Preference Assessment Research Articles

Comparing Resident, Proxy, and Staff Respondents for Nursing Home Residents' Preferences for Everyday Living.

To encourage person-centered care, the Centers for Medicare and Medicaid require nursing homes to measure resident preferences using the Preferences Assessment Tool (PAT). No known research has examined the implications of respondent type (i.e., resident, proxy, staff) on preference importance; therefore, the purpose of this study was to compare the importance of preferences depending on which respondent completed the PAT. Participants included 16,111 Veterans discharged to community-based skilled nursing facilities after hospitalization for heart failure. A majority (95%) of residents completed the PAT compared to proxy (3%) and staff (2%). Proxy responders were both more and less likely to indicate individual preferences as important compared to residents. Staff members were consistently less likely to indicate all preferences as important compared to residents. Findings from this study emphasize the need for proxy and staff to find methods to better understand residents' preferences when residents are not able to participate in assessments.

Reexamining nodality in equivalence classes.

Equivalence classes are defined according to the substitutability, or functional similarity, of the stimuli within a stimulus class. Several studies have demonstrated that the degree of functional similarity between stimuli in a class is dependent, in part, upon the number of nodes (intervening stimuli) between the stimuli. Higher nodal number is related to lower functional similarity. This effect is referred to as "nodality." There are three key factors that have not been simultaneously controlled for in the relevant studies: priming effects, reinforcement during training, and multiple stimulus functions of stimuli (sample, comparison, or both). In the present experiment, controlling for these factors, two 6-member, 4-node equivalence classes were established, and a within-class preference assessment was used to evaluate nodality. Of 12 participants, five achieved criterion accuracy (90%) during testing. These participants demonstrated nodality, showing preference for stimuli that were nodally proximal to a sample in the preference test. When distal comparisons were chosen, participants took longer, on average, to make the selection compared to selections of proximal stimuli. These findings are consistent with earlier studies demonstrating nodality, which suggests that nodality is a robust phenomenon and not an artifact of the factors that were controlled for in the present study.

An Automated Approach to Assess Relative Galectin-Glycan Affinity Following Glycan Microarray Analysis.

Numerous studies have highlighted the utility of glycan microarray analysis for the elucidation of protein-glycan interactions. However, most current glycan microarray studies analyze glycan binding protein (GBP)-glycan interactions at a single protein concentration. While this approach provides useful information related to a GBP’s overall binding capabilities, extrapolation of true glycan binding preferences using this method fails to account for printing variations or other factors that may confound relative binding. To overcome this limitation, we examined glycan array binding of three galectins over a range of concentrations to allow for a more complete assessment of binding preferences. This approach produced a richer data set than single concentration analysis and provided more accurate identification of true glycan binding preferences. However, while this approach can be highly informative, currently available data analysis approaches make it impractical to perform binding isotherms for each glycan present on currently available platforms following GBP evaluation. To overcome this limitation, we developed a method to directly optimize the efficiency of assessing association constants following multi-GBP concentration glycan array analysis. To this end, we developed programs that automatically analyze raw array data (kdMining) to generate output graphics (kaPlotting) following array analysis at multiple doses. These automatic programing methods reduced processing time from 32.8 h to 1.67 min. Taken together, these results demonstrate an effective approach to glycan array analysis that provides improved detail and efficiency when compared to previous methods.

Contraception in adolescents with obesity and diabetes mellitus

Today most adolescents have their first sexual experience at the age of 15-19. However, only 44% of girls and young women (15-24 years old) report about contraception at that moment. A decision on pregnancy in adolescence is a difficult choice and any scenario may cause serious medical and social problems. Complications after an artificial abortion have a negative impact on a woman's fertility. Diabetes mellitus type 1 and arterial hypertension accompanied with obesity within the metabolic syndrome are defined by the World Health Organization (WHO) as diseases, which increase risk of an unplanned pregnancy. The article consoders problems of interaction of a doctor and a teenage girl with endocrinopathy, when discussing her sexual health, the analysis of the literature reflecting the influence of contraception on the course of the underlying pathology is presented. The authors formed a list of drugs acceptable for use in diabetes and obesity based on assessment of risks and preferences from the use of different methods of fertility control. The work contains information about the procedure of starting contraception, the rules of future dynamic monitoring of the patient.

Patient perceptions of higher-dose naloxone nasal spray for opioid overdose.

Higher-dose formulations of naloxone were recently approved by the FDA for the treatment of opioid overdose. These products were developed based on projected saturation of high-potency fentanyl analogues in the illicit marketplace although the evidence base for their necessity is still under scrutiny. Concern has been raised that unintended reductions in patient acceptance of naloxone may occur due to increased precipitated withdrawal risk associated with higher naloxone doses. A well-founded and time-sensitive call for representation of people who use drugs in this decision-making process has been made. This study provides the first data on patient perceptions of higher-dose formulations to inform this scientific debate and distribution efforts. Patients (N=1152) entering treatment for opioid use disorder at one of 49 addiction treatment facilities located across the United States completed a preference assessment of naloxone nasal spray formulations. Patients selected a formulation preference across three scenarios (administration for self, administration to others, community responder administration). A majority of respondents that had been administered naloxone previously reported that their most recent overdose reversal included two or more naloxone administrations (59.9%). Most respondents either had no preference (48.4%) or preferred a higher-dose formulation (35.9%) if personally experiencing an overdose. Similar preference distributions were observed for administration to others and by community responders. Relative to standard-dose preference, respondents preferring higher-dose formulations had a greater odds of recent suspected fentanyl exposure. These data inform patients, advocates, and policy-makers considering distribution and utilization of naloxone formulations by reporting perspectives of patients with opioid use and overdose experience. Limited evidence for widespread avoidance of higher-dose formulations was found. As real-world evidence of acceptability and effectiveness emerges, either supporting or refuting the widespread need for higher-dose naloxone formulations, it is the responsibility of the scientific and public health community to be responsive to those data.

Older Drivers' Attitudes and Preferences about Instrument Cluster Designs in Vehicles Revealed by the Dashboard Questionnaire.

Older drivers are a rapidly growing demographic group worldwide; many have visual processing impairments. Little is known about their preferences about vehicle instrument cluster design. We evaluated the psychometric properties of a questionnaire on "dashboard" design for a population-based sample of 1000 older drivers. Topics included gauges, knobs/switches, and interior lighting; items were statements about their visual design. Response options used a Likert-scale ("Definitely True" to "Definitely False"). Factor and Rasch analyses identified underlying subscales. Driver responses revealed four thematic subscales fitting the Rasch model: cognitive processing, lighting, pattern recognition, and obstructions. Internal consistency of subscales was acceptable (0.70-0.87); all possessed a sufficiently unidimensional structure. Opportunities for improvement were identified (item scope, category ordering, discrimination of respondents' perception levels). Assessment of motor vehicle dashboard preferences indicated cognitive processing, lighting, pattern recognition, and obstructions are areas relevant to older drivers. Future work will examine the relationship between older drivers' visual function (e.g., contrast sensitivity, visual processing speed) and their design preferences as revealed by the Dashboard Questionnaire, with the aim to optimize instrument cluster displays for older drivers.

Patient-Preference Diagnostics: Adapting Stated-Preference Methods to Inform Effective Shared Decision Making.

While clinical practice guidelines underscore the need to incorporate patient preferences in clinical decision making, incorporating meaningful assessment of patient preferences in clinical encounters is challenging. Structured approaches that combine quantitative patient preferences and clinical evidence could facilitate effective patient-provider communication and more patient-centric health care decisions. Adaptive conjoint or stated-preference approaches can identify individual preference parameters, but they can require a relatively large number of choice questions or simplifying assumptions about the error with which preferences are elicited. We propose an approach to efficiently diagnose preferences of patients for outcomes of treatment alternatives by leveraging prior information on patient preferences to generate adaptive choice questions to identify a patient's proximity to known preference phenotypes. This information can be used for measuring sensitivity and specificity, much like any other diagnostic procedure. We simulated responses with varying levels of choice errors for hypothetical patients with specific preference profiles to measure sensitivity and specificity of a 2-question preference diagnostic. We identified 4 classes representing distinct preference profiles for patients who participated in a previous first-time anterior shoulder dislocation (FTASD) survey. Posterior probabilities of class membership at the end of a 2-question sequence ranged from 87% to 89%. We found that specificity and sensitivity of the 2-question sequences were robust to respondent errors. The questions appeared to have better specificity than sensitivity. Our results suggest that this approach could help diagnose patient preferences for treatments for a condition such as FTASD with acceptable precision using as few as 2 choice questions. Such preference-diagnostic tools could be used to improve and document alignment of treatment choices and patient preferences. Approaches that combine patient preferences and clinical evidence can facilitate effective patient-provider communication and more patient-centric healthcare decisions. However, diagnosing individual-level preferences is challenging, and no formal diagnostic tools exist.We propose a structured approach to efficiently diagnose patient preferences based on prior information on the distribution of patient preferences in a population.We generated a 2-question test of preferences for the outcomes associated with the treatment of first-time anterior shoulder dislocation.The diagnosis of preferences can help physicians discuss relevant aspects of the treatment options and proactively address patient concerns during the clinical encounter.

Exploring Teacher’s Perspectives about Online Assessment during the COVID-19 Pandemic in a Saudi Context

The emergency transition to online learning due to COVID-19 has forced many sectors to respond quickly. The readiness of educational institutes to attend to the abrupt crisis and shift to teach remotely is practiced at different levels. Online assessment is one of them. Rapid advances in technology and software applications are changing the practices of assessment in innumerable ways. Teachers are encouraged to implement a diverse array of assessment methods to measure the learning process of their students in an online environment which may not be the same as conventional learning. Therefore, the current study aims to explore teachers’ perspectives about online assessment during the COVID-19 pandemic in a Saudi context. This study endeavours to shed light on this aspect of online assessment by answering the main question of challenges and benefits faced by English teachers in an online environment. The study was qualitative in nature deploying semi-structured interviews with English instructors to collect data about the researched matter. The findings revealed that the most preferred online assessment tool teachers used to implement was the multiple-choice format. Also, the analysis showed that challenges associated with online assessment were diverse, and some of them were handled appropriately while others remained. For the advantages, they worked in favour of teachers, students and department. This was observed in the opportunities online assessment could provide to save time, easiness to design, take and record and objectivity in marking. Implications and recommendations were offered for further direction and research.

A user preference analysis of commercial breath ketone sensors to inform the development of portable breath ketone sensors for diabetes management in young people.

BackgroundPortable breath ketone sensors may help people with Type 1 Diabetes Mellitus (T1DM) avoid episodes of diabetic ketoacidosis; however, the design features preferred by users have not been studied. We aimed to elucidate breath sensor design preferences of young people with T1DM (age 12 to 16) and their parents to inform the development of a breath ketone sensor prototype that would best suit their diabetes management needs.Research designs and methodsTo elicit foundational experiences from which design preference ideas could be generated, two commercially available breath ketone sensors, designed for ketogenic diet monitoring, were explored over one week by ten young people with T1DM. Participants interacted with the breath ketone sensing devices, and undertook blood ketone testing, at least twice daily for five days to simulate use within a real life and ambulatory care setting. Semi-structured interviews were conducted post-testing with the ten young participants and their caregivers (n = 10) to elicit preferences related to breath sensor design and use, and to inform the co-design of a breath ketone sensor prototype for use in T1DM self-management. We triangulated our data collection with key informant interviews with two diabetes educators working in pediatric care about their perspectives related to young people using breath ketone sensors.ResultsParticipants acknowledged the non-invasiveness of breath sensors as compared to blood testing. Affordability, reliability and accuracy were identified as prerequisites for breath ketone sensors used for diabetes management. Design features valued by young people included portability, ease of use, sustainability, readability and suitability for use in public. The time required to use breath sensors was similar to that for blood testing. The requirement to maintain a 10-second breath exhalation posed a challenge for users. Diabetes educators highlighted the ease of use of breath devices especially for young people who tended to under-test using blood ketone strips.ConclusionsBreath ketone sensors for diabetes management have potential that may facilitate ketone testing in young people. Our study affirms features for young people that drive usability of breath sensors among this population, and provides a model of user preference assessment.

Climate Smart Agriculture Implementation on Coffee Smallholders in Indonesia and Strategy to Accelerate

Sustainable coffee production is significantly threatened by climate change. While implementing CSA practices offers numerous benefits, adoption rates remain low. Coffee plantations are dominated by smallholders and located in rural areas, making them more complex and requiring a comprehensive analysis and intervention. This study used an exploratory approach to assess farmers’ preferences for CSA practices, identify barriers to implement, and design a support system model. The investigation focused on Arabica and Robusta farmers, with case studies from two Indonesian production centres. Preferences assessment used conjoint analysis, barriers evaluation used Mann–Whitney analysis, model development used synthetic approaches, and priority analysis used the Analytical Hierarchy Process. The study revealed that diversification is more desirable than cultivation, soil management, and water management. Arabica farmers preferred intercropping with annual crops, whereas Robusta farmers preferred perennials crops. Robusta farmers assessed that agricultural inputs, such as labor, capital, climatic data, and farm equipment and machinery, existed as barriers. However, these represent a lesser issue for Arabica farmers. We proposed agricultural innovation support system, consisting of innovation support facilities and services, as a comprehensive support system model to accelerate CSA implementation. Further analysis showed that the priority strategy for Arabica farmers is support services that focus on network development, while for Robusta farmers is support facilities that focus on climate information system development.

Differences in psychotherapy preferences between psychotherapy trainees and laypeople

Objective: Despite increasing research on psychotherapy preferences, the preferences of psychotherapy trainees are largely unknown. Moreover, differences in preferences between trainees and their patients could (a) hinder symptom improvement and therapy success for patients and (b) represent significant obstacles in the early career and development of future therapists. Method: We compared the preferences of n = 466 psychotherapy trainees to those of n = 969 laypersons using the Cooper-Norcross Inventory of Preferences. Moreover, we compared preferences between trainees in cognitive–behavioural therapy (CBT) and psychodynamic trainees. Results: We found significant differences between both samples in 13 of 18 items, and three of four subscales. Psychotherapy trainees preferred less therapist directiveness (d = 0.58), more emotional intensity (d = 0.74), as well as more focused challenge (d = 0.35) than laypeople. CBT trainees preferred more therapist directiveness (d = 2.00), less emotional intensity (d = 0.51), more present orientation (d = 0.76) and more focused challenge (d = 0.33) than trainees in psychodynamic/psychoanalytic therapy. Conclusion: Overall, the results underline the importance of implementing preference assessment and discussion during psychotherapy training. Moreover, therapists of different orientations seem to cover a large range of preferences for patients, in order to choose the right fit.

"Assessment of Water Preferences by Gravid Female Mosquitoes in the Selection of Oviposition Sites"

"Assessment of Water Preferences by Gravid Female Mosquitoes in the Selection of Oviposition Sites"

Development of an Electronic Tool to Assess Patient Preferences in Geriatric Polypharmacy (PolyPref).

PurposeMedical decision-making in older adults with multiple chronic conditions and polypharmacy should include the individual patient’s treatment preferences. We developed and pilot-tested an electronic instrument (PolyPref) to elicit patient preferences in geriatric polypharmacy.Patients and MethodsPolyPref follows a two-stage direct approach to preference assessment. Stage 1 generates an individual preselection of relevant health outcomes and medication regimen characteristics, followed by stage 2, in which their importance is assessed using the Q-sort methodology. The feasibility of the instrument was tested in adults aged ≥70 years with ≥2 chronic conditions and regular intake of ≥5 medicines. After the assessment with PolyPref, the patients rated the tool with regard to its comprehensibility and usability and assessed the accuracy of the personal result. Evaluators rated the patients’ understanding of the task.ResultsEighteen short-term health outcomes, 3 long-term health outcomes, and 8 medication regimen characteristics were included in the instrument. The final population for the pilot study comprised 15 inpatients at a clinic for geriatric rehabilitation with a mean age of 80.6 (± 6.0) years, a median score of 28 (range 25–30) points on the Mini-Mental State Examination, and a mean of 11.6 (± 3.6) regularly taken medicines. Feedback by the patients and the evaluators revealed ratings in favor of understanding and comprehensibility of 86.7% to 100%. The majority of the patients stated that their final result summarized the most important aspects of their pharmacotherapy (93.3%) and that its ranking order reflected their personal opinion (100%). Preference assessment took an average of 35 (± 8.5) min, with the instrument being handled by the evaluator in 14 of the 15 participants.ConclusionPreference assessment with PolyPref was feasible in older adults with multiple chronic conditions and polypharmacy, offering a new strategy for the standardized evaluation of patient priorities in geriatric pharmacotherapy.

Characterizations of Milkfish Sauce on Amino Acid Content with Variations in Addition of Salt and Pineapple Extract Concentration

Fish sauce is synonymous with salty taste and distinctive fish aroma. The good quality of fish sauce is supported by the amino acid content, proximate analysis and the assessment of the organoleptic preferences of the product by the panelists. This research aimed to determine the effect of increasing the concentration of pineapple extract on the organoleptic characteristics of fish sauce and the most abundant amino acid content in fish sauce and the best quality of fish sauce treatments. The research is based on randomized design of 4 days fermentation with salt : pineapple extract concentration ratio of 20%:5%, 20%:10%, 15%:15% and 25%:20% respectively. Research analysis such as amino acid content and proximate analysis were evaluated by the ANOVA test and DMRT test, while organoleptic test was evaluated by Kruskal Wallis test. The higher of the concentration of pineapple extract, the lower of amino acid content of the fish and the taste getting sourer. The best treatment for milkfish sauce was found in the treatment with salt concentration : pineapple extract = 15%:15% indicated by the highest amino acid content of glutamate, lysine and aspartate compared to other treatments, the highest protein content and water content and the best organoleptic assessment.

The Use of Peers in Assessment for Learning: A Case Study of Trainee Teachers at Bindura University of Science Education (BUSE), Zimbabwe

The study was an exploration of trainee teachers’ understanding, perceptions of, and confidence in the use of peers in assessment for learning (AfL) at Bindura University of Science Education, Zimbabwe. Trainee teachers were enrolled in a programme that used a blended model of teaching and learning between February and June 2021. Trainees participated in online seminars and peer assessment in a course on curriculum development and completed questionnaire eliciting their attitudes toward peer assessment. A mixed-methods approach using both quantitative and qualitative methodologies was adopted. Quantitative data were analysed using descriptive statistics, mean item scores and the summated scores for the three constructs of confidence, benefits of and threats to peer assessment. Open-ended items were analysed qualitatively and emerging themes were reported. Summated scores of 4, meant trainees had positive attitudes toward peer assessment and believed in numerous benefits of using peer assessment. A summated mean score of 3 for threats to peer assessment meant trainee teachers had neutral views to the construct. Conflicting messages were evident. The same trainees who believed that peer assessment was useful still doubted sincerity of peers and preferred teacher assessment. Further research, using a larger population and sample and interviews to probe doubts in peer assessment, is recommended.

A multiple-stimulus-without-replacement assessment for sexual partners: Test-retest stability.

The stability of stimulus preference assessment results is an important consideration when using the identified stimuli in treatments and/or additional experiments. Prior research has demonstrated that the preference hierarchies identified by the multiple stimulus without replacement (MSWO) preference assessment are generally stable over time. This stability has been demonstrated with tangible and edible items, yet the extent to which that stability can be expected for other types of stimuli remains unknown. The current study tested the 2-month stability of the MSWO preference assessment in the context of college students' preferred sexual partners. Adequate stability was shown in most cases, suggesting generality of the stability of preference across tasks, populations, and stimuli.

Using Maxwell Distribution to Handle Selector’s Indecisiveness in Choice Data: A New Latent Bayesian Choice Model

This research primarily aims at the development of new pathways to facilitate the resolving of the long debated issue of handling ties or the degree of indecisiveness precipitated in comparative information. The decision chaos is accommodated by the elegant application of the choice axiom ensuring intact utility when imperfect choices are observed. The objectives are facilitated by inducing an additional parameter in the probabilistic set up of Maxwell to retain the extent of indecisiveness prevalent in the choice data. The operational soundness of the proposed model is elucidated through the rigorous employment of Gibbs sampling—a popular approach of the Markov chain Monte Carlo methods. The outcomes of this research clearly substantiate the applicability of the proposed scheme in retaining the advantages of discrete comparative data when the freedom of no indecisiveness is permitted. The legitimacy of the devised mechanism is enumerated on multi-fronts such as the estimation of preference probabilities and assessment of worth parameters, and through the quantification of the significance of choice hierarchy. The outcomes of the research highlight the effects of sample size and the extent of indecisiveness exhibited in the choice data. The estimation efficiency is estimated to be improved with the increase in sample size. For the largest considered sample of size 100, we estimated an average confidence width of 0.0097, which is notably more compact than the contemporary samples of size 25 and 50.

Comparison of functional outcome scales in paediatric acute encephalitis: Responsiveness and outcome predictors.

To compare scoring systems and their ability to capture short and long-term recovery of paediatric patients with acute encephalitis. To identify clinical predictors of short-term outcomes by correlating functional outcome measures at 1month post diagnosis of acute encephalitis. Patients with encephalitis diagnosed between July 2011 and 2016 based on Granerod's criteria were studied in this retrospective cohort study. Functional outcome scores on WeeFIM, LOS, GOS-E, mRS and ICF at initial presentation and 1, 3, 6 and 12 months later were compared. WeeFIM and LOS scores both showed maximum change in the first 3 months, reflecting highest recovery in this period. With WeeFIM, the greatest change occurred within the first month following diagnosis. On univariate analysis, seizure frequency in the first month, presence of movement disorder, presence of autonomic dysfunction and lower baseline functional score was associated with poorer WeeFIM scores at 1 month. The latter three variables remained statistically significant on multivariate analysis. WeeFIM is a potentially preferred functional outcome assessment tool as it demonstrated greatest recovery within the first month due to a trend of high responsiveness and relatively low ceiling effect. Presence of autonomic dysfunction and movement disorders at diagnosis correlated with poorer outcome at 1 month post diagnosis.

A Cross-Sectional Assessment of HIV Self-Testing Preferences and Uptake Among Key Populations in Phnom Penh, Cambodia

HIV self-testing (HIVST) is recommended by the World Health Organization, but implementation remains limited. This cross-sectional study evaluated HIVST uptake among female entertainment workers (EWs), men who have sex with men (MSM), and transgender women in Phnom Penh, Cambodia, to inform national implementation. Between December 2018 and September 2019, individuals reached through community outreach or via online advertising were offered HIVST or referrals to facility-based testing. Participants opting for HIVST could choose between test kits employing oral-fluid or finger-prick-based sample collection; and between an "assisted" option in which outreach staff offered instructions and assistance and an "unassisted" option in which participants received a kit with instructions for use. A structured questionnaire was administered to facilitate descriptive statistics and tests for associations between participant characteristics and HIV testing preferences and outcomes. Among 1,241 eligible individuals; 1,210 (97.5%) provided responses for analysis. Of these, 1,203 (99.4%) were recruited through outreach; 7 (0.6%) through online advertising. Among those recruited by outreach, 1,186 (98.6%) opted for assisted HIVST, and 1,065 (88.5%) opted for oral-fluid versus finger-prick testing. All individuals recruited through online advertisements opted for unassisted oral-fluid testing. Among all participants, 455 (37.6%) were MSM, 325 (26.9%) were transgender women, 430 (35.5%) were female EWs, and overall, 71.7% reported never previously testing for HIV. A total of 84 participants (6.9%) received reactive screening results and 81 (97.5%) were linked to treatment. Uptake of HIVST was high, and most participants preferred oral-fluid over finger-prick-based testing. Many individuals (72%) who had never previously accessed HIV testing services participated in HIVST, with high rates of reactivity.

Identifying Core Values with a Hierarchical, Ipsative, Preference Assessment

Values provide a foundation for decision making, behavior, and emotional reaction; they are often used by practitioners to design effective interventions for self-awareness and personal growth. This report describes a novel, user-friendly method that identifies core values with a hierarchical ipsatization procedure (HIP) that is transparent and efficient. Response bias, validity, and user satisfaction were examined in a study in which 602 respondents completed a survey asking them to rate 80 values and use HIP to identify their 4 most inspiring and motivating values. HIP enabled selecting these 4 core values from 80 candidates in 5–7 min, with minimal evidence of response bias. The selections made during HIP were consistent with the rating data, providing evidence for HIP’s concurrent validity. 88% of the respondents felt the 4 values identified by HIP inspired and motivated them more than any other values they could think of. These findings suggest HIP is a useful tool for identifying core values, especially in applied settings.