might influence echocardiographic response to CRT. We performed a prospective single-center hospital-based cohort study of consecutive HF patients selected to CRT (NYHA class II-IV, left ventricular ejection fraction (LVEF) <35% and QRS complex ≥120 ms). Responders were defined as those with a ≥5% absolute increase in LVEF at six months. Clinical, electrocardiographic, laboratory, echocardiographic, autonomic, endothelial and cardiopulmonary function parameters were assessed before CRT device implantation. Logistic regression models were used. Seventy-nine patients were included, 54 male (68.4%), age 68.1 years (standard deviation 10.2), 19 with ischemic etiology (24%). At six months, 51 patients (64.6%) were considered responders. Although by univariate analysis baseline tricuspid annular plane systolic excursion (TAPSE) and serum creatinine were significantly different in responders, on multivariate analysis only TAPSE was independently associated with response, with higher values predicting a positive response to CRT (OR=1.13; 95% CI: 1.02-1.26; p=0.020). TAPSE ≥15 mm was strongly associated with response, and TAPSE <15 mm with non-response (p=0.005). Responders had no TAPSE values below 10 mm. From a range of clinical and technical baseline characteristics, multivariate analysis only identified TAPSE as an independent predictor of CRT response, with TAPSE <15 mm associated with non-response. This study highlights the importance of right ventricular dysfunction in CRT response. ClinicalTrials.gov identifier: NCT02413151. Copyright © 2017 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.

Potential bias in the bank: what distinguishes refusers, nonresponders and participants in a clinic-based biobank?

PubMed

Ridgeway, J L; Han, L C; Olson, J E; Lackore, K A; Koenig, B A; Beebe, T J; Ziegenfuss, J Y

2013-01-01

Biobanks are an important resource for genetic and epidemiologic research, but bias may be introduced if those who accept the recruitment invitation differ systematically from those who do not in terms of attributes important to health-related investigations. To understand potential bias in a clinic-based biobank of biological samples, including genetic data linked to electronic health record information, we compared patient characteristics and self-reported information among participants, nonresponders and refusers. We also compared reasons for nonparticipation between refusers and nonresponders to elucidate potential pathways to reduce nonparticipation and any uncovered bias. We mailed recruitment packets to 1,600 adult patients with upcoming appointments at Mayo Clinic (Rochester, Minn., USA) and recorded their participation status. Administrative data were used to compare characteristics across groups. We used phone interviews with 26 nonresponders and 26 refusers to collect self-reported information, including reasons for nonparticipation. Participants were asked to complete a mailed questionnaire. We achieved 26.2% participation (n=419) with 12.1% refusing (n=193) and 61.8% nonresponse (n=988). In multivariate analyses, sex, age, region of residence, and race/ethnicity were significantly associated with participation. The groups differed in information-seeking behaviors and research experience. Refusers more often cited privacy concerns, while nonresponders more often identified time constraints as the reason for nonparticipation. For genomic medicine to advance, large, representative biobanks are required. Significant associations between patient characteristics and nonresponse, as well as systematic differences between refusers and nonresponders, could introduce bias. Oversampling or recruitment changes, including heightened attention to privacy protection and participation burden, may be necessary to increase participation among less-represented groups. Copyright © 2013 S. Karger AG, Basel.

Potential Bias in the Bank: What Distinguishes Refusers, Non-responders and Participants in a Clinic-based Biobank?

PubMed Central

Ridgeway, Jennifer L; Han, Leona C; Olson, Janet E; Lackore, Kandace A; Koenig, Barbara A; Beebe, Timothy J; Ziegenfuss, Jeanette Y

2013-01-01

Background Biobanks are an important resource for genetic and epidemiologic research, but bias may be introduced if those who accept the recruitment invitation differ systematically from those who do not in attributes important to health-related investigations. To understand potential bias in a clinic-based biobank of biological samples, including genetic data linked to Electronic Medical Record information, we compared patient characteristics and self-reported information among participants, non-responders, and refusers. We also compared reasons for non-participation between refusers and non-responders to elucidate potential pathways to reduce non-participation and any uncovered bias. Methods We mailed recruitment packets to 1600 adult patients with upcoming appointments at Mayo Clinic (Rochester, MN) and recorded their participation status. Administrative data were used to compare characteristics across groups. We used phone interviews with 26 non-responders and 26 refusers to collect self-reported information, including reasons for non-participation. Participants were asked to complete a mailed questionnaire. Results We achieved 26.2% participation (n=419) with 12.1% refusing (n=193) and 61.8% non-response (n=988). In multivariate analyses, sex, age, region of residence, and race/ethnicity were significantly associated with participation. The groups differed in information-seeking behaviors and research experience. Refusers more often cited privacy concerns while non-responders more often identified time constraints as the reason for non-participation. Conclusion For genomic medicine to advance, large, representative biobanks are required. Significant associations between patient characteristics and nonresponse, as well as systematic differences between refusers and nonresponders, could introduce bias. Oversampling or recruitment changes, including heightened attention to privacy protection and participation burden, may be necessary to increase participation among less-represented groups. PMID:23595106

Hepatitis B Vaccine Antibody Response and the Risk of Clinical AIDS or Death

PubMed Central

Landrum, Michael L.; Hullsiek, Katherine Huppler; O'Connell, Robert J.; Chun, Helen M.; Ganesan, Anuradha; Okulicz, Jason F.; Lalani, Tahaniyat; Weintrob, Amy C.; Crum-Cianflone, Nancy F.; Agan, Brian K.

2012-01-01

Background Whether seroresponse to a vaccine such as hepatitis B virus (HBV) vaccine can provide a measure of the functional immune status of HIV-infected persons is unknown.This study evaluated the relationship between HBV vaccine seroresponses and progression to clinical AIDS or death. Methods and Findings From a large HIV cohort, we evaluated those who received HBV vaccine only after HIV diagnosis and had anti-HBs determination 1–12 months after the last vaccine dose. Non-response and positive response were defined as anti-HBs <10 and ≥10 IU/L, respectively. Participants were followed from date of last vaccination to clinical AIDS, death, or last visit. Univariate and multivariable risk of progression to clinical AIDS or death were evaluated with Cox regression models. A total of 795 participants vaccinated from 1986–2010 were included, of which 41% were responders. During 3,872 person-years of observation, 122 AIDS or death events occurred (53% after 1995). Twenty-two percent of non-responders experienced clinical AIDS or death compared with 5% of responders (p<0.001). Non-response to HBV vaccine was associated with a greater than 2-fold increased risk of clinical AIDS or death (HR 2.47; 95% CI, 1.38–4.43) compared with a positive response, after adjusting for CD4 count, HIV viral load, HAART use, and delayed type hypersensitivity skin test responses (an in vivo marker of cell-mediated immunity). This association remained evident among those with CD4 count ≥500 cells/mm3 (HR 3.40; 95% CI, 1.39–8.32). Conclusions HBV vaccine responses may have utility in assessing functional immune status and risk stratificating HIV-infected individuals, including those with CD4 count ≥500 cells/mm3. PMID:22457767

Circular RNA Signature Predicts Gemcitabine Resistance of Pancreatic Ductal Adenocarcinoma.

PubMed

Shao, Feng; Huang, Mei; Meng, Futao; Huang, Qiang

2018-01-01

Gemcitabine resistance is currently the main problem of chemotherapy for advanced pancreatic cancer patients. The resistance is thought to be caused by altered drug metabolism or reduced apoptosis of cancer cells. However, the underlying mechanism of Gemcitabine resistance in pancreatic cancer remains unclear. In this study, we established Gemcitabine resistant PANC-1 (PANC-1-GR) cell lines and compared the circular RNAs (circRNAs) profiles between PANC-1 cells and PANC-1-GR cells by RNA sequencing. Differentially expressed circRNAs were demonstrated using scatter plot and cluster heatmap analysis. Gene ontology and pathway analysis were performed to systemically map the genes which are functionally associated to those differentially expressed circRNAs identified from our data. The expression of the differentially expressed circRNAs picked up by RNAseq in PANC-1-GR cells was further validated by qRT-PCR and two circRNAs were eventually identified as the most distinct targets. Consistently, by analyzing plasma samples form pancreatic ductal adenocarcinoma (PDAC) patients, the two circRNAs showed more significant expression in the Gemcitabine non-responsive patients than the responsive ones. In addition, we found that silencing of the two circRNAs could restore the sensitivity of PANC-1-GR cells to Gemcitabine treatment, while over-expression of them could increase the resistance of normal PANC-1 and MIA PACA-2 cells, suggesting that they might serve as drug targets for Gemcitabine resistance. Furthermore, the miRNA interaction networks were also explored based on the correlation analysis of the target microRNAs of these two circRNAs. In conclusion, we successfully established new PANC-1-GR cells, systemically characterized the circRNA and miRNA profiles, and identified two circRNAs as novel biomarkers and potential therapeutic targets for Gemcitabine non-responsive PDAC patients.

The Effect of Low Survey Response Rates on Estimates of Alcohol Consumption in a General Population Survey

PubMed Central

Meiklejohn, Jessica; Connor, Jennie; Kypri, Kypros

2012-01-01

Background Response rates for surveys of alcohol use are declining for all modes of administration (postal, telephone, face-to-face). Low response rates may result in estimates that are biased by selective non-response. We examined non-response bias in the NZ GENACIS survey, a postal survey of a random electoral roll sample, with a response rate of 49.5% (n = 1924). Our aim was to estimate the magnitude of non-response bias in estimating the prevalence of current drinking and heavy episodic (binge) drinking. Methods We used the “continuum of resistance” model to guide the investigation. In this model the likelihood of response by sample members is related to the amount of effort required from the researchers to elicit a response. First, the demographic characteristics of respondents and non-respondents were compared. Second, respondents who returned their questionnaire before the first reminder (early), before the second reminder (intermediate) or after the second reminder (late) were compared by demographic characteristics, 12-month prevalence of drinking and prevalence of binge drinking. Results Demographic characteristics and prevalence of binge drinking were significantly different between late respondents and early/intermediate respondents, with the demographics of early and intermediate respondents being similar to people who refused to participate while late respondents were similar to all other non-respondents. Assuming non-respondents who did not actively refuse to participate had the same drinking patterns as late respondents, the prevalence of binge drinking amongst current drinkers was underestimated. Adjusting the prevalence of binge drinkers amongst current drinkers using population weights showed that this method of adjustment still resulted in an underestimate of the prevalence. Conclusions The findings suggest non-respondents who did not actively refuse to participate are likely to have similar or more extreme drinking behaviours than late respondents, and that surveys of health compromising behaviours such as alcohol use are likely to underestimate the prevalence of these behaviours. PMID:22532858

Genetically determined high activity of IL-12 and IL-18 in ulcerative colitis and TLR5 in Crohns disease were associated with non-response to anti-TNF therapy.

PubMed

Bank, S; Andersen, P S; Burisch, J; Pedersen, N; Roug, S; Galsgaard, J; Turino, S Y; Brodersen, J B; Rashid, S; Rasmussen, B K; Avlund, S; Olesen, T B; Hoffmann, H J; Nexø, B A; Sode, J; Vogel, U; Andersen, V

2018-01-01

Anti-tumour necrosis factor-α (TNF-α) is used for treatment of severe cases of inflammatory bowel diseases (IBD), including Crohn's disease (CD) and ulcerative colitis (UC). However, one-third of the patients do not respond to the treatment. A recent study indicated that genetically determined high activity of pro-inflammatory cytokines, including interleukin-1β (IL-1β), IL-6 and interferon gamma (IFN-γ), are associated with non-response to anti-TNF therapy. Using a candidate gene approach, 21 functional single-nucleotide polymorphisms (SNPs) in 14 genes in the Toll-like receptors, the inflammasome and the IFNG pathways were assessed in 482 and 256 prior anti-TNF naïve Danish patients with CD and UC, respectively. The results were analysed using logistic regression (adjusted for age and gender). Eight functional SNPs were associated with anti-TNF response either among patients with CD (TLR5 (rs5744174) and IFNGR2 (rs8126756)), UC (IL12B (rs3212217), IL18 (rs1946518), IFNGR1 (rs2234711), TBX21 (rs17250932) and JAK2 (rs12343867)) or in the combined cohort of patient with CD and UC (IBD) (NLRP3 (rs10754558), IL12B (rs3212217) and IFNGR1 (rs2234711)) (P<0.05). Only the association with heterozygous genotype of IL12B (rs3212217) (OR: 0.24, 95% CI: 0.11-0.53, P=0.008) among patients with UC withstood Bonferroni correction for multiple testing. In conclusion, Our results suggest that SNPs associated with genetically determined high activity of TLR5 among patients with CD and genetically determined high IL-12 and IL-18 levels among patients with UC were associated with non-response. Further studies will evaluate whether these genes may help stratifying patients according to the expected response to anti-TNF treatment.

Evaluating telephone follow-up of a mail survey of community pharmacies.

PubMed

Westrick, Salisa C; Mount, Jeanine K

2007-06-01

Mail and telephone are commonly used modes of survey with pharmacists. Research conducted using general population surveys consistently describes mail surveys as being less expensive but yielding lower response rates than telephone surveys. However, findings obtained from the general population may not be generalizable to pharmacist surveys. This study evaluates the effectiveness of telephone follow-up of mail survey nonrespondents by comparing the 2 survey modes on response rates, cooperation rates, cost per sample unit, and cost per usable response and evaluating potential nonresponse bias in the context of immunization activities. A census mail survey of 1,143 Washington State community pharmacies and a follow-up telephone survey of 262 randomly selected mail survey nonrespondents were compared. Both surveys included the same 15 yes/no-type questions to ask respondents about their pharmacy's involvement in immunization activities. The mail survey yielded a response rate 1 of 26.7% and a cooperation rate 1 of 26.7%, compared with 83.6% and 87.8%, respectively, for the follow-up telephone survey. With respect to cost per sample unit, the mail survey was the least expensive option ($1.20). However, when comparing cost per usable response, the mail survey was the most expensive ($4.37), and the follow-up telephone survey without an advance notification was the least expensive ($1.99). Furthermore, results suggest the presence of nonresponse bias: compared with pharmacies participating in the follow-up telephone survey, pharmacies participating in the mail survey were more likely to be involved in in-house immunization services but less likely to be involved in outsourced services. The telephone survey achieved higher outcome rates with reduced cost per usable response. A telephone survey is a viable mode that holds promise in pharmacy practice research. Maximizing response rates and assessing potential nonresponse bias should be a standard practice among pharmacy practice researchers. More methodology research specific to pharmacist surveys is needed.

Maternal symptoms of stress, depression, and anxiety are related to nonresponsive feeding styles in a statewide sample of WIC participants.

PubMed

Hurley, Kristen M; Black, Maureen M; Papas, Mia A; Caulfield, Laura E; Caufield, Laura E

2008-04-01

Parenting, including nonresponsive feeding styles, has been related to under- or overweight among young children. The relationship between maternal mental health and feeding styles has not been examined. We hypothesized that mothers who report more symptoms of stress, depression, or anxiety report less responsive (e.g. more controlling, indulgent, and uninvolved) feeding styles than mothers who report fewer symptoms of stress, depression, or anxiety. Our analyses included 702 mother-infant pairs from a statewide sample of Special Supplemental Nutrition Program for Women, Infants, and Children mothers. We assessed maternal mental health and feeding styles by a telephone survey. After adjusting for potential confounding variables, maternal stress symptomatology was significantly associated with forceful (beta = 0.03; 95% CI = 0.02, 0.05) and uninvolved (OR = 1.4; 95% CI = 1.1, 1.7) feeding style scores, maternal depression symptomatology was significantly associated with forceful (beta = 0.03; 95% CI = 0.004, 0.05), indulgent (beta = 0.03; 95% CI = 0.004, 0.06), and uninvolved (OR = 1.5; 95% CI = 1.001, 2.2) feeding styles scores, and maternal anxiety symptomatology was significantly related to restrictive (beta = 0.11; 95% CI = 0.01, 0.21), forceful (beta = 0.04; 95% CI = 0.02, 0.06), and uninvolved (OR = 1.4; 95% CI = 1.01, 1.9) feeding style scores. Among mothers who perceived their infant as temperamentally fussy, there was a significant positive relationship between restrictive feeding styles scores and 3 indices of maternal mental health (stress, beta = 0.18; 95% CI = 0.07, 0.28; depression, beta = 0.21; 95% CI = 0.04, 0.38; and cumulative mental health symptomatology, beta = 0.29; 95% CI = 0.10, 0.48). Mothers who report stress, depression, or anxiety symptoms are at risk for nonresponsive feeding styles. These findings provide support for broadening the focus of existing child nutrition programs to include strategies that recognize how issues of maternal mental health can affect feeding styles.

Nonparametric Bayesian Multiple Imputation for Incomplete Categorical Variables in Large-Scale Assessment Surveys

ERIC Educational Resources Information Center

Si, Yajuan; Reiter, Jerome P.

2013-01-01

In many surveys, the data comprise a large number of categorical variables that suffer from item nonresponse. Standard methods for multiple imputation, like log-linear models or sequential regression imputation, can fail to capture complex dependencies and can be difficult to implement effectively in high dimensions. We present a fully Bayesian,…

Lathosterol to cholesterol ratio in serum predicts cholesterol lowering response to plant sterol consumption in a dual center, randomized, single-blind placebo controlled trial

USDA-ARS?s Scientific Manuscript database

Benefits of plant sterols (PS) for cholesterol lowering are compromised by large variability in efficacy across individuals. High fractional cholesterol synthesis measured by deuterium incorporation has been associated with non-response to PS consumption; however, prospective studies showing this as...

Response problems in a vacation panel study

Treesearch

Christine A. Vogt; Susan I. Stewart

2001-01-01

This paper investigates response problems encountered in a panel study of travel behavior. Though the overall response rate to the three-wave panel study was acceptable (over 60%), three types of response problems were encountered: refusal, non-response, and attrition. In a follow-up phone survey, a sample of individuals from each problem response group was questioned...

Age-Related Differences in the Involvement of the Prefrontal Cortex in Attentional Control

ERIC Educational Resources Information Center

Prakash, Ruchika Shaurya; Erickson, Kirk I.; Colcombe, Stanley J.; Kim, Jennifer S.; Voss, Michelle W.; Kramer, Arthur F.

2009-01-01

We investigated the relative involvement of cortical regions supporting attentional control in older and younger adults during performance on a modified version of the Stroop task. Participants were exposed to two different types of incongruent trials. One of these, an incongruent-ineligible condition, produces conflict at the non-response level,…

Preventing Bandwidth Abuse at the Router through Sending Rate Estimate-based Active Queue Management

DTIC Science & Technology

2007-06-01

behavior is growing in the Internet. These non-responsive sources can monopolize network bandwidth and starve the “congestion friendly” flows. Without...unnecessarily complex because most of the flows in the Internet are short flows usually termed as “web mice ” [7]. Moreover, having a separate queue for each

Assessing the Presence of Lexical Competition across Languages: Evidence from the Stroop Task

ERIC Educational Resources Information Center

Costa, Albert; Albareda, Barbara; Santesteban, Mikel

2008-01-01

Do the lexical representations of the non-response language enter into lexical competition during speech production? This issue has been studied by means of the picture-word interference paradigm in which two paradoxical effects have been observed. The so-called CROSS-LANGUAGE IDENTITY EFFECT (Costa, Miozzo and Caramazza, 1999) has been taken as…

Another Look at Cross-Language Competition in Bilingual Speech Production: Lexical and Phonological Factors

ERIC Educational Resources Information Center

Costa, Albert; Colome, Angels; Gomez, Olga; Sebastian-Galles, Nuria

2003-01-01

How does lexical selection function in highly-proficient bilingual speakers? What is the role of the non-response language during the course of lexicalization? Evidence of cross-language interference was obtained by Hermans, Bongaerts, De Bot and Schreuder (1998) using the picture-word interference paradigm: participants took longer to name the…

Combining Tier 2 and Tier 3 Supports for Students with Disabilities in General Education Settings

ERIC Educational Resources Information Center

MacLeod, K. Sandra; Hawken, Leanne S.; O'Neill, Robert E.; Bundock, Kaitlin

2016-01-01

Secondary level or Tier 2 interventions such as the Check-in Check-out (CICO) intervention effectively reduce problem behaviors of students who are non-responsive to school-wide interventions. However, some students will not be successful with Tier 2 interventions. This study investigated the effects of adding individualized function-based support…

Molecular insight into the differential anti-androgenic activity of resveratrol and its natural analogs: In Silico approach to understand biological actions

USDA-ARS?s Scientific Manuscript database

The androgen receptor (AR) is a therapeutic target for the treatment of prostate cancer. Androgen receptor reactivation during the androgen-independent stage of prostate cancer is mediated by numerous mechanisms including expression of AR mutants and splice variants that become non-responsive to con...

The Evolution of "Enhanced" Cognitive Behavior Therapy for Eating Disorders: Learning from Treatment Nonresponse

ERIC Educational Resources Information Center

Cooper, Zafra; Fairburn, Christopher G.

2011-01-01

In recent years there has been widespread acceptance that cognitive behavior therapy (CBT) is the treatment of choice for bulimia nervosa. The cognitive behavioral treatment of bulimia nervosa (CBT-BN) was first described in 1981. Over the past decades the theory and treatment have evolved in response to a variety of challenges. The treatment has…

Comparing Two Survey Research Approaches: E-Mail and Web-Based Technology versus Traditional Mail.

ERIC Educational Resources Information Center

Howes, Colleen M.; Mailloux, Mark R.

2001-01-01

Contrasted two survey methodologies: e-mail-Web and traditional mail. Found that: (1) e-mail-Web respondents were proportionately more likely to be male and enrolled in school full-time; (2) more individual question non-response was present for the e-mail-Web sample; and (3) e-mail-Web respondents value different aspects of graduate school. (EV)

Treatment of Nonresponse Items on Scale Validation: What "Don't Know" Responses Indicate about College Readiness

ERIC Educational Resources Information Center

Lombardi, Allison; Seburn, Mary; Conley, David

2011-01-01

In this study, Don't Know/Not Applicable (DK/NA) responses on a measure of academic behaviors associated with college readiness for high school students were treated with: (a) casewise deletion, (b) scale inclusion at the lowest level, and (c) imputation using E/M algorithm. Significant differences in mean responses according to treatment…

Teaching Experientially with the Madeline Hunter Method: An Application in a Marketing Research Course

ERIC Educational Resources Information Center

Burns, Alvin C.

2006-01-01

Due to concerns about the disparity of learning and the high nonresponse rates encountered by student marketing research teams working with sponsors, the author adopted the Hunter Method to restructure his course. This method requires the use of a model onto which students can map their learning via guided practice as well as independent practice.…

Adequacy of Reporting Results of School Surveys and Nonresponse Effects: A Review of the Literature and a Case Study

ERIC Educational Resources Information Center

Kano, Megumi; Franke, Todd; Afifi, Abdelmonem A.; Bourque, Linda B.

2008-01-01

To ensure accurate interpretation of research findings, researchers should report details about their research design, data collection method, and response rates when presenting findings from survey research. A review of 100 peer-reviewed articles reporting the results of survey research on K-12 schools with principals as the designated…

Why Don't They Respond? An Investigation of Longitudinal Survey Nonresponse among College Students Attending Four-Year Institutions

ERIC Educational Resources Information Center

Sharkness, Jessica Ann

2012-01-01

Over the past few decades, college student survey response rates have been declining. This is a problematic trend because student survey data are used extensively in endeavors such as accreditation, institutional improvement, and scholarly research. While low survey response rates are not necessarily a problem, they will be if they impact the…

Sample Selectivity and the Validity of International Student Achievement Tests in Economic Research. NBER Working Paper No. 15867

ERIC Educational Resources Information Center

Hanushek, Eric A.; Woessmann, Ludger

2010-01-01

Critics of international student comparisons argue that results may be influenced by differences in the extent to which countries adequately sample their entire student populations. In this research note, we show that larger exclusion and non-response rates are related to better country average scores on international tests, as are larger…

Affects of road sign wording on visitor survey - non-response bias

Treesearch

Susan M. Kocis; Stanley J. Zarnoch; Donald B.K. English

2004-01-01

On-site visitor interviewer data collection is a key component of the USDA Forest Service National Visitor Use Monitoring (NVUM) program. In many areas, especially higher speed roads and roads with non-recreation traffic, many vehicles may not stop for an interview. Wording on the sign may condition non-recreation visitors to self-select as to whether or not they...

Constraints of nonresponding flows based on cross layers in the networks

NASA Astrophysics Data System (ADS)

Zhou, Zhi-Chao; Xiao, Yang; Wang, Dong

2016-02-01

In the active queue management (AQM) scheme, core routers cannot manage and constrain user datagram protocol (UDP) data flows by the sliding window control mechanism in the transport layer due to the nonresponsive nature of such traffic flows. However, the UDP traffics occupy a large part of the network service nowadays which brings a great challenge to the stability of the more and more complex networks. To solve the uncontrollable problem, this paper proposes a cross layers random early detection (CLRED) scheme, which can control the nonresponding UDP-like flows rate effectively when congestion occurs in the access point (AP). The CLRED makes use of the MAC frame acknowledgement (ACK) transmitting congestion information to the sources nodes and utilizes the back-off windows of the MAC layer throttling data rate. Consequently, the UDP-like flows data rate can be restrained timely by the sources nodes in order to alleviate congestion in the complex networks. The proposed CLRED can constrain the nonresponsive flows availably and make the communication expedite, so that the network can sustain stable. The simulation results of network simulator-2 (NS2) verify the proposed CLRED scheme.

Sex, college major, and attribution of responsibility in empathic responding to persons with HIV infection.

PubMed

Bécares, Laia; Turner, Castellano

2004-10-01

This investigation studied the influence of sex, college major, and attributed responsibility on college students' empathic responding towards persons infected with HIV. We hypothesized that (1) women would score higher on empathy than men; (2) nursing and psychology majors would score higher on empathy than business and computer science majors; and (3) participants would score higher on empathy towards a target who contracted HIV through blood transfusion (presented as a Nonresponsible target) rather than through unprotected sex (presented as a Responsible target). Two hundred and fifty-eight undergraduate students (110 male, 148 female) attending a large urban university in the northeast filled out an anonymous demographic questionnaire, the Interpersonal Reactivity Index of Davis (1983), and an Empathy Reaction Scale that was developed by the authors. Results indicated a higher mean Empathy Reaction score from nursing and psychology students as compared to business and computer science students. There was no difference in Empathy Reaction scores between men and women. A higher Empathy Reaction score was found among participants who had read a diary from the target portrayed as Nonresponsible, as opposed to those who read a diary from the target portrayed as Responsible.

Enhanced CDC of B cell chronic lymphocytic leukemia cells mediated by rituximab combined with a novel anti-complement factor H antibody.

PubMed

Winkler, Mark T; Bushey, Ryan T; Gottlin, Elizabeth B; Campa, Michael J; Guadalupe, Eross S; Volkheimer, Alicia D; Weinberg, J Brice; Patz, Edward F

2017-01-01

Rituximab therapy for B cell chronic lymphocytic leukemia (B-CLL) has met with mixed success. Among several factors to which resistance can be attributed is failure to activate complement dependent cytotoxicity (CDC) due to protective complement regulatory proteins, including the soluble regulator complement factor H (CFH). We hypothesized that rituximab killing of non-responsive B-CLL cells could be augmented by a novel human monoclonal antibody against CFH. The B cells from 11 patients with B-CLL were tested ex vivo in CDC assays with combinations of CFH monoclonal antibody, rituximab, and a negative control antibody. CDC of rituximab non-responsive malignant B cells from CLL patients could in some cases be augmented by the CFH monoclonal antibody. Antibody-mediated cytotoxicity of cells was dependent upon functional complement. In one case where B-CLL cells were refractory to CDC by the combination of rituximab plus CFH monoclonal antibody, additionally neutralizing the membrane complement regulatory protein CD59 allowed CDC to occur. Inhibiting CDC regulatory proteins such as CFH holds promise for overcoming resistance to rituximab therapy in B-CLL.

A Systematic Review of Responsive Feeding and Child Obesity in High-Income Countries123

PubMed Central

Hurley, Kristen M.; Cross, Matthew B.; Hughes, Sheryl O.

2011-01-01

Child overweight/obesity continues to be a serious public health problem in high-income countries. The current review had 3 goals: 1) to summarize the associations between responsive feeding and child weight status in high-income countries; 2) to describe existing responsive feeding measures; and 3) to generate suggestions for future research. Articles were obtained from PubMed and PsycInfo using specified search criteria. The majority (24/31) of articles reported significant associations between nonresponsive feeding and child weight-for-height Z-score, BMI Z-score, overweight/obesity, or adiposity. Most studies identified were conducted exclusively in the United States (n = 22), were cross-sectional (n = 25), and used self-report feeding questionnaires (n = 28). A recent trend exists toward conducting research among younger children (i.e. infants and toddlers) and low-income and/or minority populations. Although current evidence suggests that nonresponsive feeding is associated with child BMI or overweight/obesity, more research is needed to understand causality, the reliability and validity between and within existing feeding measures, and to test the efficacy of responsive feeding interventions in the prevention and treatment of child overweight/obesity in high-income countries. PMID:21270360

Community-acquired pneumonia: identification and evaluation of nonresponders.

PubMed

Gonçalves-Pereira, João; Conceição, Catarina; Póvoa, Pedro

2013-02-01

Community acquired pneumonia (CAP) is a relevant public health problem, constituting an important cause of morbidity and mortality. It accounts for a significant number of adult hospital admissions and a large number of those patients ultimately die, especially the population who needed mechanical ventilation or vasopressor support. Thus, early identification of CAP patients and its rapid and appropriate treatment are important features with impact on hospital resource consumption and overall mortality. Although CAP diagnosis may sometimes be straightforward, the diagnostic criteria commonly used are highly sensitive but largely unspecific. Biomarkers and microbiological documentation may be useful but have important limitations. Evaluation of clinical response is also critical especially to identify patients who fail to respond to initial treatment since these patients have a high risk of in-hospital death. However, the criteria of definition of non-response in CAP are largely empirical and frequently markedly diverse between different studies. In this review, we aim to identify criteria defining nonresponse in CAP and the pitfalls associated with this diagnosis. We also aim to overview the main causes of treatment failure especially in severe CAP and the possible strategies to identify and reassess non-responders trying to change the dismal prognosis associated with this condition.

Effect of questionnaire length, personalisation and reminder type on response rate to a complex postal survey: randomised controlled trial

PubMed Central

2011-01-01

Background Minimising participant non-response in postal surveys helps to maximise the generalisability of the inferences made from the data collected. The aim of this study was to examine the effect of questionnaire length, personalisation and reminder type on postal survey response rate and quality and to compare the cost-effectiveness of the alternative survey strategies. Methods In a pilot study for a population study of travel behaviour, physical activity and the environment, 1000 participants sampled from the UK edited electoral register were randomly allocated using a 2 × 2 factorial design to receive one of four survey packs: a personally addressed long (24 page) questionnaire pack, a personally addressed short (15 page) questionnaire pack, a non-personally addressed long questionnaire pack or a non-personally addressed short questionnaire pack. Those who did not return a questionnaire were stratified by initial randomisation group and further randomised to receive either a full reminder pack or a reminder postcard. The effects of the survey design factors on response were examined using multivariate logistic regression. Results An overall response rate of 17% was achieved. Participants who received the short version of the questionnaire were more likely to respond (OR = 1.48, 95% CI 1.06 to 2.07). In those participants who received a reminder, personalisation of the survey pack and reminder also increased the odds of response (OR = 1.44, 95% CI 1.01 to 1.95). Item non-response was relatively low, but was significantly higher in the long questionnaire than the short (9.8% vs 5.8%; p = .04). The cost per additional usable questionnaire returned of issuing the reminder packs was £23.1 compared with £11.3 for the reminder postcards. Conclusions In contrast to some previous studies of shorter questionnaires, this trial found that shortening a relatively lengthy questionnaire significantly increased the response. Researchers should consider the trade off between the value of additional questions and a larger sample. If low response rates are expected, personalisation may be an important strategy to apply. Sending a full reminder pack to non-respondents appears a worthwhile, albeit more costly, strategy. PMID:21548947

A Comparison of Web and Telephone Responses From a National HIV and AIDS Survey

PubMed Central

Calzavara, Liviana; Allman, Dan; Worthington, Catherine A; Tyndall, Mark; Iveniuk, James

2016-01-01

Background Response differences to survey questions are known to exist for different modes of questionnaire completion. Previous research has shown that response differences by mode are larger for sensitive and complicated questions. However, it is unknown what effect completion mode may have on HIV and AIDS survey research, which addresses particularly sensitive and stigmatized health issues. Objectives We seek to compare responses between self-selected Web and telephone respondents in terms of social desirability and item nonresponse in a national HIV and AIDS survey. Methods A survey of 2085 people in Canada aged 18 years and older was conducted to explore public knowledge, attitudes, and behaviors around HIV and AIDS in May 2011. Participants were recruited using random-digit dialing and could select to be interviewed on the telephone or self-complete through the Internet. For this paper, 15 questions considered to be either sensitive, stigma-related, or less-sensitive in nature were assessed to estimate associations between responses and mode of completion. Multivariate regression analyses were conducted for questions with significant (P≤.05) bivariate differences in responses to adjust for sociodemographic factors. As survey mode was not randomly assigned, we created a propensity score variable and included it in our multivariate models to control for mode selection bias. Results A total of 81% of participants completed the questionnaire through the Internet, and 19% completed by telephone. Telephone respondents were older, reported less education, had lower incomes, and were more likely from the province of Quebec. Overall, 2 of 13 questions assessed for social desirability and 3 of 15 questions assessed for item nonresponse were significantly associated with choice of mode in the multivariate analysis. For social desirability, Web respondents were more likely than telephone respondents to report more than 1 sexual partner in the past year (fully adjusted odds ratio (OR)=3.65, 95% CI 1.80-7.42) and more likely to have donated to charity in the past year (OR=1.63, 95% CI 1.15-2.29). For item nonresponse, Web respondents were more likely than telephone respondents to have a missing or “don’t know” response when asked about: the disease they were most concerned about (OR=3.02, 95% CI 1.67-5.47); if they had ever been tested for HIV (OR=8.04, 95% CI 2.46-26.31); and when rating their level of comfort with shopping at grocery store if the owner was known to have HIV or AIDS (OR=3.11, 95% CI 1.47-6.63). Conclusion Sociodemographic differences existed between Web and telephone respondents, but for 23 of 28 questions considered in our analysis, there were no significant differences in responses by mode. For surveys with very sensitive health content, such as HIV and AIDS, Web administration may be subject to less social desirability bias but may also have greater item nonresponse for certain questions. PMID:27473597

Effects of unconditional cash transfers on the outcome of treatment for severe acute malnutrition (SAM): a cluster-randomised trial in the Democratic Republic of the Congo.

PubMed

Grellety, Emmanuel; Babakazo, Pélagie; Bangana, Amina; Mwamba, Gustave; Lezama, Ines; Zagre, Noël Marie; Ategbo, Eric-Alain

2017-04-26

Cash transfer programs (CTPs) aim to strengthen financial security for vulnerable households. This potentially enables improvements in diet, hygiene, health service access and investment in food production or income generation. The effect of CTPs on the outcome of children already severely malnourished is not well delineated. The objective of this study was to test whether CTPs will improve the outcome of children treated for severe acute malnutrition (SAM) in the Democratic Republic of the Congo over 6 months. We conducted a cluster-randomised controlled trial in children with uncomplicated SAM who received treatment according to the national protocol and counselling with or without a cash supplement of US$40 monthly for 6 months. Analyses were by intention to treat. The hazard ratio of reaching full recovery from SAM was 35% higher in the intervention group than the control group (adjusted hazard ratio, 1.35, 95% confidence interval (CI) = 1.10 to 1.69, P = 0.007). The adjusted hazard ratios in the intervention group for relapse to moderate acute malnutrition (MAM) and SAM were 0.21 (95% CI = 0.11 to 0.41, P = 0.001) and 0.30 (95% CI = 0.16 to 0.58, P = 0.001) respectively. Non-response and defaulting were lower when the households received cash. All the nutritional outcomes in the intervention group were significantly better than those in the control group. After 6 months, 80% of cash-intervened children had re-gained their mid-upper arm circumference measurements and weight-for-height/length Z-scores and showed evidence of catch-up. Less than 40% of the control group had a fully successful outcome, with many deteriorating after discharge. There was a significant increase in diet diversity and food consumption scores for both groups from baseline; the increase was significantly greater in the intervention group than the control group. CTPs can increase recovery from SAM and decrease default, non-response and relapse rates during and following treatment. Household developmental support is critical in food insecure areas to maximise the efficiency of SAM treatment programs. ClinicalTrials.gov, NCT02460848 . Registered on 27 May 2015.

Disclosure of sexual assault experiences among undergraduate women at historically black colleges and universities (HBCUs).

PubMed

Lindquist, Christine H; Crosby, Carmen M; Barrick, Kelle; Krebs, Christopher P; Settles-Reaves, Beverlyn

2016-01-01

To document the sexual assault disclosure experiences of historically black college or university (HBCU) students. A total of 3,951 female, undergraduate students at 4 HBCUs. All women at the participating schools were recruited in November 2008 to participate in a Web-based survey including both closed- and open-ended questions. Survey data were weighted for nonresponse bias. The majority of sexual assault survivors disclosed their experience to someone close to them, but disclosure to formal supports, particularly law enforcement agencies, was extremely rare. Nonreporters had concerns about the seriousness of the incident and their privacy. On the basis of qualitative data, strategies identified by students to increase reporting included more education and awareness about sexual assault, more survivor services and alternative mechanisms for reporting, and better strategies for protecting the confidentiality of survivors. Official sexual assault victimization data are of limited utility in conveying the extent of sexual assault among HBCU students, and efforts to increase reporting, such as peer education and enhanced confidentiality procedures, are needed.

An Assessment of Nonresponse Bias in Mail Surveys of Naval Personnel

DTIC Science & Technology

1976-02-01

Hollowell, Ida Harloff, and Marge Covher. Special thanks are due to Jim Herbert who spent many hours keep- ing track of cases, tabulating, and...volunteering for psychological experiments has revealed that the type of experiment (Martin & Marcuse , 1958), the alterna- tives to participating...M., & Marcuse , F. L. Characteristics of volunteers and nonvol- unteers in psychological experimentation. Journal of Consulting Psychology, 1958

The Vacuous Rhetoric of Diversity: Exploring How Institutional Responses to National Racial Incidences Effect Faculty of Color Perceptions of University Commitment to Diversity

ERIC Educational Resources Information Center

Squire, Dian

2017-01-01

Recent news cycles have illuminated the disparate, racialized experiences of Black people in the United States but university leadership responses have been reactionary, or worse non-responsive. This study examines how university responses to national racial incidences such as the police brutality affect how faculty of color in one discipline…

Making every word count for nonresponsive patients.

PubMed

Naci, Lorina; Owen, Adrian M

2013-10-01

Despite the apparent absence of external signs of consciousness, a significant small proportion of patients with disorders of consciousness can respond to commands by willfully modulating their brain activity, even respond to yes or no questions, by performing mental imagery tasks. However, little is known about the mental life of such responsive patients, for example, with regard to whether they can have coherent thoughts or selectively maintain attention to specific events in their environment. The ability to selectively pay attention would provide evidence of a patient's preserved cognition and a method for brain-based communication, thus far untested with functional magnetic resonance imaging in this patient group. To test whether selective auditory attention can be used to detect conscious awareness and communicate with behaviorally nonresponsive patients. Case study performed in 3 patients with severe brain injury, 2 diagnosed as being in a minimally conscious state and 1 as being in a vegetative state. The patients constituted a convenience sample. Functional magnetic resonance imaging data were acquired as the patients were asked to selectively attend to auditory stimuli, thereby conveying their ability to follow commands and communicate. All patients demonstrated command following according to instructions. Two patients (1 in a minimally conscious state and 1 in a vegetative state) were also able to guide their attention to repeatedly communicate correct answers to binary (yes or no) questions. To our knowledge, we show for the first time with functional magnetic resonance imaging that behaviorally nonresponsive patients can use selective auditory attention to convey their ability to follow commands and communicate. One patient in a minimally conscious state was able to use attention to establish functional communication in the scanner, despite his inability to produce any communication responses in repeated bedside examinations. More important, 1 patient, who had been in a vegetative state for 12 years before the scanning and subsequent to it, was able to use attention to correctly communicate answers to several binary questions. The technique may be useful in establishing basic communication with patients who appear unresponsive to bedside examinations and cannot respond with existing neuroimaging methods.

Interindividual responses to different exercise stimuli among insulin-resistant women.

PubMed

Álvarez, C; Ramírez-Vélez, R; Ramírez-Campillo, R; Ito, S; Celis-Morales, C; García-Hermoso, A; Rodriguez-Mañas, L; Lucia, A; Izquierdo, M

2018-05-11

We aimed to investigate which among 20 cardiometabolic and performance outcomes do and do not respond to high-intensity interval training (HIT), resistance training (RT), or concurrent training (CT) in insulin-resistant adult women. A secondary aim was to report the training-induced changes and the prevalence of non-responders. Forty-five insulin-resistant adult women were randomly assigned to one of the following 4 groups: HIT (39.2 ± 9.5 years [y]; body mass index [BMI], 29.3 ± 3.3; n = 14), RT (33.9 ± 9.3 y; BMI, 29.4 ± 5.5; n = 8), CT (43.3 ± 8.1 y; BMI, 29.1 ± 2.9; n = 10), and a control group (CG, 40.1 ± 11.4 y; BMI, 28.3 ± 3.5; n = 13). Nine body composition, 3 cardiovascular, 3 metabolic, and 5 performance outcomes were assessed at baseline and after 12 weeks of intervention. Considering all outcomes, the lowest number of total non-responses for one or more variables was found in the RT group, followed by the CT and HIT groups. Individuals in the CG group were classified as non-responders for almost all the variables. Moreover, there were several significant changes in body composition and metabolic parameters, including fasting glucose (HIT: -5.7, RT -5.1 mg/d), fasting insulin (HIT: -0.6, RT -0.6 μIU/mL), and HOMA-IR (HIT: -0.3, RT -0.4), in addition to improvements in cardiovascular and performance parameters. Also, there were significant differences among groups in the prevalence of non-responders for the variables where a non-response was detected. Overall, the study suggests that independent of the mode of training including volume and frequency, RT has an important ability to reduce the prevalence of non-response to improve the 20 outcomes of health and performance in insulin-resistant adult women. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Investigation of Fat Metabolism during Antiobesity Interventions by Magnetic Resonance Imaging and Spectroscopy.

PubMed

Pola, Arunima; Sadananthan, Suresh Anand; Gopalan, Venkatesh; Tan, Min-Li Sandra; Keong, Terry Yew; Zhou, Zhihong; Ishino, Seigo; Nakano, Yoshihide; Watanabe, Masanori; Horiguchi, Takashi; Nishimoto, Tomoyuki; Zhu, Bin; Velan, S Sendhil

2014-01-01

The focus of current treatments for obesity is to reduce the body weight or visceral fat, which requires longer duration to show effect. In this study, we investigated the short-term changes in fat metabolism in liver, abdomen, and skeletal muscle during antiobesity interventions including Sibutra mine treatment and diet restriction in obese rats using magnetic resonance imaging, magnetic resonance spectroscopy, and blood chemistry. Sibutramine is an antiobesity drug that results in weight loss by increasing satiety and energy expenditure. The Sibutramine-treated rats showed reduction of liver fat and intramyocellular lipids on day 3. The triglycerides (TG) decreased on day 1 and 3 compared to baseline (day 0). The early response/nonresponse in different fat depots will permit optimization of treatment for better clinical outcome rather than staying with a drug for longer periods.

Electromagnetic fields in the treatment of chronic lower back pain in patients with degenerative disc disease

PubMed Central

Arneja, Amarjit S; Kotowich, Alan; Staley, Doug; Summers, Randy; Tappia, Paramjit S

2016-01-01

Aim: To examine the effects of low-amplitude, low frequency electromagnetic field therapy (EMF) therapy in patients with persistent chronic lower back pain associated with degenerative disc disease. Design: Double-blind, randomized and placebo controlled. Intervention: EMF using a medical device resonator; control group underwent same procedures, except the device was turned off. Outcome measures: Pain reduction and mobility. Results: Improvements in overall physical health, social functioning and reduction in bodily pain were observed in the EMF group. The pain relief rating scale showed a higher level of pain relief at the target area in the EMF group. An increase in left lateral mobility was seen only in the EMF group. Conclusion: EMF treatment may be of benefit to patients with chronic nonresponsive lower back pain associated with degenerative disc disease. PMID:28031951

IL1RN Variation Influences both Disease Susceptibility and Response to Human Recombinant IL-1RA Therapy in Systemic Juvenile Idiopathic Arthritis.

PubMed

Arthur, Victoria L; Shuldiner, Emily; Remmers, Elaine F; Hinks, Anne; Grom, Alexei A; Foell, Dirk; Martini, Alberto; Gattorno, Marco; Özen, Seza; Prahalad, Sampath; Zeft, Andrew S; Bohnsack, John F; Ilowite, Norman T; Mellins, Elizabeth D; Russo, Ricardo; Len, Claudio; Oliveira, Sheila; Yeung, Rae S M; Rosenberg, Alan M; Wedderburn, Lucy R; Anton, Jordi; Haas, Johannes-Peter; Rösen-Wolff, Angela; Minden, Kirsten; Szymanski, Ann Marie; Thomson, Wendy; Kastner, Daniel L; Woo, Patricia; Ombrello, Michael J

2018-04-02

To determine whether systemic juvenile idiopathic arthritis (sJIA) susceptibility loci identified by candidate gene studies demonstrated association with sJIA in the largest study population assembled to date. Single nucleotide polymorphisms (SNPs) from 11 previously reported sJIA risk loci were examined for association in 9 populations, including 770 sJIA cases and 6947 control subjects. The effect of sJIA-associated SNPs on gene expression was evaluated in silico in paired whole genome and RNA sequencing data from lymphoblastoid cell lines (LCL) of 373 European 1000 Genomes Project subjects. The relationship between sJIA-associated SNPs and response to anakinra treatment was evaluated in 38 US patients for whom treatment response data were available. We found no association of the 26 SNPs previously reported as sJIA-associated. Expanded analysis of the regions containing the 26 SNPs revealed only one significant association, the promoter region of IL1RN (p<1E-4). sJIA-associated SNPs correlated with IL1RN expression in LCLs, with an inverse correlation between sJIA risk and IL1RN expression. The presence of homozygous IL1RN high expression alleles correlated strongly with non-response to anakinra therapy (OR 28.7 [3.2, 255.8]). IL1RN was the only candidate locus associated with sJIA in our study. The implicated SNPs are among the strongest known determinants of IL1RN and IL1RA levels, linking low expression with increased sJIA risk. Homozygous high expression alleles predicted non-response to anakinra therapy, nominating them as candidate biomarkers to guide sJIA treatment. This is an important first step towards the personalized treatment of sJIA. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Nanomaterial-dependent immunoregulation of dendritic cells and its effects on biological activities of contraceptive nanovaccines.

PubMed

Xu, Pingping; Tang, Shuai; Jiang, Luping; Yang, Lihua; Zhang, Dinglin; Feng, Shibin; Zhao, Tingting; Dong, Yajun; He, Wei; Wang, Ruibing; Zhang, Jianxiang; Liang, Zhiqing

2016-03-10

Nanovehicles are promising delivery systems for various vaccines. Nevertheless, different biophysicochemical properties of nanoparticles (NPs), dominating their in vitro and in vivo performances for vaccination, remain unclear. We attempted to elucidate the effects of NPs and their pH-sensitivity on in vitro and in vivo efficacy of resulting prophylactic nanovaccines containing a contraceptive peptide (FSHR). To this end, pH-responsive and non-responsive nanovaccines were produced using acetalated β-cyclodextrin (Ac-bCD) and poly(lactic-co-glycolic acid) (PLGA), respectively. Meanwhile, FSHR derived from an epitope of the follicle-stimulating hormone receptor was used as the model antigen. FSHR-containing Ac-bCD and PLGA NPs were successfully prepared by a nanoemulsion technique, leading to well-shaped nanovaccines with high loading efficiency. The pH-sensitivity of Ac-bCD and PLGA nanovaccines was examined by in vitro hydrolysis and antigen release studies. Nanovaccines could be effectively engulfed by dendritic cells (DCs) via endocytosis in both dose and time dependent manners, and their intracellular trafficking was closely related to the pH-sensitivity of the carrier materials. Furthermore, nanovaccines could induce the secretion of inflammatory cytokines by DCs and T cells co-cultured with the stimulated DCs. In vivo evaluations demonstrated that nanovaccines were more potent than that based on the complete Freund's adjuvant, with respect to inducing anti-FSHR antibody, reducing the sperm count, inhibiting the sperm motility, and increasing the teratosperm rate. Immunization of male mice with nanovaccines notably decreased the parturition incidence of the mated females. Consequently, both in vitro and in vivo activities of FSHR could be considerably augmented by NPs. More importantly, our studies indicated that the pH-responsive nanovaccine was not superior over the non-responsive counterpart for the examined peptide antigen. Copyright © 2016 Elsevier B.V. All rights reserved.

The Pregnancy in Polycystic Ovary Syndrome II (PPCOS II) trial: rationale and design of a double-blind randomized trial of clomiphene citrate and letrozole for the treatment of infertility in women with polycystic ovary syndrome.

PubMed

Legro, Richard S; Kunselman, Allen R; Brzyski, Robert G; Casson, Peter R; Diamond, Michael P; Schlaff, William D; Christman, Gregory M; Coutifaris, Christos; Taylor, Hugh S; Eisenberg, Esther; Santoro, Nanette; Zhang, Heping

2012-05-01

Polycystic Ovary Syndrome (PCOS) is a common cause of female infertility and first line treatment is currently oral clomiphene citrate, a selective estrogen receptor modulator, which results in both a high nonresponse rate and multiple pregnancy rate. Aromatase inhibitors such as letrozole may have more favorable ovarian and endometrial effects. The goal of the Pregnancy in Polycystic Ovary Syndrome II (PPCOSII) study is to determine the safety and efficacy of clomiphene citrate (CC) compared to letrozole, in achieving live birth in infertile women with PCOS. The population will consist of 750 infertile women with PCOS. Additionally, the couple will have no other major infertility factor. This will be a multi-center, prospective, double-blind clinical trial of CC vs. letrozole for 5 treatment cycles (or approximately up to 25 weeks). The randomization scheme will be coordinated through the central data coordinating center (DCC) and the randomization is stratified by each participating site. After progestin withdrawal as needed, 750 women will be equally randomized to two different treatment arms: A) CC 50mg every day for 5 days (days 3-7 of cycle), or B) letrozole 2.5mg every day for 5 days (days 3-7 of cycle), for a total of 5 cycles or 25 weeks. The dose will be increased in subsequent cycles in both treatment groups for non-response or poor ovulatory response up to a maximum of 150 mg of CC a day (×5 days) or 7.5mg of letrozole a day (×5 days). The primary analysis will use an intent-to-treat approach to examine differences in the live birth rate in the two treatment arms. Copyright © 2012 Elsevier Inc. All rights reserved.

Gene expression profiling reveals activation of the FA/BRCA pathway in advanced squamous cervical cancer with intrinsic resistance and therapy failure.

PubMed

Balacescu, Ovidiu; Balacescu, Loredana; Tudoran, Oana; Todor, Nicolae; Rus, Meda; Buiga, Rares; Susman, Sergiu; Fetica, Bogdan; Pop, Laura; Maja, Laura; Visan, Simona; Ordeanu, Claudia; Berindan-Neagoe, Ioana; Nagy, Viorica

2014-04-08

Advanced squamous cervical cancer, one of the most commonly diagnosed cancers in women, still remains a major problem in oncology due to treatment failure and distant metastasis. Antitumor therapy failure is due to both intrinsic and acquired resistance; intrinsic resistance is often decisive for treatment response. In this study, we investigated the specific pathways and molecules responsible for baseline therapy failure in locally advanced squamous cervical cancer. Twenty-one patients with locally advanced squamous cell carcinoma were enrolled in this study. Primary biopsies harvested prior to therapy were analyzed for whole human gene expression (Agilent) based on the patient's 6 months clinical response. Ingenuity Pathway Analysis was used to investigate the altered molecular function and canonical pathways between the responding and non-responding patients. The microarray results were validated by qRT-PCR and immunohistochemistry. An additional set of 24 formalin-fixed paraffin-embedded cervical cancer samples was used for independent validation of the proteins of interest. A 2859-gene signature was identified to distinguish between responder and non-responder patients. 'DNA Replication, Recombination and Repair' represented one of the most important mechanisms activated in non-responsive cervical tumors, and the 'Role of BRCA1 in DNA Damage Response' was predicted to be the most significantly altered canonical pathway involved in intrinsic resistance (p = 1.86E-04, ratio = 0.262). Immunohistological staining confirmed increased expression of BRCA1, BRIP1, FANCD2 and RAD51 in non-responsive compared with responsive advanced squamous cervical cancer, both in the initial set of 21 cervical cancer samples and the second set of 24 samples. Our findings suggest that FA/BRCA pathway plays an important role in treatment failure in advanced cervical cancer. The assessment of FANCD2, RAD51, BRCA1 and BRIP1 nuclear proteins could provide important information about the patients at risk for treatment failure.

Comparative Effectiveness of Intravenous Immunoglobulin for Children with Kawasaki Disease: A Nationwide Cohort Study

PubMed Central

Lin, Ming-Chih; Fu, Yun-Ching; Jan, Sheng-Ling; Lai, Mei-Shu

2013-01-01

Introduction Different immunoglobulin manufacturing processes may influence its effectiveness for Kawasaki disease. However, nationwide studies with longitudinal follow-up are still lacking. The aim of this study was to evaluate the comparative effectiveness of immunoglobulin preparations from a nationwide perspective. Materials and Methods This is a nationwide retrospective cohort study with a new user design. Data came from the National Health Insurance Research Database of Taiwan. From 1997 to 2008, children under 2 years old who received immunoglobulin therapy for the first time under the main diagnosis of Kawasaki disease were enrolled. The manufacturing processes were divided into β-propiolactonation, acidification and those containing IgA. The endpoints were immunoglobulin non-responsiveness, acute aneurysm, prolonged use of anti-platelets or anti-coagulants, and recurrence. Results In total, 3830 children were enrolled. β-propiolactonation had a relative risk of 1.45 (95% CI 1.08∼1.94) of immunoglobulin non-responsiveness, however, the relative risks for acidification and containing IgA were non-significant. For acute aneurysms, acidification had a relative risk of 1.49 (95% CI 1.17∼1.90), however the relative risks for β-propiolactonation and containing IgA were non-significant. For prolonged use of anti-platelets or anti-coagulants, β-propiolactonation had a relative risk of 1.44 (95% CI 1.18∼1.76), and acidification protected against them both with a relative risk of 0.82 (95% CI 0.69∼0.97), whereas the relative risk for containing IgA was non-significant. For recurrence, all three factors were non-significant. Conclusions The effectiveness of immunoglobulin may differ among different manufacturing processes. β-propiolactonation had a higher risk of treatment failure and prolonged use of anti-platelets or anti-coagulants. Acidification may increase the risk of acute coronary aneurysms. PMID:23650564

THE PREGNANCY IN POLYCYSTIC OVARY SYNDROME II (PPCOS II) TRIAL: RATIONALE AND DESIGN OF A DOUBLE-BLIND RANDOMIZED TRIAL OF CLOMIPHENE CITRATE AND LETROZOLE FOR THE TREATMENT OF INFERTILITY IN WOMEN WITH POLYCYSTIC OVARY SYNDROME

PubMed Central

Legro, Richard S.; Kunselman, Allen R.; Brzyski, Robert G.; Casson, Peter R.; Diamond, Michael P.; Schlaff, William D.; Christman, Gregory M.; Coutifaris, Christos; Taylor, Hugh S.; Eisenberg, Esther; Santoro, Nanette; Zhang, Heping

2012-01-01

Polycystic Ovary Syndrome (PCOS) is a common cause of female infertility and first line treatment is currently oral clomiphene citrate, a selective estrogen receptor modulator, which results in both a high nonresponse rate and multiple pregnancy rate. Aromatase inhibitors such as letrozole may have more favorable ovarian and endometrial effects. The goal of the Pregnancy in Polycystic Ovary Syndrome II (PPCOSII) study is to determine the safety and efficacy of clomiphene citrate (CC) compared to letrozole, in achieving live birth in infertile women with PCOS. The population will consist of 750 infertile women with PCOS. Additionally, the couple will have no other major infertility factor. This will be a multi-center, prospective, double-blind clinical trial of CC vs. letrozole for 5 treatment cycles (or approximately up to 25 weeks). The randomization scheme will be coordinated through the central data coordinating center (DCC) and the randomization is stratified by each participating site. After progestin withdrawal as needed, 750 women will be equally randomized to two different treatment arms: A) CC 50 mg every day for 5 days (day 3–7 of cycle), or B) letrozole 2.5 mg every day for 5 days (day 3–7 of cycle), for a total of 5 cycles or 25 weeks. The dose will be increased in subsequent cycles in both treatment groups for non-response or poor ovulatory response up to a maximum of 150 mg of CC a day (× 5 days) or 7.5 mg of letrozole a day (× 5 days). The primary analysis will use an intent-to-treat approach to examine differences in the live birth rate in the two treatment arms. PMID:22265923

Biomarkers of Risk for Post-Traumatic Stress Disorder (PTSD)

DTIC Science & Technology

2010-05-01

Price, L.H., Carpenter, L.L., Alberto Del Porto, J. Depression and stress: is there an endophenotype? Revista Brasileira de Psiquiatria, 29 (Supl...insufficient power, and the lack of inclusion of subsequent diagnoses as well as lifetime diagnoses in these analyses. Further analyses will include...partial or nonresponse to antidepressants. Journal of Clinical Psychiatry, 66, 1234- 8, 2005. 16. Carpenter, L.L, Schecter, J.M., Tyrka, A.R., Feijo de

Multiple imputation: an application to income nonresponse in the National Survey on Recreation and the Environment

Treesearch

Stanley J. Zarnoch; H. Ken Cordell; Carter J. Betz; John C. Bergstrom

2010-01-01

Multiple imputation is used to create values for missing family income data in the National Survey on Recreation and the Environment. We present an overview of the survey and a description of the missingness pattern for family income and other key variables. We create a logistic model for the multiple imputation process and to impute data sets for family income. We...

Effective Use of Collaborative Information Technology to Enhance Group Performance

DTIC Science & Technology

2004-09-01

Estimating Nonresponse Bias in Mail Surveys,” Journal of Marketing Research , 19, (1976), pp. 396-402. Bandura, A., Self-efficacy: The exercise of...Marketing Constructs,” Journal of Marketing Research , 16, 1, (1979), pp. 64-73. Communication News, “Web Meetings Benefit Bottom Line,” Communication News...Efforts: Collaboration Processes in Buyer-Supplier Relationships,” Journal of Marketing Research , 36, (1999), 461-475. Jap, S. D., “Perspectives on

Representative Sampling: Follow-up of Spring 1972 and Spring 1973 Students. TEX-SIS FOLLOW-UP SC3.

ERIC Educational Resources Information Center

Wilkinson, Larry; And Others

This report presents the findings of a research study, conducted by the College of the Mainland (COM) as a subcontractor for Project FOLLOW-UP, designed to test the accuracy of random sampling and to measure non-response bias in mail surveys. In 1975, a computer-generated random sample of 500 students was drawn from a population of 1,256 students…

Rebuilding Government Legitimacy in Post-conflict Societies: Case Studies of Nepal and Afghanistan

DTIC Science & Technology

2015-09-09

administered via the verbal scales due to reduced time spent explaining the visual show cards. Statistical results corresponded with observations from...a three-step strategy for dealing with item non-response. First, basic descriptive statistics are calculated to determine the extent of item...descriptive statistics for all items in the survey), however this section of the report highlights just some of the findings. Thus, the results

Strategies to compensate for the effects of nonresponse on forest carbon baseline estimates from the national forest inventory of the United States

Treesearch

Grant M. Domke; Christopher W. Woodall; Brian F. Walters; Ronald E. McRoberts; Mark A. Hatfield

2014-01-01

Forest ecosystem carbon (C) stocks and stock change in the United States (US) have been documented using Intergovernmental Panel on Climate Change (IPCC) procedures and guidance with 1990 as a baseline reference for all United Nations Framework Convention on Climate Change reports. In the US, estimates of forest C stocks and stock change are obtained from data...

A clinician's perspective on memory reconsolidation as the primary basis for psychotherapeutic change in posttraumatic stress disorder (PTSD).

PubMed

Kimbrel, Nathan A; Meyer, Eric C; Beckham, Jean C

2015-01-01

Lane et al.'s proposal that psychotherapeutic change comes about through memory reconsolidation is compelling; however, the model would be strengthened by the inclusion of predictions regarding additional factors that might influence treatment response, predictions for improving outcomes for non-responsive patients, and a discussion of how the proposed model might explain individual differences in vulnerability for mental health problems.

Human Immune Response to Dengue Infections

DTIC Science & Technology

1989-07-31

antigens of all 4 serotypes. These CTL lysed autologous fibroblasts infected with vaccinia-dengue recombinant viruses containing the E, or several non...responses of PBMC from a dengue 4-immune donor to call-free dengue viruses . .. ........... 6 Table 2. Lysis of dengue virus-infected fibroblasts by dengue...4-immune PBMC stimulated with dengue viruses ... ...... 7 Table 3. Inhibition of the lysis of dengue- infected fibroblasts by monoclonal anti-CD8

Novel echocardiographic prediction of non-response to cardiac resynchronization therapy

NASA Astrophysics Data System (ADS)

Chan, R.; Tournoux, F.; Tournoux, A. C.; Nandigam, V.; Manzke, R.; Dalal, S.; Solis-Martin, J.; McCarty, D.; Ruskin, J. N.; Picard, M. H.; Weyman, A. E.; Singh, J. P.

2009-02-01

Imaging techniques try to identify patients who may respond to cardiac resynchronization therapy (CRT). However, it may be clinically more useful to identify patients for whom CRT would not be beneficial as the procedure would not be indicated for this group. We developed a novel, clinically feasible and technically-simple echocardiographic dyssynchrony index and tested its negative predictive value. Subjects with standard indications for CRT had echo preand post-device implantation. Atrial-ventricular dyssynchrony was defined as a left ventricular (LV) filling time of <40% of the cardiac cycle. Intra-ventricular dyssynchrony was quantified as the magnitude of LV apical rocking. The apical rocking was measured using tissue displacement estimates from echo data. In a 4-chamber view, a region of interest was positioned within the apical end of the middle segment within each wall. Tissue displacement curves were analyzed with custom software in MATLAB. Rocking was quantified as a percentage of the cardiac cycle over which the displacement curves showed discordant behavior and classified as non-significant for values <35%. Validation in 50 patients showed that absence of significant LV apical rocking or atrial-ventricular dyssynchrony was associated with non-response to CRT. This measure may therefore be useful in screening to avoid non-therapeutic CRT procedures.

Infant Responsiveness, Alertness, Hemoglobin and Growth in Rural Sidama, Ethiopia

PubMed Central

Aubuchon-Endsley, Nicki L.; Grant, Stephanie L.; Thomas, David G.; Kennedy, Tay S.; Berhanu, Getenesh; Stoecker, Barbara J.; Hubbs-Tait, Laura; Hambidge, K. Michael

2011-01-01

Several recent studies have supported relations between infant behavior (alertness and responsiveness) and nutrition (e.g. Dempsey 2008, Wachs et al 2005) in addition to investigating infant behavior within the context of changes in iron status over time (e.g. Black et al. 2004, Murray-Kolb & Beard 2009). Existing research is typically limited to investigation of the effects of a single vitamin or mineral and no studies have been found that examined the influence that early alertness and responsiveness have on growth in early infancy, despite the fact that relations between behavior and nutritional status may be bidirectional (Hulthén 2003). The current study used a sample of Ethiopian infants and investigated anthropometrics, hemoglobin, the frequency of alertness, and the frequency of responsiveness at 6 and 9 months of age. Six-month weight-for-age predicted 9-month frequency of alertness, while 6-month hemoglobin predicted 9-month frequency of responsiveness. Compared to responsive infants, non-responsive infants at 6 months remained more non-responsive at 9 months, though weight-for-age for both groups converged at 9 months. Results support relations between nutrition and behavior (alertness and responsiveness) and provide evidence of a potentially useful tool (the Laboratory Temperament Assessment Battery [Lab-TAB]) that was adapted to evaluate these relations in Ethiopia. PMID:22233352

Alkaline phosphatase: the next independent predictor of the poor 90-day outcome in alcoholic hepatitis.

PubMed

Kasztelan-Szczerbinska, Beata; Slomka, Maria; Celinski, Krzysztof; Szczerbinski, Mariusz

2013-01-01

Determination of risk factors relevant to 90-day prognosis in AH. Comparison of the conventional prognostic models such as Maddrey's modified discriminant function (mDF) and Child-Pugh-Turcotte (CPT) score with newer ones: the Glasgow Alcoholic Hepatitis Score (GAHS); Age, Bilirubin, INR, Creatinine (ABIC) score, Model for End-Stage Liver Disease (MELD), and MELD-Na in the death prediction. The clinical and laboratory variables obtained at admission were assessed. The mDF, CPT, GAHS, ABIC, MELD, and MELD-Na scores' different areas under the curve (AUCs) and the best threshold values were compared. Logistic regression was used to assess predictors of the 90-day outcome. One hundred sixteen pts fulfilled the inclusion criteria. Twenty (17.4%) pts died and one underwent orthotopic liver transplantation (OLT) within 90 days of follow-up. No statistically significant differences in the models' performances were found. Multivariate logistic regression identified CPT score, alkaline phosphatase (AP) level higher than 1.5 times the upper limit of normal (ULN), and corticosteroids (CS) nonresponse as independent predictors of mortality. The CPT score, AP > 1.5 ULN, and the CS nonresponse had an independent impact on the 90-day survival in AH. Accuracy of all studied scoring systems was comparable.

Cognitive Processing in Non-Communicative Patients: What Can Event-Related Potentials Tell Us?

PubMed Central

Lugo, Zulay R.; Quitadamo, Lucia R.; Bianchi, Luigi; Pellas, Fréderic; Veser, Sandra; Lesenfants, Damien; Real, Ruben G. L.; Herbert, Cornelia; Guger, Christoph; Kotchoubey, Boris; Mattia, Donatella; Kübler, Andrea; Laureys, Steven; Noirhomme, Quentin

2016-01-01

Event-related potentials (ERP) have been proposed to improve the differential diagnosis of non-responsive patients. We investigated the potential of the P300 as a reliable marker of conscious processing in patients with locked-in syndrome (LIS). Eleven chronic LIS patients and 10 healthy subjects (HS) listened to a complex-tone auditory oddball paradigm, first in a passive condition (listen to the sounds) and then in an active condition (counting the deviant tones). Seven out of nine HS displayed a P300 waveform in the passive condition and all in the active condition. HS showed statistically significant changes in peak and area amplitude between conditions. Three out of seven LIS patients showed the P3 waveform in the passive condition and five of seven in the active condition. No changes in peak amplitude and only a significant difference at one electrode in area amplitude were observed in this group between conditions. We conclude that, in spite of keeping full consciousness and intact or nearly intact cortical functions, compared to HS, LIS patients present less reliable results when testing with ERP, specifically in the passive condition. We thus strongly recommend applying ERP paradigms in an active condition when evaluating consciousness in non-responsive patients. PMID:27895567

Mealtime Structure and Responsive Feeding Practices Are Associated With Less Food Fussiness and More Food Enjoyment in Children.

PubMed

Finnane, Julia M; Jansen, Elena; Mallan, Kimberley M; Daniels, Lynne A

2017-01-01

To identify associations between structure-related and non-responsive feeding practices and children's eating behaviors. Cross-sectional online survey design. Parents (n = 413) of 1- to 10-year-old children. Parental feeding practices and child eating behaviors were measured via the validated Feeding Practices and Structure and Children's Eating Behaviour questionnaires. Associations between parental feeding practices and children's eating behaviors were tested using hierarchical multivariable linear regression models, adjusted for covariates. Feeding practices accounted for 28% and 21% of the variance in food fussiness and enjoyment of food, respectively (P < .001). For all other eating behaviors the amount of variance explained by feeding practices was < 10% (P < .001). Key findings were that more structure and less non-responsive practices were associated with lower food fussiness and higher enjoyment of food. Overall, the findings suggested that mealtime structure and responsive feeding are associated with more desirable eating behaviors. Contrary to predictions, there was no evidence to indicate that these practices are associated with better self-regulation of energy intake. Longitudinal research and intervention studies are needed to confirm the importance of these feeding practices for children's eating behaviors and weight outcomes. Copyright © 2016 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

A Nonresponse Bias Analysis of the Health Information National Trends Survey (HINTS).

PubMed

Maitland, Aaron; Lin, Amy; Cantor, David; Jones, Mike; Moser, Richard P; Hesse, Bradford W; Davis, Terisa; Blake, Kelly D

2017-07-01

We conducted a nonresponse bias analysis of the Health Information National Trends Survey (HINTS) 4, Cycles 1 and 3, collected in 2011 and 2013, respectively, using three analysis methods: comparison of response rates for subgroups, comparison of estimates with weighting adjustments and external benchmarks, and level-of-effort analysis. Areas with higher concentrations of low socioeconomic status, higher concentrations of young households, and higher concentrations of minority and Hispanic populations had lower response rates. Estimates of health information seeking behavior were higher in HINTS compared to the National Health Interview Survey (NHIS). The HINTS estimate of doctors always explaining things in a way that the patient understands was not significantly different from the same estimate from the Medical Expenditure Panel Survey (MEPS); however, the HINTS estimate of health professionals always spending enough time with the patient was significantly lower than the same estimate from MEPS. A level-of-effort analysis found that those who respond later in the survey field period were less likely to have looked for information about health in the past 12 months, but found only small differences between early and late respondents for the majority of estimates examined. There is some evidence that estimates from HINTS could be biased toward finding higher levels of health information seeking.

[Inpatient Treatment of Complex PTSD Following Childhood Abuse: Effectiveness and Predictors of Treatment Outcome].

PubMed

Kratzer, Leonhard; Heinz, Peter; Schennach, Rebecca; Schiepek, Günter Karl; Padberg, Frank; Jobst, Andrea

2018-05-30

There is a lack of studies investigating the effectiveness of inpatient trauma-focused psychotherapy of complex post-traumatic stress disorder. The first aim of this retrospective investigation was to analyze the course of PTSD. Second, possible predictors of treatment response were investigated. 150 inpatients of Clinic St. Irmingard with complex PTSD following childhood physical and childhood sexual abuse were assessed regarding childhood abuse, PTSD symptomatology, mindfulness, dissociation and general psychopathology. Differences in pre and post scores were analyzed using regression analyses. A classification tree was used to identify predictors of response. The significant reduction of PTSD symptoms corresponded to a large effect (d=1.8) and a reponse rate of 52% according to the reliable change index (p<0.05). Effect sizes for other symptoms were medium to large (0.5

The effect of perceived racial discrimination on bodily pain among older African American men.

PubMed

Burgess, Diana J; Grill, Joseph; Noorbaloochi, Siamak; Griffin, Joan M; Ricards, Jennifer; van Ryn, Michelle; Partin, Melissa R

2009-11-01

We examined the extent to which experiences of racial discrimination are associated with bodily pain reported by African American men. The study sample consisted of 393 African American male veterans who responded to a national survey of patients aged 50-75 who received care from the Veterans Health Administration (VHA). Veterans were surveyed by mail, with a telephone follow-up. The response rate for African Americans in the sample was 60.5%. Pain (assessed using the bodily pain subscale of the 36-item short-form health survey), experiences of discrimination, employment, education, and income were obtained through the survey. Age, race, and mental health comorbidities were obtained from VA administrative data. Multiple regression analysis adjusting for item non-response (via imputation) and unit non-response (via propensity scores and weighting) was used to assess the association between racial discrimination and likelihood of experiencing moderate or severe pain over the past 4 weeks. Experiences of racial discrimination were associated with greater bodily pain (beta = -0.25, P < 0.0001), even after controlling for socioeconomic and health-related characteristics. Perceived racial discrimination was associated with greater pain among a sample of older African American male patients in the VA. Additional research is needed to replicate this finding among other populations of African Americans.

Respiratory Morbidity among Rice Mill Workers in an Urban Area of Burdwan District, West Bengal: A Cross-sectional Study.

PubMed

Rana, Madhab Ch; Naskar, Somnath; Roy, Ramaprasad; Das, Dilip Kr; Das, Soumya

2018-01-01

Rice mill workers constitute a special group from the perspective of occupational health. Unprotected dust exposure among them adversely affects their respiratory health, which needs to be evaluated. Adequate evidence is still lacking in many parts of India including West Bengal. Burdwan is one of the main rice-producing districts in the state with abundant rice mills. The aim of the study was to find out the prevalence and pattern of respiratory morbidity and associated background characteristics of rice mill workers. A descriptive cross-sectional study was conducted at Burdwan municipality area during July-December 2016. Considering 44.2% prevalence, 95% confidence interval, 15% allowable error, 10% non-response, a sample of 252 directly engaged rice mill workers were selected through multistage random sampling. With prior consent, the subjects were interviewed, clinically examined, and underwent spirometry; relevant records were also reviewed using a pre-designed schedule. Any abnormal spirometry finding was considered as respiratory morbidity. Ethical approval was obtained from institutional ethics committee. Data were analyzed using SPSS version 20. Chi-square test and multiple logistic regression were applied. Prevalence of respiratory morbidity was 40.73% with obstructive and restrictive respiratory morbidity being 24.60% and 16.13%, respectively. Non-use of any protective measure, duration (years) of working in rice mill and average daily working hours were significant predictors of respiratory morbidity. Respiratory morbidity is quite high in the area. Proper health education and provision of personal protective equipments need to be provided.

Multiple sensitive estimation and optimal sample size allocation in the item sum technique.

PubMed

Perri, Pier Francesco; Rueda García, María Del Mar; Cobo Rodríguez, Beatriz

2018-01-01

For surveys of sensitive issues in life sciences, statistical procedures can be used to reduce nonresponse and social desirability response bias. Both of these phenomena provoke nonsampling errors that are difficult to deal with and can seriously flaw the validity of the analyses. The item sum technique (IST) is a very recent indirect questioning method derived from the item count technique that seeks to procure more reliable responses on quantitative items than direct questioning while preserving respondents' anonymity. This article addresses two important questions concerning the IST: (i) its implementation when two or more sensitive variables are investigated and efficient estimates of their unknown population means are required; (ii) the determination of the optimal sample size to achieve minimum variance estimates. These aspects are of great relevance for survey practitioners engaged in sensitive research and, to the best of our knowledge, were not studied so far. In this article, theoretical results for multiple estimation and optimal allocation are obtained under a generic sampling design and then particularized to simple random sampling and stratified sampling designs. Theoretical considerations are integrated with a number of simulation studies based on data from two real surveys and conducted to ascertain the efficiency gain derived from optimal allocation in different situations. One of the surveys concerns cannabis consumption among university students. Our findings highlight some methodological advances that can be obtained in life sciences IST surveys when optimal allocation is achieved. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

[Diagnostic value of serum procalcitonin in identifying the etiology of non-responding community-acquired pneumonia after initial antibiotic therapy].

PubMed

Wang, Zheng; Zhang, Xiaoju; Wu, Jizhen; Zhang, Wenping; Kuang, Hongyan; Li, Xiao; Xuan, Weixia; Wang, Kai; Ma, Lijun

2014-11-01

This study was to investigate the diagnostic value of serum procalcitonin(PCT) in identifying the etiology of non-responding community-acquired pneumonia (CAP) after initial antibiotic therapy. A retrospective analysis was performed for 232 hospitalized CAP patients admitted to the People's Hospital of Zhengzhou University during June 2013 and January 2014. Early treatment failure was defined as the presence of persistent fever (>38 °C) and/or clinical symptoms (malaise, cough, expectoration, dyspnea) or deterioration after at least 72 h of initial antimicrobial treatment, or development of respiratory failure requiring mechanical ventilation, or septic shock. Bronchoscopy or transthoracic lung biopsy was performed in case of early treatment failure when indicated. Serum level of PCT was detected by double antibody sandwich method. The differences between 2 or more groups were compared using 2-independent student t test, one-way ANOVA; Mann-Whitney U test, Kruskal-Wallis rank sum test, or χ(2) test. Risk factors and odds ratios for nonresponsiveness were analyzed by setting up a Logistic regression model. The diagnostic values of PCT were determined by receiver operating characteristic curves (ROC curves). Of the 232 CAP patients enrolled, 124 were male and 108 were female, with an average age of (46 ± 20) years. Thirty-six patients failed to respond to the initial antibiotic therapy. As shown by Logistic regression analysis, the risk factors for treatment failure included hypoalbuminemia, type 2 diabetes, previous history of splenectomy , PSI 4-5 grade, and lung infiltration ≥ 3 lobes. The most common causes of non-responsiveness were antimicrobial insufficiency (n = 23), and misdiagnosis of noninfectious mimics of pneumonia (n = 11), with 2 cases of unidentified etiology. The serum PCT level in admission was 0.19 (0.07-0.66) µg/L in the antimicrobial insufficiency subgroup, which was significantly higher than that in the misdiagnosis subgroup [0.06(0.05-0.08)µg/L; P < 0.01]. The antimicrobial insufficiency subgroup included 11 cases of bacterial infection (5 of G(+) cocci and 6 of G(-) bacilli) and 12 cases of nonbacterial infection; their PCT levels were 0.66(0.19-5.80) µg/L and 0.08(0.05-0.20) µg/L, respectively (P < 0.01). There was no statistically significant difference among PCT levels of the 4 subgroups of nonbacterial infections (4 tuberculosis, 3 fungi, 3 atypical pathogens, 2 viruses) (F = 3.025, P = 0.094). The cut-off values of PCT were >0.13 µg/L and >0.115 µg/L for differentiating non-responsiveness originated from bacterial infection or other causes, and infection vs non-infection, which yielded a sensitivity of 100% (11/11) and 65% (14/23) , specificity of 83% (19/23) and 91% (10/11) , and AUC of 0.955 and 0.802, respectively. Antibiotic failure to cover the microbial pathogens, infectious complications and misdiagnosis are the most common causes of early treatment failure in patients with CAP. Serum PCT level fails to predict non-responsiveness, but is suggestive of bacterial infections in hospitalized CAP patients with early treatment failure.

Pharmacodynamic assessment of vedolizumab for the treatment of ulcerative colitis.

PubMed

McLean, Leon P; Cross, Raymond K

2016-07-01

Vedolizumab is an anti-integrin approved for the treatment of Crohn's disease and ulcerative colitis. By binding the α4β7-integrin heterodimer, vedolizumab blocks leukocyte translocation into gastrointestinal tissue. This review discusses the chemistry, pharmacologic properties, clinical efficacy, and safety of vedolizumab in ulcerative colitis. Other medications available for the treatment of ulcerative colitis are also discussed. Vedolizumab is a promising new agent for the treatment of ulcerative colitis. Its mechanism of action differs from TNF-α inhibitors and immune suppressants, allowing it to be used in cases of TNF-α inhibitor failure or non-response, or as a first-line biologic drug. Available safety data suggests that vedolizumab is not associated with an increased risk of infection or malignancy; however, additional post-marketing data are required to confirm these initial reports. Vedolizumab is likely to be used in growing numbers of patients over the coming years.

DRUG EVALUATION

PubMed Central

McLean, Leon P.; Cross, Raymond K.

2016-01-01

Introduction Vedolizumab is an anti-integrin approved for the treatment of Crohn’s disease and ulcerative colitis. By binding the α4β7-integrin heterodimer, vedolizumab blocks leukocyte translocation into gastrointestinal tissue. Areas Covered This review discusses the chemistry, pharmacologic properties, clinical efficacy, and safety of vedolizumab in ulcerative colitis. Other medications available for the treatment of ulcerative colitis are also discussed. Expert Opinion Vedolizumab is a promising new agent for the treatment of ulcerative colitis. Its mechanism of action differs from TNF-α inhibitors and immune suppressants, allowing it to be used in cases of TNF-α inhibitor failure or non-response, or as a first-line biologic drug. Available safety data suggests that vedolizumab is not associated with an increased risk of infection or malignancy; however, additional post-marketing data are required to confirm these initial reports. Vedolizumab is likely to be used in growing numbers of patients over the coming years. PMID:27096357

The challenges of implementing a multi-centre audit of end-of-life care in care homes.

PubMed

Levy, Jean; Kinley, Julie; Conway, Frances

2016-11-02

This article aims to share the experience of a hospice in facilitating a multi-centre audit of end-of-life care in care homes, particularly noting the challenges and enablers of carrying out the audit. The audit was a retrospective multi-centre survey of bereaved relatives/next of kin of residents who died in the care home, using an anonymous, validated questionnaire: the Family Perception of Care Scale. Questionnaires were sent 3-months after bereavement. Returned questionnaires were analysed using SPSS and Excel. The care homes were in areas encompassing outer and inner city populations. The team identified eight challenges to the audit process, in particular, embedding procedures within the care homes, non-responses and developing action plans for improvement. Overall, the audit provided an indication of where improvements could be made and where care was already excellent, built confidence and increased expertise in the care-home staff.

Eosinophilic oesophagitis: investigations and management.

PubMed

Kumar, Mayur; Sweis, Rami; Wong, Terry

2014-05-01

Eosinophilic oesophagitis (EO) is an immune/antigen mediated, chronic, relapsing disease characterised by dysphagia, food bolus impaction and a dense oesophageal eosinophilic infiltrate. Characteristic endoscopic features include corrugated rings, linear furrows and white exudates, but none are diagnostic. Despite its increasing prevalence, EO remains underdiagnosed. There is a strong association with other atopic conditions. Symptoms, histology and endoscopic findings can overlap with gastro-oesophageal reflux disease. Currently endoscopy and oesophageal biopsies are the investigation of choice. Oesophageal physiology studies, endoscopic ultrasound, impedance planimetry and serology may have a role in the diagnosis and monitoring of response to therapy. Acid reducing medication is advocated as first line or adjuvant therapy. Dietary therapy is comprised of elimination diets or can be guided by allergen assessment. In adults, topical corticosteroids are the mainstay of therapy. Endoscopic dilatation is safe and effective for the treatment of non-responsive strictures. Other therapeutic options (immunomodulators, biological agents, leukotriene receptor antagonists) are under investigation.

Sexual Assault and Sexual Harassment in the U.S. Military: Evaluating Estimates from the 2014 RAND Military Workplace Study

DTIC Science & Technology

2016-01-01

harassment, and gender discrimination in the military. The RAND Military Workplace Study (RMWS) included one of the largest surveys of its kind: Almost...approach to counting service members who experienced sexual assault, sexual harassment, and gender discrimination , providing DoD with unprecedented...harassment, or gender discrimination . Specifically, both the phone and web follow-up surveys revealed possible nonresponse bias in the RMWS estimates, but

Alteration of a motor learning rule under mirror-reversal transformation does not depend on the amplitude of visual error.

PubMed

Kasuga, Shoko; Kurata, Makiko; Liu, Meigen; Ushiba, Junichi

2015-05-01

Human's sophisticated motor learning system paradoxically interferes with motor performance when visual information is mirror-reversed (MR), because normal movement error correction further aggravates the error. This error-increasing mechanism makes performing even a simple reaching task difficult, but is overcome by alterations in the error correction rule during the trials. To isolate factors that trigger learners to change the error correction rule, we manipulated the gain of visual angular errors when participants made arm-reaching movements with mirror-reversed visual feedback, and compared the rule alteration timing between groups with normal or reduced gain. Trial-by-trial changes in the visual angular error was tracked to explain the timing of the change in the error correction rule. Under both gain conditions, visual angular errors increased under the MR transformation, and suddenly decreased after 3-5 trials with increase. The increase became degressive at different amplitude between the two groups, nearly proportional to the visual gain. The findings suggest that the alteration of the error-correction rule is not dependent on the amplitude of visual angular errors, and possibly determined by the number of trials over which the errors increased or statistical property of the environment. The current results encourage future intensive studies focusing on the exact rule-change mechanism. Copyright © 2014 Elsevier Ireland Ltd and the Japan Neuroscience Society. All rights reserved.

Antidepressant and antipsychotic medication errors reported to United States poison control centers.

PubMed

Kamboj, Alisha; Spiller, Henry A; Casavant, Marcel J; Chounthirath, Thitphalak; Hodges, Nichole L; Smith, Gary A

2018-05-08

To investigate unintentional therapeutic medication errors associated with antidepressant and antipsychotic medications in the United States and expand current knowledge on the types of errors commonly associated with these medications. A retrospective analysis of non-health care facility unintentional therapeutic errors associated with antidepressant and antipsychotic medications was conducted using data from the National Poison Data System. From 2000 to 2012, poison control centers received 207 670 calls reporting unintentional therapeutic errors associated with antidepressant or antipsychotic medications that occurred outside of a health care facility, averaging 15 975 errors annually. The rate of antidepressant-related errors increased by 50.6% from 2000 to 2004, decreased by 6.5% from 2004 to 2006, and then increased 13.0% from 2006 to 2012. The rate of errors related to antipsychotic medications increased by 99.7% from 2000 to 2004 and then increased by 8.8% from 2004 to 2012. Overall, 70.1% of reported errors occurred among adults, and 59.3% were among females. The medications most frequently associated with errors were selective serotonin reuptake inhibitors (30.3%), atypical antipsychotics (24.1%), and other types of antidepressants (21.5%). Most medication errors took place when an individual inadvertently took or was given a medication twice (41.0%), inadvertently took someone else's medication (15.6%), or took the wrong medication (15.6%). This study provides a comprehensive overview of non-health care facility unintentional therapeutic errors associated with antidepressant and antipsychotic medications. The frequency and rate of these errors increased significantly from 2000 to 2012. Given that use of these medications is increasing in the US, this study provides important information about the epidemiology of the associated medication errors. Copyright © 2018 John Wiley & Sons, Ltd.

Recognizing and Reducing Analytical Errors and Sources of Variation in Clinical Pathology Data in Safety Assessment Studies.

PubMed

Schultze, A E; Irizarry, A R

2017-02-01

Veterinary clinical pathologists are well positioned via education and training to assist in investigations of unexpected results or increased variation in clinical pathology data. Errors in testing and unexpected variability in clinical pathology data are sometimes referred to as "laboratory errors." These alterations may occur in the preanalytical, analytical, or postanalytical phases of studies. Most of the errors or variability in clinical pathology data occur in the preanalytical or postanalytical phases. True analytical errors occur within the laboratory and are usually the result of operator or instrument error. Analytical errors are often ≤10% of all errors in diagnostic testing, and the frequency of these types of errors has decreased in the last decade. Analytical errors and increased data variability may result from instrument malfunctions, inability to follow proper procedures, undetected failures in quality control, sample misidentification, and/or test interference. This article (1) illustrates several different types of analytical errors and situations within laboratories that may result in increased variability in data, (2) provides recommendations regarding prevention of testing errors and techniques to control variation, and (3) provides a list of references that describe and advise how to deal with increased data variability.

Patterns of c-reactive protein RATIO response in severe community-acquired pneumonia: a cohort study.

PubMed

Coelho, Luís M; Salluh, Jorge I F; Soares, Márcio; Bozza, Fernando A; Verdeal, Juan Carlos R; Castro-Faria-Neto, Hugo C; Lapa e Silva, José Roberto; Bozza, Patrícia T; Póvoa, Pedro

2012-12-12

Community-acquired pneumonia (CAP) requiring intensive care unit (ICU) admission remains a severe medical condition, presenting ICU mortality rates reaching 30%. The aim of this study was to assess the value of different patterns of C-reactive protein (CRP)-ratio response to antibiotic therapy in patients with severe CAP requiring ICU admission as an early maker of outcome. In total, 191 patients with severe CAP were prospectively included and CRP was sampled every other day from D1 to D7 of antibiotic prescription. CRP-ratio was calculated in relation to D1 CRP concentration. Patients were classified according to an individual pattern of CRP-ratio response with the following criteria: fast response - when D5 CRP was less than or equal to 0.4 of D1 CRP concentration; slow response - when D5 CRP was > 0.4 and D7 less than or equal to 0.8 of D1 CRP concentration; nonresponse - when D7 CRP was > 0.8 of D1 CRP concentration. Comparison between ICU survivors and non-survivors was performed. CRP-ratio from D1 to D7 decreased faster in survivors than in non-survivors (p = 0.01). The ability of CRP-ratio by D5 to predict ICU outcome assessed by the area under the ROC curve was 0.73 (95% Confidence Interval, 0.64 - 0.82). By D5, a CRP concentration above 0.5 of the initial level was a marker of poor outcome (sensitivity 0.81, specificity 0.58, positive likelihood ratio 1.93, negative likelihood ratio 0.33). The time-dependent analysis of CRP-ratio of the three patterns (fast response n = 66; slow response n = 81; nonresponse n = 44) was significantly different between groups (p < 0.001). The ICU mortality rate was considerably different according to the patterns of CRP-ratio response: fast response 4.8%, slow response 17.3% and nonresponse 36.4% (p < 0.001). In severe CAP, sequential evaluation of CRP-ratio was useful in the early identification of patients with poor outcome. The evaluation of CRP-ratio pattern of response to antibiotics during the first week of therapy was useful in the recognition of the individual clinical evolution.

Dietary Fiber and Bacterial SCFA Enhance Oral Tolerance and Protect against Food Allergy through Diverse Cellular Pathways.

PubMed

Tan, Jian; McKenzie, Craig; Vuillermin, Peter J; Goverse, Gera; Vinuesa, Carola G; Mebius, Reina E; Macia, Laurence; Mackay, Charles R

2016-06-21

The incidence of food allergies in western countries has increased dramatically in recent decades. Tolerance to food antigens relies on mucosal CD103(+) dendritic cells (DCs), which promote differentiation of regulatory T (Treg) cells. We show that high-fiber feeding in mice improved oral tolerance and protected from food allergy. High-fiber feeding reshaped gut microbial ecology and increased the release of short-chain fatty acids (SCFAs), particularly acetate and butyrate. High-fiber feeding enhanced oral tolerance and protected against food allergy by enhancing retinal dehydrogenase activity in CD103(+) DC. This protection depended on vitamin A in the diet. This feeding regimen also boosted IgA production and enhanced T follicular helper and mucosal germinal center responses. Mice lacking GPR43 or GPR109A, receptors for SCFAs, showed exacerbated food allergy and fewer CD103(+) DCs. Dietary elements, including fiber and vitamin A, therefore regulate numerous protective pathways in the gastrointestinal tract, necessary for immune non-responsiveness to food antigens. Copyright © 2016 The Author(s). Published by Elsevier Inc. All rights reserved.

Raptor mortality due to West Nile virus in the United States, 2002

USGS Publications Warehouse

Saito, E.K.; Sileo, L.; Green, D.E.; Meteyer, C.U.; McLaughlin, G.S.; Converse, K.A.; Docherty, D.E.

2007-01-01

West Nile virus (WNV) has affected many thousands of birds since it was first detected in North America in 1999, but the overall impact on wild bird populations is unknown. In mid-August 2002, wildlife rehabilitators and local wildlife officials from multiple states began reporting increasing numbers of sick and dying raptors, mostly red-tailed hawks (Buteo jamaicensis) and great horned owls (Bubo virginianus. Commonly reported clinical signs were nonspecific and included emaciation, lethargy, weakness, inability to perch, fly or stand, and nonresponse to danger. Raptor carcasses from 12 states were received, and diagnostic evaluation of 56 raptors implicated WNV infection in 40 (71%) of these cases. Histologically, nonsuppurative encephalitis and myocarditis were the salient lesions (79% and 61%, respectively). Other causes of death included lead poisoning, trauma, aspergillosis, and Salmonella spp. and Clostridium spp. infections. The reason(s) for the reported increase in raptor mortality due to WNV in 2002 compared with the previous WNV seasons is unclear, and a better understanding of the epizootiology and pathogenesis of the virus in raptor populations is needed. ?? Wildlife Disease Association 2007.

Assessing and adjusting for non response in the Millennium Cohort Family Study (Open Access Publisher’s Version)

DTIC Science & Technology

2017-01-28

missingness was positively correlated across variables, as evidenced by the much greater spousal response for service members complet- ing the entire survey ...Mike Battaglia1, Hope Seib McMaster2,3 and Valerie A. Stander2 Abstract Background: In conducting population-based surveys , it is important to...reporting findings. This paper examines factors contributing to second stage survey non-response during the baseline data collection for the

2012 Workplace and Gender Relations Survey of Active Duty Members: Nonresponse Bias Analysis Report

DTIC Science & Technology

2014-01-01

Control and Prevention ), or command climate surveys (e.g., DEOCS). 6 Table 1. Comparison of Trends in WGRA and SOFS-A Response Rates (Shown in...DMDC draws optimized samples to reduce survey burden on members as well as produce high levels of precision for important domain estimates by using...statistical significance at α= .05 Because paygrade is a significant predictor of survey response, we next examined the odds ratio of each paygrade levels

Statistical Application and Cost Saving in a Dental Survey.

PubMed

Chyou, Po-Huang; Schroeder, Dixie; Schwei, Kelsey; Acharya, Amit

2017-06-01

To effectively achieve a robust survey response rate in a timely manner, an alternative approach to survey distribution, informed by statistical modeling, was applied to efficiently and cost-effectively achieve the targeted rate of return. A prospective environmental scan surveying adoption of health information technology utilization within their practices was undertaken in a national pool of dental professionals (N=8000) using an alternative method of sampling. The piloted approach to rate of cohort sampling targeted a response rate of 400 completed surveys from among randomly targeted eligible providers who were contacted using replicated subsampling leveraging mailed surveys. Two replicated subsample mailings (n=1000 surveys/mailings) were undertaken to project the true response rate and estimate the total number of surveys required to achieve the final target. Cost effectiveness and non-response bias analyses were performed. The final mailing required approximately 24% fewer mailings compared to targeting of the entire cohort, with a final survey capture exceeding the expected target. An estimated $5000 in cost savings was projected by applying the alternative approach. Non-response analyses found no evidence of bias relative to demographics, practice demographics, or topically-related survey questions. The outcome of this pilot study suggests that this approach to survey studies will accomplish targeted enrollment in a cost effective manner. Future studies are needed to validate this approach in the context of other survey studies. © 2017 Marshfield Clinic.

Clinical efficacy of adalimumab in Crohn's disease: a real practice observational study in Japan.

PubMed

Takeshima, Fuminao; Yoshikawa, Daisuke; Higashi, Syuntaro; Morisaki, Tomohito; Oda, Hidetoshi; Ikeda, Maho; Machida, Haruhisa; Matsushima, Kayoko; Minami, Hitomi; Akazawa, Yuko; Yamaguchi, Naoyuki; Ohnita, Ken; Isomoto, Hajime; Ueno, Masato; Nakao, Kazuhiko

2016-07-29

There are few reports of the efficacy of adalimumab (ADA) for clinical remission and preventing postoperative recurrence in Crohn's disease (CD) in Asian real practice settings. We conducted a Japanese multicenter retrospective observational study. We evaluated patients with CD who were treated with ADA at 11 medical institutions in Japan to investigate the clinical efficacy of remission up to 52 weeks and the associated factors to achieve remission with a CD Activity Index (CDAI) < 150. The effects of preventing postoperative recurrence were also evaluated. In 62 patients, the remission rates were 33.9, 74.2, 75.8, 77.4, and 66.1 % at 0, 4, 12, 26, and 52 weeks, respectively. Although 10 patients discontinued treatment due to primary nonresponse, secondary nonresponse, or adverse events, the ongoing treatment rate at 52 weeks was 83.9 %. Comparison of remission and non-remission on univariate analysis identified colonic type and baseline CDAI value as significant associated factors (P < 0.05). In 16 patients who received ADA to prevent postoperative recurrence, the clinical remission maintenance rate was 93.8 % and the mucosal healing rate was 64.3 % during a mean postoperative follow-up period of 32.3 months. ADA effectively induced remission and prevented postoperative recurrence in patients with CD in a real practice setting.

[A comparison of assessments of criminal responsibility between psychiatrists and judges: analyses of 50 judicial cases based on a national-wide survey].

PubMed

Osawa, Tatsuya

2007-01-01

In spite of the mounting concerns about forensic psychiatric examination, there are no concrete standards of assessment with regard to criminal responsibility in Japan. Also, some cases have led to disagreements between psychiatrists and judges. To elucidate the tendency in the assessment of criminal responsibility, this study retrospectively examined seventy-one psychiatric assessments and sixty-four judgments in fifty judicial cases. The results revealed that: 1) 97.2% of psychiatrists and 100% of judges assessed the criminal responsibility of defendants based on the gnostic approach; 2) 56.3% of psychiatric assessments of criminal responsibility were consistent with the court's decision; 3) in comparison with judges, psychiatrists did not significantly examine situational factors when they assessed their cases; and 4) their descriptions of the assessment were variable and not standardized. These results show that we psychiatrists should consider at least fourteen factors: motive/cause, modus operandi, hesitation, surrendering, escape, knowledge of crime, their statements, their specific behaviors/emotions (before, during and after the fact), and memory, as considerable items. To standardize the classification and description of the psychiatric assessment of criminal responsibility, the German five-grade assessment (responsible, diminished responsibility cannot be excluded, diminished responsibility, non-responsibility cannot be excluded, and non-responsibility) is applicable to the Japanese criminal justice system.

Iron deficiency and iron-deficiency anemia in the first two years of life: strategies to prevent loss of developmental potential.

PubMed

Black, Maureen M; Quigg, Anna M; Hurley, Kristen M; Pepper, Margery Reese

2011-11-01

This article examines the association of iron deficiency (ID) and iron deficiency anemia (IDA) with children's development and behavior, with the goal of providing recommendations to prevent the developmental loss associated with these conditions. Children's risk for ID and IDA is particularly high during the second 6 months of life when prenatal stores are depleted. Longitudinal studies from infancy through adolescence and early adulthood suggest that socioemotional development is uniquely vulnerable to ID and IDA, perhaps being associated with shared neural pathways, and the effects of early iron deficiencies may be irreversible. In addition to direct effects on brain function, ID and IDA may also affect child development indirectly through non-responsive mother-child interactions. Maternal ID is a global problem that may contribute to high rates of maternal depression and non-responsive caregiving. Intervention trials illustrate that children benefit from both nutritional intervention and early learning interventions that promote responsive mother-child interactions. Recommendations to reduce the developmental loss associated with ID and IDA are to reduce the incidence of these conditions by efforts to prevent premature birth, delay cord clamping, ensure adequate maternal iron status, provide iron-rich complementary foods, and ensure access to postnatal interventions that promote responsive mother-infant interaction patterns and early learning opportunities for infants. © 2011 International Life Sciences Institute.

Inverse probability weighting and doubly robust methods in correcting the effects of non-response in the reimbursed medication and self-reported turnout estimates in the ATH survey.

PubMed

Härkänen, Tommi; Kaikkonen, Risto; Virtala, Esa; Koskinen, Seppo

2014-11-06

To assess the nonresponse rates in a questionnaire survey with respect to administrative register data, and to correct the bias statistically. The Finnish Regional Health and Well-being Study (ATH) in 2010 was based on a national sample and several regional samples. Missing data analysis was based on socio-demographic register data covering the whole sample. Inverse probability weighting (IPW) and doubly robust (DR) methods were estimated using the logistic regression model, which was selected using the Bayesian information criteria. The crude, weighted and true self-reported turnout in the 2008 municipal election and prevalences of entitlements to specially reimbursed medication, and the crude and weighted body mass index (BMI) means were compared. The IPW method appeared to remove a relatively large proportion of the bias compared to the crude prevalence estimates of the turnout and the entitlements to specially reimbursed medication. Several demographic factors were shown to be associated with missing data, but few interactions were found. Our results suggest that the IPW method can improve the accuracy of results of a population survey, and the model selection provides insight into the structure of missing data. However, health-related missing data mechanisms are beyond the scope of statistical methods, which mainly rely on socio-demographic information to correct the results.

The application of subset correspondence analysis to address the problem of missing data in a study on asthma severity in childhood.

PubMed

Hendry, G; North, D; Zewotir, T; Naidoo, R N

2014-09-28

Non-response in cross-sectional data is not uncommon and requires careful handling during the analysis stage so as not to bias results. In this paper, we illustrate how subset correspondence analysis can be applied in order to manage the non-response while at the same time retaining all observed data. This variant of correspondence analysis was applied to a set of epidemiological data in which relationships between numerous environmental, genetic, behavioural and socio-economic factors and their association with asthma severity in children were explored. The application of subset correspondence analysis revealed interesting associations between the measured variables that otherwise may not have been exposed. Many of the associations found confirm established theories found in literature regarding factors that exacerbate childhood asthma. Moderate to severe asthma was found to be associated with needing neonatal care, male children, 8- to 9-year olds, exposure to tobacco smoke in vehicles and living in areas that suffer from extreme air pollution. Associations were found between mild persistent asthma and low birthweight, and being exposed to smoke in the home and living in a home with up to four people. The classification of probable asthma was associated with a group of variables that indicate low socio-economic status. Copyright © 2014 John Wiley & Sons, Ltd.

Inpatient schema therapy for nonresponsive patients with personality pathology: Changes in symptomatic distress, schemas, schema modes, coping styles, experienced parenting styles, and mental well-being.

PubMed

Schaap, Grietje M; Chakhssi, Farid; Westerhof, Gerben J

2016-12-01

This study provides an evaluation of group schema therapy (ST) for inpatient treatment of patients with personality pathology who did not respond to previous psychotherapeutic interventions. Forty-two patients were assessed pre- and posttreatment, and 35 patients were evaluated at follow-up 6 months later. The results showed a dropout rate of 35%. Those who dropped out did not differ from those who completed treatment with regard to demographic and clinical variables; the only exception was that those who dropped out showed a lower prevalence of mood disorders. Furthermore, intention-to-treat analyses showed a significant improvement in maladaptive schemas, schema modes, maladaptive coping styles, mental well-being, and psychological distress after treatment, and these improvements were maintained at follow-up. On the other hand, there was no significant change in experienced parenting style as self-reported by patients. Changes in schemas and schema modes measured from pre- to posttreatment were predictive of general psychological distress at follow-up. Overall, these preliminary findings suggest that positive treatment results can be obtained with group ST-based inpatient treatment for patients who did not respond to previous psychotherapeutic interventions. Moreover, these findings are comparable with treatment results for patients without such a nonresponsive treatment history. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Laboratory signs of aspirin response in haemodialysis patients.

PubMed

Kilickesmez, Kadriye O; Kocas, Cuneyt; Okcun, Baris; Abaci, Okay; Kaya, Aysem; Arat, Alev; Gorcin, Bilal; Gurmen, Tevfik

2011-09-01

Aspirin is effective in the secondary prevention and high-risk primary prevention of cardiovascular events. However, clinical and laboratory evidence demonstrates diminished or no response to aspirin in some patients. This study was designed to assess aspirin response in haemodialysis patients. We prospectively enrolled 78 haemodialysis patients (28 female; 58.4 ± 12.6 years old) and 79 patients (29 female; 58.4 ± 10.6 years old) with normal renal function (glomerular filtration rate (GFR) >60 mL/min/1.73 m(2)). All subjects in both the haemodialysis patient group and the control group were taking aspirin (80-300 mg) for at least 30 days and were not taking other antiplatelet agents. Platelet function was assessed by arachidonic acid-induced aggregometry with a Multiplate analyser (Dynabyte Medical, Munich, Germany). Multiplate electrode aggregometry values below 300 AU were applied as a cut-off for response to aspirin. Aspirin non-response was two-fold more prevalent in haemodialysis patients (42.3%) than in patients with normal renal function (21.5%), and this difference was statistically significant (p = 0.005). The two groups were similar in terms of sex, age, tobacco use, the presence of diabetes mellitus, and platelet count. The frequency of aspirin non-response as defined in this study was higher in haemodialysis patients than in patients with normal renal function. However, larger subsets of patients are needed to confirm the present study.

Statistical Application and Cost Saving in a Dental Survey

PubMed Central

Chyou, Po-Huang; Schroeder, Dixie; Schwei, Kelsey; Acharya, Amit

2017-01-01

Objective To effectively achieve a robust survey response rate in a timely manner, an alternative approach to survey distribution, informed by statistical modeling, was applied to efficiently and cost-effectively achieve the targeted rate of return. Design A prospective environmental scan surveying adoption of health information technology utilization within their practices was undertaken in a national pool of dental professionals (N=8000) using an alternative method of sampling. The piloted approach to rate of cohort sampling targeted a response rate of 400 completed surveys from among randomly targeted eligible providers who were contacted using replicated subsampling leveraging mailed surveys. Methods Two replicated subsample mailings (n=1000 surveys/mailings) were undertaken to project the true response rate and estimate the total number of surveys required to achieve the final target. Cost effectiveness and non-response bias analyses were performed. Results The final mailing required approximately 24% fewer mailings compared to targeting of the entire cohort, with a final survey capture exceeding the expected target. An estimated $5000 in cost savings was projected by applying the alternative approach. Non-response analyses found no evidence of bias relative to demographics, practice demographics, or topically-related survey questions. Conclusion The outcome of this pilot study suggests that this approach to survey studies will accomplish targeted enrollment in a cost effective manner. Future studies are needed to validate this approach in the context of other survey studies. PMID:28373286

The Influence of Observation Errors on Analysis Error and Forecast Skill Investigated with an Observing System Simulation Experiment

NASA Technical Reports Server (NTRS)

Prive, N. C.; Errico, R. M.; Tai, K.-S.

2013-01-01

The Global Modeling and Assimilation Office (GMAO) observing system simulation experiment (OSSE) framework is used to explore the response of analysis error and forecast skill to observation quality. In an OSSE, synthetic observations may be created that have much smaller error than real observations, and precisely quantified error may be applied to these synthetic observations. Three experiments are performed in which synthetic observations with magnitudes of applied observation error that vary from zero to twice the estimated realistic error are ingested into the Goddard Earth Observing System Model (GEOS-5) with Gridpoint Statistical Interpolation (GSI) data assimilation for a one-month period representing July. The analysis increment and observation innovation are strongly impacted by observation error, with much larger variances for increased observation error. The analysis quality is degraded by increased observation error, but the change in root-mean-square error of the analysis state is small relative to the total analysis error. Surprisingly, in the 120 hour forecast increased observation error only yields a slight decline in forecast skill in the extratropics, and no discernable degradation of forecast skill in the tropics.

2012 Workplace and Gender Relations Survey of Reserve Component Members: Statistical Methodology Report

DTIC Science & Technology

2012-09-01

3,435 10,461 9.1 3.1 63 Unmarried with Children+ Unmarried without Children 439,495 0.01 10,350 43,870 10.1 2.2 64 Married with Children+ Married ...logistic regression model was used to predict the probability of eligibility for the survey (known eligibility vs . unknown eligibility). A second logistic...regression model was used to predict the probability of response among eligible sample members (complete response vs . non-response). CHAID (Chi

Response to eperisone in patients of therapy-resistant dissociative convulsions: A report of two cases.

PubMed

Jha, Vijendra Nath; Singh, Pramod Kumar

2017-01-01

Dissociative convulsions or pseudoseizures are a difficult to treat common psychiatric condition. In a subset of these patients, the chief complaint is clenching of teeth with apparent nonresponsiveness alone. Neither drugs nor psychotherapeutic interventions have been found to be of much help in its management. Report of two such subsets of cases is presented, in which patients with dissociative convulsions showed sudden, dramatic, and sustained good response to the addition of a muscle relaxant eperisone.

Nonrashes. Part I: The Koebner nonreaction

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bernhard, J.D.; Haynes, H.A.

1982-02-01

''Nonrashes'' range from pruritus that may signal an underlying systemic illness to delusional parasitosis associated with severe psychological disturbance. We report another kind of nonrash, the Koebner nonreaction or isomorphic nonresponse, that was manifested by the absence of a drug rash at the site of recently administered x-irradiation. We also present a compilation of a number of other nonrashes, such as the mitempfindungen (referred itch) and the prodrome of herpes zoster. The recognition of certain types of nonrashes may be lifesaving.

Voluntary Medication Error Reporting by ED Nurses: Examining the Association With Work Environment and Social Capital.

PubMed

Farag, Amany; Blegen, Mary; Gedney-Lose, Amalia; Lose, Daniel; Perkhounkova, Yelena

2017-05-01

Medication errors are one of the most frequently occurring errors in health care settings. The complexity of the ED work environment places patients at risk for medication errors. Most hospitals rely on nurses' voluntary medication error reporting, but these errors are under-reported. The purpose of this study was to examine the relationship among work environment (nurse manager leadership style and safety climate), social capital (warmth and belonging relationships and organizational trust), and nurses' willingness to report medication errors. A cross-sectional descriptive design using a questionnaire with a convenience sample of emergency nurses was used. Data were analyzed using descriptive, correlation, Mann-Whitney U, and Kruskal-Wallis statistics. A total of 71 emergency nurses were included in the study. Emergency nurses' willingness to report errors decreased as the nurses' years of experience increased (r = -0.25, P = .03). Their willingness to report errors increased when they received more feedback about errors (r = 0.25, P = .03) and when their managers used a transactional leadership style (r = 0.28, P = .01). ED nurse managers can modify their leadership style to encourage error reporting. Timely feedback after an error report is particularly important. Engaging experienced nurses to understand error root causes could increase voluntary error reporting. Published by Elsevier Inc.

Impact of a reengineered electronic error-reporting system on medication event reporting and care process improvements at an urban medical center.

PubMed

McKaig, Donald; Collins, Christine; Elsaid, Khaled A

2014-09-01

A study was conducted to evaluate the impact of a reengineered approach to electronic error reporting at a 719-bed multidisciplinary urban medical center. The main outcome of interest was the monthly reported medication errors during the preimplementation (20 months) and postimplementation (26 months) phases. An interrupted time series analysis was used to describe baseline errors, immediate change following implementation of the current electronic error-reporting system (e-ERS), and trend of error reporting during postimplementation. Errors were categorized according to severity using the National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP) Medication Error Index classifications. Reported errors were further analyzed by reporter and error site. During preimplementation, the monthly reported errors mean was 40.0 (95% confidence interval [CI]: 36.3-43.7). Immediately following e-ERS implementation, monthly reported errors significantly increased by 19.4 errors (95% CI: 8.4-30.5). The change in slope of reported errors trend was estimated at 0.76 (95% CI: 0.07-1.22). Near misses and no-patient-harm errors accounted for 90% of all errors, while errors that caused increased patient monitoring or temporary harm accounted for 9% and 1%, respectively. Nurses were the most frequent reporters, while physicians were more likely to report high-severity errors. Medical care units accounted for approximately half of all reported errors. Following the intervention, there was a significant increase in reporting of prevented errors and errors that reached the patient with no resultant harm. This improvement in reporting was sustained for 26 months and has contributed to designing and implementing quality improvement initiatives to enhance the safety of the medication use process.

Impact of probiotic Saccharomyces boulardii on the gut microbiome composition in HIV-treated patients: A double-blind, randomised, placebo-controlled trial.

PubMed

Villar-García, Judit; Güerri-Fernández, Robert; Moya, Andrés; González, Alicia; Hernández, Juan J; Lerma, Elisabet; Guelar, Ana; Sorli, Luisa; Horcajada, Juan P; Artacho, Alejandro; D Auria, Giuseppe; Knobel, Hernando

2017-01-01

Dysbalance in gut microbiota has been linked to increased microbial translocation, leading to chronic inflammation in HIV-patients, even under effective HAART. Moreover, microbial translocation is associated with insufficient reconstitution of CD4+T cells, and contributes to the pathogenesis of immunologic non-response. In a double-blind, randomised, placebo-controlled trial, we recently showed that, compared to placebo, 12 weeks treatment with probiotic Saccharomyces boulardii significantly reduced plasma levels of bacterial translocation (Lipopolysaccharide-binding protein or LBP) and systemic inflammation (IL-6) in 44 HIV virologically suppressed patients, half of whom (n = 22) had immunologic non-response to antiretroviral therapy (<270 CD4+Tcells/μL despite long-term suppressed viral load). The aim of the present study was to investigate if this beneficial effect of the probiotic Saccharomyces boulardii is due to modified gut microbiome composition, with a decrease of some species associated with higher systemic levels of microbial translocation and inflammation. In this study, we used 16S rDNA gene amplification and parallel sequencing to analyze the probiotic impact on the composition of the gut microbiome (faecal samples) in these 44 patients randomized to receive oral supplementation with probiotic or placebo for 12 weeks. Compared to the placebo group, in individuals treated with probiotic we observed lower concentrations of some gut species, such as those of the Clostridiaceae family, which were correlated with systemic levels of bacterial translocation and inflammation markers. In a sub-study of these patients, we observed significantly higher parameters of microbial translocation (LBP, soluble CD14) and systemic inflammation in immunologic non-responders than in immunologic responders, which was correlated with a relative abundance of specific gut bacterial groups (Lachnospiraceae genus and Proteobacteria). Thus, in this work, we propose a new therapeutic strategy using the probiotic yeast S. boulardii to modify gut microbiome composition. Identifying pro-inflammatory species in the gut microbiome could also be a useful new marker of poor immune response and a new therapeutic target.

Impact of probiotic Saccharomyces boulardii on the gut microbiome composition in HIV-treated patients: A double-blind, randomised, placebo-controlled trial

PubMed Central

Güerri-Fernández, Robert; Moya, Andrés; González, Alicia; Hernández, Juan J.; Lerma, Elisabet; Guelar, Ana; Sorli, Luisa; Horcajada, Juan P.; Artacho, Alejandro; D´Auria, Giuseppe; Knobel, Hernando

2017-01-01

Dysbalance in gut microbiota has been linked to increased microbial translocation, leading to chronic inflammation in HIV-patients, even under effective HAART. Moreover, microbial translocation is associated with insufficient reconstitution of CD4+T cells, and contributes to the pathogenesis of immunologic non-response. In a double-blind, randomised, placebo-controlled trial, we recently showed that, compared to placebo, 12 weeks treatment with probiotic Saccharomyces boulardii significantly reduced plasma levels of bacterial translocation (Lipopolysaccharide-binding protein or LBP) and systemic inflammation (IL-6) in 44 HIV virologically suppressed patients, half of whom (n = 22) had immunologic non-response to antiretroviral therapy (<270 CD4+Tcells/μL despite long-term suppressed viral load). The aim of the present study was to investigate if this beneficial effect of the probiotic Saccharomyces boulardii is due to modified gut microbiome composition, with a decrease of some species associated with higher systemic levels of microbial translocation and inflammation. In this study, we used 16S rDNA gene amplification and parallel sequencing to analyze the probiotic impact on the composition of the gut microbiome (faecal samples) in these 44 patients randomized to receive oral supplementation with probiotic or placebo for 12 weeks. Compared to the placebo group, in individuals treated with probiotic we observed lower concentrations of some gut species, such as those of the Clostridiaceae family, which were correlated with systemic levels of bacterial translocation and inflammation markers. In a sub-study of these patients, we observed significantly higher parameters of microbial translocation (LBP, soluble CD14) and systemic inflammation in immunologic non-responders than in immunologic responders, which was correlated with a relative abundance of specific gut bacterial groups (Lachnospiraceae genus and Proteobacteria). Thus, in this work, we propose a new therapeutic strategy using the probiotic yeast S. boulardii to modify gut microbiome composition. Identifying pro-inflammatory species in the gut microbiome could also be a useful new marker of poor immune response and a new therapeutic target. PMID:28388647

Increasing point-count duration increases standard error

USGS Publications Warehouse

Smith, W.P.; Twedt, D.J.; Hamel, P.B.; Ford, R.P.; Wiedenfeld, D.A.; Cooper, R.J.

1998-01-01

We examined data from point counts of varying duration in bottomland forests of west Tennessee and the Mississippi Alluvial Valley to determine if counting interval influenced sampling efficiency. Estimates of standard error increased as point count duration increased both for cumulative number of individuals and species in both locations. Although point counts appear to yield data with standard errors proportional to means, a square root transformation of the data may stabilize the variance. Using long (>10 min) point counts may reduce sample size and increase sampling error, both of which diminish statistical power and thereby the ability to detect meaningful changes in avian populations.

IMRT QA: Selecting gamma criteria based on error detection sensitivity.

PubMed

Steers, Jennifer M; Fraass, Benedick A

2016-04-01

The gamma comparison is widely used to evaluate the agreement between measurements and treatment planning system calculations in patient-specific intensity modulated radiation therapy (IMRT) quality assurance (QA). However, recent publications have raised concerns about the lack of sensitivity when employing commonly used gamma criteria. Understanding the actual sensitivity of a wide range of different gamma criteria may allow the definition of more meaningful gamma criteria and tolerance limits in IMRT QA. We present a method that allows the quantitative determination of gamma criteria sensitivity to induced errors which can be applied to any unique combination of device, delivery technique, and software utilized in a specific clinic. A total of 21 DMLC IMRT QA measurements (ArcCHECK®, Sun Nuclear) were compared to QA plan calculations with induced errors. Three scenarios were studied: MU errors, multi-leaf collimator (MLC) errors, and the sensitivity of the gamma comparison to changes in penumbra width. Gamma comparisons were performed between measurements and error-induced calculations using a wide range of gamma criteria, resulting in a total of over 20 000 gamma comparisons. Gamma passing rates for each error class and case were graphed against error magnitude to create error curves in order to represent the range of missed errors in routine IMRT QA using 36 different gamma criteria. This study demonstrates that systematic errors and case-specific errors can be detected by the error curve analysis. Depending on the location of the error curve peak (e.g., not centered about zero), 3%/3 mm threshold = 10% at 90% pixels passing may miss errors as large as 15% MU errors and ±1 cm random MLC errors for some cases. As the dose threshold parameter was increased for a given %Diff/distance-to-agreement (DTA) setting, error sensitivity was increased by up to a factor of two for select cases. This increased sensitivity with increasing dose threshold was consistent across all studied combinations of %Diff/DTA. Criteria such as 2%/3 mm and 3%/2 mm with a 50% threshold at 90% pixels passing are shown to be more appropriately sensitive without being overly strict. However, a broadening of the penumbra by as much as 5 mm in the beam configuration was difficult to detect with commonly used criteria, as well as with the previously mentioned criteria utilizing a threshold of 50%. We have introduced the error curve method, an analysis technique which allows the quantitative determination of gamma criteria sensitivity to induced errors. The application of the error curve method using DMLC IMRT plans measured on the ArcCHECK® device demonstrated that large errors can potentially be missed in IMRT QA with commonly used gamma criteria (e.g., 3%/3 mm, threshold = 10%, 90% pixels passing). Additionally, increasing the dose threshold value can offer dramatic increases in error sensitivity. This approach may allow the selection of more meaningful gamma criteria for IMRT QA and is straightforward to apply to other combinations of devices and treatment techniques.

New options for national population surveys: The implications of internet and smartphone coverage.

PubMed

Couper, Mick P; Gremel, Garret; Axinn, William; Guyer, Heidi; Wagner, James; West, Brady T

2018-07-01

Challenges to survey data collection have increased the costs of social research via face-to-face surveys so much that it may become extremely difficult for social scientists to continue using these methods. A key drawback to less expensive Internet-based alternatives is the threat of biased results from coverage errors in survey data. The rise of Internet-enabled smartphones presents an opportunity to re-examine the issue of Internet coverage for surveys and its implications for coverage bias. Two questions (on Internet access and smartphone ownership) were added to the National Survey of Family Growth (NSFG), a U.S. national probability survey of women and men age 15-44, using a continuous sample design. We examine 16 quarters (4 years) of data, from September 2012 to August 2016. Overall, we estimate that 82.9% of the target NSFG population has Internet access, and 81.6% has a smartphone. Combined, this means that about 90.7% of U.S. residents age 15-44 have Internet access, via either traditional devices or a smartphone. We find some evidence of compensatory coverage when looking at key race/ethnicity and age subgroups. For instance, while Black teens (15-18) have the lowest estimated rate of Internet access (81.9%) and the lowest rate of smartphone usage (72.6%), an estimated 88.0% of this subgroup has some form of Internet access. We also examine the socio-demographic correlates of Internet and smartphone coverage, separately and combined, as indicators of technology access in this population. In addition, we look at the effect of differential coverage on key estimates produced by the NSFG, related to fertility, family formation, and sexual activity. While this does not address nonresponse or measurement biases that may differ for alternative modes, our paper has implications for possible coverage biases that may arise when switching to a Web-based mode of data collection, either for follow-up surveys or to replace the main face-to-face data collection. Copyright © 2018. Published by Elsevier Inc.

Analysis of the “naming game” with learning errors in communications

NASA Astrophysics Data System (ADS)

Lou, Yang; Chen, Guanrong

2015-07-01

Naming game simulates the process of naming an objective by a population of agents organized in a certain communication network. By pair-wise iterative interactions, the population reaches consensus asymptotically. We study naming game with communication errors during pair-wise conversations, with error rates in a uniform probability distribution. First, a model of naming game with learning errors in communications (NGLE) is proposed. Then, a strategy for agents to prevent learning errors is suggested. To that end, three typical topologies of communication networks, namely random-graph, small-world and scale-free networks, are employed to investigate the effects of various learning errors. Simulation results on these models show that 1) learning errors slightly affect the convergence speed but distinctively increase the requirement for memory of each agent during lexicon propagation; 2) the maximum number of different words held by the population increases linearly as the error rate increases; 3) without applying any strategy to eliminate learning errors, there is a threshold of the learning errors which impairs the convergence. The new findings may help to better understand the role of learning errors in naming game as well as in human language development from a network science perspective.

Analysis of the "naming game" with learning errors in communications.

PubMed

Lou, Yang; Chen, Guanrong

2015-07-16

Naming game simulates the process of naming an objective by a population of agents organized in a certain communication network. By pair-wise iterative interactions, the population reaches consensus asymptotically. We study naming game with communication errors during pair-wise conversations, with error rates in a uniform probability distribution. First, a model of naming game with learning errors in communications (NGLE) is proposed. Then, a strategy for agents to prevent learning errors is suggested. To that end, three typical topologies of communication networks, namely random-graph, small-world and scale-free networks, are employed to investigate the effects of various learning errors. Simulation results on these models show that 1) learning errors slightly affect the convergence speed but distinctively increase the requirement for memory of each agent during lexicon propagation; 2) the maximum number of different words held by the population increases linearly as the error rate increases; 3) without applying any strategy to eliminate learning errors, there is a threshold of the learning errors which impairs the convergence. The new findings may help to better understand the role of learning errors in naming game as well as in human language development from a network science perspective.

Error-Transparent Quantum Gates for Small Logical Qubit Architectures

NASA Astrophysics Data System (ADS)

Kapit, Eliot

2018-02-01

One of the largest obstacles to building a quantum computer is gate error, where the physical evolution of the state of a qubit or group of qubits during a gate operation does not match the intended unitary transformation. Gate error stems from a combination of control errors and random single qubit errors from interaction with the environment. While great strides have been made in mitigating control errors, intrinsic qubit error remains a serious problem that limits gate fidelity in modern qubit architectures. Simultaneously, recent developments of small error-corrected logical qubit devices promise significant increases in logical state lifetime, but translating those improvements into increases in gate fidelity is a complex challenge. In this Letter, we construct protocols for gates on and between small logical qubit devices which inherit the parent device's tolerance to single qubit errors which occur at any time before or during the gate. We consider two such devices, a passive implementation of the three-qubit bit flip code, and the author's own [E. Kapit, Phys. Rev. Lett. 116, 150501 (2016), 10.1103/PhysRevLett.116.150501] very small logical qubit (VSLQ) design, and propose error-tolerant gate sets for both. The effective logical gate error rate in these models displays superlinear error reduction with linear increases in single qubit lifetime, proving that passive error correction is capable of increasing gate fidelity. Using a standard phenomenological noise model for superconducting qubits, we demonstrate a realistic, universal one- and two-qubit gate set for the VSLQ, with error rates an order of magnitude lower than those for same-duration operations on single qubits or pairs of qubits. These developments further suggest that incorporating small logical qubits into a measurement based code could substantially improve code performance.

Will Veterans Answer Sexual Orientation and Gender Identity Questions?

PubMed

Ruben, Mollie A; Blosnich, John R; Dichter, Melissa E; Luscri, Lorry; Shipherd, Jillian C

2017-09-01

The Veterans Health Administration does not routinely collect and document sexual orientation and gender identity (SOGI) data, despite existing health disparities among sexual and gender minority Veterans. Because of the legacy of previous Department of Defense (DoD) policies that prohibited disclosure of sexual or gender minority identities among active duty personnel, Veterans may be reluctant to respond to SOGI questions. This population-based study assesses item nonresponse to SOGI questions by Veteran status. This is a secondary analysis of data from a population-based sample of adults in 20 US states that elected to administer a SOGI module in the 2014 Behavioral Risk Factor Surveillance System survey. Prevalence of SOGI refusals and responses of "don't know" were compared for Veterans and non-Veterans. Veterans (n=22,587) and non-Veterans (n=146,475) were surveyed. Nearly all Veteran respondents (≥98%) completed the SOGI questions, with 95.4% identifying as heterosexual, 1.2% as gay or lesbian, 1.2% as bisexual, and 0.59% as transgender. A significantly lower proportion of Veterans than non-Veterans refuse to answer sexual orientation (1.5% vs. 1.9%). There was no difference between Veterans and non-Veterans in responses for gender identity. Veterans are just as likely as non-Veterans to complete SOGI items in survey research. Asking Veterans about SOGI is unlikely to yield significant nonresponse. These data suggest that future research should investigate Veterans' perspectives on being asked about SOGI in research settings and as part of routine clinical care.

A B lymphocyte mitogen is a Brucella abortus virulence factor required for persistent infection

PubMed Central

Spera, Juan Manuel; Ugalde, Juan Esteban; Mucci, Juan; Comerci, Diego J.; Ugalde, Rodolfo Augusto

2006-01-01

Microbial pathogens with the ability to establish chronic infections have evolved strategies to actively modulate the host immune response. Brucellosis is a disease caused by a Gram-negative intracellular pathogen that if not treated during the initial phase of the infection becomes chronic as the bacteria persist for the lifespan of the host. How this pathogen and others achieve this action is a largely unanswered question. We report here the identification of a Brucella abortus gene (prpA) directly involved in the immune modulation of the host. PrpA belongs to the proline-racemase family and elicits a B lymphocyte polyclonal activation that depends on the integrity of its proline-racemase catalytic site. Stimulation of splenocytes with PrpA also results in IL-10 secretion. Construction of a B. abortus-prpA mutant allowed us to assess the contribution of PrpA to the infection process. Mice infected with B. abortus induced an early and transient nonresponsive status of splenocytes to both Escherichia coli LPS and ConA. This phenomenon was not observed when mice were infected with a B. abortus-prpA mutant. Moreover, the B. abortus-prpA mutant had a reduced capacity to establish a chronic infection in mice. We propose that an early and transient nonresponsive immune condition of the host mediated by this B cell polyclonal activator is required for establishing a successful chronic infection by Brucella. PMID:17053080

Methodological Aspects of Subjective Life Expectancy: Effects of Culture-Specific Reporting Heterogeneity Among Older Adults in the United States.

PubMed

Lee, Sunghee; Smith, Jacqui

2016-05-01

Subjective life expectancy (SLE) has been suggested as a predictor of mortality and mortality-related behaviors. Although critical for culturally diverse societies, these findings do not consider cross-cultural methodological comparability. Culture-specific reporting heterogeneity is a well-known phenomenon introducing biases, and research on this issue with SLE is not established. Using data from the Health and Retirement Study, we examined reporting heterogeneity in SLE focusing on item nonresponse, focal points, and reports over time for five ethnic-cultural groups: non-Hispanic Whites, non-Hispanic Blacks, non-Hispanic other races, English-interviewed Hispanics, and Spanish-interviewed Hispanics. On item nonresponse, Spanish-interviewed Hispanics said, "I don't know," to SLE significantly more than any other groups. Nearly half of the respondents chose 0, 50, or 100, making them focal points. However, the focal points differed: 50 for Whites, 100 for Blacks, and 0 for Spanish-interviewed Hispanics. The relationship of SLE measured at two time points was higher for Whites than minorities. Moreover, those who said "I don't know" to SLE showed higher subsequent mortality than those who gave an answer. SLE was not a significant mortality predictor for Hispanics. Overall, SLE is not free from culture-specific reporting heterogeneity. This warrants further research about its culture-relevant measurement mechanisms. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Expression of AR-V7 in Circulating Tumour Cells Does Not Preclude Response to Next Generation Androgen Deprivation Therapy in Patients with Castration Resistant Prostate Cancer.

PubMed

Bernemann, Christof; Schnoeller, Thomas J; Luedeke, Manuel; Steinestel, Konrad; Boegemann, Martin; Schrader, Andres J; Steinestel, Julie

2017-01-01

The androgen receptor splice variant AR-V7 has recently been discussed as a predictive biomarker for nonresponse to next-generation androgen deprivation therapy (ADT) in patients with castration-resistant prostate cancer. However, we recently identified one patient showing a response from abiraterone despite expression of AR-V7 in his circulating tumour cells (CTC). Therefore, we precisely assessed the response in a cohort of 21 AR-V7 positive castration-resistant prostate cancer patients who had received therapy with abiraterone or enzalutamide. We detected a subgroup of six AR-V7 positive patients showing benefit from either abiraterone or enzalutamide. Their progression free survival was 26 d (censored) to 188 d. Four patients displayed a prostate-specific antigen decrease of >50%. When analysing prior therapies, we noticed that only one of the six patients had received next-generation ADT prior to CTC collection. As a result, we conclude that AR-V7 status in CTC cannot entirely predict nonresponse to next generation ADT and AR-V7-positive patients should not be systematically denied abiraterone or enzalutamide treatment, especially as effective alternative treatment options are still limited. A subgroup of patients can benefit from abiraterone and/or enzalutamide despite detection of AR-V7 splice variants in their circulating tumour cells. Copyright © 2016 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Antibiotic treatment of acute respiratory infections in acute care settings.

PubMed

Gonzales, Ralph; Camargo, Carlos A; MacKenzie, Thomas; Kersey, Ayanna S; Maselli, Judith; Levin, Sara K; McCulloch, Charles E; Metlay, Joshua P

2006-03-01

To examine the patterns of antibiotic use for acute respiratory tract infections (ARIs) in acute care settings. Chart reviews were performed retrospectively on a random sample of adult ARI visits to seven Veterans Affairs (VA) and seven non-VA emergency departments (EDs) for the period of November 2003 to February 2004. Visits were limited to those discharged to home and those with primary diagnoses of antibiotic-responsive (pneumonia, acute exacerbation of chronic bronchitis, pharyngitis, sinusitis) and antibiotic-nonresponsive conditions (acute bronchitis, nonspecific upper respiratory tract infection [URI]). Results are expressed as adjusted odds ratios with 95% confidence intervals. Of 2,270 ARI visits, 62% were for antibiotic-nonresponsive diagnoses. Seventy-two percent of acute bronchitis and 38% of URI visits were treated with antibiotics (p < 0.001). Stratified analyses show that antibiotic prescription rates were similar among attending-only and housestaff-associated visits for antibiotic-responsive diagnoses (p = 0.11), and acute bronchitis (76% vs. 59%; p = 0.31). However, the antibiotic prescription rate for URIs was greater for attending-only visits compared with housestaff-associated visits (48% vs. 15%; p = 0.01). Antibiotic prescription rates for total ARIs varied between sites, ranging from 42% to 89%. Patient age, gender, race and ethnicity, smoking status, comorbidities, and clinical setting (VA vs. non-VA) were not independently associated with antibiotic prescribing. Acute care settings are important targets for reducing inappropriate antibiotic prescribing. The mechanisms accounting for lower antibiotic prescription rates observed with housestaff-associated visits merit further study.

Low testosterone in non-responsive coeliac disease: A case series, case-control study with comparisons to the National Health and Nutrition Examination Survey.

PubMed

Kurada, Satya; Veeraraghavan, Gopal; Kaswala, Dharmesh; Hansen, Josh; Cohen, David; Kelly, Ciaran; Leffler, Daniel

2016-10-01

Adults with coeliac disease (CD) often report persistent fatigue, even when CD appears well controlled for unknown reasons. To evaluate common indications for testosterone panel (TP) testing and prevalence of low testosterone (T) in CD. In our case series, we determined common indications for checking TP in CD. Next, we conducted a case-control study to compare TP in CD vs. healthy controls (HC). We compared mean total T (TT), free T (FT) based on serologic, histologic disease activity. Finally, we assessed TT in tissue transglutaminase (tTG)+ vs. tTG- subjects and CD vs. HC obtained from the National Health and Nutrition Examination Survey (NHANES). 53 coeliac males had TP tested. Common indications included osteoporosis and fatigue. Low FT was observed in 7/13 men with osteoporosis and 5/6 with fatigue. In our case-control study (n=26 each), there was no difference in mean TT or FT between CD vs. HC, tTG+ vs tTG- or Marsh 0 vs. Marsh 3 groups. NHANES data showed no difference in mean TT between tTG+ vs tTG- (n=16 each) or CD vs. HC subjects (n=5 each). Low T occurs in CD patients at a similar rate as the general population. Common presentations of low T may mimic non-responsive CD symptoms. Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Psychometric assessment of the Family Satisfaction in the Intensive Care Unit questionnaire in the United Kingdom.

PubMed

Harrison, David A; Ferrando-Vivas, Paloma; Wright, Stephen E; McColl, Elaine; Heyland, Daren K; Rowan, Kathryn M

2017-04-01

To establish the psychometric properties of the Family Satisfaction in the Intensive Care Unit 24-item (FS-ICU-24) questionnaire in the United Kingdom. The Family-Reported Experiences Evaluation study recruited family members of patients staying at least 24 hours in 20 participating intensive care units. Questionnaires were evaluated for nonresponse, floor/ceiling effects, redundancy, and construct validity. Internal consistency was evaluated with item-to-own scale correlations and Cronbach α. Confirmatory and exploratory factor analyses were used to explore the underlying structure. Twelve thousand three hundred forty-six family members of 6380 patients were recruited and 7173 (58%) family members of 4615 patients returned a completed questionnaire. One family member per patient was included in the psychometric assessment. Six items had greater than 10% nonresponse; 1 item had a ceiling effect; and 11 items had potential redundancy. Internal consistency was high (Cronbach α, overall .96; satisfaction with care, .94; satisfaction with decision making, .93). The 2-factor solution was not a good fit. Exploratory factor analysis indicated that satisfaction with decision making encompassed 2 constructs-satisfaction with information and satisfaction with the decision-making process. The Family Satisfaction in the Intensive Care Unit 24-item questionnaire demonstrated good psychometric properties in the United Kingdom setting. Construct validity could be improved by use of 3 domains and some scope for further improvement was identified. Copyright © 2016 Elsevier Inc. All rights reserved.

Hepatitis B vaccine in celiac disease: yesterday, today and tomorrow.

PubMed

Vitaliti, Giovanna; Praticò, Andrea Domenico; Cimino, Carla; Di Dio, Giovanna; Lionetti, Elena; La Rosa, Mario; Leonardi, Salvatore

2013-02-14

Some studies showed that in celiac patients the immunological response to vaccination is similar to that one found in general population except for vaccine against hepatitis B virus (HBV). The non-responsiveness to HBV vaccine has also been described in healthy people, nevertheless the number of non-responders has been demonstrated to be higher in celiac disease (CD) patients than in healthy controls. Several hypothesis explaining this higher rate of unresponsiveness to HBV vaccine in CD patients have been described, such as the genetic hypothesis, according with CD patients carrying the disease-specific haplotype HLA-B8, DR3, and DQ2, show a lower response to HBV vaccine both in clinical expressed CD patients and in healthy people carrying the same haplotype. On the other hand, it has been demonstrated that the gluten intake during the vaccination seems to influence the response to the same vaccine. Moreover, it has been demonstrated a possible genetic predisposition to hepatitis B vaccine non-responsiveness likely due to the presence of specific human leukocyte antigen haplotypes and specific single nucleotide polymorphism in genes of cytokine/cytokine receptors and toll like receptors, but the pathogenic mechanism responsible for this low responsiveness still remains unclear. The aim of this review is to focus on the possible pathogenic causes of unresponsiveness to HBV vaccine in CD patients and to propose an alternative vaccination schedule in order to improve the responsiveness to HBV vaccine in this at-risk patients.

High-density Genotyping of Immune Loci in Kawasaki Disease and IVIG Treatment Response in European-American Case-parent Trio Study

PubMed Central

Shendre, Aditi; Wiener, Howard W.; Zhi, Degui; Vazquez, Ana I; Portman, Michael A.; Shrestha, Sadeep

2014-01-01

Kawasaki disease (KD) is a diffuse and acute small-vessel vasculitis observed in children and has genetic and autoimmune components. We genotyped 112 case-parent trios of European decent (confirmed by AIMS) using the ImmunoChip array and performed association analyses with susceptibility to KD and IVIG non-response. KD susceptibility was assessed using the transmission disequilibrium test whereas IVIG non-response was evaluated using multivariable logistic regression analysis. We replicated SNPs in three gene regions (FCGR, CD40/CDH22, and HLA-DQB2/HLA-DOB) that have been previously associated with KD and provide support to other findings of several novel SNPs in genes with potential pathway in KD pathogenesis. SNP rs838143 in the 3′ UTR of FUT1 gene (2.7×10-5) and rs9847915 in the intergenic region of LOC730109 ∣ BRD7P2 (6.81×10-7) were the top hits for KD susceptibility in additive and dominant models, respectively. The top hits for IVIG responsiveness were rs1200332 in the intergenic region of BAZ1A ∣ C14orf19 (1.4×10-4) and rs4889606 in the intron of the STX1B gene (6.95×10-5) in additive and dominant models, respectively. Our study suggests that genes and biological pathways involved in autoimmune diseases play an important role in the pathogenesis of KD and IVIG response mechanism. PMID:25101798

Case Report: Aquatic Therapy and End-Stage Dementia.

PubMed

Becker, Bruce E; Lynch, Stacy

2018-04-01

A 54-year-old woman, retired due to progressive cognitive decline, was diagnosed with early-onset Alzheimer dementia. Conventional medication therapy for dementia had proven futile. Initial evaluation revealed a nonverbal female seated in a wheelchair, dependent on 2-person assist for all transfers and activities of daily living. She had been either nonresponsive or actively resistive for both activities of daily living and transfers in the 6 months before assessment. After a total of 17 1-hour therapy sessions over 19 weeks in a warm water therapy pool, she achieved the ability to tread water for 15 minutes, transfers improved to moderate-to-maximum assist from seated, and ambulation improved to 1000 feet with minimum-to-moderate assist of 2 persons. Communication increased to appropriate "yes," "no," and "okay" appropriate responses, and an occasional "thank you" and "very nice." The authors propose that her clinical progress may be related to her aquatic therapy intervention. IV. Copyright © 2018 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Preschoolers' Performance on the Brazilian Adaptation of the Preschool Language Assessment Instrument - Second Edition.

PubMed

Lindau, Tâmara Andrade; Rossi, Natalia Freitas; Giacheti, Celia Maria

2016-01-01

The objective was to test whether the Brazilian version of the Preschool Language Assessment Instrument - Second Edition (PLAI-2) has the potential to assess and identify differences in typical language development of Portuguese-speaking preschoolers. The study included 354 children of both genders with typical language development who were between the ages of 3 years and 5 years 11 months. The version of the PLAI-2 previously translated into Brazilian Portuguese was used to assess the communication skills of these preschool-age children. Statistically significant differences were found between the age groups, and the raw score tended to increase as a function of age. With nonstandardized assessments, the performances of the younger groups revealed behavioral profiles (e.g., nonresponsive, impulsive behavior) that directly influenced the evaluation. The findings of this study show that the PLAI-2 is effective in identifying differences in language development among Brazilian children of preschool age. Future research should include studies validating and standardizing these findings. © 2016 S. Karger AG, Basel.

Dual-Responsive pH and Temperature Sensitive Nanoparticles Based on Methacrylic Acid and Di(ethylene glycol) Methyl Ether Methacrylate for the Triggered Release of Drugs.

PubMed

Khine, Yee Yee; Jiang, Yanyan; Dag, Aydan; Lu, Hongxu; Stenzel, Martina H

2015-08-01

A series of thermo-and pH-responsive poly(methyl methacrylate)-block-poly[methacrylic acid-co-di(ethylene glycol) methyl ether methacrylate] PMMA-b-P[MAA-co-DEGMA] block copolymers were synthesized by RAFT polymerization and self-assembled into micelles. The molar ratio of MAA was altered from 0-12% in order to modulate the lower critical solution temperature (LCST) of PDEGMA. The release of the drug albendazole from the micelle was strongly dependent on the temperature and the LCST value of the polymer. Systems below the LCST released the drug slowly while increasing the temperature above the LCST or decreasing the pH value to 5 resulted in the burst-like release of the drug. ABZ delivered in this pH-responsive drug carrier had a higher toxicity than the free drug or the drug delivered in a non-responsive drug carrier. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Personalized prescribing: a new medical model for clinical implementation of psychotropic drugs

PubMed Central

Eap, Chin B.

2016-01-01

The use of pharmacogenetic tests was already being proposed in psychiatry in the early 2000s because genetic factors were known to influence drug pharmacokinetics and pharmacodynamics. However, sufficient levels of evidence to justify routine use have been achieved for only a few tests (eg, major histocompatibility complex, class I, B, allele 1502 [HLA-B*1502] for carbamazepine in epilepsy and bipolar disorders); many findings are too preliminary or, when replicated, of low clinical relevance because of a small effect size. Although drug selection and dose adaptation according to cytochrome P450 genotypes are sound, a large number of patients need to be genotyped in order to prevent one case of severe side effect and/or nonresponse. The decrease in cost for genetic analysis shifts the cost: benefit ratio toward increasing use of pharmacogenetic tests. However, they have to be combined with careful clinical evaluations and other tools (eg, therapeutic drug monitoring and phenotyping) to contribute to the general aim of providing the best care for psychiatric patients. PMID:27757065

Personalized prescribing: a new medical model for clinical implementation of psychotropic drugs.

PubMed

Eap, Chin B

2016-09-01

The use of pharmacogenetic tests was already being proposed in psychiatry in the early 2000s because genetic factors were known to influence drug pharmacokinetics and pharmacodynamics. However, sufficient levels of evidence to justify routine use have been achieved for only a few tests (eg, major histocompatibility complex, class I, B, allele 1502 [HLA-B*1502] for carbamazepine in epilepsy and bipolar disorders); many findings are too preliminary or, when replicated, of low clinical relevance because of a small effect size. Although drug selection and dose adaptation according to cytochrome P450 genotypes are sound, a large number of patients need to be genotyped in order to prevent one case of severe side effect and/or nonresponse. The decrease in cost for genetic analysis shifts the cost: benefit ratio toward increasing use of pharmacogenetic tests. However, they have to be combined with careful clinical evaluations and other tools (eg, therapeutic drug monitoring and phenotyping) to contribute to the general aim of providing the best care for psychiatric patients.

Primary continuous unilateral headaches: a nosologic model for hemicrania continua.

PubMed

Pareja, Juan A; Cuadrado, María-Luz; Fernández-de-las-Peñas, César; Montojo, Teresa; Álvarez, Mónica; López-de-Silanes, Carlos

2012-04-01

Hemicrania continua was originally described as a strictly unilateral, continuous headache with an absolute response to indomethacin. Recognition of an increasing number of patients with the same clinical features except for a lack of response to indomethacin has generated controversy about whether the responsive/non-responsive phenotypes belong to the same disorder. We suggest that the non-responsive phenotype should be differentiated from the original concept of hemicrania continua, because it probably indicates a separate type of headache of undetermined nature, i.e. hemicrania incerta. However, differentiating hemicrania incerta from hemicrania continua does not imply that the two headaches are unrelated. Both hemicranias may outline a continuum, giving rise to a broader diagnostic field. There seems to be a syndrome of 'primary continuous unilateral headache' with at least two distinctive categories: hemicrania continua and hemicrania incerta, which are differentiated by their respective response to indomethacin. This division means plurality but adds precision, and allows a clear-cut diagnosis of some controversial cases.

[Validation of a method for notifying and monitoring medication errors in pediatrics].

PubMed

Guerrero-Aznar, M D; Jiménez-Mesa, E; Cotrina-Luque, J; Villalba-Moreno, A; Cumplido-Corbacho, R; Fernández-Fernández, L

2014-12-01

To analyze the impact of a multidisciplinary and decentralized safety committee in the pediatric management unit, and the joint implementation of a computing network application for reporting medication errors, monitoring the follow-up of the errors, and an analysis of the improvements introduced. An observational, descriptive, cross-sectional, pre-post intervention study was performed. An analysis was made of medication errors reported to the central safety committee in the twelve months prior to introduction, and those reported to the decentralized safety committee in the management unit in the nine months after implementation, using the computer application, and the strategies generated by the analysis of reported errors. Number of reported errors/10,000 days of stay, number of reported errors with harm per 10,000 days of stay, types of error, categories based on severity, stage of the process, and groups involved in the notification of medication errors. Reported medication errors increased 4.6 -fold, from 7.6 notifications of medication errors per 10,000 days of stay in the pre-intervention period to 36 in the post-intervention, rate ratio 0.21 (95% CI; 0.11-0.39) (P<.001). The medication errors with harm or requiring monitoring reported per 10,000 days of stay, was virtually unchanged from one period to the other ratio rate 0,77 (95% IC; 0,31-1,91) (P>.05). The notification of potential errors or errors without harm per 10,000 days of stay increased 17.4-fold (rate ratio 0.005., 95% CI; 0.001-0.026, P<.001). The increase in medication errors notified in the post-intervention period is a reflection of an increase in the motivation of health professionals to report errors through this new method. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

How the credit assignment problems in motor control could be solved after the cerebellum predicts increases in error.

PubMed

Verduzco-Flores, Sergio O; O'Reilly, Randall C

2015-01-01

We present a cerebellar architecture with two main characteristics. The first one is that complex spikes respond to increases in sensory errors. The second one is that cerebellar modules associate particular contexts where errors have increased in the past with corrective commands that stop the increase in error. We analyze our architecture formally and computationally for the case of reaching in a 3D environment. In the case of motor control, we show that there are synergies of this architecture with the Equilibrium-Point hypothesis, leading to novel ways to solve the motor error and distal learning problems. In particular, the presence of desired equilibrium lengths for muscles provides a way to know when the error is increasing, and which corrections to apply. In the context of Threshold Control Theory and Perceptual Control Theory we show how to extend our model so it implements anticipative corrections in cascade control systems that span from muscle contractions to cognitive operations.

How the credit assignment problems in motor control could be solved after the cerebellum predicts increases in error

PubMed Central

Verduzco-Flores, Sergio O.; O'Reilly, Randall C.

2015-01-01

We present a cerebellar architecture with two main characteristics. The first one is that complex spikes respond to increases in sensory errors. The second one is that cerebellar modules associate particular contexts where errors have increased in the past with corrective commands that stop the increase in error. We analyze our architecture formally and computationally for the case of reaching in a 3D environment. In the case of motor control, we show that there are synergies of this architecture with the Equilibrium-Point hypothesis, leading to novel ways to solve the motor error and distal learning problems. In particular, the presence of desired equilibrium lengths for muscles provides a way to know when the error is increasing, and which corrections to apply. In the context of Threshold Control Theory and Perceptual Control Theory we show how to extend our model so it implements anticipative corrections in cascade control systems that span from muscle contractions to cognitive operations. PMID:25852535

IMRT QA: Selecting gamma criteria based on error detection sensitivity

DOE Office of Scientific and Technical Information (OSTI.GOV)

Steers, Jennifer M.; Fraass, Benedick A., E-mail: benedick.fraass@cshs.org

Purpose: The gamma comparison is widely used to evaluate the agreement between measurements and treatment planning system calculations in patient-specific intensity modulated radiation therapy (IMRT) quality assurance (QA). However, recent publications have raised concerns about the lack of sensitivity when employing commonly used gamma criteria. Understanding the actual sensitivity of a wide range of different gamma criteria may allow the definition of more meaningful gamma criteria and tolerance limits in IMRT QA. We present a method that allows the quantitative determination of gamma criteria sensitivity to induced errors which can be applied to any unique combination of device, delivery technique,more » and software utilized in a specific clinic. Methods: A total of 21 DMLC IMRT QA measurements (ArcCHECK®, Sun Nuclear) were compared to QA plan calculations with induced errors. Three scenarios were studied: MU errors, multi-leaf collimator (MLC) errors, and the sensitivity of the gamma comparison to changes in penumbra width. Gamma comparisons were performed between measurements and error-induced calculations using a wide range of gamma criteria, resulting in a total of over 20 000 gamma comparisons. Gamma passing rates for each error class and case were graphed against error magnitude to create error curves in order to represent the range of missed errors in routine IMRT QA using 36 different gamma criteria. Results: This study demonstrates that systematic errors and case-specific errors can be detected by the error curve analysis. Depending on the location of the error curve peak (e.g., not centered about zero), 3%/3 mm threshold = 10% at 90% pixels passing may miss errors as large as 15% MU errors and ±1 cm random MLC errors for some cases. As the dose threshold parameter was increased for a given %Diff/distance-to-agreement (DTA) setting, error sensitivity was increased by up to a factor of two for select cases. This increased sensitivity with increasing dose threshold was consistent across all studied combinations of %Diff/DTA. Criteria such as 2%/3 mm and 3%/2 mm with a 50% threshold at 90% pixels passing are shown to be more appropriately sensitive without being overly strict. However, a broadening of the penumbra by as much as 5 mm in the beam configuration was difficult to detect with commonly used criteria, as well as with the previously mentioned criteria utilizing a threshold of 50%. Conclusions: We have introduced the error curve method, an analysis technique which allows the quantitative determination of gamma criteria sensitivity to induced errors. The application of the error curve method using DMLC IMRT plans measured on the ArcCHECK® device demonstrated that large errors can potentially be missed in IMRT QA with commonly used gamma criteria (e.g., 3%/3 mm, threshold = 10%, 90% pixels passing). Additionally, increasing the dose threshold value can offer dramatic increases in error sensitivity. This approach may allow the selection of more meaningful gamma criteria for IMRT QA and is straightforward to apply to other combinations of devices and treatment techniques.« less

Effects of phenytoin on N100 augmenting/reducing and the late positive complex of the event-related potential: a topographic analysis.

PubMed

Pritchard, W S; Barratt, E S; Faulk, D M; Brandt, M E; Bryant, S G

1986-01-01

The effects of 100 mg of phenytoin on the topographic distribution of augmenting/reducing (amplitude response/nonresponse to increases in stimulus intensity) of the visual N100 component of the event-related potential (ERP) were examined. In normal subjects, visual N100 augmenting is associated with impulsivity and attentional distraction. Effects of phenytoin on the topographic distributions of the P300 and slow-wave cognitive ERP components were also examined. Subjects counted the total number of light flashes presented at two highly discriminable but equiprobable intensities. Results indicated that phenytoin had a significant reducing effect on the intensity response of N100 at the vertex and anterior temporal electrode sites, and approached significance at the frontal pole. That is, at these loci N100 showed less of an increase in amplitude (or, in some subjects, more of a decrease) in going from baseline to drug than in going from baseline to placebo. Results also indicated that phenytoin significantly enhanced the amplitude of the frontal, negative portion of slow wave, but not the posterior, positive portion or the P300 component. These findings are consistent with behavioral evidence that phenytoin reduces impulsivity and improves concentration.

Photo-induced micro-mechanical optical switch

DOEpatents

Rajic, Slobodan; Datskos, Panagiotis George; Egert, Charles M.

2002-01-01

An optical switch is formed by introducing light lengthwise to a microcantilever waveguide directed toward a second waveguide. The microcantilever is caused to bend by light emitted from a laser diode orthogonal to the microcantilever and at an energy above the band gap, which induces stress as a result of the generation of free carriers. The bending of the waveguide directs the carrier frequency light to a second receptor waveguide or to a non-responsive surface. The switch may be combined in an array to perform multiple switching functions rapidly and at low energy losses.

Leveraging Competence in the Use of Leveraging Collaborative Tools Competence: facilitating an Open Architecture Approach to Acquiring Integrated Warfare Systems

DTIC Science & Technology

2006-12-30

Nonresponse Bias in Mail Surveys,” Journal of Marketing Research , 19, (1976), pp. 396-402. Bandura, A., Self-efficacy: The exercise of control, New York: W.H...Journal of Marketing Research , 16, 1, (1979), pp. 64-73. Communication News, “Web Meetings Benefit Bottom Line,” Communication News, 40, 6, (2003...Structural Equation Models: LISREL and PLS Applied to Consumer Exit-Voice Theory," Journal of Marketing Research , 19, (1982), 440-452. Grantham, C.E. and L

An Empirical Examination of Reverse Auction Appropriateness in B2B Source Selection

DTIC Science & Technology

2006-01-01

Measures of Marketing Constructs," Journal of Marketing Research , Vol. 16, No.2, pp. 64 - 73. Cohn, L. (2000), "B2B: The Hottest Net Bet Yet...34 Psycholgical Bulletin, Vol. 103, No.3, pp. 411-423. Armstrong, J.S. and T.S. Overton (1977), "Estimating Nonresponse Bias in Mail Surveys," Journal of Marketing ... Research , Vol.14, No.3, pp. 396-402. Bagozzi, R. (1983), "Issues in the Application of Covariance Structure Analysis: A Further Comment," Journal of

The Effect of Random Error on Diagnostic Accuracy Illustrated with the Anthropometric Diagnosis of Malnutrition

PubMed Central

2016-01-01

Background It is often thought that random measurement error has a minor effect upon the results of an epidemiological survey. Theoretically, errors of measurement should always increase the spread of a distribution. Defining an illness by having a measurement outside an established healthy range will lead to an inflated prevalence of that condition if there are measurement errors. Methods and results A Monte Carlo simulation was conducted of anthropometric assessment of children with malnutrition. Random errors of increasing magnitude were imposed upon the populations and showed that there was an increase in the standard deviation with each of the errors that became exponentially greater with the magnitude of the error. The potential magnitude of the resulting error of reported prevalence of malnutrition were compared with published international data and found to be of sufficient magnitude to make a number of surveys and the numerous reports and analyses that used these data unreliable. Conclusions The effect of random error in public health surveys and the data upon which diagnostic cut-off points are derived to define “health” has been underestimated. Even quite modest random errors can more than double the reported prevalence of conditions such as malnutrition. Increasing sample size does not address this problem, and may even result in less accurate estimates. More attention needs to be paid to the selection, calibration and maintenance of instruments, measurer selection, training & supervision, routine estimation of the likely magnitude of errors using standardization tests, use of statistical likelihood of error to exclude data from analysis and full reporting of these procedures in order to judge the reliability of survey reports. PMID:28030627

Estimates of fetch-induced errors in Bowen-ratio energy-budget measurements of evapotranspiration from a prairie wetland, Cottonwood Lake Area, North Dakota, USA

USGS Publications Warehouse

Stannard, David L.; Rosenberry, Donald O.; Winter, Thomas C.; Parkhurst, Renee S.

2004-01-01

Micrometeorological measurements of evapotranspiration (ET) often are affected to some degree by errors arising from limited fetch. A recently developed model was used to estimate fetch-induced errors in Bowen-ratio energy-budget measurements of ET made at a small wetland with fetch-to-height ratios ranging from 34 to 49. Estimated errors were small, averaging −1.90%±0.59%. The small errors are attributed primarily to the near-zero lower sensor height, and the negative bias reflects the greater Bowen ratios of the drier surrounding upland. Some of the variables and parameters affecting the error were not measured, but instead are estimated. A sensitivity analysis indicates that the uncertainty arising from these estimates is small. In general, fetch-induced error in measured wetland ET increases with decreasing fetch-to-height ratio, with increasing aridity and with increasing atmospheric stability over the wetland. Occurrence of standing water at a site is likely to increase the appropriate time step of data integration, for a given level of accuracy. Occurrence of extensive open water can increase accuracy or decrease the required fetch by allowing the lower sensor to be placed at the water surface. If fetch is highly variable and fetch-induced errors are significant, the variables affecting fetch (e.g., wind direction, water level) need to be measured. Fetch-induced error during the non-growing season may be greater or smaller than during the growing season, depending on how seasonal changes affect both the wetland and upland at a site.

Development and implementation of a human accuracy program in patient foodservice.

PubMed

Eden, S H; Wood, S M; Ptak, K M

1987-04-01

For many years, industry has utilized the concept of human error rates to monitor and minimize human errors in the production process. A consistent quality-controlled product increases consumer satisfaction and repeat purchase of product. Administrative dietitians have applied the concepts of using human error rates (the number of errors divided by the number of opportunities for error) at four hospitals, with a total bed capacity of 788, within a tertiary-care medical center. Human error rate was used to monitor and evaluate trayline employee performance and to evaluate layout and tasks of trayline stations, in addition to evaluating employees in patient service areas. Long-term employees initially opposed the error rate system with some hostility and resentment, while newer employees accepted the system. All employees now believe that the constant feedback given by supervisors enhances their self-esteem and productivity. Employee error rates are monitored daily and are used to counsel employees when necessary; they are also utilized during annual performance evaluation. Average daily error rates for a facility staffed by new employees decreased from 7% to an acceptable 3%. In a facility staffed by long-term employees, the error rate increased, reflecting improper error documentation. Patient satisfaction surveys reveal satisfaction, for tray accuracy increased from 88% to 92% in the facility staffed by long-term employees and has remained above the 90% standard in the facility staffed by new employees.

Accounting for independent nondifferential misclassification does not increase certainty that an observed association is in the correct direction.

PubMed

Greenland, Sander; Gustafson, Paul

2006-07-01

Researchers sometimes argue that their exposure-measurement errors are independent of other errors and are nondifferential with respect to disease, resulting in estimation bias toward the null. Among well-known problems with such arguments are that independence and nondifferentiality are harder to satisfy than ordinarily appreciated (e.g., because of correlation of errors in questionnaire items, and because of uncontrolled covariate effects on error rates); small violations of independence or nondifferentiality may lead to bias away from the null; and, if exposure is polytomous, the bias produced by independent nondifferential error is not always toward the null. The authors add to this list by showing that, in a 2 x 2 table (for which independent nondifferential error produces bias toward the null), accounting for independent nondifferential error does not reduce the p value even though it increases the point estimate. Thus, such accounting should not increase certainty that an association is present.

Risk Factors for Increased Severity of Paediatric Medication Administration Errors

PubMed Central

Sears, Kim; Goodman, William M.

2012-01-01

Patients' risks from medication errors are widely acknowledged. Yet not all errors, if they occur, have the same risks for severe consequences. Facing resource constraints, policy makers could prioritize factors having the greatest severe–outcome risks. This study assists such prioritization by identifying work-related risk factors most clearly associated with more severe consequences. Data from three Canadian paediatric centres were collected, without identifiers, on actual or potential errors that occurred. Three hundred seventy-two errors were reported, with outcome severities ranging from time delays up to fatalities. Four factors correlated significantly with increased risk for more severe outcomes: insufficient training; overtime; precepting a student; and off-service patient. Factors' impacts on severity also vary with error class: for wrong-time errors, the factors precepting a student or working overtime significantly increase severe-outcomes risk. For other types, caring for an off-service patient has greatest severity risk. To expand such research, better standardization is needed for categorizing outcome severities. PMID:23968607

Sensitivity to prediction error in reach adaptation

PubMed Central

Haith, Adrian M.; Harran, Michelle D.; Shadmehr, Reza

2012-01-01

It has been proposed that the brain predicts the sensory consequences of a movement and compares it to the actual sensory feedback. When the two differ, an error signal is formed, driving adaptation. How does an error in one trial alter performance in the subsequent trial? Here we show that the sensitivity to error is not constant but declines as a function of error magnitude. That is, one learns relatively less from large errors compared with small errors. We performed an experiment in which humans made reaching movements and randomly experienced an error in both their visual and proprioceptive feedback. Proprioceptive errors were created with force fields, and visual errors were formed by perturbing the cursor trajectory to create a visual error that was smaller, the same size, or larger than the proprioceptive error. We measured single-trial adaptation and calculated sensitivity to error, i.e., the ratio of the trial-to-trial change in motor commands to error size. We found that for both sensory modalities sensitivity decreased with increasing error size. A reanalysis of a number of previously published psychophysical results also exhibited this feature. Finally, we asked how the brain might encode sensitivity to error. We reanalyzed previously published probabilities of cerebellar complex spikes (CSs) and found that this probability declined with increasing error size. From this we posit that a CS may be representative of the sensitivity to error, and not error itself, a hypothesis that may explain conflicting reports about CSs and their relationship to error. PMID:22773782

Users’ dissatisfaction with dental care: a population-based household study

PubMed Central

Martins, Andréa Maria Eleutério de Barros Lima; Ferreira, Raquel Conceição; dos Santos, Pedro Eleutério; Carreiro, Danilo Lima; Souza, João Gabriel Silva; Ferreira e Ferreira, Efigênia

2015-01-01

OBJECTIVE To examine whether demographic, socioeconomic conditions, oral health subjectivity and characterization of dental care are associated with users’ dissatisfaction with such are. METHODS Cross-sectional study of 781 people who required dental care in Montes Claros, MG, Southeastern Brazil, in 2012, a city with of medium-sized population situated in the North of Minas Gerais. Household interviews were conducted to assess the users’ dissatisfaction with dental care (dependent variable), demographic, socioeconomic conditions, oral health subjectivity and characterization of dental care (independent variables). Sample calculation was used for the finite population, with estimates made for proportions of dissatisfaction in 50.0% of the population, a 5.0% error margin, a non-response rate of 5.0% and a 2.0% design effect. Logistic regression was used, and the odds ratio was calculated with a 5% significance level and 95% confidence intervals. RESULTS Of the interviewed individuals, 9.0% (7.9%, with correction for design effect) were dissatisfied with the care provided. These were associated with lower educational level; negative self-assessment of oral health; perception that the care provider was unable to give dental care; negative evaluation of the way the patient was treated, the cleanliness of the rooms, based on the examination rooms and the toilets, and the size of the waiting and examination rooms. CONCLUSIONS The rate of dissatisfaction with dental care was low. This dissatisfaction was associated with socioeconomic conditions, subjectivity of oral health, skill of the health professionals relating to the professional-patient relationship and facility infrastructure. Educational interventions are suggested that aim at improving the quality of care among professionals by responsible agencies as is improving the infrastructure of the care units. PMID:26270017

Molecular epidemiology, genotype-phenotype correlation and BH4 responsiveness in Spanish patients with phenylketonuria.

PubMed

Aldámiz-Echevarría, Luis; Llarena, Marta; Bueno, María A; Dalmau, Jaime; Vitoria, Isidro; Fernández-Marmiesse, Ana; Andrade, Fernando; Blasco, Javier; Alcalde, Carlos; Gil, David; García, María C; González-Lamuño, Domingo; Ruiz, Mónica; Ruiz, María A; Peña-Quintana, Luis; González, David; Sánchez-Valverde, Felix; Desviat, Lourdes R; Pérez, Belen; Couce, María L

2016-08-01

Phenylketonuria (PKU), the most common inborn error of amino acid metabolism, is caused by mutations in the phenylalanine-4-hydroxylase (PAH) gene. This study aimed to assess the genotype-phenotype correlation in the PKU Spanish population and the usefulness in establishing genotype-based predictions of BH4 responsiveness in our population. It involved the molecular characterization of 411 Spanish PKU patients: mild hyperphenylalaninemia non-treated (mild HPA-NT) (34%), mild HPA (8.8%), mild-moderate (20.7%) and classic (36.5%) PKU. BH4 responsiveness was evaluated using a 6R-BH4 loading test. We assessed genotype-phenotype associations and genotype-BH4 responsiveness in our population according to literature and classification of the mutations. The mutational spectrum analysis showed 116 distinct mutations, most missense (70.7%) and located in the catalytic domain (62.9%). The most prevalent mutations were c.1066-11G>A (9.7%), p.Val388Met (6.6%) and p.Arg261Gln (6.3%). Three novel mutations (c.61-13del9, p.Ile283Val and p.Gly148Val) were reported. Although good genotype-phenotype correlation was observed, there was no exact correlation for some genotypes. Among the patients monitored for the 6R-BH4 loading test: 102 were responders (87, carried either one or two BH4-responsive alleles) and 194 non-responders (50, had two non-responsive mutations). More discrepancies were observed in non-responders. Our data reveal a great genetic heterogeneity in our population. Genotype is quite a good predictor of phenotype and BH4 responsiveness, which is relevant for patient management, treatment and follow-up.

Percussion use and training: a survey of music therapy clinicians.

PubMed

Scheffel, Stephanie; Matney, Bill

2014-01-01

Percussion instruments are commonly used in music therapy practice; however, the body of published literature regarding music therapy-related percussion training and practice is limited. The purpose of our survey study was to describe: (a) clinician perspectives of their academic percussion training; (b) use of percussion testing during academic training; (c) clinician perspectives on relevance, adequacy, and importance of academic percussion training; (d) clinician perspectives of their nonacademic percussion training; and (e) current use of percussion in clinical practice. Through comparisons of these parameters, we sought to provide information that may inform future percussion use and training. Participants were selected using an email list from the Certification Board for Music Therapists. Board-certified music therapists (MT-BC) were provided with a researcher-created survey about academic percussion training, nonacademic percussion training, and use of percussion in clinical practice. Survey response rate was 14.4% (611/4234). We used demographic data to address potential nonresponse error and ensure population representation for region of residence and region of academic training. Results revealed concerns about perceived adequacy of percussion training received during music therapy education (14.6% reported receiving no academic percussion training; 40.6% reported training was not adequate), and absence of percussion-specific proficiency exams. Of the training received, 62.8% indicated that training was relevant; however, a majority (76.5%) recommended current music therapy students receive more percussion training on instruments and skills most relevant to clinical practice. Comparisons between academic training, perceived needs in academic training, and clinical usage may inform future training and clinical competency. We provide suggestions for developing future training, as well as for furthering clinical implementation and research. © the American Music Therapy Association 2014. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Increasing skepticism toward potential liars: effects of existential threat on veracity judgments and the moderating role of honesty norm activation

PubMed Central

Schindler, Simon; Reinhard, Marc-André

2015-01-01

With the present research, we investigated effects of existential threat on veracity judgments. According to several meta-analyses, people judge potentially deceptive messages of other people as true rather than as false (so-called truth bias). This judgmental bias has been shown to depend on how people weigh the error of judging a true message as a lie (error 1) and the error of judging a lie as a true message (error 2). The weight of these errors has been further shown to be affected by situational variables. Given that research on terror management theory has found evidence that mortality salience (MS) increases the sensitivity toward the compliance of cultural norms, especially when they are of focal attention, we assumed that when the honesty norm is activated, MS affects judgmental error weighing and, consequently, judgmental biases. Specifically, activating the norm of honesty should decrease the weight of error 1 (the error of judging a true message as a lie) and increase the weight of error 2 (the error of judging a lie as a true message) when mortality is salient. In a first study, we found initial evidence for this assumption. Furthermore, the change in error weighing should reduce the truth bias, automatically resulting in better detection accuracy of actual lies and worse accuracy of actual true statements. In two further studies, we manipulated MS and honesty norm activation before participants judged several videos containing actual truths or lies. Results revealed evidence for our prediction. Moreover, in Study 3, the truth bias was increased after MS when group solidarity was previously emphasized. PMID:26388815

Characterizing the SWOT discharge error budget on the Sacramento River, CA

NASA Astrophysics Data System (ADS)

Yoon, Y.; Durand, M. T.; Minear, J. T.; Smith, L.; Merry, C. J.

2013-12-01

The Surface Water and Ocean Topography (SWOT) is an upcoming satellite mission (2020 year) that will provide surface-water elevation and surface-water extent globally. One goal of SWOT is the estimation of river discharge directly from SWOT measurements. SWOT discharge uncertainty is due to two sources. First, SWOT cannot measure channel bathymetry and determine roughness coefficient data necessary for discharge calculations directly; these parameters must be estimated from the measurements or from a priori information. Second, SWOT measurement errors directly impact the discharge estimate accuracy. This study focuses on characterizing parameter and measurement uncertainties for SWOT river discharge estimation. A Bayesian Markov Chain Monte Carlo scheme is used to calculate parameter estimates, given the measurements of river height, slope and width, and mass and momentum constraints. The algorithm is evaluated using simulated both SWOT and AirSWOT (the airborne version of SWOT) observations over seven reaches (about 40 km) of the Sacramento River. The SWOT and AirSWOT observations are simulated by corrupting the ';true' HEC-RAS hydraulic modeling results with the instrument error. This experiment answers how unknown bathymetry and roughness coefficients affect the accuracy of the river discharge algorithm. From the experiment, the discharge error budget is almost completely dominated by unknown bathymetry and roughness; 81% of the variance error is explained by uncertainties in bathymetry and roughness. Second, we show how the errors in water surface, slope, and width observations influence the accuracy of discharge estimates. Indeed, there is a significant sensitivity to water surface, slope, and width errors due to the sensitivity of bathymetry and roughness to measurement errors. Increasing water-surface error above 10 cm leads to a corresponding sharper increase of errors in bathymetry and roughness. Increasing slope error above 1.5 cm/km leads to a significant degradation due to direct error in the discharge estimates. As the width error increases past 20%, the discharge error budget is dominated by the width error. Above two experiments are performed based on AirSWOT scenarios. In addition, we explore the sensitivity of the algorithm to the SWOT scenarios.

Discretization vs. Rounding Error in Euler's Method

ERIC Educational Resources Information Center

Borges, Carlos F.

2011-01-01

Euler's method for solving initial value problems is an excellent vehicle for observing the relationship between discretization error and rounding error in numerical computation. Reductions in stepsize, in order to decrease discretization error, necessarily increase the number of steps and so introduce additional rounding error. The problem is…

Influence of measurement error on Maxwell's demon

NASA Astrophysics Data System (ADS)

Sørdal, Vegard; Bergli, Joakim; Galperin, Y. M.

2017-06-01

In any general cycle of measurement, feedback, and erasure, the measurement will reduce the entropy of the system when information about the state is obtained, while erasure, according to Landauer's principle, is accompanied by a corresponding increase in entropy due to the compression of logical and physical phase space. The total process can in principle be fully reversible. A measurement error reduces the information obtained and the entropy decrease in the system. The erasure still gives the same increase in entropy, and the total process is irreversible. Another consequence of measurement error is that a bad feedback is applied, which further increases the entropy production if the proper protocol adapted to the expected error rate is not applied. We consider the effect of measurement error on a realistic single-electron box Szilard engine, and we find the optimal protocol for the cycle as a function of the desired power P and error ɛ .

The effect of monetary punishment on error evaluation in a Go/No-go task.

PubMed

Maruo, Yuya; Sommer, Werner; Masaki, Hiroaki

2017-10-01

Little is known about the effects of the motivational significance of errors in Go/No-go tasks. We investigated the impact of monetary punishment on the error-related negativity (ERN) and error positivity (Pe) for both overt errors and partial errors, that is, no-go trials without overt responses but with covert muscle activities. We compared high and low punishment conditions where errors were penalized with 50 or 5 yen, respectively, and a control condition without monetary consequences for errors. Because we hypothesized that the partial-error ERN might overlap with the no-go N2, we compared ERPs between correct rejections (i.e., successful no-go trials) and partial errors in no-go trials. We also expected that Pe amplitudes should increase with the severity of the penalty for errors. Mean error rates were significantly lower in the high punishment than in the control condition. Monetary punishment did not influence the overt-error ERN and partial-error ERN in no-go trials. The ERN in no-go trials did not differ between partial errors and overt errors; in addition, ERPs for correct rejections in no-go trials without partial errors were of the same size as in go-trial. Therefore the overt-error ERN and the partial-error ERN may share similar error monitoring processes. Monetary punishment increased Pe amplitudes for overt errors, suggesting enhanced error evaluation processes. For partial errors an early Pe was observed, presumably representing inhibition processes. Interestingly, even partial errors elicited the Pe, suggesting that covert erroneous activities could be detected in Go/No-go tasks. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Do treatment improvements in PTSD severity affect substance use outcomes? A secondary analysis from a randomized clinical trial in NIDA's Clinical Trials Network.

PubMed

Hien, Denise A; Jiang, Huiping; Campbell, Aimee N C; Hu, Mei-Chen; Miele, Gloria M; Cohen, Lisa R; Brigham, Gregory S; Capstick, Carrie; Kulaga, Agatha; Robinson, James; Suarez-Morales, Lourdes; Nunes, Edward V

2010-01-01

The purpose of the analysis was to examine the temporal course of improvement in symptoms of posttraumatic stress disorder (PTSD) and substance use disorder among women in outpatient substance abuse treatment. Participants were 353 women randomly assigned to 12 sessions of either trauma-focused or health education group treatment. PTSD and substance use assessments were conducted during treatment and posttreatment at 1 week and after 3, 6, and 12 months. A continuous Markov model was fit on four defined response categories (nonresponse, substance use response, PTSD response, or global response [improvement in both PTSD and substance use]) to investigate the temporal association between improvement in PTSD and substance use symptom severity during the study's treatment phase. A generalized linear model was applied to test this relationship over the follow-up period. Subjects exhibiting nonresponse, substance use response, or global response tended to maintain original classification; subjects exhibiting PTSD response were significantly more likely to transition to global response over time, indicating maintained PTSD improvement was associated with subsequent substance use improvement. Trauma-focused treatment was significantly more effective than health education in achieving substance use improvement, but only among those who were heavy substance users at baseline and had achieved significant PTSD reductions. PTSD severity reductions were more likely to be associated with substance use improvement, with minimal evidence of substance use symptom reduction improving PTSD symptoms. Results support the self-medication model of coping with PTSD symptoms and an empirical basis for integrated interventions for improved substance use outcomes in patients with severe symptoms.

Self-reported weight and predictors of missing responses in youth.

PubMed

Aceves-Martins, Magaly; Whitehead, Ross; Inchley, Jo; Giralt, Montse; Currie, Candace; Solà, Rosa

2018-02-12

The aims of the present manuscript are to analyse self-reported data on weight, including the missing data, from the 2014 Scottish Health Behaviour in School-Aged Children (HBSC) Study, and to investigate whether behavioural factors related with overweight and obesity, namely dietary habits, physical activity and sedentary behaviour, are associated with weight non-response. 10839 11-, 13- and 15-year-olds participated in the cross-national 2014 Scottish HBSC Study. Weight missing data was evaluated using Little's Missing Completely at Random (MCAR) test. Afterwards, a fitted multivariate logistic regression model was used to determine all possible multivariate associations between weight response and each of the behavioural factors related with obesity. 58.9% of self-reported weight was missing, not at random (MCAR p < 0.001). Weight was self-reported less frequently by girls (19.2%) than by boys (21.9%). Participants who reported low physical activity (OR 1.2, p < 0.001), low vegetable consumption (OR 1.24, p < 0.001) and high computer gaming on weekdays (OR 1.18, p = 0.003) were more likely to not report their weight. There are groups of young people in Scotland who are less likely to report their weight. Their weight status may be of the greatest concern because of their poorer health profile, based on key behaviours associated with their non-response. Furthermore, knowing the value of a healthy weight and reinforcing healthy lifestyle messages may help raise youth awareness of how diet, physical activity and sedentary behaviours can influence weight. Copyright © 2018 Elsevier Inc. All rights reserved.

Variability of residual platelet function despite clopidogrel treatment in patients with peripheral arterial occlusive disease.

PubMed

Linnemann, Birgit; Schwonberg, Jan; Toennes, Stefan W; Mani, Helen; Lindhoff-Last, Edelgard

2010-04-01

Residual platelet function despite treatment with clopidogrel may predict an unfavourable cardiovascular outcome. The majority of studies have investigated the effects of clopidogrel administration in conjunction with aspirin in patients undergoing percutaneous coronary intervention. The primary objective of the present study was to assess the platelet response to clopidogrel in the absence of aspirin in patients with peripheral arterial occlusive disease (PAOD) and to investigate whether non-responsiveness to clopidogrel is reproducible during long-term follow-up. Fifty-four clinically stable PAOD patients on a maintenance dose of 75 mg/d clopidogrel were enrolled in this study. Platelet function was assessed at baseline and after a median follow-up of 18 months using light transmittance aggregometry (LTA) with 2 microM ADP as an agonist. HPLC-coupled mass spectrometry was used to detect clopidogrel and clopidogrel carboxylic acid, the main metabolite of clopidogrel. Residual platelet function, as defined by late aggregation values within the reference range (i.e., >43%), was observed in 35.2% of patients at baseline and 17.6% during follow-up. During the observation period, 26.5% had switched from responder to non-responder status or vice versa. Among non-responders, either clopidogrel or its metabolite was detected in 89.5% and 83.3% of patients at baseline and at follow-up, respectively. We conclude that non-responsiveness to clopidogrel as determined by ADP-induced LTA is not stable over time. This phenomenon cannot be attributed to non-compliance alone. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

Predictors of non-response and non-compliance in African American lupus patients: Findings from the Balancing Lupus Experiences with Stress Strategies (BLESS) Study.

PubMed

Williams, Edith M; Zhang, Jiajia; Zhou, Jie; Kamen, Diane; Oates, James C

2014-02-01

Arthritis self-management education has demonstrated significant improvements in health distress, self-reported global health, and activity limitation, with trends toward improvement in self efficacy and mental stress management. Consequently, numerous national agencies have recommended arthritis self-management education to complement medical care. Despite these recommendations, arthritis self-management education has reached only a limited number of people. Compliance is also a persistent problem in standardized programs. As part of the Balancing Lupus Experiences with Stress Strategies (BLESS) Study, a validated psychosocial stress intervention was piloted among a cohort of African American lupus patients participating in an SLE database project at the Medical University of South Carolina (MUSC). Recruitment attempts were made with the 330 database participants who met eligibility requirements for the study. While enrollment was limited to 30 participants (n=15 controls and n=15 intervention), two of the participants assigned to the intervention group did not attend any intervention sessions and several participants did not complete post-intervention questionnaires. Therefore, data were analyzed on 30 participants at baseline, 25 (n=13 controls and n=12 intervention) at post-intervention, and 22 (n=12 controls and n=10 intervention) at four months post-intervention. In an effort to characterize those who fully participated in the study and those who were non-compliant or non-responsive to recruitment attempts, we obtained descriptive data from African-American Lupus patients participating in the SLE Clinic Database Project. This information can be used to develop and refine future intervention activities.

What's the fuss about? Parent presentations of fussy eating to a parenting support helpline.

PubMed

Harris, Holly A; Ria-Searle, Bonnie; Jansen, Elena; Thorpe, Karen

2018-06-01

To characterise parent presentations of fussy eating and mealtime interactions at a point of crisis, through analyses of real-time recordings of calls to a parenting helpline. Qualitative analysis included an inductive thematic approach to examine clinical parent presentations of fussy eating and derive underlying themes relating to mealtime interactions. Calls made to the Child Health Line regarding feeding concerns were recorded and transcribed verbatim. From a corpus of 723 calls made during a 4-week period in 2009, twelve were from parents of children aged 6-48 months. Parents of infants (≤12 months, n 6) presented feeding concerns as learning challenges in the process of transitioning from a milk-based to a solid-based diet, while parents of toddlers (13-48 months, n 6) presented emotional accounts of feeding as an intractable problem. Parents presented their child's eating behaviour as a battle (conflict), in which their children's agency over limited intake and variety of foods (child control) was constructed as 'bad' or 'wrong'. Escalating parent anxiety (parent concern) had evoked parent non-responsive feeding practices or provision of foods the child preferred. Real-time descriptions of young children's fussy eating at a time of crisis that initiated parents' call for help have captured the highly charged emotional underpinnings of mealtime interactions associated with fussy eating. Importantly, they show the child's emerging assertion of food autonomy can escalate parents' emotional distress that, in the short term, initiates non-responsive feeding practices. The current study identifies the importance of educational and emotional support for parents across the period of introducing solids.

A new look at patient satisfaction: learning from self-organizing maps.

PubMed

Voutilainen, Ari; Kvist, Tarja; Sherwood, Paula R; Vehviläinen-Julkunen, Katri

2014-01-01

To some extent, results always depend on the methods used, and the complete picture of the phenomenon of interest can be drawn only by combining results of different data processing techniques. This emphasizes the use of a wide arsenal of methods for processing and analyzing patient satisfaction surveys. The purpose of this study was to introduce the self-organizing map (SOM) to nursing science and to illustrate the use of the SOM with patient satisfaction data. The SOM is a widely used artificial neural network suitable for clustering and exploring all kind of data sets. The study was partly a secondary analysis of data collected for the Attractive and Safe Hospital Study from four Finnish hospitals in 2008 and 2010 using the Revised Humane Caring Scale. The sample consisted of 5,283 adult patients. The SOM was used to cluster the data set according to (a) respondents and (b) questionnaire items. The SOM was also used as a preprocessor for multinomial logistic regression. An analysis of missing data was carried out to improve the data interpretation. Combining results of the two SOMs and the logistic regression revealed associations between the level of satisfaction, different components of satisfaction, and item nonresponse. The common conception that the relationship between patient satisfaction and age is positive may partly be due to positive association between the tendency of item nonresponse and age. The SOM proved to be a useful method for clustering a questionnaire data set even when the data set was low dimensional per se. Inclusion of empty responses in analyses may help to detect possible misleading noncausative relationships.

Testing for clinical inertia in medication treatment of bipolar disorder.

PubMed

Hodgkin, Dominic; Merrick, Elizabeth L; O'Brien, Peggy L; McGuire, Thomas G; Lee, Sue; Deckersbach, Thilo; Nierenberg, Andrew A

2016-11-15

Clinical inertia has been defined as lack of change in medication treatment at visits where a medication adjustment appears to be indicated. This paper seeks to identify the extent of clinical inertia in medication treatment of bipolar disorder. A second goal is to identify patient characteristics that predict this treatment pattern. Data describe 23,406 visits made by 1815 patients treated for bipolar disorder during the STEP-BD practical clinical trial. Visits were classified in terms of whether a medication adjustment appears to be indicated, and also whether or not one occurred. Multivariable regression analyses were conducted to find which patient characteristics were predictive of whether adjustment occurred. 36% of visits showed at least 1 indication for adjustment. The most common indications were non-response to medication, side effects, and start of a new illness episode. Among visits with an indication for adjustment, no adjustment occurred 19% of the time, which may be suggestive of clinical inertia. In multivariable models, presence of any indication for medication adjustment was a predictor of receiving one (OR=1.125, 95% CI =1.015, 1.246), although not as strong as clinical status measures. The associations observed are not necessarily causal, given the study design. The data also lack information about physician-patient communication. Many patients remained on the same medication regimen despite indications of side effects or non-response to treatment. Although lack of adjustment does not necessarily reflect clinical inertia in all cases, the reasons for this treatment pattern merit further examination. Copyright © 2016 Elsevier B.V. All rights reserved.

The reason for discontinuation of the first tumor necrosis factor (TNF) blocking agent does not influence the effect of a second TNF blocking agent in patients with rheumatoid arthritis.

PubMed

Blom, Marlies; Kievit, Wietske; Fransen, Jaap; Kuper, Ina H; den Broeder, Alfons A; De Gendt, Carla M A; Jansen, Tim L; Brus, Herman L M; van de Laar, Mart A F J; van Riel, Piet L C M

2009-10-01

To investigate whether the reason for discontinuation of the first tumor necrosis factor (TNF) blocking agent influences the effect of a second TNF blocking agent. Data were used from 2 Dutch registries including patients with rheumatoid arthritis (RA) treated with TNF blocking agents. Patients were divided into 3 groups based on reason for discontinuation of the first: nonresponse, loss of response, or adverse events. The primary outcome was the change from baseline of the disease activity (by DAS28) at 6 months, corrected for the baseline DAS28 score. Secondary outcomes were the change from baseline at 3 months, EULAR response rates, and the percentages of patients who reached a DAS28 score < or = 3.2 at 3 and at 6 months. In total, 49 patients who failed due to nonresponse, 75 due to loss of response, and 73 due to adverse events were included. At 6 months, the change of DAS28 score from baseline did not differ significantly between the groups (-0.6 to -1.3; p > or = 0.173) and similar good and moderate response rates were found (12% to 18%, p > or = 0.523, and 34% to 55%, p > or = 0.078, respectively). The secondary outcomes were also comparable between the 3 groups. The results of our observational study suggest that a second TNF blocking agent may be effective after failure of the first, regardless of the reason for discontinuation of the first TNF blocking agent.

The Role of Electroconvulsive Therapy (ECT) in Bipolar Disorder: Effectiveness in 522 Patients with Bipolar Depression, Mixed-state, Mania and Catatonic Features.

PubMed

Perugi, Giulio; Medda, Pierpaolo; Toni, Cristina; Mariani, Michela Giorgi; Socci, Chiara; Mauri, Mauro

2017-04-01

We evaluated the effectiveness of Electroconvulsive Therapy (ECT) in the treatment of Bipolar Disorder (BD) in a large sample of bipolar patients with drug resistant depression, mania, mixed state and catatonic features. 522 consecutive patients with DSM-IV-TR BD were evaluated prior to and after the ECT course. Responders and nonresponders were compared in subsamples of depressed and mixed patients. Descriptive analyses were reported for patients with mania and with catatonic features. Of the original sample only 22 patients were excluded for the occurrence of side effects or consent withdrawal. After the ECT course, 344 (68.8%) patients were considered responders (final CGIi score ≤2) and 156 (31.2%) nonresponders. Response rates were respectively 68.1% for BD depression, 72.9% for mixed state, 75% for mania and 80.8% for catatonic features. Length of current episode and global severity of the illness were the only statistically significant predictors of nonresponse. ECT resulted to be an effective and safe treatment for all the phases of severe and drug-resistant BD. Positive response was observed in approximately two-thirds of the cases and in 80% of the catatonic patients. The duration of the current episode was the major predictor of nonresponse. The risk of ECT-induced mania is virtually absent and mood destabilization very unlikely. Our results clearly indicate that current algorithms for the treatment of depressive, mixed, manic and catatonic states should be modified and, at least for the most severe patients, ECT should not be considered as a "last resort".

Testing for Clinical Inertia in Medication Treatment of Bipolar Disorder

PubMed Central

Hodgkin, Dominic; Merrick, Elizabeth L.; O'Brien, Peggy L.; McGuire, Thomas G.; Lee, Sue; Deckersbach, Thilo; Nierenberg, Andrew A.

2016-01-01

Background Clinical inertia has been defined as lack of change in medication treatment at visits where a medication adjustment appears to be indicated. This paper seeks to identify the extent of clinical inertia in medication treatment of bipolar disorder. A second goal is to identify patient characteristics that predict this treatment pattern. Method Data describe 23,406 visits made by 1,815 patients treated for bipolar disorder during the STEP-BD practical clinical trial. Visits were classified in terms of whether a medication adjustment appears to be indicated, and also whether or not one occurred. Multivariable regression analyses were conducted to find which patient characteristics were predictive of whether adjustment occurred. Results 36% of visits showed at least 1 indication for adjustment. The most common indications were non-response to medication, side effects, and start of a new illness episode. Among visits with an indication for adjustment, no adjustment occurred 19% of the time, which may be suggestive of clinical inertia. In multivariable models, presence of any indication for medication adjustment was a predictor of receiving one (OR=1.125, 95% CI = 1.015, 1.246), although not as strong as clinical status measures. Limitations The associations observed are not necessarily causal, given the study design. The data also lack information about physician-patient communication. Conclusions Many patients remained on the same medication regimen despite indications of side effects or non-response to treatment. Although lack of adjustment does not necessarily reflect clinical inertia in all cases, the reasons for this treatment pattern merit further examination. PMID:27391267

Self-Reported and Observed Punitive Parenting Prospectively Predicts Increased Error-Related Brain Activity in Six-Year-Old Children.

PubMed

Meyer, Alexandria; Proudfit, Greg Hajcak; Bufferd, Sara J; Kujawa, Autumn J; Laptook, Rebecca S; Torpey, Dana C; Klein, Daniel N

2015-07-01

The error-related negativity (ERN) is a negative deflection in the event-related potential (ERP) occurring approximately 50 ms after error commission at fronto-central electrode sites and is thought to reflect the activation of a generic error monitoring system. Several studies have reported an increased ERN in clinically anxious children, and suggest that anxious children are more sensitive to error commission--although the mechanisms underlying this association are not clear. We have previously found that punishing errors results in a larger ERN, an effect that persists after punishment ends. It is possible that learning-related experiences that impact sensitivity to errors may lead to an increased ERN. In particular, punitive parenting might sensitize children to errors and increase their ERN. We tested this possibility in the current study by prospectively examining the relationship between parenting style during early childhood and children's ERN approximately 3 years later. Initially, 295 parents and children (approximately 3 years old) participated in a structured observational measure of parenting behavior, and parents completed a self-report measure of parenting style. At a follow-up assessment approximately 3 years later, the ERN was elicited during a Go/No-Go task, and diagnostic interviews were completed with parents to assess child psychopathology. Results suggested that both observational measures of hostile parenting and self-report measures of authoritarian parenting style uniquely predicted a larger ERN in children 3 years later. We previously reported that children in this sample with anxiety disorders were characterized by an increased ERN. A mediation analysis indicated that ERN magnitude mediated the relationship between harsh parenting and child anxiety disorder. Results suggest that parenting may shape children's error processing through environmental conditioning and thereby risk for anxiety, although future work is needed to confirm this hypothesis.

Clinical Dental Faculty Members' Perceptions of Diagnostic Errors and How to Avoid Them.

PubMed

Nikdel, Cathy; Nikdel, Kian; Ibarra-Noriega, Ana; Kalenderian, Elsbeth; Walji, Muhammad F

2018-04-01

Diagnostic errors are increasingly recognized as a source of preventable harm in medicine, yet little is known about their occurrence in dentistry. The aim of this study was to gain a deeper understanding of clinical dental faculty members' perceptions of diagnostic errors, types of errors that may occur, and possible contributing factors. The authors conducted semi-structured interviews with ten domain experts at one U.S. dental school in May-August 2016 about their perceptions of diagnostic errors and their causes. The interviews were analyzed using an inductive process to identify themes and key findings. The results showed that the participants varied in their definitions of diagnostic errors. While all identified missed diagnosis and wrong diagnosis, only four participants perceived that a delay in diagnosis was a diagnostic error. Some participants perceived that an error occurs only when the choice of treatment leads to harm. Contributing factors associated with diagnostic errors included the knowledge and skills of the dentist, not taking adequate time, lack of communication among colleagues, and cognitive biases such as premature closure based on previous experience. Strategies suggested by the participants to prevent these errors were taking adequate time when investigating a case, forming study groups, increasing communication, and putting more emphasis on differential diagnosis. These interviews revealed differing perceptions of dental diagnostic errors among clinical dental faculty members. To address the variations, the authors recommend adopting shared language developed by the medical profession to increase understanding.

Aberrant error processing in relation to symptom severity in obsessive–compulsive disorder: A multimodal neuroimaging study

PubMed Central

Agam, Yigal; Greenberg, Jennifer L.; Isom, Marlisa; Falkenstein, Martha J.; Jenike, Eric; Wilhelm, Sabine; Manoach, Dara S.

2014-01-01

Background Obsessive–compulsive disorder (OCD) is characterized by maladaptive repetitive behaviors that persist despite feedback. Using multimodal neuroimaging, we tested the hypothesis that this behavioral rigidity reflects impaired use of behavioral outcomes (here, errors) to adaptively adjust responses. We measured both neural responses to errors and adjustments in the subsequent trial to determine whether abnormalities correlate with symptom severity. Since error processing depends on communication between the anterior and the posterior cingulate cortex, we also examined the integrity of the cingulum bundle with diffusion tensor imaging. Methods Participants performed the same antisaccade task during functional MRI and electroencephalography sessions. We measured error-related activation of the anterior cingulate cortex (ACC) and the error-related negativity (ERN). We also examined post-error adjustments, indexed by changes in activation of the default network in trials surrounding errors. Results OCD patients showed intact error-related ACC activation and ERN, but abnormal adjustments in the post- vs. pre-error trial. Relative to controls, who responded to errors by deactivating the default network, OCD patients showed increased default network activation including in the rostral ACC (rACC). Greater rACC activation in the post-error trial correlated with more severe compulsions. Patients also showed increased fractional anisotropy (FA) in the white matter underlying rACC. Conclusions Impaired use of behavioral outcomes to adaptively adjust neural responses may contribute to symptoms in OCD. The rACC locus of abnormal adjustment and relations with symptoms suggests difficulty suppressing emotional responses to aversive, unexpected events (e.g., errors). Increased structural connectivity of this paralimbic default network region may contribute to this impairment. PMID:25057466

Effects of Correlated Errors on the Analysis of Space Geodetic Data

NASA Technical Reports Server (NTRS)

Romero-Wolf, Andres; Jacobs, C. S.

2011-01-01

As thermal errors are reduced instrumental and troposphere correlated errors will increasingly become more important. Work in progress shows that troposphere covariance error models improve data analysis results. We expect to see stronger effects with higher data rates. Temperature modeling of delay errors may further reduce temporal correlations in the data.

Diagnostic Errors in Ambulatory Care: Dimensions and Preventive Strategies

ERIC Educational Resources Information Center

Singh, Hardeep; Weingart, Saul N.

2009-01-01

Despite an increasing focus on patient safety in ambulatory care, progress in understanding and reducing diagnostic errors in this setting lag behind many other safety concerns such as medication errors. To explore the extent and nature of diagnostic errors in ambulatory care, we identified five dimensions of ambulatory care from which errors may…

Determination and error analysis of emittance and spectral emittance measurements by remote sensing

NASA Technical Reports Server (NTRS)

Dejesusparada, N. (Principal Investigator); Kumar, R.

1977-01-01

The author has identified the following significant results. From the theory of remote sensing of surface temperatures, an equation of the upper bound of absolute error of emittance was determined. It showed that the absolute error decreased with an increase in contact temperature, whereas, it increased with an increase in environmental integrated radiant flux density. Change in emittance had little effect on the absolute error. A plot of the difference between temperature and band radiance temperature vs. emittance was provided for the wavelength intervals: 4.5 to 5.5 microns, 8 to 13.5 microns, and 10.2 to 12.5 microns.

Topical treatment of actinic keratoses with low-dose 5-fluorouracil in combination with salicylic acid--pilot study.

PubMed

Schlaak, Max; Simon, Jan C

2010-03-01

Actinic keratoses (AK) are carcinomas in situ and can progress to invasive squamous cell carcinomas. Treatment of actinic keratoses can be achieved by physical ablation, chemotherapeutic agents, immunomodulators or photodynamic therapy. We conducted a proof of concept study with 15 patients. Overall 66 actinic keratoses were treated with 5-FU (0.5%) and salicylic acid (10%) for 4 weeks (3 times per week). After 12 weeks complete response of 47 AK (77%), partial response of 13 AK (21%) and non-response of 1 AK (2%) were achieved. Treatment was well tolerated and efficient.

Local indicators of geocoding accuracy (LIGA): theory and application

PubMed Central

Jacquez, Geoffrey M; Rommel, Robert

2009-01-01

Background Although sources of positional error in geographic locations (e.g. geocoding error) used for describing and modeling spatial patterns are widely acknowledged, research on how such error impacts the statistical results has been limited. In this paper we explore techniques for quantifying the perturbability of spatial weights to different specifications of positional error. Results We find that a family of curves describes the relationship between perturbability and positional error, and use these curves to evaluate sensitivity of alternative spatial weight specifications to positional error both globally (when all locations are considered simultaneously) and locally (to identify those locations that would benefit most from increased geocoding accuracy). We evaluate the approach in simulation studies, and demonstrate it using a case-control study of bladder cancer in south-eastern Michigan. Conclusion Three results are significant. First, the shape of the probability distributions of positional error (e.g. circular, elliptical, cross) has little impact on the perturbability of spatial weights, which instead depends on the mean positional error. Second, our methodology allows researchers to evaluate the sensitivity of spatial statistics to positional accuracy for specific geographies. This has substantial practical implications since it makes possible routine sensitivity analysis of spatial statistics to positional error arising in geocoded street addresses, global positioning systems, LIDAR and other geographic data. Third, those locations with high perturbability (most sensitive to positional error) and high leverage (that contribute the most to the spatial weight being considered) will benefit the most from increased positional accuracy. These are rapidly identified using a new visualization tool we call the LIGA scatterplot. Herein lies a paradox for spatial analysis: For a given level of positional error increasing sample density to more accurately follow the underlying population distribution increases perturbability and introduces error into the spatial weights matrix. In some studies positional error may not impact the statistical results, and in others it might invalidate the results. We therefore must understand the relationships between positional accuracy and the perturbability of the spatial weights in order to have confidence in a study's results. PMID:19863795

Amygdala Reactivity to Emotional Faces in the Prediction of General and Medication-Specific Responses to Antidepressant Treatment in the Randomized iSPOT-D Trial.

PubMed

Williams, Leanne M; Korgaonkar, Mayuresh S; Song, Yun C; Paton, Rebecca; Eagles, Sarah; Goldstein-Piekarski, Andrea; Grieve, Stuart M; Harris, Anthony W F; Usherwood, Tim; Etkin, Amit

2015-09-01

Although the cost of poor treatment outcomes of depression is staggering, we do not yet have clinically useful methods for selecting the most effective antidepressant for each depressed person. Emotional brain activation is altered in major depressive disorder (MDD) and implicated in treatment response. Identifying which aspects of emotional brain activation are predictive of general and specific responses to antidepressants may help clinicians and patients when making treatment decisions. We examined whether amygdala activation probed by emotion stimuli is a general or differential predictor of response to three commonly prescribed antidepressants, using functional magnetic resonance imaging (fMRI). A test-retest design was used to assess patients with MDD in an academic setting as part of the International Study to Predict Optimized Treatment in Depression. A total of 80 MDD outpatients were scanned prior to treatment and 8 weeks after randomization to the selective serotonin reuptake inhibitors escitalopram and sertraline and the serotonin-norepinephrine reuptake inhibitor, venlafaxine-extended release (XR). A total of 34 matched controls were scanned at the same timepoints. We quantified the blood oxygen level-dependent signal of the amygdala during subliminal and supraliminal viewing of facial expressions of emotion. Response to treatment was defined by ⩾50% symptom improvement on the 17-item Hamilton Depression Rating Scale. Pre-treatment amygdala hypo-reactivity to subliminal happy and threat was a general predictor of treatment response, regardless of medication type (Cohen's d effect size 0.63 to 0.77; classification accuracy, 75%). Responders showed hypo-reactivity compared to controls at baseline, and an increase toward 'normalization' post-treatment. Pre-treatment amygdala reactivity to subliminal sadness was a differential moderator of non-response to venlafaxine-XR (Cohen's d effect size 1.5; classification accuracy, 81%). Non-responders to venlafaxine-XR showed pre-treatment hyper-reactivity, which progressed to hypo-reactivity rather than normalization post-treatment, and hypo-reactivity post-treatment was abnormal compared to controls. Impaired amygdala activation has not previously been highlighted in the general vs differential prediction of antidepressant outcomes. Amygdala hypo-reactivity to emotions signaling reward and threat predicts the general capacity to respond to antidepressants. Amygdala hyper-reactivity to sad emotion is involved in a specific non-response to a serotonin-norepinephrine reuptake inhibitor. The findings suggest amygdala probes may help inform the personal selection of antidepressant treatments.

Potential link between biotic defense activation and recalcitrance to induction of somatic embryogenesis in shoot primordia from adult trees of white spruce (Picea glauca)

PubMed Central

2013-01-01

Background Among the many commercial opportunities afforded by somatic embryogenesis (SE), it is the ability to clonally propagate individual plants with rare or elite traits that has some of the most significant implications. This is particularly true for many long-lived species, such as conifers, but whose long generation times pose substantive challenges, including increased recalcitrance for SE as plants age. Identification of a clonal line of somatic embryo-derived trees whose shoot primordia have remained responsive to SE induction for over a decade, provided a unique opportunity to examine the molecular aspects underpinning SE within shoot tissues of adult white spruce trees. Results Microarray analysis was used to conduct transcriptome-wide expression profiling of shoot explants taken from this responsive genotype following one week of SE induction, which when compared with that of a nonresponsive genotype, led to the identification of four of the most differentially expressed genes within each genotype. Using absolute qPCR to expand the analysis to three weeks of induction revealed that differential expression of all eight candidate genes was maintained to the end of the induction treatment, albeit to differing degrees. Most striking was that both the magnitude and duration of candidate gene expression within the nonresponsive genotype was indicative of an intense physiological response. Examining their putative identities further revealed that all four encoded for proteins with similarity to angiosperm proteins known to play prominent roles in biotic defense, and that their high-level induction over an extended period is consistent with activation of a biotic defense response. In contrast, the more temperate response within the responsive genotype, including induction of a conifer-specific dehydrin, is more consistent with elicitation of an adaptive stress response. Conclusions While additional evidence is required to definitively establish an association between SE responsiveness and a specific physiological response, these results suggest that biotic defense activation may be antagonistic, likely related to the massive transcriptional and metabolic reprogramming that it elicits. A major issue for future work will be to determine how and if suppressing biotic defense activation could be used to promote a physiological state more conducive to SE induction. PMID:23937238

Modeling the effects of multicontextual physics instruction on learner expectations and understanding of force and motion systems

NASA Astrophysics Data System (ADS)

Deese Becht, Sara-Maria Francis

1999-11-01

The purpose of this study is two-fold involving both practical and theoretical modeling components. The practical component, an experiential-learning phase, investigated a study population for effects that increasing levels of multicontextual physics activities have on student understanding of Newtonian systems of motion. This contextual-learning model measured learner convictions and non-response gaps and analyzed learner response trends on context, technology, challenge, growth, and success. The theoretical component, a model-building phase, designed a dynamic-knowing model for learning along a range of experiential tasks, from low to high context, monitored for indicators of learning in science and mathematics: learner academic performance and ability, learner control and academic attitude, and a learner non- response gap. This knowing model characterized a learner's process-of-knowing on a less to more expert- like learner-response continuum using performance and perspective indices associated with level of contextual- imagery referent system. Data for the contextual-learning model were collected on 180 secondary subjects: 72 middle and 108 high, with 36 physics subjects as local experts. Subjects were randomly assigned to one of three experimental groups differing only on context level of force and motion activities. Three levels of information were presented through context-based tasks: momentum constancy as inertia, momentum change as impulse, and momentum rate of change as force. The statistical analysis used a multi-level factorial design with repeated measures and discriminate analysis of response-conviction items. Subject grouping criteria included school level, ability level in science and mathematics, gender and race. Assessment criteria used pre/post performance scores, confidence level in physics concepts held, and attitude towards science, mathematics, and technology. Learner indices were computed from logit- transforms applied to learner outcomes and to study control and prediction criteria parameters. Findings suggest learner success rates vary with multicontextual experience level. When controlling for context, learner success seems to depend on technology level of assessment tool, learner attitude toward technology learning tools, learner attitude toward science and mathematics, and challenge level of force and motion problems. A learner non-response gap seems important when monitoring learner conviction. Application of the knowing model to the study population pictures learners on a journey towards success referenced to a local expert response.

Variability in Post-Error Behavioral Adjustment Is Associated with Functional Abnormalities in the Temporal Cortex in Children with ADHD

ERIC Educational Resources Information Center

Spinelli, Simona; Vasa, Roma A.; Joel, Suresh; Nelson, Tess E.; Pekar, James J.; Mostofsky, Stewart H.

2011-01-01

Background: Error processing is reflected, behaviorally, by slower reaction times (RT) on trials immediately following an error (post-error). Children with attention-deficit hyperactivity disorder (ADHD) fail to show RT slowing and demonstrate increased intra-subject variability (ISV) on post-error trials. The neural correlates of these behavioral…

[Allocation of attentional resource and monitoring processes under rapid serial visual presentation].

PubMed

Nishiura, K

1998-08-01

With the use of rapid serial visual presentation (RSVP), the present study investigated the cause of target intrusion errors and functioning of monitoring processes. Eighteen students participated in Experiment 1, and 24 in Experiment 2. In Experiment 1, different target intrusion errors were found depending on different kinds of letters --romaji, hiragana, and kanji. In Experiment 2, stimulus set size and context information were manipulated in an attempt to explore the cause of post-target intrusion errors. Results showed that as stimulus set size increased, the post-target intrusion errors also increased, but contextual information did not affect the errors. Results concerning mean report probability indicated that increased allocation of attentional resource to response-defining dimension was the cause of the errors. In addition, results concerning confidence rating showed that monitoring of temporal and contextual information was extremely accurate, but it was not so for stimulus information. These results suggest that attentional resource is different from monitoring resource.

Feature Migration in Time: Reflection of Selective Attention on Speech Errors

PubMed Central

Nozari, Nazbanou; Dell, Gary S.

2012-01-01

This paper describes an initial study of the effect of focused attention on phonological speech errors. In three experiments, participants recited four-word tongue-twisters, and focused attention on one (or none) of the words. The attended word was singled out differently in each experiment; participants were under instructions to either avoid errors on the attended word, to stress it, or to say it silently. The experiments showed that all methods of attending to a word decreased errors on that word, while increasing errors on the surrounding words. However, this error increase did not result from a relative increase in phonemic migrations originating from the attended word. This pattern is inconsistent with conceptualizing attention either as higher activation of the attended word or greater inhibition of the unattended words throughout the production of the sequence. Instead, it is consistent with a model which presumes that attention exerts its effect at the time of production of the attended word, without lingering effects on the past or the future. PMID:22268910

Trial-to-trial adaptation in control of arm reaching and standing posture

PubMed Central

Pienciak-Siewert, Alison; Horan, Dylan P.

2016-01-01

Classical theories of motor learning hypothesize that adaptation is driven by sensorimotor error; this is supported by studies of arm and eye movements that have shown that trial-to-trial adaptation increases with error. Studies of postural control have shown that anticipatory postural adjustments increase with the magnitude of a perturbation. However, differences in adaptation have been observed between the two modalities, possibly due to either the inherent instability or sensory uncertainty in standing posture. Therefore, we hypothesized that trial-to-trial adaptation in posture should be driven by error, similar to what is observed in arm reaching, but the nature of the relationship between error and adaptation may differ. Here we investigated trial-to-trial adaptation of arm reaching and postural control concurrently; subjects made reaching movements in a novel dynamic environment of varying strengths, while standing and holding the handle of a force-generating robotic arm. We found that error and adaptation increased with perturbation strength in both arm and posture. Furthermore, in both modalities, adaptation showed a significant correlation with error magnitude. Our results indicate that adaptation scales proportionally with error in the arm and near proportionally in posture. In posture only, adaptation was not sensitive to small error sizes, which were similar in size to errors experienced in unperturbed baseline movements due to inherent variability. This finding may be explained as an effect of uncertainty about the source of small errors. Our findings suggest that in rehabilitation, postural error size should be considered relative to the magnitude of inherent movement variability. PMID:27683888

Trial-to-trial adaptation in control of arm reaching and standing posture.

PubMed

Pienciak-Siewert, Alison; Horan, Dylan P; Ahmed, Alaa A

2016-12-01

Classical theories of motor learning hypothesize that adaptation is driven by sensorimotor error; this is supported by studies of arm and eye movements that have shown that trial-to-trial adaptation increases with error. Studies of postural control have shown that anticipatory postural adjustments increase with the magnitude of a perturbation. However, differences in adaptation have been observed between the two modalities, possibly due to either the inherent instability or sensory uncertainty in standing posture. Therefore, we hypothesized that trial-to-trial adaptation in posture should be driven by error, similar to what is observed in arm reaching, but the nature of the relationship between error and adaptation may differ. Here we investigated trial-to-trial adaptation of arm reaching and postural control concurrently; subjects made reaching movements in a novel dynamic environment of varying strengths, while standing and holding the handle of a force-generating robotic arm. We found that error and adaptation increased with perturbation strength in both arm and posture. Furthermore, in both modalities, adaptation showed a significant correlation with error magnitude. Our results indicate that adaptation scales proportionally with error in the arm and near proportionally in posture. In posture only, adaptation was not sensitive to small error sizes, which were similar in size to errors experienced in unperturbed baseline movements due to inherent variability. This finding may be explained as an effect of uncertainty about the source of small errors. Our findings suggest that in rehabilitation, postural error size should be considered relative to the magnitude of inherent movement variability. Copyright © 2016 the American Physiological Society.

The Sustained Influence of an Error on Future Decision-Making.

PubMed

Schiffler, Björn C; Bengtsson, Sara L; Lundqvist, Daniel

2017-01-01

Post-error slowing (PES) is consistently observed in decision-making tasks after negative feedback. Yet, findings are inconclusive as to whether PES supports performance accuracy. We addressed the role of PES by employing drift diffusion modeling which enabled us to investigate latent processes of reaction times and accuracy on a large-scale dataset (>5,800 participants) of a visual search experiment with emotional face stimuli. In our experiment, post-error trials were characterized by both adaptive and non-adaptive decision processes. An adaptive increase in participants' response threshold was sustained over several trials post-error. Contrarily, an initial decrease in evidence accumulation rate, followed by an increase on the subsequent trials, indicates a momentary distraction of task-relevant attention and resulted in an initial accuracy drop. Higher values of decision threshold and evidence accumulation on the post-error trial were associated with higher accuracy on subsequent trials which further gives credence to these parameters' role in post-error adaptation. Finally, the evidence accumulation rate post-error decreased when the error trial presented angry faces, a finding suggesting that the post-error decision can be influenced by the error context. In conclusion, we demonstrate that error-related response adaptations are multi-component processes that change dynamically over several trials post-error.

Competition between learned reward and error outcome predictions in anterior cingulate cortex.

PubMed

Alexander, William H; Brown, Joshua W

2010-02-15

The anterior cingulate cortex (ACC) is implicated in performance monitoring and cognitive control. Non-human primate studies of ACC show prominent reward signals, but these are elusive in human studies, which instead show mainly conflict and error effects. Here we demonstrate distinct appetitive and aversive activity in human ACC. The error likelihood hypothesis suggests that ACC activity increases in proportion to the likelihood of an error, and ACC is also sensitive to the consequence magnitude of the predicted error. Previous work further showed that error likelihood effects reach a ceiling as the potential consequences of an error increase, possibly due to reductions in the average reward. We explored this issue by independently manipulating reward magnitude of task responses and error likelihood while controlling for potential error consequences in an Incentive Change Signal Task. The fMRI results ruled out a modulatory effect of expected reward on error likelihood effects in favor of a competition effect between expected reward and error likelihood. Dynamic causal modeling showed that error likelihood and expected reward signals are intrinsic to the ACC rather than received from elsewhere. These findings agree with interpretations of ACC activity as signaling both perceptions of risk and predicted reward. Copyright 2009 Elsevier Inc. All rights reserved.

Effects of alcohol on pilot performance in simulated flight

NASA Technical Reports Server (NTRS)

Billings, C. E.; Demosthenes, T.; White, T. R.; O'Hara, D. B.

1991-01-01

Ethyl alcohol's known ability to produce reliable decrements in pilot performance was used in a study designed to evaluate objective methods for assessing pilot performance. Four air carrier pilot volunteers were studied during eight simulated flights in a B727 simulator. Total errors increased linearly and significantly with increasing blood alcohol. Planning and performance errors, procedural errors and failures of vigilance each increased significantly in one or more pilots and in the group as a whole.

Evidence for specificity of the impact of punishment on error-related brain activity in high versus low trait anxious individuals.

PubMed

Meyer, Alexandria; Gawlowska, Magda

2017-10-01

A previous study suggests that when participants were punished with a loud noise after committing errors, the error-related negativity (ERN) was enhanced in high trait anxious individuals. The current study sought to extend these findings by examining the ERN in conditions when punishment was related and unrelated to error commission as a function of individual differences in trait anxiety symptoms; further, the current study utilized an electric shock as an aversive unconditioned stimulus. Results confirmed that the ERN was increased when errors were punished among high trait anxious individuals compared to low anxious individuals; this effect was not observed when punishment was unrelated to errors. Findings suggest that the threat-value of errors may underlie the association between certain anxious traits and punishment-related increases in the ERN. Copyright © 2017 Elsevier B.V. All rights reserved.

Human errors and occupational injuries of older female workers in the residential healthcare facilities for the elderly.

PubMed

Kim, Jun Sik; Jeong, Byung Yong

2018-05-03

The study aimed to describe the characteristics of occupational injuries of female workers in the residential healthcare facilities for the elderly, and analyze human errors as causes of accidents. From the national industrial accident compensation data, 506 female injuries were analyzed by age and occupation. The results showed that medical service worker was the most prevalent (54.1%), followed by social welfare worker (20.4%). Among injuries, 55.7% were <1 year of work experience, and 37.9% were ≥60 years old. Slips/falls were the most common type of accident (42.7%), and proportion of injured by slips/falls increases with age. Among human errors, action errors were the primary reasons, followed by perception errors, and cognition errors. Besides, the ratios of injuries by perception errors and action errors increase with age, respectively. The findings of this study suggest that there is a need to design workplaces that accommodate the characteristics of older female workers.

Comparison of a Medication Inventory and a Dietary Supplement Interview in Assessing Dietary Supplement Use in the Hispanic Community Health Study/Study of Latinos

PubMed Central

Faurot, Keturah R.; Siega-Riz, Anna Maria; Gardiner, Paula; Rivera, José O.; Young, Laura A.; Poole, Charles; Whitsel, Eric A.; González, Hector M.; Chirinos-Medina, Diana A.; Talavera, Gregory A.; Castañeda, Sheila F.; Daviglus, Martha L.; Barnhart, Janice; Giacinto, Rebeca E.; Van Horn, Linda

2016-01-01

Although dietary supplement use is common, its assessment is challenging, especially among ethnic minority populations such as Hispanics/Latinos. Using the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) (n = 16,415), this report compares two strategies for capturing dietary supplement use over a 30-day period: a medication-based inventory and a nutrition-based dietary supplement interview. Age-standardized prevalence was calculated across multiple dietary supplement definitions, adjusted with survey/nonresponse weights. The prevalence of dietary supplement use was substantially higher as measured in the dietary supplement interview, compared to the medication inventory: for total dietary supplements (39% vs 26%, respectively), for nonvitamin, nonmineral supplements (24% vs 12%), and for botanicals (9.2% vs 4.5%). Concordance between the two assessments was fair to moderate (Cohen’s kappa: 0.31–0.52). Among women, inclusion of botanical teas increased the prevalence of botanical supplement use from 7% to 15%. Supplement assessment that includes queries about botanical teas yields more information about patient supplement use. PMID:26917949

Effects of a Mechanical Response-Contingent Surrogate on the Development of Behaviors in Nursery-Reared Rhesus Macaques (Macaca mulatta)

PubMed Central

Brunelli, Rebecca L; Blake, Jennifer; Willits, Neil; Rommeck, Ina; McCowan, Brenda

2014-01-01

Nursery-reared infants have several behavioral and physiologic differences from their mother-reared counterparts. We investigated whether a response-contingent surrogate mitigated some of those differences by decreasing fearfulness and partner-clinging and increasing environmental exploration in nursery-reared infants continuously paired with a peer. Six nursery-reared infant rhesus macaques (in pairs) were given a mechanical responsive surrogate (RS), and 6 (in pairs) were given an identical but nonresponsive surrogate (NRS). The 2 treatment groups were compared and then combined into a single group of all 12 of surrogate-exposed animals (CS) that was compared with a nonsurrogate control group (NS) of 10 nursery-reared infants. Results showed significant differences between CS and NS infants but no significant differences between the RS and NRS infants. As compared with NS infants, CS infants showed less partner-clinging, less affiliation directed toward only partner, and more foraging and tactile–oral exploration of the environment. These advantageous effects support additional research to develop improved surrogate and the implementation of surrogate programs for nursery-reared infants. PMID:25255068

Effects of a mechanical response-contingent surrogate on the development of behaviors in nursery-reared rhesus macaques (Macaca mulatta).

PubMed

Brunelli, Rebecca L; Blake, Jennifer; Willits, Neil; Rommeck, Ina; McCowan, Brenda

2014-09-01

Nursery-reared infants have several behavioral and physiologic differences from their mother-reared counterparts. We investigated whether a response-contingent surrogate mitigated some of those differences by decreasing fearfulness and partner-clinging and increasing environmental exploration in nursery-reared infants continuously paired with a peer. Six nursery-reared infant rhesus macaques (in pairs) were given a mechanical responsive surrogate (RS), and 6 (in pairs) were given an identical but nonresponsive surrogate (NRS). The 2 treatment groups were compared and then combined into a single group of all 12 of surrogate-exposed animals (CS) that was compared with a nonsurrogate control group (NS) of 10 nursery-reared infants. Results showed significant differences between CS and NS infants but no significant differences between the RS and NRS infants. As compared with NS infants, CS infants showed less partner-clinging, less affiliation directed toward only partner, and more foraging and tactile-oral exploration of the environment. These advantageous effects support additional research to develop improved surrogate and the implementation of surrogate programs for nursery-reared infants.

Improving response rate and quality of survey data with a scratch lottery ticket incentive

PubMed Central

2012-01-01

Background The quality of data collected in survey research is usually indicated by the response rate; the representativeness of the sample, and; the rate of completed questions (item-response). In attempting to improve a generally declining response rate in surveys considerable efforts are being made through follow-up mailings and various types of incentives. This study examines effects of including a scratch lottery ticket in the invitation letter to a survey. Method Questionnaires concerning oral health were mailed to a random sample of 2,400 adults. A systematically selected half of the sample (1,200 adults) received a questionnaire including a scratch lottery ticket. One reminder without the incentive was sent. Results The incentive increased the response rate and improved representativeness by reaching more respondents with lower education. Furthermore, it reduced item nonresponse. The initial incentive had no effect on the propensity to respond after the reminder. Conclusion When attempting to improve survey data, three issues become important: response rate, representativeness, and item-response. This study shows that including a scratch lottery ticket in the invitation letter performs well on all the three. PMID:22515335

Delayed-Type Hypersensitivity and Hepatitis B Vaccine Responses, in vivo Markers of Cellular and Humoral Immune Function, and the Risk of AIDS or Death

PubMed Central

Patterson, Shane B.; Landrum, Michael L; Okulicz, Jason F.

2014-01-01

Background Delayed-type hypersensitivity (DTH) test responsiveness is associated with HIV disease progression; however it is unknown whether other immune markers, such as hepatitis B virus (HBV) vaccine seroresponse, also predict HIV outcomes. Methods Eligible participants received HBV vaccine after HIV diagnosis, had non-anergic DTH testing at the time of last HBV vaccination, and available post-vaccine HBV antibody responses. The risk of progression to AIDS or death from the time of last HBV vaccination was evaluated. Results Of 369 eligible participants with non-anergic DTH responses, 148 (40%) were HBV vaccine responders. In a multivariate model adjusted for age, CD4 count, viral load, and number of vaccinations, HBV vaccine non-responders had an increased risk of progression to AIDS or death (HR 1.81; 95% CI, 1.03–3.19). Conclusions HBV vaccine seroresponses were independent of DTH responses which suggest that non-response to HBV vaccine is not solely due to cell-mediated immune dysfunction in HIV-infected persons. PMID:24793945

Single-Trial Analysis of Inter-Beat Interval Perturbations Accompanying Single-Switch Scanning: Case Series of Three Children With Severe Spastic Quadriplegic Cerebral Palsy.

PubMed

Leung, Brian; Chau, Tom

2016-02-01

Single-switch access in conjunction with scanning remains a fundamental solution in restoring communication for many children with profound physical disabilities. However, untimely switch inaction and unintentional switch activations can lead to user frustration and impede functional communication. A previous preliminary study, in the context of a case series with three single-switch users, reported that correct, accidental and missed switch activations could elicit cardiac deceleration and increased phasic skin conductance on average, while deliberate switch non-use was associated with autonomic nonresponse. The present study investigated the possibility of using blood volume pulse recordings from the same three pediatric single-switch users to track the aforementioned switch events on a single-trial basis. Peaks of the line length time series derived from the empirical mode decomposition of the inter-beat interval time series matched, on average, a high percentage (above 80%) of single-switch events, while unmatched peaks coincided moderately (below 37%) with idle time during scanning. These results encourage further study of autonomic measures as complementary information channels to enhance single-switch access.

A sweet taste receptor‐dependent mechanism of glucosensing in hypothalamic tanycytes

PubMed Central

Benford, Heather; Bolborea, Matei; Pollatzek, Eric; Lossow, Kristina; Hermans‐Borgmeyer, Irm; Liu, Beihui; Meyerhof, Wolfgang; Kasparov, Sergey

2017-01-01

Abstract Hypothalamic tanycytes are glial‐like glucosensitive cells that contact the cerebrospinal fluid of the third ventricle, and send processes into the hypothalamic nuclei that control food intake and body weight. The mechanism of tanycyte glucosensing remains undetermined. While tanycytes express the components associated with the glucosensing of the pancreatic β cell, they respond to nonmetabolisable glucose analogues via an ATP receptor‐dependent mechanism. Here, we show that tanycytes in rodents respond to non‐nutritive sweeteners known to be ligands of the sweet taste (Tas1r2/Tas1r3) receptor. The initial sweet tastant‐evoked response, which requires the presence of extracellular Ca2+, leads to release of ATP and a larger propagating Ca2+ response mediated by P2Y1 receptors. In Tas1r2 null mice the proportion of glucose nonresponsive tanycytes was greatly increased in these mice, but a subset of tanycytes retained an undiminished sensitivity to glucose. Our data demonstrate that the sweet taste receptor mediates glucosensing in about 60% of glucosensitive tanycytes while the remaining 40% of glucosensitive tanycytes use some other, as yet unknown mechanism. PMID:28205335

Obtaining active parental consent for school-based research: a guide for researchers.

PubMed

Wolfenden, Luke; Kypri, Kypros; Freund, Megan; Hodder, Rebecca

2009-06-01

Schools increasingly require researchers to obtain active parental consent for students to participate in health research. We sought to identify effective strategies for the recruitment of child research participants through schools. A search of Medline, PsycINFO, Educational Resources Information Center, ProQuest 5000 and the Cochrane Library electronic databases was conducted for the period 1988 to 2008. The review found evidence that the following strategies may be effective in enhancing participation rates: 1) promotion of the research to school principals, teachers, parents and students; 2) dissemination of study information using methods allowing direct contact with parents (i.e. telephone or face-to-face); 3) provision of incentives to teachers, students and at a class level; 4) making reminder contacts; and 5) having a member of the research team co-ordinate and closely monitor the recruitment process. Application of these strategies should reduce the risk of non-response and other biases that result from selective non-participation. Further randomised controlled trials of these and other strategies are required to strengthen the evidence base.

Learning time-dependent noise to reduce logical errors: real time error rate estimation in quantum error correction

NASA Astrophysics Data System (ADS)

Huo, Ming-Xia; Li, Ying

2017-12-01

Quantum error correction is important to quantum information processing, which allows us to reliably process information encoded in quantum error correction codes. Efficient quantum error correction benefits from the knowledge of error rates. We propose a protocol for monitoring error rates in real time without interrupting the quantum error correction. Any adaptation of the quantum error correction code or its implementation circuit is not required. The protocol can be directly applied to the most advanced quantum error correction techniques, e.g. surface code. A Gaussian processes algorithm is used to estimate and predict error rates based on error correction data in the past. We find that using these estimated error rates, the probability of error correction failures can be significantly reduced by a factor increasing with the code distance.

The dependence of crowding on flanker complexity and target-flanker similarity

PubMed Central

Bernard, Jean-Baptiste; Chung, Susana T.L.

2013-01-01

We examined the effects of the spatial complexity of flankers and target-flanker similarity on the performance of identifying crowded letters. On each trial, observers identified the middle character of random strings of three characters (“trigrams”) briefly presented at 10° below fixation. We tested the 26 lowercase letters of the Times-Roman and Courier fonts, a set of 79 characters (letters and non-letters) of the Times-Roman font, and the uppercase letters of two highly complex ornamental fonts, Edwardian and Aristocrat. Spatial complexity of characters was quantified by the length of the morphological skeleton of each character, and target-flanker similarity was defined based on a psychometric similarity matrix. Our results showed that (1) letter identification error rate increases with flanker complexity up to a certain value, beyond which error rate becomes independent of flanker complexity; (2) the increase of error rate is slower for high-complexity target letters; (3) error rate increases with target-flanker similarity; and (4) mislocation error rate increases with target-flanker similarity. These findings, combined with the current understanding of the faulty feature integration account of crowding, provide some constraints of how the feature integration process could cause perceptual errors. PMID:21730225

Pharmacological and Safety Profile of Dexlansoprazole: A New Proton Pump Inhibitor - Implications for Treatment of Gastroesophageal Reflux Disease in the Asia Pacific Region.

PubMed

Goh, Khean Lee; Choi, Myung Gyu; Hsu, Ping I; Chun, Hoon Jai; Mahachai, Varocha; Kachintorn, Udom; Leelakusolvong, Somchai; Kim, Nayoung; Rani, Abdul Aziz; Wong, Benjamin C Y; Wu, Justin; Chiu, Cheng Tang; Shetty, Vikram; Bocobo, Joseph C; Chan, Melchor M; Lin, Jaw-Town

2016-07-30

Although gastroesophageal reflux disease is not as common in Asia as in western countries, the prevalence has increased substantially during the past decade. Gastroesophageal reflux disease is associated with considerable reductions in subjective well-being and work productivity, as well as increased healthcare use. Proton pump inhibitors (PPIs) are currently the most effective treatment for gastroesophageal reflux disease. However, there are limitations associated with these drugs in terms of partial and non-response. Dexlansoprazole is the first PPI with a dual delayed release formulation designed to provide 2 separate releases of medication to extend the duration of effective plasma drug concentration. Dexlansoprazole has been shown to be effective for healing of erosive esophagitis, and to improve subjective well-being by controlling 24-hour symptoms. Dexlansoprazole has also been shown to achieve good plasma concentration regardless of administration with food, providing flexible dosing. Studies in healthy volunteers showed no clinically important effects on exposure to the active metabolite of clopidogrel or clopidogrel-induced platelet inhibition, with no dose adjustment of clopidogrel necessary when coprescribed. This review discusses the role of the new generation PPI, dexlansoprazole, in the treatment of gastroesophageal reflux disease in Asia.

Evaluating cost-efficiency and accuracy of hunter harvest survey designs

USGS Publications Warehouse

Lukacs, P.M.; Gude, J.A.; Russell, R.E.; Ackerman, B.B.

2011-01-01

Effective management of harvested wildlife often requires accurate estimates of the number of animals harvested annually by hunters. A variety of techniques exist to obtain harvest data, such as hunter surveys, check stations, mandatory reporting requirements, and voluntary reporting of harvest. Agencies responsible for managing harvested wildlife such as deer (Odocoileus spp.), elk (Cervus elaphus), and pronghorn (Antilocapra americana) are challenged with balancing the cost of data collection versus the value of the information obtained. We compared precision, bias, and relative cost of several common strategies, including hunter self-reporting and random sampling, for estimating hunter harvest using a realistic set of simulations. Self-reporting with a follow-up survey of hunters who did not report produces the best estimate of harvest in terms of precision and bias, but it is also, by far, the most expensive technique. Self-reporting with no followup survey risks very large bias in harvest estimates, and the cost increases with increased response rate. Probability-based sampling provides a substantial cost savings, though accuracy can be affected by nonresponse bias. We recommend stratified random sampling with a calibration estimator used to reweight the sample based on the proportions of hunters responding in each covariate category as the best option for balancing cost and accuracy. ?? 2011 The Wildlife Society.

Differential regulation of betacellulin and heparin-binding EGF-like growth factor in cultured zebrafish ovarian follicle cells by EGF family ligands.

PubMed

Tse, Anna Chung-Kwan; Ge, Wei

2009-05-01

Recently the roles of epidermal growth factor (EGF) family ligands in vertebrate ovaries have received increasing attention, including betacellulin (BTC), amphiregulin (AR), heparin-binding EGF-like growth factor (HB-EGF), transforming growth factor alpha (TGFalpha), epiregulin, and EGF itself. In the zebrafish (Danio rerio), four members of EGF family have been identified by either molecular cloning or genome sequencing, which are EGF, TGFalpha, BTC, and HB-EGF. Although they are mostly expressed in the oocytes in the ovary, the present study demonstrated the expression of all the four EGF family ligands (egf, btc, tgfa, and hbegf) in cultured zebrafish follicle cells albeit at very low levels. Treatment of the cultured follicle cells with EGF, BTC, and HB-EGF demonstrated differential effects of these ligands on the expression of themselves. While the expression of egf was rather non-responsive to EGF, BTC, and HB-EGF, the expression of btc was consistently down-regulated by all the three molecules. In contrast, hbegf increased its expression in response to these molecules. These results suggest that there is an EGF signaling network in the zebrafish ovarian follicle, and the functionality of this network is self-regulated by its own members.

Pharmacological and Safety Profile of Dexlansoprazole: A New Proton Pump Inhibitor – Implications for Treatment of Gastroesophageal Reflux Disease in the Asia Pacific Region

PubMed Central

Goh, Khean Lee; Choi, Myung Gyu; Hsu, Ping I; Chun, Hoon Jai; Mahachai, Varocha; Kachintorn, Udom; Leelakusolvong, Somchai; Kim, Nayoung; Rani, Abdul Aziz; Wong, Benjamin C Y; Wu, Justin; Chiu, Cheng Tang; Shetty, Vikram; Bocobo, Joseph C; Chan, Melchor M; Lin, Jaw-Town

2016-01-01

Although gastroesophageal reflux disease is not as common in Asia as in western countries, the prevalence has increased substantially during the past decade. Gastroesophageal reflux disease is associated with considerable reductions in subjective well-being and work productivity, as well as increased healthcare use. Proton pump inhibitors (PPIs) are currently the most effective treatment for gastroesophageal reflux disease. However, there are limitations associated with these drugs in terms of partial and non-response. Dexlansoprazole is the first PPI with a dual delayed release formulation designed to provide 2 separate releases of medication to extend the duration of effective plasma drug concentration. Dexlansoprazole has been shown to be effective for healing of erosive esophagitis, and to improve subjective well-being by controlling 24-hour symptoms. Dexlansoprazole has also been shown to achieve good plasma concentration regardless of administration with food, providing flexible dosing. Studies in healthy volunteers showed no clinically important effects on exposure to the active metabolite of clopidogrel or clopidogrel-induced platelet inhibition, with no dose adjustment of clopidogrel necessary when coprescribed. This review discusses the role of the new generation PPI, dexlansoprazole, in the treatment of gastroesophageal reflux disease in Asia. PMID:26932927

Selecting Statistical Quality Control Procedures for Limiting the Impact of Increases in Analytical Random Error on Patient Safety.

PubMed

Yago, Martín

2017-05-01

QC planning based on risk management concepts can reduce the probability of harming patients due to an undetected out-of-control error condition. It does this by selecting appropriate QC procedures to decrease the number of erroneous results reported. The selection can be easily made by using published nomograms for simple QC rules when the out-of-control condition results in increased systematic error. However, increases in random error also occur frequently and are difficult to detect, which can result in erroneously reported patient results. A statistical model was used to construct charts for the 1 ks and X /χ 2 rules. The charts relate the increase in the number of unacceptable patient results reported due to an increase in random error with the capability of the measurement procedure. They thus allow for QC planning based on the risk of patient harm due to the reporting of erroneous results. 1 ks Rules are simple, all-around rules. Their ability to deal with increases in within-run imprecision is minimally affected by the possible presence of significant, stable, between-run imprecision. X /χ 2 rules perform better when the number of controls analyzed during each QC event is increased to improve QC performance. Using nomograms simplifies the selection of statistical QC procedures to limit the number of erroneous patient results reported due to an increase in analytical random error. The selection largely depends on the presence or absence of stable between-run imprecision. © 2017 American Association for Clinical Chemistry.

Single-Isocenter Multiple-Target Stereotactic Radiosurgery: Risk of Compromised Coverage

DOE Office of Scientific and Technical Information (OSTI.GOV)

Roper, Justin, E-mail: justin.roper@emory.edu; Department of Biostatistics and Bioinformatics, Winship Cancer Institute of Emory University, Atlanta, Georgia; Chanyavanich, Vorakarn

2015-11-01

Purpose: To determine the dosimetric effects of rotational errors on target coverage using volumetric modulated arc therapy (VMAT) for multitarget stereotactic radiosurgery (SRS). Methods and Materials: This retrospective study included 50 SRS cases, each with 2 intracranial planning target volumes (PTVs). Both PTVs were planned for simultaneous treatment to 21 Gy using a single-isocenter, noncoplanar VMAT SRS technique. Rotational errors of 0.5°, 1.0°, and 2.0° were simulated about all axes. The dose to 95% of the PTV (D95) and the volume covered by 95% of the prescribed dose (V95) were evaluated using multivariate analysis to determine how PTV coverage was relatedmore » to PTV volume, PTV separation, and rotational error. Results: At 0.5° rotational error, D95 values and V95 coverage rates were ≥95% in all cases. For rotational errors of 1.0°, 7% of targets had D95 and V95 values <95%. Coverage worsened substantially when the rotational error increased to 2.0°: D95 and V95 values were >95% for only 63% of the targets. Multivariate analysis showed that PTV volume and distance to isocenter were strong predictors of target coverage. Conclusions: The effects of rotational errors on target coverage were studied across a broad range of SRS cases. In general, the risk of compromised coverage increased with decreasing target volume, increasing rotational error and increasing distance between targets. Multivariate regression models from this study may be used to quantify the dosimetric effects of rotational errors on target coverage given patient-specific input parameters of PTV volume and distance to isocenter.« less

Evaluation of Faculty and Non-faculty Physicians’ Medication Errors in Outpatients’ Prescriptions in Shiraz, Iran

PubMed Central

Misagh, Pegah; Vazin, Afsaneh; Namazi, Soha

2018-01-01

This study was aimed at finding the occurrence rate of prescription errors in the outpatients› prescriptions written by faculty and non-faculty physicians practicing in Shiraz, Iran. In this cross-sectional study 2000 outpatient prescriptions were randomly collected from pharmacies affiliated with Shiraz University of Medical Sciences (SUMS) and social security insurance in Shiraz, Iran. Patient information including age, weight, diagnosis and chief complain were recorded. Physicians ‘characteristics were extracted from prescriptions. Prescription errors including errors in spelling, instruction, strength, dosage form and quantity as well as drug-drug interactions and contraindications were identified. The mean ± SD age of patients was 37.91 ± 21.10 years. Most of the patients were male (77.15%) and 81.50% of patients were adults. The average total number of drugs per prescription was 3.19 ± 1.60. The mean ± SD of prescription errors was 7.38 ± 4.06. Spelling error (26.4%), instruction error (21.03%), and strength error (19.18%) were the most frequent prescription errors. The mean ± SD of prescription errors was 7.83 ± 4.2 and 6.93 ± 3.88 in non-faculty and faculty physicians, respectively (P < 0.05). Number of prescription errors increased significantly as the number of prescribed drugs increased. All prescriptions had at least one error. The rate of prescription errors was higher in non-faculty physicians. Number of prescription errors related with the prescribed drugs in the prescription.

Factors that influence the generation of autobiographical memory conjunction errors

PubMed Central

Devitt, Aleea L.; Monk-Fromont, Edwin; Schacter, Daniel L.; Addis, Donna Rose

2015-01-01

The constructive nature of memory is generally adaptive, allowing us to efficiently store, process and learn from life events, and simulate future scenarios to prepare ourselves for what may come. However, the cost of a flexibly constructive memory system is the occasional conjunction error, whereby the components of an event are authentic, but the combination of those components is false. Using a novel recombination paradigm, it was demonstrated that details from one autobiographical memory may be incorrectly incorporated into another, forming autobiographical memory conjunction errors that elude typical reality monitoring checks. The factors that contribute to the creation of these conjunction errors were examined across two experiments. Conjunction errors were more likely to occur when the corresponding details were partially rather than fully recombined, likely due to increased plausibility and ease of simulation of partially recombined scenarios. Brief periods of imagination increased conjunction error rates, in line with the imagination inflation effect. Subjective ratings suggest that this inflation is due to similarity of phenomenological experience between conjunction and authentic memories, consistent with a source monitoring perspective. Moreover, objective scoring of memory content indicates that increased perceptual detail may be particularly important for the formation of autobiographical memory conjunction errors. PMID:25611492

Factors that influence the generation of autobiographical memory conjunction errors.

PubMed

Devitt, Aleea L; Monk-Fromont, Edwin; Schacter, Daniel L; Addis, Donna Rose

2016-01-01

The constructive nature of memory is generally adaptive, allowing us to efficiently store, process and learn from life events, and simulate future scenarios to prepare ourselves for what may come. However, the cost of a flexibly constructive memory system is the occasional conjunction error, whereby the components of an event are authentic, but the combination of those components is false. Using a novel recombination paradigm, it was demonstrated that details from one autobiographical memory (AM) may be incorrectly incorporated into another, forming AM conjunction errors that elude typical reality monitoring checks. The factors that contribute to the creation of these conjunction errors were examined across two experiments. Conjunction errors were more likely to occur when the corresponding details were partially rather than fully recombined, likely due to increased plausibility and ease of simulation of partially recombined scenarios. Brief periods of imagination increased conjunction error rates, in line with the imagination inflation effect. Subjective ratings suggest that this inflation is due to similarity of phenomenological experience between conjunction and authentic memories, consistent with a source monitoring perspective. Moreover, objective scoring of memory content indicates that increased perceptual detail may be particularly important for the formation of AM conjunction errors.

Self-reported and observed punitive parenting prospectively predicts increased error-related brain activity in six-year-old children

PubMed Central

Meyer, Alexandria; Proudfit, Greg Hajcak; Bufferd, Sara J.; Kujawa, Autumn J.; Laptook, Rebecca S.; Torpey, Dana C.; Klein, Daniel N.

2017-01-01

The error-related negativity (ERN) is a negative deflection in the event-related potential (ERP) occurring approximately 50 ms after error commission at fronto-central electrode sites and is thought to reflect the activation of a generic error monitoring system. Several studies have reported an increased ERN in clinically anxious children, and suggest that anxious children are more sensitive to error commission—although the mechanisms underlying this association are not clear. We have previously found that punishing errors results in a larger ERN, an effect that persists after punishment ends. It is possible that learning-related experiences that impact sensitivity to errors may lead to an increased ERN. In particular, punitive parenting might sensitize children to errors and increase their ERN. We tested this possibility in the current study by prospectively examining the relationship between parenting style during early childhood and children’s ERN approximately three years later. Initially, 295 parents and children (approximately 3 years old) participated in a structured observational measure of parenting behavior, and parents completed a self-report measure of parenting style. At a follow-up assessment approximately three years later, the ERN was elicited during a Go/No-Go task, and diagnostic interviews were completed with parents to assess child psychopathology. Results suggested that both observational measures of hostile parenting and self-report measures of authoritarian parenting style uniquely predicted a larger ERN in children 3 years later. We previously reported that children in this sample with anxiety disorders were characterized by an increased ERN. A mediation analysis indicated that ERN magnitude mediated the relationship between harsh parenting and child anxiety disorder. Results suggest that parenting may shape children’s error processing through environmental conditioning and thereby risk for anxiety, although future work is needed to confirm this hypothesis. PMID:25092483

Anxiety and Error Monitoring: Increased Error Sensitivity or Altered Expectations?

ERIC Educational Resources Information Center

Compton, Rebecca J.; Carp, Joshua; Chaddock, Laura; Fineman, Stephanie L.; Quandt, Lorna C.; Ratliff, Jeffrey B.

2007-01-01

This study tested the prediction that the error-related negativity (ERN), a physiological measure of error monitoring, would be enhanced in anxious individuals, particularly in conditions with threatening cues. Participants made gender judgments about faces whose expressions were either happy, angry, or neutral. Replicating prior studies, midline…

Antiretroviral medication prescribing errors are common with hospitalization of HIV-infected patients.

PubMed

Commers, Tessa; Swindells, Susan; Sayles, Harlan; Gross, Alan E; Devetten, Marcel; Sandkovsky, Uriel

2014-01-01

Errors in prescribing antiretroviral therapy (ART) often occur with the hospitalization of HIV-infected patients. The rapid identification and prevention of errors may reduce patient harm and healthcare-associated costs. A retrospective review of hospitalized HIV-infected patients was carried out between 1 January 2009 and 31 December 2011. Errors were documented as omission, underdose, overdose, duplicate therapy, incorrect scheduling and/or incorrect therapy. The time to error correction was recorded. Relative risks (RRs) were computed to evaluate patient characteristics and error rates. A total of 289 medication errors were identified in 146/416 admissions (35%). The most common was drug omission (69%). At an error rate of 31%, nucleoside reverse transcriptase inhibitors were associated with an increased risk of error when compared with protease inhibitors (RR 1.32; 95% CI 1.04-1.69) and co-formulated drugs (RR 1.59; 95% CI 1.19-2.09). Of the errors, 31% were corrected within the first 24 h, but over half (55%) were never remedied. Admissions with an omission error were 7.4 times more likely to have all errors corrected within 24 h than were admissions without an omission. Drug interactions with ART were detected on 51 occasions. For the study population (n = 177), an increased risk of admission error was observed for black (43%) compared with white (28%) individuals (RR 1.53; 95% CI 1.16-2.03) but no significant differences were observed between white patients and other minorities or between men and women. Errors in inpatient ART were common, and the majority were never detected. The most common errors involved omission of medication, and nucleoside reverse transcriptase inhibitors had the highest rate of prescribing error. Interventions to prevent and correct errors are urgently needed.

A critical eye: praise directed toward traits increases children's eye fixations on errors and decreases motivation.

PubMed

Zentall, Shannon R; Morris, Bradley J

2012-12-01

Although there is evidence that praise of different types (i.e., generic vs. nongeneric) influences motivation, it is unclear how this occurs. Generic praise (e.g., "You are smart") conveys that a child possesses a trait responsible for their performance, whereas nongeneric praise (e.g., "You worked hard") conveys that performance is effort-based. Because praise conveys the basis for success, praise may change the interpretation and salience of errors. Specifically, generic praise may highlight the threatening nature of error (i.e., the child does not possess this trait). Because attention is drawn to threats in the environment, we expected generic praise to increase attention to error. We used eyetracking to measure implicit responses to errors (i.e., visual attention: fixation counts and durations) in order to determine the relation between visual attention and verbal reports of motivation (persistence and self-evaluations) in 30 four- to seven-year-old children. Children first saw pictures attributed to them, for which they received either generic or nongeneric praise. The children then saw pictures attributed to them that contained errors--that is, missing features. As a pretest and posttest, the children saw pictures that were "drawn by other children," half of which contained errors. The results indicated that children who received generic praise ("you are a good drawer") produced more and longer fixations on errors, both their "own" and on "other children's," than did children who received nongeneric praise ("you did a good job drawing"). More fixations on errors were related to lower persistence and lower self-evaluations. These results suggest that generic praise increases attention to errors because error threatens the possession of a positive trait.

EEG Theta Dynamics within Frontal and Parietal Cortices for Error Processing during Reaching Movements in a Prism Adaptation Study Altering Visuo-Motor Predictive Planning

PubMed Central

Bonfiglio, Luca; Minichilli, Fabrizio; Cantore, Nicoletta; Carboncini, Maria Chiara; Piccotti, Emily; Rossi, Bruno

2016-01-01

Modulation of frontal midline theta (fmθ) is observed during error commission, but little is known about the role of theta oscillations in correcting motor behaviours. We investigate EEG activity of healthy partipants executing a reaching task under variable degrees of prism-induced visuo-motor distortion and visual occlusion of the initial arm trajectory. This task introduces directional errors of different magnitudes. The discrepancy between predicted and actual movement directions (i.e. the error), at the time when visual feedback (hand appearance) became available, elicits a signal that triggers on-line movement correction. Analysis were performed on 25 EEG channels. For each participant, the median value of the angular error of all reaching trials was used to partition the EEG epochs into high- and low-error conditions. We computed event-related spectral perturbations (ERSP) time-locked either to visual feedback or to the onset of movement correction. ERSP time-locked to the onset of visual feedback showed that fmθ increased in the high- but not in the low-error condition with an approximate time lag of 200 ms. Moreover, when single epochs were sorted by the degree of motor error, fmθ started to increase when a certain level of error was exceeded and, then, scaled with error magnitude. When ERSP were time-locked to the onset of movement correction, the fmθ increase anticipated this event with an approximate time lead of 50 ms. During successive trials, an error reduction was observed which was associated with indices of adaptations (i.e., aftereffects) suggesting the need to explore if theta oscillations may facilitate learning. To our knowledge this is the first study where the EEG signal recorded during reaching movements was time-locked to the onset of the error visual feedback. This allowed us to conclude that theta oscillations putatively generated by anterior cingulate cortex activation are implicated in error processing in semi-naturalistic motor behaviours. PMID:26963919

EEG Theta Dynamics within Frontal and Parietal Cortices for Error Processing during Reaching Movements in a Prism Adaptation Study Altering Visuo-Motor Predictive Planning.

PubMed

Arrighi, Pieranna; Bonfiglio, Luca; Minichilli, Fabrizio; Cantore, Nicoletta; Carboncini, Maria Chiara; Piccotti, Emily; Rossi, Bruno; Andre, Paolo

2016-01-01

Modulation of frontal midline theta (fmθ) is observed during error commission, but little is known about the role of theta oscillations in correcting motor behaviours. We investigate EEG activity of healthy partipants executing a reaching task under variable degrees of prism-induced visuo-motor distortion and visual occlusion of the initial arm trajectory. This task introduces directional errors of different magnitudes. The discrepancy between predicted and actual movement directions (i.e. the error), at the time when visual feedback (hand appearance) became available, elicits a signal that triggers on-line movement correction. Analysis were performed on 25 EEG channels. For each participant, the median value of the angular error of all reaching trials was used to partition the EEG epochs into high- and low-error conditions. We computed event-related spectral perturbations (ERSP) time-locked either to visual feedback or to the onset of movement correction. ERSP time-locked to the onset of visual feedback showed that fmθ increased in the high- but not in the low-error condition with an approximate time lag of 200 ms. Moreover, when single epochs were sorted by the degree of motor error, fmθ started to increase when a certain level of error was exceeded and, then, scaled with error magnitude. When ERSP were time-locked to the onset of movement correction, the fmθ increase anticipated this event with an approximate time lead of 50 ms. During successive trials, an error reduction was observed which was associated with indices of adaptations (i.e., aftereffects) suggesting the need to explore if theta oscillations may facilitate learning. To our knowledge this is the first study where the EEG signal recorded during reaching movements was time-locked to the onset of the error visual feedback. This allowed us to conclude that theta oscillations putatively generated by anterior cingulate cortex activation are implicated in error processing in semi-naturalistic motor behaviours.

Lumbar extensor muscle force control is associated with disability in people with chronic low back pain.

PubMed

Pranata, Adrian; Perraton, Luke; El-Ansary, Doa; Clark, Ross; Fortin, Karine; Dettmann, Tim; Brandham, Robert; Bryant, Adam

2017-07-01

The ability to control lumbar extensor force output is necessary for daily activities. However, it is unknown whether this ability is impaired in chronic low back pain patients. Similarly, it is unknown whether lumbar extensor force control is related to the disability levels of chronic low back pain patients. Thirty-three chronic low back pain and 20 healthy people performed lumbar extension force-matching task where they increased and decreased their force output to match a variable target force within 20%-50% maximal voluntary isometric contraction. Force control was quantified as the root-mean-square-error between participants' force output and target force across the entire, during the increasing and decreasing portions of the force curve. Within- and between-group differences in force-matching error and the relationship between back pain group's force-matching results and their Oswestry Disability Index scores were assessed using ANCOVA and linear regression respectively. Back pain group demonstrated more overall force-matching error (mean difference=1.60 [0.78, 2.43], P<0.01) and more force-matching error while increasing force output (mean difference=2.19 [1.01, 3.37], P<0.01) than control group. The back pain group demonstrated more force-matching error while increasing than decreasing force output (mean difference=1.74, P<0.001, 95%CI [0.87, 2.61]). A unit increase in force-matching error while decreasing force output is associated with a 47% increase in Oswestry score in back pain group (R 2 =0.19, P=0.006). Lumbar extensor muscle force control is compromised in chronic low back pain patients. Force-matching error predicts disability, confirming the validity of our force control protocol for chronic low back pain patients. Copyright © 2017 Elsevier Ltd. All rights reserved.

Pain sensitisation and the risk of poor outcome following physiotherapy for patients with moderate to severe knee osteoarthritis: protocol for a prospective cohort study

PubMed Central

O'Leary, Helen; Smart, Keith M; Moloney, Niamh A; Blake, Catherine; Doody, Catherine M

2015-01-01

Introduction Pain is the dominant symptom of knee osteoarthritis (OA), and recent evidence suggests factors outside of local joint pathology, such as pain sensitisation, can contribute significantly to the pain experience. It is unknown how pain sensitisation influences outcomes from commonly employed interventions such as physiotherapy. The aims of this study are, first, to provide a comprehensive description of the somatosensory characteristics of people with pain associated with knee OA. Second, we will investigate if indicators of pain sensitisation in patients with knee osteoarthritis are predictive of non-response to physiotherapy. Methods and analysis This is a multicentre prospective cohort study with 140 participants. Eligible patients with moderate to severe symptomatic knee osteoarthritis will be identified at outpatient orthopaedic and rheumatology clinics. A baseline assessment will provide a comprehensive description of the somatosensory characteristics of each participant by means of clinical examination, quantitative sensory testing, and validated questionnaires measuring pain and functional capacity. Participants will then undergo physiotherapy treatment. The primary outcome will be non-response to physiotherapy on completion of the physiotherapy treatment programme as defined by the Osteoarthritis Research Society International treatment responder criteria. A principal component analysis will identify measures related to pain sensitisation to include in the predictive model. Regression analyses will explore the relationship between responder status and pain sensitisation while accounting for confounders. Ethics and dissemination This study has been approved by St James’ Hospital/AMNCH Research Ethics Committee and by the St Vincent's Healthcare Group Ethics and Medical Research Committee. The results will be presented at international conferences and published in a peer review journal. Trial registration number NCT02310945. PMID:26059523

Celiac disease: management of persistent symptoms in patients on a gluten-free diet.

PubMed

Dewar, David H; Donnelly, Suzanne C; McLaughlin, Simon D; Johnson, Matthew W; Ellis, H Julia; Ciclitira, Paul J

2012-03-28

To investigate all patients referred to our center with non-responsive celiac disease (NRCD), to establish a cause for their continued symptoms. We assessed all patients referred to our center with non-responsive celiac disease over an 18-mo period. These individuals were investigated to establish the eitiology of their continued symptoms. The patients were first seen in clinic where a thorough history and examination were performed with routine blood work including tissue transglutaminase antibody measurement. They were also referred to a specialist gastroenterology dietician to try to identift any lapses in the diet and sources of hidden gluten ingestion. A repeat small intestinal biopsy was also performed and compared to biopsies from the referring hospital where possible. Colonoscopy, lactulose hydrogen breath testing, pancreolauryl testing and computed tomography scan of the abdomen were undertaken if the symptoms persisted. Their clinical progress was followed over a minimum of 2 years. One hundred and twelve consecutive patients were referred with NRCD. Twelve were found not to have celiac disease (CD). Of the remaining 100 patients, 45% were not adequately adhering to a strict gluten-free diet, with 24 (53%) found to be inadvertently ingesting gluten, and 21 (47%) admitting non-compliance. Microscopic colitis was diagnosed in 12% and small bowel bacterial overgrowth in 9%. Refractory CD was diagnosed in 9%. Three of these were diagnosed with intestinal lymphoma. After 2 years, 78 patients remained well, eight had continuing symptoms, and four had died. In individuals with NRCD, a remediable cause can be found in 90%: with continued gluten ingestion as the leading cause. We propose an algorithm for investigation.

Effect of inadequate response to treatment in patients with depression.

PubMed

Knoth, Russell L; Bolge, Susan C; Kim, Edward; Tran, Quynh-Van

2010-08-01

To assess the effects of inadequate response to antidepressant treatment on healthcare resource utilization and on work productivity in patients diagnosed as having major depressive disorder (MDD). This study used data from the 2006 US National Health and Wellness Survey, a cross-sectional survey of adults 18 years and older. Patients who self-reported a confirmed diagnosis of depression and were currently taking antidepressant medication were included in the analyses. Adequacy of antidepressant treatment response was determined from responses to the mental health domain of the 8-Item Short Form Health Survey (SF-8). Logistic regression analyses adjusted for demographics, comorbidity, and component scores on the SF-8 were used to determine the associations between inadequacy of treatment response and health outcomes. Of 5988 patients who met the inclusion criteria for the study, 30.9% were classified as antidepressant treatment responders, 31.2% were partial responders, and 37.9% were nonresponders. Partial response and nonresponse to treatment were associated with greater likelihood of emergency department utilization (odds ratios [ORs], 1.26 and 1.54, respectively; P <.01 for both) and hospitalization (OR, 1.23; P = .05 and OR, 1.39; P <.01, respectively). Similarly, partial response and nonresponse were associated with lower likelihood of current employment (OR, 0.83; P = .01 and OR, 0.63; P <.01, respectively) and with greater likelihood of work productivity loss among the employed (ORs, 1.42 and 1.99, respectively; P <.01 for both). Patients with MDD who failed to respond to antidepressant treatment as evidenced by poor self-reported mental health status used more healthcare resources, were less likely to be employed, and had more work productivity loss than those who responded to antidepressant therapy.

Semen says: Assessing the accuracy of adolescents’ self-reported sexual abstinence using a semen Y-chromosome biomarker

PubMed Central

Rosenbaum, Janet E.; Zenilman, Jonathan M.; Rose, Eve; Wingood, Gina M.; DiClemente, Ralph J.

2016-01-01

Objective Researchers often assess condom use only among participants who report recent sexual behaviour, excluding participants who report no recent vaginal sex or who did not answer questions about their sexual behaviour, but self-reported sexual behaviour may be inaccurate. This study uses a semen Y-chromosome biomarker to assess semen exposure among participants who reported sexual abstinence or did not report their sexual behaviour. Methods This prospective cohort study uses data from 715 sexually active African-American female adolescents in Atlanta, surveyed at baseline, 6 months, and 12 months. Participants completed a 40-minute interview and were tested for semen Y-chromosome with polymerase chain reaction from a self-administered vaginal swab. We predicted Y-chromosome test results from self-reported sexual behaviour using within-subject panel regression. Results Among participants who reported abstinence from vaginal sex in the past 14 days, 9.4% tested positive for semen Y-chromosome. Among item non-respondents, 6.3% tested positive for semen Y-chromosome. Women who reported abstinence and engaged in item non-response regarding their sexual behaviour had respectively 62% and 78% lower odds of testing positive for Y-chromosome (OR 0.38 (0.21, 0.67), OR 0.22 (0.12, 0.40)), controlling for smoking, survey wave, and non-coital sexual behaviours reported during abstinence. Conclusions Adolescents who report sexual abstinence under-report semen exposure. Research should validate self-reported sexual behaviour with biomarkers. Adolescents who engage in item non-response regarding vaginal sex test positive for semen Y-chromosome at similar rates, which supports the practice of grouping non-respondents with adolescents reporting abstinence in statistical analysis. PMID:27147615

The requirement for prior consent to participate on survey response rates: a population-based survey in Grampian

PubMed Central

Angus, Val C; Entwistle, Vikki A; Emslie, Margaret J; Walker, Kim A; Andrew, Jane E

2003-01-01

Background A survey was carried out in the Grampian region of Scotland with a random sample of 10,000 adults registered with a General Practitioner in Grampian. The study complied with new legislation requiring a two-stage approach to identify and recruit participants, and examined the implications of this for response rates, non-response bias and speed of response. Methods A two-stage survey was carried out consistent with new confidentiality guidelines. Individuals were contacted by post and asked by the Director of Public Health to consent to receive a postal or electronic questionnaire about communicating their views to the NHS. Those who consented were then sent questionnaires. Response rates at both stages were measured. Results 25% of people returned signed consent forms and were invited to complete questionnaires. Respondents at the consent stage were more likely to be female (odds ratio (OR) response rate of women compared to men = 1.5, 95% CI 1.4, 1.7), less likely to live in deprived postal areas (OR = 0.59, 95% CI 0.45, 0.78) and more likely to be older (OR for people born in 1930–39 compared to people born in 1970–79 = 2.82, 95% CI 2.36, 3.37). 80% of people who were invited to complete questionnaires returned them. Response rates were higher among older age groups. The overall response rate to the survey was 20%, relative to the original number approached for consent (1951/10000). Conclusion The requirement of a separate, prior consent stage may significantly reduce overall survey response rates and necessitate the use of substantially larger initial samples for population surveys. It may also exacerbate non-response bias with respect to demographic variables. PMID:14622444

Early non-response to certolizumab pegol in rheumatoid arthritis predicts treatment failure at one year. Data from a randomised phase III clinical trial.

PubMed

Berenbaum, Francis; Pham, Thao; Claudepierre, Pascal; de Chalus, Thibault; Joubert, Jean-Michel; Saadoun, Carine; Riou França, Lionel; Fautrel, Bruno

2018-01-01

To compare different early clinical criteria of non-response determined at three months as predictors of clinical failure at one year in patients with rheumatoid arthritis starting therapy with certolizumab pegol. Data were derived from a randomised Phase III clinical trial in patients with rheumatoid arthritis who failed to respond to methotrexate monotherapy. Patients included in this post-hoc analysis were treated with certolizumab pegol (400mg qd reduced to 200mg qd after one month) and with methotrexate. The study duration was twelve months. Response at three months was determined with the American College of Rheumatology-50, Disease Assessment Score-28 ESR, Health Assessment Questionnaire and the Clinical Disease Activity Index. The performance of these measures at predicting treatment failure at twelve months defined by the American College of Rheumatology-50 criteria was determined, using the positive predictive values as the principal evaluation criterion. Three hundred and eighty two patients were available for analysis and 225 completed the twelve-month follow-up. At Week 52, 149 (38.1%) patients met the American College of Rheumatology-50 response criterion. Positive predictive values ranged from 81% for a decrease in Health Assessment Questionnaire- Disability index score since baseline >0.22 to 95% for a decrease in Disease Assessment Score-28 score since baseline≥1.2. Sensitivity was≤70% in all cases. Performance of these measures was similar irrespective of the definition of treatment failure at 12months. Simple clinical measures of disease activity can predict future treatment failure reliably and are appropriate for implementing treat-to-target treatment strategies in everyday practice. Copyright © 2017 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

Staphylococcal enterotoxin A (SEA) stimulates STAT3 activation and IL-17 expression in cutaneous T-cell lymphoma.

PubMed

Willerslev-Olsen, Andreas; Krejsgaard, Thorbjørn; Lindahl, Lise M; Litvinov, Ivan V; Fredholm, Simon; Petersen, David L; Nastasi, Claudia; Gniadecki, Robert; Mongan, Nigel P; Sasseville, Denis; Wasik, Mariusz A; Bonefeld, Charlotte M; Geisler, Carsten; Woetmann, Anders; Iversen, Lars; Kilian, Mogens; Koralov, Sergei B; Odum, Niels

2016-03-10

Cutaneous T-cell lymphoma (CTCL) is characterized by proliferation of malignant T cells in a chronic inflammatory environment. With disease progression, bacteria colonize the compromised skin barrier and half of CTCL patients die of infection rather than from direct organ involvement by the malignancy. Clinical data indicate that bacteria play a direct role in disease progression, but little is known about the mechanisms involved. Here, we demonstrate that bacterial isolates containing staphylococcal enterotoxin A (SEA) from the affected skin of CTCL patients, as well as recombinant SEA, stimulate activation of signal transducer and activator of transcription 3 (STAT3) and upregulation of interleukin (IL)-17 in immortalized and primary patient-derived malignant and nonmalignant T cells. Importantly, SEA induces STAT3 activation and IL-17 expression in malignant T cells when cocultured with nonmalignant T cells, indicating an indirect mode of action. In accordance, malignant T cells expressing an SEA-nonresponsive T-cell receptor variable region β chain are nonresponsive to SEA in monoculture but display strong STAT3 activation and IL-17 expression in cocultures with SEA-responsive nonmalignant T cells. The response is induced via IL-2 receptor common γ chain cytokines and a Janus kinase 3 (JAK3)-dependent pathway in malignant T cells, and blocked by tofacitinib, a clinical-grade JAK3 inhibitor. In conclusion, we demonstrate that SEA induces cell cross talk-dependent activation of STAT3 and expression of IL-17 in malignant T cells, suggesting a mechanism whereby SEA-producing bacteria promote activation of an established oncogenic pathway previously implicated in carcinogenesis. © 2016 by The American Society of Hematology.

Response assessment of bevacizumab therapy in GBM with integrated 11C-MET-PET/MRI: a feasibility study.

PubMed

Deuschl, Cornelius; Moenninghoff, Christoph; Goericke, Sophia; Kirchner, Julian; Köppen, Susanne; Binse, Ina; Poeppel, Thorsten D; Quick, Harald H; Forsting, Michael; Umutlu, Lale; Herrmann, Ken; Hense, Joerg; Schlamann, Marc

2017-08-01

The objective of this study was to evaluate the potential of integrated 11C-MET PET/MR for response assessment of relapsed glioblastoma (GBM) receiving bevacizumab treatment. Eleven consecutive patients with relapsed GBM were enrolled for an integrated 11C-MET PET/MRI at baseline and at follow-up. Treatment response for MRI was evaluated according to Response Assessment in Neuro-oncology (RANO) criteria and integrated 11C-MET PET was assessed by the T/N ratio. MRI showed no patient with complete response (CR), six of 11 patients with PR, four of 11 patients with SD, and one of 11 patients with progressive disease (PD). PET revealed metabolic response in five of the six patients with partial response (PR) and in two of the four patients with stable disease (SD), whereas metabolic non-response was detected in one of the six patients with PR, in two of the four patients with SD, and in the one patient with PD. Morphological imaging was predictive for PFS and OS when response was defined as CR, PR, SD, and non-response as PD. Metabolic imaging was predictive when using T/N ratio reduction of >25 as discriminator. Based on the morphologic and metabolic findings of this study a proposal for applying integrated PET/MRI for treatment response in relapsed GBM was developed, which was significantly predictive for PFS and OS (P = 0.010 respectively 0,029, log). This study demonstrates the potential of integrated 11C-MET-PET/MRI for response assessment of GBM and the utility of combined assessment of morphologic and metabolic information with the proposal for assessing relapsed GBM.

Whole blood transcriptional profiles as a prognostic tool in complete and incomplete Kawasaki Disease.

PubMed

Jaggi, Preeti; Mejias, Asuncion; Xu, Zhaohui; Yin, Han; Moore-Clingenpeel, Melissa; Smith, Bennett; Burns, Jane C; Tremoulet, Adriana H; Jordan-Villegas, Alejandro; Chaussabel, Damien; Texter, Karen; Pascual, Virginia; Ramilo, Octavio

2018-01-01

Early identification of children with Kawasaki Disease (KD) is key for timely initiation of intravenous immunoglobulin (IVIG) therapy. However, the diagnosis of the disease remains challenging, especially in children with an incomplete presentation (inKD). Moreover, we currently lack objective tools for identification of non-response (NR) to IVIG. Children with KD were enrolled and samples obtained before IVIG treatment and sequentially at 24 h and 4-6 weeks post-IVIG in a subset of patients. We also enrolled children with other febrile illnesses [adenovirus (AdV); group A streptococcus (GAS)] and healthy controls (HC) for comparative analyses. Blood transcriptional profiles were analyzed to define: a) the cKD and inKD biosignature, b) compare the KD signature with other febrile illnesses and, c) identify biomarkers predictive of clinical outcomes. We identified a cKD biosignature (n = 39; HC, n = 16) that was validated in two additional cohorts of children with cKD (n = 37; HC, n = 20) and inKD (n = 13; HC, n = 8) and was characterized by overexpression of inflammation, platelets, apoptosis and neutrophil genes, and underexpression of T and NK cell genes. Classifier genes discriminated KD from adenovirus with higher sensitivity and specificity (92% and 100%, respectively) than for GAS (75% and 87%, respectively). We identified a genomic score (MDTH) that was higher at baseline in IVIG-NR [median 12,290 vs. 5,572 in responders, p = 0.009] and independently predicted IVIG-NR. A reproducible biosignature from KD patients was identified, and was similar in children with cKD and inKD. A genomic score allowed early identification of children at higher risk for non-response to IVIG.

Antidepressant-like Responses to Lithium in Genetically Diverse Mouse Strains

PubMed Central

Can, Adem; Blackwell, Robert A.; Piantadosi, Sean C.; Dao, David T.; O’Donnell, Kelley C.; Gould, Todd D.

2011-01-01

A mood stabilizing and antidepressant response to lithium is only found in a subgroup of bipolar disorder and depression patients. Identifying strains of mice that are responsive and non-responsive to lithium may elucidate genomic and other biological factors that play a role in lithium responsiveness. Mouse strains were tested in the forced swim, tail suspension, and open field tests after acute and chronic systemic, and intracerebroventricular and chronic lithium treatments. Serum and brain lithium levels were measured. Three (129S6/SvEvTac, C3H/HeNHsd, C57BL/6J) of the eight inbred strains tested, and one (CD-1) of the three outbred strains, showed an antidepressant-like response in the forced swim test following acute systemic administration of lithium. The three responsive inbred strains, as well as the DBA/2J strain, were also responsive in the forced swim test after chronic administration of lithium. However, in the tail suspension test, acute lithium resulted in an antidepressant-like effect only in C3H/HeNHsd mice. Only C57BL/6J and DBA/2J were responsive in the tail suspension test after chronic administration of lithium. Intracerebroventricular lithium administration resulted in a similar response profile in BALB/cJ (non-responsive) and C57BL/6J (responsive) strains. Serum and brain lithium concentrations demonstrated that behavioral results were not due to differential pharmacokinetics of lithium in individual strains, suggesting that genetic factors likely regulate responsiveness to lithium. Our results indicate that responsiveness to lithium in tests of antidepressant efficacy varies among genetically diverse mouse strains. These results will assist in identifying genomic factors associated with lithium responsiveness and the mechanisms of lithium action. PMID:21306560

Pain sensitisation and the risk of poor outcome following physiotherapy for patients with moderate to severe knee osteoarthritis: protocol for a prospective cohort study.

PubMed

O'Leary, Helen; Smart, Keith M; Moloney, Niamh A; Blake, Catherine; Doody, Catherine M

2015-06-09

Pain is the dominant symptom of knee osteoarthritis (OA), and recent evidence suggests factors outside of local joint pathology, such as pain sensitisation, can contribute significantly to the pain experience. It is unknown how pain sensitisation influences outcomes from commonly employed interventions such as physiotherapy. The aims of this study are, first, to provide a comprehensive description of the somatosensory characteristics of people with pain associated with knee OA. Second, we will investigate if indicators of pain sensitisation in patients with knee osteoarthritis are predictive of non-response to physiotherapy. This is a multicentre prospective cohort study with 140 participants. Eligible patients with moderate to severe symptomatic knee osteoarthritis will be identified at outpatient orthopaedic and rheumatology clinics. A baseline assessment will provide a comprehensive description of the somatosensory characteristics of each participant by means of clinical examination, quantitative sensory testing, and validated questionnaires measuring pain and functional capacity. Participants will then undergo physiotherapy treatment. The primary outcome will be non-response to physiotherapy on completion of the physiotherapy treatment programme as defined by the Osteoarthritis Research Society International treatment responder criteria. A principal component analysis will identify measures related to pain sensitisation to include in the predictive model. Regression analyses will explore the relationship between responder status and pain sensitisation while accounting for confounders. This study has been approved by St James' Hospital/AMNCH Research Ethics Committee and by the St Vincent's Healthcare Group Ethics and Medical Research Committee. The results will be presented at international conferences and published in a peer review journal. NCT02310945. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

The Role of Electroconvulsive Therapy (ECT) in Bipolar Disorder: Effectiveness in 522 Patients with Bipolar Depression, Mixed-state, Mania and Catatonic Features

PubMed Central

Perugi, Giulio; Medda, Pierpaolo; Toni, Cristina; Mariani, Michela Giorgi; Socci, Chiara; Mauri, Mauro

2017-01-01

Objective: We evaluated the effectiveness of Electroconvulsive Therapy (ECT) in the treatment of Bipolar Disorder (BD) in a large sample of bipolar patients with drug resistant depression, mania, mixed state and catatonic features. Method: 522 consecutive patients with DSM-IV-TR BD were evaluated prior to and after the ECT course. Responders and nonresponders were compared in subsamples of depressed and mixed patients. Descriptive analyses were reported for patients with mania and with catatonic features. Results: Of the original sample only 22 patients were excluded for the occurrence of side effects or consent withdrawal. After the ECT course, 344 (68.8%) patients were considered responders (final CGIi score ≤2) and 156 (31.2%) nonresponders. Response rates were respectively 68.1% for BD depression, 72.9% for mixed state, 75% for mania and 80.8% for catatonic features. Length of current episode and global severity of the illness were the only statistically significant predictors of nonresponse. Conclusion: ECT resulted to be an effective and safe treatment for all the phases of severe and drug-resistant BD. Positive response was observed in approximately two-thirds of the cases and in 80% of the catatonic patients. The duration of the current episode was the major predictor of nonresponse. The risk of ECT-induced mania is virtually absent and mood destabilization very unlikely. Our results clearly indicate that current algorithms for the treatment of depressive, mixed, manic and catatonic states should be modified and, at least for the most severe patients, ECT should not be considered as a “last resort”. PMID:28503107

Detecting and interpreting conscious experiences in behaviorally non-responsive patients.

PubMed

Naci, Lorina; Sinai, Leah; Owen, Adrian M

2017-01-15

Decoding the contents of consciousness from brain activity is one of the most challenging frontiers of cognitive neuroscience. The ability to interpret mental content without recourse to behavior is most relevant for understanding patients who may be demonstrably conscious, but entirely unable to speak or move willfully in any way, precluding any systematic investigation of their conscious experience. The lack of consistent behavioral responsivity engenders unique challenges to decoding any conscious experiences these patients may have solely based on their brain activity. For this reason, paradigms that have been successful in healthy individuals cannot serve to interpret conscious mental states in this patient group. Until recently, patient studies have used structured instructions to elicit willful modulation of brain activity according to command, in order to decode the presence of willful brain-based responses in this patient group. In recent work, we have used naturalistic paradigms, such as watching a movie or listening to an audio-story, to demonstrate that a common neural code supports conscious experiences in different individuals. Moreover, we have demonstrated that this code can be used to interpret the conscious experiences of a patient who had remained non-responsive for several years. This approach is easy to administer, brief, and does not require compliance with task instructions. Rather, it engages attention naturally through meaningful stimuli that are similar to the real-world sensory information in a patient's environment. Therefore, it may be particularly suited to probing consciousness and revealing residual brain function in highly impaired, acute, patients in a comatose state, thus helping to improve diagnostication and prognostication for this vulnerable patient group from the critical early stages of severe brain-injury. Copyright © 2015 Elsevier Inc. All rights reserved.

Outcomes and predictors of treatment response with sofosbuvir plus daclatasvir with or without ribavirin in Egyptian patients with genotype 4 hepatitis C virus infection

PubMed Central

Ahmed, Ossama A; Elsebaey, Mohamed A; Fouad, Mohamed Hassan A; Elashry, Heba; Elshafie, Ahmed I; Elhadidy, Ahmed A; Esheba, Noha E; Elnaggar, Mohammed H; Soliman, Shaimaa; Abd-Elsalam, Sherief

2018-01-01

Background and aims Treatment of hepatitis C virus (HCV) changed dramatically with the introduction of oral direct-acting antiviral drugs due to their high antiviral potency and safety profile. Sofosbuvir plus daclatasvir combination therapy was extensively investigated in HCV genotypes 1, 2, and 3, while published data regarding its real-life application in the treatment of genotype 4 is lacking. Therefore, we conducted this study to assess the outcomes and predictors of treatment response with sofosbuvir plus daclatasvir with or without ribavirin in Egyptian patients with genotype 4 hepatitis C virus infection. Patients and methods This prospective study included 300 Egyptian patients with chronic genotype 4 HCV, treated with sofosbuvir plus daclatasvir with or without ribavirin for 12–24 weeks. Primary outcome was the number of patients who achieved sustained virologic response (SVR12), and secondary outcome was the occurrence of adverse events. Results A total of 92.67% of all patients achieved SVR12. SVR12 rates of 96.55% and 84.54% were reported in non-cirrhotic and cirrhotic patients, respectively. SVR12 in treatment-naïve and treatment-experienced patients were 94.12% and 87.01%, respectively. A total of 19.7% of patients experienced mild adverse events. Older age, cirrhosis, and low platelet count were the predictors of treatment non-response. Conclusion Based on this multi-center prospective study, sofosbuvir plus daclatasvir with or without ribavirin for 12–24 weeks appears to have favorable outcomes in the treatment of genotype 4 HCV-infected Egyptian patients. Older age, cirrhosis, especially Child–Pugh class B, and low platelet count are independent risk factors of treatment non-response. PMID:29628768

Do Dads Make a Difference? Family Feeding Dynamics and Child Fussy Eating.

PubMed

Harris, Holly A; Jansen, Elena; Mallan, Kimberley M; Daniels, Lynne; Thorpe, Karen

2018-06-01

Few studies on child feeding have focused on family dynamics or disadvantaged families, yet feeding occurs in the complex social, economic, and relational context of the family. We examined how the level (high vs low) and concordance (concordant vs discordant) of nonresponsive feeding practices of mothers and fathers are associated with child fussy eating, in a socioeconomically disadvantaged Australian sample. Mother-father pairs (N = 208) of children aged 2 to 5 years old independently completed validated questionnaires reporting their "persuasive feeding," "reward for eating," "reward for behavior," and child's "food fussiness." The fussiness scores did not differ between mother-father pairs and were averaged to derive a single dependent variable. K-means cluster analyses were used to assign mother-father pairs to clusters for each feeding practice, based on mean scores. Three ANCOVAs, corresponding to each feeding practice, tested differences in child fussiness across clusters while controlling for covariates. Four clusters were identified for each feeding practice-concordant: (1) high (MHi/FHi) for both parents and (2) low (MLo/FLo) for both parents; and discordant: (3) high for mother but low for father (MHi/FLo); and (4) low for mother but high for father (MLo/FHi). For "persuasive feeding," MLo/FLo reported lower levels of fussiness compared with MHi/FLo, MHi/FHi, and MLo/FHi (p values < 0.05). For "reward for eating," MLo/FLo reported lower levels of fussiness than did MHi/FHi (p < 0.05). Child fussiness did not differ across "reward for behavior" clusters. In socioeconomically disadvantaged families, when parents are concordant in avoiding nonresponsive feeding practices, less child "food fussiness" is reported. Findings suggest that feeding interventions should consider inclusion of both parents in 2-parent households.

The utility of online panel surveys versus computer-assisted interviews in obtaining substance-use prevalence estimates in the Netherlands.

PubMed

Spijkerman, Renske; Knibbe, Ronald; Knoops, Kim; Van De Mheen, Dike; Van Den Eijnden, Regina

2009-10-01

Rather than using the traditional, costly method of personal interviews in a general population sample, substance-use prevalence rates can be derived more conveniently from data collected among members of an online access panel. To examine the utility of this method, we compared the outcomes of an online survey with those obtained with the computer-assisted personal interviews (CAPI) method. Data were gathered from a large sample of online panellists and in a two-stage stratified sample of the Dutch population using the CAPI method. The Netherlands. Participants  The online sample comprised 57 125 Dutch online panellists (15-64 years) of Survey Sampling International LLC (SSI), and the CAPI cohort 7204 respondents (15-64 years). All participants answered identical questions about their use of alcohol, cannabis, ecstasy, cocaine and performance-enhancing drugs. The CAPI respondents were asked additionally about internet access and online panel membership. Both data sets were weighted statistically according to the distribution of demographic characteristics of the general Dutch population. Response rates were 35.5% (n = 20 282) for the online panel cohort and 62.7% (n = 4516) for the CAPI cohort. The data showed almost consistently lower substance-use prevalence rates for the CAPI respondents. Although the observed differences could be due to bias in both data sets, coverage and non-response bias were higher in the online panel survey. Despite its economic advantage, the online panel survey showed stronger non-response and coverage bias than the CAPI survey, leading to less reliable estimates of substance use in the general population. © 2009 The Authors. Journal compilation © 2009 Society for the Study of Addiction.

Endovascular ultrasound for renal sympathetic denervation in patients with therapy-resistant hypertension not responding to radiofrequency renal sympathetic denervation.

PubMed

Stiermaier, Thomas; Okon, Thomas; Fengler, Karl; Mueller, Ulrike; Hoellriegel, Robert; Schuler, Gerhard; Desch, Steffen; Lurz, Philipp

2016-06-12

Recent studies have reported a considerable number of non-responders after renal sympathetic de-nervation (RSD) with radiofrequency technology. Here we report our results of repeat RSD using ultrasound in these patients. A cohort study was performed in patients who underwent ultrasound RSD after non-response to RSD with radiofrequency. Non-response was defined as mean daytime systolic blood pressure ≥140 mmHg and/or a reduction of ≤10 mmHg in ambulatory blood pressure measurement (ABPM) ≥6 months after radiofrequency denervation. ABPM was recorded at baseline, post radiofrequency RSD as well as at three and six months post ultrasound RSD. A total of 24 non-responders underwent retreatment with the ultrasound device at a mean 15.3±8.2 months after radiofrequency RSD. Ultrasound RSD was performed successfully in all patients without severe adverse events. Mean daytime systolic blood pressure changed from 161.7±14.6 mmHg at baseline to 158.5±9.5 mmHg post radiofrequency RSD and to 150.5±10.4 mmHg and 151.6±11.0 mmHg at three and six months, respectively, post ultrasound RSD (p<0.01 with repeated measures analysis of variance). The main results of post hoc testing were as follows: baseline versus post radiofrequency RSD, p=0.83; baseline versus three months post ultrasound RSD, p=0.01; and baseline versus six months post ultrasound RSD, p=0.04. Ultrasound RSD appears to be safe and an effective therapeutic approach in patients not responding to previous RSD with radiofrequency technology.

Whole blood transcriptional profiles as a prognostic tool in complete and incomplete Kawasaki Disease

PubMed Central

Xu, Zhaohui; Yin, Han; Moore-Clingenpeel, Melissa; Smith, Bennett; Burns, Jane C.; Tremoulet, Adriana H.; Jordan-Villegas, Alejandro; Chaussabel, Damien; Texter, Karen; Pascual, Virginia; Ramilo, Octavio

2018-01-01

Background Early identification of children with Kawasaki Disease (KD) is key for timely initiation of intravenous immunoglobulin (IVIG) therapy. However, the diagnosis of the disease remains challenging, especially in children with an incomplete presentation (inKD). Moreover, we currently lack objective tools for identification of non-response (NR) to IVIG. Methods Children with KD were enrolled and samples obtained before IVIG treatment and sequentially at 24 h and 4–6 weeks post-IVIG in a subset of patients. We also enrolled children with other febrile illnesses [adenovirus (AdV); group A streptococcus (GAS)] and healthy controls (HC) for comparative analyses. Blood transcriptional profiles were analyzed to define: a) the cKD and inKD biosignature, b) compare the KD signature with other febrile illnesses and, c) identify biomarkers predictive of clinical outcomes. Results We identified a cKD biosignature (n = 39; HC, n = 16) that was validated in two additional cohorts of children with cKD (n = 37; HC, n = 20) and inKD (n = 13; HC, n = 8) and was characterized by overexpression of inflammation, platelets, apoptosis and neutrophil genes, and underexpression of T and NK cell genes. Classifier genes discriminated KD from adenovirus with higher sensitivity and specificity (92% and 100%, respectively) than for GAS (75% and 87%, respectively). We identified a genomic score (MDTH) that was higher at baseline in IVIG-NR [median 12,290 vs. 5,572 in responders, p = 0.009] and independently predicted IVIG-NR. Conclusion A reproducible biosignature from KD patients was identified, and was similar in children with cKD and inKD. A genomic score allowed early identification of children at higher risk for non-response to IVIG. PMID:29813106

Defining response to anti-VEGF therapies in neovascular AMD.

PubMed

Amoaku, W M; Chakravarthy, U; Gale, R; Gavin, M; Ghanchi, F; Gibson, J; Harding, S; Johnston, R L; Kelly, S P; Kelly, S; Lotery, A; Mahmood, S; Menon, G; Sivaprasad, S; Talks, J; Tufail, A; Yang, Y

2015-06-01

The introduction of anti-vascular endothelial growth factor (anti-VEGF) has made significant impact on the reduction of the visual loss due to neovascular age-related macular degeneration (n-AMD). There are significant inter-individual differences in response to an anti-VEGF agent, made more complex by the availability of multiple anti-VEGF agents with different molecular configurations. The response to anti-VEGF therapy have been found to be dependent on a variety of factors including patient's age, lesion characteristics, lesion duration, baseline visual acuity (VA) and the presence of particular genotype risk alleles. Furthermore, a proportion of eyes with n-AMD show a decline in acuity or morphology, despite therapy or require very frequent re-treatment. There is currently no consensus as to how to classify optimal response, or lack of it, with these therapies. There is, in particular, confusion over terms such as 'responder status' after treatment for n-AMD, 'tachyphylaxis' and 'recalcitrant' n-AMD. This document aims to provide a consensus on definition/categorisation of the response of n-AMD to anti-VEGF therapies and on the time points at which response to treatment should be determined. Primary response is best determined at 1 month following the last initiation dose, while maintained treatment (secondary) response is determined any time after the 4th visit. In a particular eye, secondary responses do not mirror and cannot be predicted from that in the primary phase. Morphological and functional responses to anti-VEGF treatments, do not necessarily correlate, and may be dissociated in an individual eye. Furthermore, there is a ceiling effect that can negate the currently used functional metrics such as >5 letters improvement when the baseline VA is good (ETDRS>70 letters). It is therefore important to use a combination of both the parameters in determining the response.The following are proposed definitions: optimal (good) response is defined as when there is resolution of fluid (intraretinal fluid; IRF, subretinal fluid; SRF and retinal thickening), and/or improvement of >5 letters, subject to the ceiling effect of good starting VA. Poor response is defined as <25% reduction from the baseline in the central retinal thickness (CRT), with persistent or new IRF, SRF or minimal or change in VA (that is, change in VA of 0+4 letters). Non-response is defined as an increase in fluid (IRF, SRF and CRT), or increasing haemorrhage compared with the baseline and/or loss of >5 letters compared with the baseline or best corrected vision subsequently. Poor or non-response to anti-VEGF may be due to clinical factors including suboptimal dosing than that required by a particular patient, increased dosing intervals, treatment initiation when disease is already at an advanced or chronic stage), cellular mechanisms, lesion type, genetic variation and potential tachyphylaxis); non-clinical factors including poor access to clinics or delayed appointments may also result in poor treatment outcomes. In eyes classified as good responders, treatment should be continued with the same agent when disease activity is present or reactivation occurs following temporary dose holding. In eyes that show partial response, treatment may be continued, although re-evaluation with further imaging may be required to exclude confounding factors. Where there is persistent, unchanging accumulated fluid following three consecutive injections at monthly intervals, treatment may be withheld temporarily, but recommenced with the same or alternative anti-VEGF if the fluid subsequently increases (lesion considered active). Poor or non-response to anti-VEGF treatments requires re-evaluation of diagnosis and if necessary switch to alternative therapies including other anti-VEGF agents and/or with photodynamic therapy (PDT). Idiopathic polypoidal choroidopathy may require treatment with PDT monotherapy or combination with anti-VEGF. A committee comprised of retinal specialists with experience of managing patients with n-AMD similar to that which developed the Royal College of Ophthalmologists Guidelines to Ranibizumab was assembled. Individual aspects of the guidelines were proposed by the committee lead (WMA) based on relevant reference to published evidence base following a search of Medline and circulated to all committee members for discussion before approval or modification. Each draft was modified according to feedback from committee members until unanimous approval was obtained in the final draft. A system for categorising the range of responsiveness of n-AMD lesions to anti-VEGF therapy is proposed. The proposal is based primarily on morphological criteria but functional criteria have been included. Recommendations have been made on when to consider discontinuation of therapy either because of success or futility. These guidelines should help clinical decision-making and may prevent over and/or undertreatment with anti-VEGF therapy.

Syntactic and semantic errors in radiology reports associated with speech recognition software.

PubMed

Ringler, Michael D; Goss, Brian C; Bartholmai, Brian J

2017-03-01

Speech recognition software can increase the frequency of errors in radiology reports, which may affect patient care. We retrieved 213,977 speech recognition software-generated reports from 147 different radiologists and proofread them for errors. Errors were classified as "material" if they were believed to alter interpretation of the report. "Immaterial" errors were subclassified as intrusion/omission or spelling errors. The proportion of errors and error type were compared among individual radiologists, imaging subspecialty, and time periods. In all, 20,759 reports (9.7%) contained errors, of which 3992 (1.9%) were material errors. Among immaterial errors, spelling errors were more common than intrusion/omission errors ( p < .001). Proportion of errors and fraction of material errors varied significantly among radiologists and between imaging subspecialties ( p < .001). Errors were more common in cross-sectional reports, reports reinterpreting results of outside examinations, and procedural studies (all p < .001). Error rate decreased over time ( p < .001), which suggests that a quality control program with regular feedback may reduce errors.

New double-byte error-correcting codes for memory systems

NASA Technical Reports Server (NTRS)

Feng, Gui-Liang; Wu, Xinen; Rao, T. R. N.

1996-01-01

Error-correcting or error-detecting codes have been used in the computer industry to increase reliability, reduce service costs, and maintain data integrity. The single-byte error-correcting and double-byte error-detecting (SbEC-DbED) codes have been successfully used in computer memory subsystems. There are many methods to construct double-byte error-correcting (DBEC) codes. In the present paper we construct a class of double-byte error-correcting codes, which are more efficient than those known to be optimum, and a decoding procedure for our codes is also considered.

Relating physician's workload with errors during radiation therapy planning.

PubMed

Mazur, Lukasz M; Mosaly, Prithima R; Hoyle, Lesley M; Jones, Ellen L; Chera, Bhishamjit S; Marks, Lawrence B

2014-01-01

To relate subjective workload (WL) levels to errors for routine clinical tasks. Nine physicians (4 faculty and 5 residents) each performed 3 radiation therapy planning cases. The WL levels were subjectively assessed using National Aeronautics and Space Administration Task Load Index (NASA-TLX). Individual performance was assessed objectively based on the severity grade of errors. The relationship between the WL and performance was assessed via ordinal logistic regression. There was an increased rate of severity grade of errors with increasing WL (P value = .02). As the majority of the higher NASA-TLX scores, and the majority of the performance errors were in the residents, our findings are likely most pertinent to radiation oncology centers with training programs. WL levels may be an important factor contributing to errors during radiation therapy planning tasks. Published by Elsevier Inc.