Different Subgroups Of People Research Articles

Are virtual harm reduction interventions right for everyone?: A qualitative study of the appropriateness of overdose response hotlines and applications for different subgroups of people who use substances

IntroductionOverdose response hotlines and apps are novel virtual harm reduction technologies that allow remote monitoring of individuals while they use substances (especially if they use alone) through electronic means. The authors explored partner perspectives to determine which groups of people who use substances (PWUS) these services would be most appropriate for, with the aim of better informing service providers on how to target their use to maximize benefit for clients. MethodsThe study conducted 64 semi-structured interviews with participants from a variety of backgrounds (individuals with lived or living experience of substance use, lay persons, health care providers, harm reduction workers, and operational experts). All information from interviews was kept confidential, de-identified, and stored on a secure server. Inductive thematic analysis identified major themes and subthemes. Two evaluators coded transcripts using Dedoose software. Once initial coding was complete, transcript coders selected quotes and shared them with a consulting project manager to cross-validate themes. The study conducted interviews until thematic saturation across all participants was reached based on the consensus of the two evaluators and the primary investigator. ResultsOverall, the study determined that overdose response hotlines and apps would potentially have at least some utility for any PWUS. However, some were found to have a varying level of appropriateness for specific subgroups of PWUS. There were 11 different subgroups identified in this study and of these subgroups, the majority were identified as groups for whom virtual harm reduction services would be appropriate interventions. ConclusionsOverdose response hotlines and apps are helpful and potentially life-saving adjunctive options which may be more appropriate for some subgroups of PWUS than others. These results may help service providers to target groups with the most potential to benefit.

Plain language summary of the CheckMate 76K study results: nivolumab given after stage 2B/2Cmelanoma is removed by surgery.

In this article, we summarize results from the ongoing phase 3 CheckMate 76K clinical study published online in Nature Medicine in October 2023. The study goal was to learn whether nivolumab works as an adjuvant therapy (that is, helps to keep cancer from coming back when it is given after surgery) for stage 2 melanoma (skin cancer) that has not spread to other parts of the body. Nivolumab is an immunotherapy that activates a person's immune system so it can destroy cancer cells. In melanoma, staging describes the severity of the cancer. Melanoma staging ranges from 0 (very thin and confined to the upper layer of the skin) to 4 (spread to distant parts of the body), with earlier stages removed by surgery. The people in this study had stage 2 melanoma that had not spread to the lymph nodes or other organs in the body. People 12years and older with stage 2 melanoma that had not spread and had been removed by surgery were included in CheckMate 76K. People were randomly assigned to receive either nivolumab (526 patients) or placebo (264 patients). A placebo resembles the test medicine but does not contain any active medicines. The researchers assessed whether people who received nivolumab lived longer without their cancer returning and/or spreading to other parts of their bodies (compared with placebo) and if nivolumab was well tolerated. Researchers found that people who received nivolumab were 58% less likely to have their cancer return and 53% less likely of having their cancer spread to distant parts of their body, compared with placebo. These reductions in risk with nivolumab were seen in different subgroups of people with a range of characteristics, and regardless of how deep the melanoma had gone into the skin. People taking nivolumab had more side effects than those taking placebo, but most were mild to moderate and manageable. Results from CheckMate 76K support the benefit of using nivolumab as a treatment option for people with stage 2 melanoma post-surgery.

Estimating the Prevalence of Rare Diseases: Long-Chain Fatty Acid Oxidation Disorders as an Illustrative Example.

IntroductionDetermining the epidemiology of disease is critical for multiple reasons, including to perform risk assessment, compare disease rates in varying populations, support diagnostic decisions, evaluate health care needs and disease burden, and determine the economic benefit of treatment. However, establishing epidemiological measures for rare diseases can be difficult owing to small patient populations, variable diagnostic techniques, and potential disease and diagnostic heterogeneity. To determine the epidemiology of rare diseases, investigators often develop estimation models to account for missing or unobtainable data, and to ensure that their findings are representative of their desired patient population.MethodsA modeling methodology to estimate the prevalence of rare diseases in one such population—patients with long-chain fatty acid oxidation disorders (LC-FAOD)—as an illustrative example of its applicability.ResultsThe proposed model begins with reliable source data from newborn screening reports and applies to them key modifiers. These modifiers include changes in population growth over time and variable standardization rates of LC-FAOD screening that lead to (1) a confirmed diagnosis and (2) improvements in standards of care and survival estimates relative to the general population. The model also makes necessary assumptions to allow the broad applicability of the estimation of LC-FAOD prevalence, including rates of diagnosed versus undiagnosed patients in the USA over time.ConclusionsAlthough each rare disease is unique, the approach described here and demonstrated in the estimation of LC-FAOD prevalence provides the necessary tools to calculate key epidemiological estimates useful in performing risk assessment analyses; comparing disease rates between different subgroups of people; supporting diagnostic decisions; planning health care needs; comparing disease burden, including cost; and determining the economic benefit of treatment.Supplementary InformationThe online version contains supplementary material available at 10.1007/s12325-022-02186-2.

Predictors of and reasons for early discharge from inpatient withdrawal management settings: A scoping review.

Early discharges, also known as 'against medical advice' discharges, frequently occur in inpatient withdrawal management settings and can result in negative outcomes for patients. The purpose of this scoping review is to identify what is known about predictors of and reasons for the early discharge among adults accessing inpatient withdrawal management settings. MEDLINE, CINAHL, PsycINFO, ASSIA and EMBASE were searched, resulting in 2587 articles for screening. Title and abstract screening and full-text review were completed by two independent reviewers. Results were synthesised in quantitative and qualitative formats. Sixty-two studies were included in this scoping review. All studies focused on predictors of early discharge, except one which only described reasons for the early discharge. Forty-eight percent of studies involved retrospective review of health records data. The most frequently examined variables were demographics. Variables related to the treatment setting, such as referral source and treatment received, were examined less frequently but were more consistently associated with early discharge compared to demographics. Only six studies described patient reasons for the early discharge, which were retrieved via clinical documentation. The most common reasons for early discharge were dissatisfaction with treatment and family issues. Most demographic variables do not consistently predict early discharge, and reasons for early discharge are not well understood. Future studies should focus on the predictive value of non-patient-level variables, or conduct analyses to account for predictors of early discharge among different subgroups of people (e.g. by gender or ethnicity). Qualitative research exploring patient perspectives is needed.

Review of Covid-19 vaccine clinical trials - A puzzle with missing pieces.

A year after the initial outbreak of Covid-19 pandemic, several Phase III clinical trials investigating vaccine safety and efficacy have been published. These vaccine candidates were developed by different research groups and pharmaceutical companies with various vaccine technologies including mRNA, recombinant protein, adenoviral vector and inactivated virus-based platforms. Despite numerous successful clinical trials, participants enrolled in these trials are limited by trial inclusion and exclusion criteria, geographic location and viral outbreak situation. Many questions still remain, especially for specific subgroups, including the elderly, females with pregnancy and breastfeeding status, and adolescents. At the same time, vaccine efficacy towards asymptomatic infection and specific viral variants are still largely unknown. This review will cover vaccine candidates with Phase III clinical trial data released and discuss the scientific data available so far for these vaccine candidates for different subgroups of people and different viral variants.

The LAIs Are Coming! Implementation Science Considerations for Long-Acting Injectable Antiretroviral Therapy in the United States: A Scoping Review.

Long-acting injectable antiretroviral therapy (LAI-ART) is one of the latest advancements in HIV control with the potential to overcome oral ART barriers to adherence. The objective of this article is to anticipate and examine implementation considerations for LAI-ART using components of the PRISM model, a Practical, Robust Implementation and Sustainability Model for integrating research findings into practice. We conducted a scoping review from January to August 2020 of the growing literature on LAI-ART implementation and other fields using LAI therapies. Key considerations regarding LAI-ART were parsed from the searches and entered into the PRISM implementation science framework. The PRISM framework posed multiple questions for consideration in the development of an optimal implementation strategy for LAI-ART in the United States. These questions revealed the necessity for more data, including acceptability of LAI-ART among many different subgroups of people living with HIV (PLWH), cost effectiveness, patient satisfaction, and patient-reported outcomes, as well as more detailed information related to the external environment for optimal LAI-ART implementation. Ethical considerations of LAI-ART will also need to be considered. The anticipation of, and excitement for, LAI-ART represent the hope for a new direction for HIV treatment that reduces adherence barriers and improves prognoses for PLWH. We have a unique window of opportunity to anticipate implementation considerations for LAI-ART, so this new therapy can be used to its fullest potential. Outstanding questions remain, however, that need to be addressed to help achieve HIV suppression goals in diverse populations.

Different information needs in subgroups of people with diabetes mellitus: a latent class analysis

BackgroundCurrent evidence suggests that the information needs of people with diabetes mellitus differ across patient groups. With a view to being able to provide individualized information, this study aims to identify (i) the diabetes-related information needs of people with diabetes mellitus; (ii) different subgroups of people with specific information needs; and (iii) associated characteristics of the identified subgroups, such as sociodemographic characteristics, diabetes-related comorbidities, and well-being.MethodsThis cross-sectional study was based on data from 837 respondents with diabetes mellitus who participated in the population-based KORA (Cooperative Health Research in the Augsburg Region) Health Survey 2016 in Southern Germany (KORA GEFU 4 study) (45.6% female, mean age 71.1 years, 92.8% Type 2 diabetes). Diabetes-related information needs were assessed with a questionnaire asking about patients’ information needs concerning 11 diabetes-related topics, e.g. ‘long-term complications’ and ‘treatment/therapy’. Subgroups of people with different information needs and associated characteristics were identified using latent class analysis.ResultsWe identified the following four classes of people with different information needs: ‘high needs on all topics’, ‘low needs on all topics’, ‘moderate needs with a focus on complications and diabetes in everyday life’, and ‘advanced needs with a focus on social and legal aspects and diabetes research’. The classes differed significantly in age, years of education, type of diabetes, diabetes duration, diabetes-related comorbidities, smoking behaviour, diabetes education, current level of information, and time preference.ConclusionsKnowledge about different patient subgroups can be useful for tailored information campaigns or physician-patient interactions. Further research is needed to analyse health care needs in these groups, changes in information needs over the course of the disease, and prospective health outcomes.

Assessing natural metalinguistic skills in people with Alzheimer’s disease and frontotemporal dementia

ObjectiveThe aim of this paper is to assess whether the use of natural metalinguistic skills can be used to differentiate linguistic-communicative profiles of people with dementia (Alzheimer’s disease and frontotemporal dementia in the behavioural and primary progressive aphasia variants) in the earliest stages of the disease. MethodA sample of 180 people was selected. Sixty had Alzheimer’s disease, 20 had frontotemporal dementia of the behavioural variant, and 40 had frontotemporal dementia of the primary progressive aphasia variant (20 had non-fluent primary progressive aphasia and 20 had semantic dementia). The control group was composed of 60 healthy people with ages, gender, and professions as similar as possible to those of the people in the dementia groups. All the participants were administered the Spanish adaptation of the Mini-Mental State Examination (MMSE) and the Global Deterioration Scale (GDS) to assess dementia severity. To assess the use of natural metalinguistic skills, a 40-item test (MetAphAs), specifically designed for this aim, was administered. ResultsThe test showed high internal validity and high positive correlations with the MMSE. Statistically significant differences were observed in the total scores on this test and in the scores on each of its sections, when comparing the whole group and the subgroups of people with dementia with the control group. Additionally, the scores on most of the sections of the MetAphAs test presented statistically significant differences when the different subgroups of people with dementia were compared. ConclusionsA test like the MetAphAs, specifically designed to assess natural metalinguistic abilities, may be useful for obtaining differential communicative-linguistic profiles according to the type of dementia in the early stages of the disease. However, additional research is needed to obtain more conclusive results.

Community dependence on the natural resources of Parambikulam Tiger Reserve, Kerala, India

Forest ecosystems are vital for terrestrial biodiversity and the effective management of these natural resources stands essential, owing to the subsistence needs of humans. The resources derived from the forest ecosystem meet multiple purpose for different sub groups of people. On a macro perspective, the vulnerable groups, i.e., the tribals depend on forest resources for meeting their employment and livelihood requirements. The Forest Dependence Index, a numeric indicator of the social and economic dependence of the community in Parambikulam Tiger Reserve highlights 43.5 per cent dependency on the forest resources to meet their livelihood needs. This clearly depicts the relevance and significance of forests in the livelihood of the resident community in the Reserve. Assessing the dependency of the community on the forest will help in creating awareness on the resource dependence and specify strategies for sustainable forest management. This paper analyses the forest dependency of the tribal communities residing within Parambikulam Tiger Reserve, one of the well-protected ecological niche of Anamalai sub unit of the Western Ghats and its policy implications on the livelihood of the forest dependents in the wake of Forest Rights Act, 2006.

A quantitative dynamic systems model of health-related quality of life among older adults.

Health-related quality of life (HRQOL) is a person-centered concept. The analysis of HRQOL is highly relevant in the aged population, which is generally suffering from health decline. Starting from a conceptual dynamic systems model that describes the development of HRQOL in individuals over time, this study aims to develop and test a quantitative dynamic systems model, in order to reveal the possible dynamic trends of HRQOL among older adults. The model is tested in different ways: first, with a calibration procedure to test whether the model produces theoretically plausible results, and second, with a preliminary validation procedure using empirical data of 194 older adults. This first validation tested the prediction that given a particular starting point (first empirical data point), the model will generate dynamic trajectories that lead to the observed endpoint (second empirical data point). The analyses reveal that the quantitative model produces theoretically plausible trajectories, thus providing support for the calibration procedure. Furthermore, the analyses of validation show a good fit between empirical and simulated data. In fact, no differences were found in the comparison between empirical and simulated final data for the same subgroup of participants, whereas the comparison between different subgroups of people resulted in significant differences. These data provide an initial basis of evidence for the dynamic nature of HRQOL during the aging process. Therefore, these data may give new theoretical and applied insights into the study of HRQOL and its development with time in the aging population.

Tracking alternative flame retardants: hand-to-mouth exposures in adults.

Since polybrominated diphenyl ether (PBDE) flame retardants were withdrawn from use in polyurethane foam padding, alternatives including tris(1,3-dichloropropyl) phosphate (TDCIPP) and triphenyl phosphate (TPHP) are now used in consumer goods including furniture, automobiles, carpet padding, and baby products.1,2,3,4 Like PBDEs, these replacement compounds have been widely found in dust samples from homes, offices, and vehicle interiors.2,3,4 A new study in this issue of EHP examines whether they also resemble PBDEs in another way: the routes by which people are exposed.5 TDCIPP and TPHP are members of the family of organophosphate flame retardants (PFRs). TDCIPP is listed as a human carcinogen under California’s Proposition 65,6 and a small human study found evidence that exposure to both TDCIPP and TPHP was associated with altered levels of some hormones and lower sperm concentration.2 In vitro and animal data have linked TDCIPP to neurotoxicity and both TDCIPP and TPHP to endocrine disruption.7,8,9,10,11 Organophosphate flame retardants have replaced PBDEs in many products containing polyurethane foam. The new study focused on home exposures. The study included 53 men and women who provided hand-wipe and urine samples. Most (92%) of these volunteers also provided a dust sample from their home. The two PFRs were found in all the dust samples at widely varying levels. There was a 200-fold increase from the lowest to highest dust concentration of TDCIPP and a 400-fold increase from the lowest to highest TPHP concentration.5 Metabolites of the PFRs were detected in most of the urine samples. The primary metabolite of TPHP (DPHP) was found in 91% of samples, and the primary metabolite of TDCIPP (BDCIPP) was found in 83% of samples.5 Women had urinary levels of DPHP nearly twice those of men.5 “This is a very unusual finding. We haven’t seen that before [for flame retardants], which suggests to us that there is likely exposure through a personal care product,” says corresponding author Heather Stapleton, the Dan and Bunny Gabel Associate Professor of Environmental Ethics and Sustainable Environmental Management at Duke University’s Nicholas School of the Environment. She and first author Kate Hoffman, a research scientist at Nicholas School of the Environment, are part of a group currently investigating nail polish as a possible source of exposure to TPHP. The authors also point out that sex-specific differences in metabolism could explain some of this finding.5 People with higher concentrations of the PFRs in their dust tended to have higher concentrations in their urine, but the correspondence was not consistent. In comparison, the levels of PFRs measured on the study participants’ hands were more closely correlated with their urine levels. The work suggests that hand-to-mouth contact or dermal absorption may be important pathways of exposure to these compounds.5 “Anytime you have orders of magnitude in ranges of exposure, you might expect to see very different responses along the distribution and within different subgroups of people,” says John Meeker, an associate professor of environmental health sciences at the University of Michigan School of Public Health. “The widespread exposure highlights the need for additional toxicology and human studies, as well as research on how people are being exposed.” The investigators also assessed how urinary metabolite concentrations varied over a five-day period. Eleven participants provided urine samples over five consecutive days, and concentrations of the rapidly eliminated metabolites remained consistent over time for each participant, indicating ongoing exposure.5 The study’s limitations include the fact that paired dust, hand-wipe, and urine samples were collected a single time, providing only a snapshot of exposure. The authors note that TDCIPP and TPHP have previously been detected in household air, and inhalation exposure may be an important pathway to consider in future assessments,4,12 but this study did not include home air sampling. However, the new work does add to the growing evidence that hand wipes can provide valuable information to complement measurements of contaminants in air and dust, Stapleton says. It also demonstrates that urine samples have potential as a biomarker of exposure, particularly for TDCIPP, Hoffman says. Previous studies of PBDEs and other flame retardants have reported associations between more frequent hand washing and lower potential exposures as measured by hand-wipe samples.13,14 In the current study, this was true for TDCIPP, and the researchers also found associations between more frequent hand washing and lower levels of metabolites of both TDCIPP and TPHP in urine.5 According to Hoffman, this suggests that frequent hand washing may be a good way to reduce exposure.

Antiviral treatment for preventing postherpetic neuralgia.

Postherpetic neuralgia (PHN) is a painful and refractory complication of herpes zoster. Treatments are either partially or totally ineffective for many people with PHN. Antiviral agents, used at the time of the rash, have been proposed as an intervention to prevent the development of PHN. This is the first update since the first publication of the review in 2009. To assess the effectiveness of antiviral agents in preventing PHN. On 26 April 2013, we updated the searches in the Cochrane Neuromuscular Disease Group Specialized Register, CENTRAL, MEDLINE, EMBASE, LILACS, and the Chinese Biomedical Retrieval System. We checked the references of published studies to identify additional trials, and contacted authors to obtain additional data. We searched other databases in The Cochrane Library for information for the Discussion and two clinical trials registries for ongoing trials. We considered all randomised controlled trials (RCTs) of antiviral treatment given within 72 hours after the onset of herpes zoster for preventing PHN. There were no language restrictions. Two authors independently selected trials, evaluated the risk of bias in included trials, and extracted and analysed data. Six RCTs with a total of 1211 participants were eligible; five trials evaluated oral aciclovir, and one, with 419 participants, evaluated oral famciclovir. We were able to conduct meta-analyses as there were sufficient similarities in the included studies, such as the reporting of the presence of PHN, duration of rash before treatment initiation and treatment regimen. For our primary outcome, based on three trials (609 participants) we found no significant difference between the aciclovir and control groups in the incidence of PHN four months after the onset of the acute herpetic rash (risk ratio (RR) 0.75, 95% confidence interval (CI) 0.51 to 1.11), nor was there a significant difference at six months (RR 1.05, 95% CI 0.87 to 1.27, two trials, 476 participants). In four of the trials (692 participants), there was some evidence for a reduction in the incidence of pain four weeks after the onset of rash. In the trial of famciclovir versus placebo, neither 500 mg nor 750 mg doses of famciclovir reduced the incidence of herpetic neuralgia significantly. The most commonly reported adverse events were nausea, vomiting, diarrhoea and headache for aciclovir, and headache and nausea for famciclovir. For neither treatment was the incidence of adverse events significantly different from placebo. None of the studies were at high risk of bias, although the risk of bias was unclear in at least one domain for all but one study. We found no new RCTs when we updated the searches in April 2013. There is high quality evidence that oral aciclovir does not reduce the incidence of PHN significantly. In addition, there is insufficient evidence to determine the effect of other antiviral treatments; therefore, further well-designed RCTs are needed to investigate famciclovir or other new antiviral agents in preventing PHN. Future trials should pay more attention to the severity of pain and quality of life of participants, and should be conducted among different subgroups of people, such as people who are immunocompromised.

Risk of fall for people with diabetes

Purpose: To examine the risk of fall for people with diabetes compared with healthy control subjects. Correlation between tactile sensation and postural control was examined for subjects with diabetes. Methods: Subjects with type 2 diabetes were classified into two groups: (i) diabetes without neuropathy (n = 23) and (ii) diabetic peripheral neuropathy (DPN) (n = 9). Age-matched healthy control subjects (n = 32) were recruited. Tactile sensation, equilibrium scores (ES), strategy scores and sensory analysis scores from the Sensory Organization Test (SOT) were compared among the groups. Results: Subjects with diabetes without neuropathy demonstrated impaired postural control upon the disruption of somatosensory inputs. Subjects with DPN lost balance upon being deprived of visual inputs. A decrease in tactile sensation was associated with a decrease in the ESs in all subjects with diabetes (r = −0.35 to −0.77; p < 0.05), and they tend to use more hip strategy for postural control upon being deprived of visual inputs. Conclusions: Different postural control strategies are adopted by various subgroups of subjects with diabetes. Subjects with DPN demonstrated a significant shift from ankle to hip strategies for balance tests when vision was deprived.Implications for RehabilitationThe severity of diabetic peripheral neuropathy (DPN) is associated with the risk of fall.Different compensatory strategies in balance control have been adopted by different subgroups of people with diabetes.In order to minimize the risk of fall, specific balance training program should be offered to different subgroups of people with diabetes.The balance training should emphasize on optimizing the competence of their existing compensatory postural control strategies.

Rasch Validation of the Streamlined Wolf Motor Function Test in People With Chronic Stroke and Subacute Stroke

The construct validity and reliability of the short form of the Wolf Motor Function Test (S-WMFT) in people with subacute stroke and chronic stroke (S-WMFT subacute stroke and chronic stroke versions) have not been investigated. Objective The purpose of this study was to investigate the dimensionality, item difficulty hierarchy, differential item functioning (DIF), and reliability of the S-WMFT subacute stroke and chronic stroke versions in people with mild to moderate upper-extremity (UE) dysfunction. Design This was a secondary study in which data collected from randomized controlled trials were used. Data were collected at baseline from 97 people with chronic stroke (>12 months after stroke) and 75 people with subacute stroke (3-9 months after stroke) at 3 medical centers in Taiwan. Test structure, hierarchical properties, DIF, and reliability were assessed with Rasch analysis. The test structure for both versions was unidimensional. No DIF relevant to sex, age, or stroke location (hemispheric laterality) was detected. The tasks of moving a hand to a box and moving a hand to a table in the S-WMFT for subacute stroke showed a significantly high correlation. The reliability coefficients for both versions were approximately .90. Limitations The findings were limited to people with stroke and mild to moderate impairment of UE function. The S-WMFT subacute stroke and chronic stroke versions are useful tools for assessing UE function in different subgroups of people with stroke and show evidence of construct validity and reliability. A high correlation between the tasks of moving a hand to a box and moving a hand to a table in the S-WMFT for subacute stroke suggests that the removal of 1 of these 2 items is warranted.

Factorial validity and invariance of the Life Satisfaction Index in older people across groups and time: Addressing the heterogeneity of age, functional ability, and depression

In the last decades, extensive research efforts have been directed at exploring life satisfaction in old age, and the Life Satisfaction Index A (LSIA) scale, developed by Neugarten et al. in the 1960s, is one of the most commonly used instruments. However, studies have focused on predicting and comparing changes in people's life satisfaction without testing if the LSIA instrument is equally valid for different subgroups of people. The present study investigated the underlying dimensions of the LSIA in a Swedish population (n=1402) of people 60–96 years of age. The study also examined factorial invariance across age, gender, functional ability and depression during a six-year period. The results showed that while a five-factor solution of the LSIA did not exhibit an acceptable fit to the data, a three-factor solution did show a close fit. The two three-factor models that demonstrated the best fit showed invariance across gender and across time, but noninvariance across groups with different levels of reduced functional ability, depressive symptoms and age. These findings suggest that the psychometric properties of life satisfaction instruments like the LSIA need to be taken into consideration before drawing conclusions about life satisfaction when comparing older people of different ages and with different depression and function levels.

Schizophrenia Course, Long-Term Outcome, Recovery, and Prognosis

Our 26-year longitudinal study and other longitudinal studies confirm older views that outcome for schizophrenia, while showing some variation for different schizophrenia patients, is still significantly poorer than that for other psychiatric disorders, with the exception of the dementias. Our research leads us to propose that risk factors, either stress related or those related to vulnerability to psychosis, account for the episodic course of periods of recovery followed by periods of recurrence that is experienced by most schizophrenia patients. These risk factors interact with personality, temperament, and cognitive traits that, while not causing psychosis, influence its course. It is these interactions that account for the heterogeneous outcome trajectories of different subgroups of people with this condition. Our research and that of others has focused on the contributions of these risk factors, such as vulnerability to trait anxiety, poor developmental achievements before the illness, personality traits such as locus of control, cognitive styles, neurocognitive impairments, length of untreated psychosis, and several others. Despite the proven efficacy of antipsychotic medications over the short term, there is a subgroup of schizophrenia patients who, a few years after the acute phase, function adequately or experience periods of recovery for a number of years, without treatment.

The Impact of Information on Death Penalty Support, Revisited

In 1972, former Supreme Court Justice Marshall postulated that the public was uninformed about the death penalty and information would change their support for it. There is some indication that information about the death penalty may change people’s level of support. This study re-examines data used by Lambert and Clarke (2001). Using multivariate analyses, the impact that information has on death penalty support is tested, along with level of prior knowledge about the death penalty, personal characteristics (gender, age, political affiliation, race, being a criminal justice major, academic level), and religious factors. The results suggest that information on both deterrence and innocence leads to a reduction in death penalty support and views on the death penalty. Furthermore, the results suggest that the information presented may have varying effects among different subgroups of people.

Symmetry of Timing of Hip and Lumbopelvic Rotation Motion in 2 Different Subgroups of People With Low Back Pain

Van Dillen LR, Gombatto SP, Collins DR, Engsberg JR, Sahrmann SA. Symmetry of timing of hip and lumbopelvic rotation motion in 2 different subgroups of people with low back pain. Objectives To examine whether lumbopelvic motion associated with a clinical test of active hip lateral rotation (HLR) systematically varied between people classified into 1 of 2 low back pain (LBP) subgroups: lumbar rotation (Rot) or lumbar rotation with extension (RotExt); and, specifically, to determine whether the timing of hip and lumbopelvic rotation with HLR would be more symmetric, right versus left, in people in the Rot subgroup compared with the RotExt subgroup. Design Two-group, cross-sectional. Setting A university-based movement science laboratory. Participants Subjects were 39 people (23 men, 16 women; mean age, 28.1±8.0y) with chronic or recurrent LBP who regularly participated in a rotation-related sport and associated their LBP symptoms with participation. Interventions Not applicable. Main Outcome Measures Subjects participated in a standardized clinical examination to classify their LBP problem. A 3-dimensional movement system was used to capture kinematics of hip and lumbopelvic rotation during the test of active HLR. To examine timing of motion between the hip and lumbopelvic region, the difference in time between the start of hip and lumbopelvic rotation was calculated (startdiff). Symmetry of motion was indexed by the correlation ( r) between right and left startdiff and the coefficient of determination ( r 2) for each LBP subgroup. Results There were no significant differences between the 2 groups with regard to subject, LBP, activity, and range of motion variables ( P range, >.05 for all comparisons). People in the Rot subgroup displayed significantly more symmetry of timing of hip and lumbopelvic rotation motion with active HLR than people in the RotExt subgroup (Rot subgroup: r=.94, r 2=.88, P=.00; RotExt subgroup: r=.31, r 2=.10, P=.12). Conclusions People in the Rot and RotExt subgroups displayed systematic differences in how they moved the hip and lumbopelvic region with the clinical test of active HLR. These findings are potentially important because such differences in movement patterns between subgroups of people with LBP suggest different contributing factors and may require different treatments to affect the movement patterns.

Does Money Matter? A Theory-Driven Growth Mixture Model to Explain Travel-Mode Choice with Experimental Data

In the present article we apply a growth mixture model using Mplus via STREAMS to delineate the mechanism underlying travel-mode choice. Three waves of an experimental field study conducted in Frankfurt Main, Germany, are applied for the statistical analysis. Five major questions are addressed: (1) whether the choice of public transport rather than the car changes over time; (2) whether a soft policy intervention to change travel mode choice has any effect on the travel-mode chosen; (3) whether one can identify different groups of people regarding the importance allocated to monetary and time considerations for the decision of which travel mode to use; (4) whether the different subgroups of people have different initial states and rates of change in their travel-model choices; (5) whether sociodemographic variables have an additional effect on the latent class variables and on the changes in travel-mode choice over time. We also found that choice of public transportation in our study is stable over time. Moreover, the intervention has an effect only on one of the classes. We identify four classes of individuals. One class allocates a low importance to both monetary and time considerations, the second allocates high importance to money and low importance to time, the third allocates high importance to both, and the fourth allocates a low importance to money and a high importance to time. We found no difference in the patterns of travel-mode changes over time in the four classes. We also found some additional effects of sociodemographic characteristics on the latent class variables and on behavior in the different classes. The model specification and the empirical findings are discussed in light of the theory of the allocation of time of Gary Becker.

Pain catastrophizing and general health status in a large Dutch community sample.

The aim of the present study was to examine the association between pain catastrophizing and general health status in a Dutch adult community sample, including various subgroups of people with musculoskeletal pain in the analyses. For exploratory reasons this study partly replicated previous studies of the factor structure, reliability, and validity of the Pain Catastrophizing Scale (PCS). Results demonstrated that across different pain subgroups, catastrophizing uniquely contributed variance to the prediction of the various aspects of general health status beyond the variance explained by pain intensity, age, gender, and chronicity. Across subgroups strongest associations were found between catastrophizing and mental health, general health perception, social functioning, and vitality. Furthermore, the association between catastrophizing and the various aspects of general health status was not moderated by the chronicity of the pain. Results of the confirmatory factor analysis statistically confirmed a three-factor model of the PCS, which was invariant across different subgroups of people with musculoskeletal pain. Inter-factor correlations were high, and the incremental explanatory power of the three-factor model over that of a one-factor model was only marginal. This implies that a one-factor model might be justifiable as well, at least in the general community. Across various pain subgroups the reliability of the PCS total and subscales was adequate. Additional evidence for the concurrent validity of the PCS was found as well.