Follow-up Survey Research Articles

Real-world patterns in remote longitudinal study participation: A study of the Swiss Multiple Sclerosis Registry.

Remote longitudinal studies are on the rise and promise to increase reach and reduce participation barriers in chronic disease research. However, maintaining long-term retention in these studies remains challenging. Early identification of participants with different patterns of long-term retention offers the opportunity for tailored survey adaptations. Using data from the online arm of the Swiss Multiple Sclerosis Registry (SMSR), we assessed sociodemographic, health-related, and daily-life related baseline variables against measures of long-term retention in the follow-up surveys through multivariable logistic regressions and unsupervised clustering analyses. We further explored follow-up survey completion measures against survey requirements to inform future survey designs. Our analysis included data from 1,757 participants who completed a median of 4 (IQR 2-8) follow-up surveys after baseline with a maximum of 13 possible surveys. Survey start year, age, citizenship, MS type, symptom burden and independent driving were significant predictors of long-term retention at baseline. Three clusters of participants emerged, with no differences in long-term retention outcomes revealed across the clusters. Exploratory assessments of follow-up surveys suggest possible trends in increased survey complexity with lower rates of survey completion. Our findings offer insights into characteristics associated with long-term retention in remote longitudinal studies, yet they also highlight the possible influence of various unexplored factors on retention outcomes. Future studies should incorporate additional objective measures that reflect participants' individual contexts to understand their ability to remain engaged long-term and inform survey adaptations accordingly.

The Effectiveness of Online Courses in Building Nemeth Code Within UEB Contexts Skills and Increasing Knowledge of Strategies to Support Prekindergarten Through Eighth-Grade Students in Their Mathematics Learning

Introduction Professional development can assist individuals in learning a variety of new skills and refining their teaching practice. The purpose of this study was to explore the effectiveness of asynchronous online courses designed to assist individuals in building their Nemeth Code within Unified English Braille (UEB) Contexts skills and strategies for teaching the code to prekindergarten through eighth-grade students. Methods Four teachers of students with visual impairments designed five asynchronous online courses. The courses provided multiple opportunities for participants to actively complete course content as well as learn about strategies and resources for teaching the Nemeth Code within UEB Contexts to children and youths. Each course included an initial survey, pretest, seven self-paced lessons, and posttest. Participants were also invited to complete a follow-up survey. Results Between spring 2020 and spring 2023, 452 participants completed between 1 and 5 of the courses for a total of 620 courses completed. Almost all completers ( n = 598) scored higher on the posttest. Of the 227 individuals who completed the follow-up survey, 223 reported that what they learned in the course had positively impacted how they support or will support students who read braille in their math classes. Discussion Effective professional development goes beyond learning. When individuals actively consume content and reflect upon their learning, their professional practice is transformed. Implications for Practitioners Well-designed asynchronous instructional modules allow professionals to increase their knowledge and skills. Opportunities to practice skills and check one's work, access to instructional videos, and the availability of downloadable slides and resources are helpful to professionals.

Implementation of a Mobile Health Approach to a Long-Lasting Insecticidal Net Uptake Intervention for Malaria Prevention Among Pregnant Women in Tanzania: Process Evaluation of the Hati Salama (HASA) Randomized Controlled Trial Study.

Malaria infection is associated with many adverse outcomes for pregnant women and neonates, yet pregnant women in East and Southern Africa remain frequently exposed to malaria. Long-lasting insecticidal nets (LLINs) can help prevent malarial infections and the associated adverse events. The Hati Salama (HASA) study was a cluster-randomized controlled trial implemented in 100 antenatal health facilities in urban and rural settings of Tanzania that provided pregnant women in both intervention and control groups with e-vouchers to redeem for LLINs for malaria prevention. The intervention group received behavior change communication mobile messages across a 14-day period while the e-voucher was active, and no significant difference between the rates of e-voucher redemption was found across the two groups. This study was a process evaluation of the HASA randomized controlled trial to determine barriers and facilitators to e-voucher reception and LLIN acquisition for pregnant women enrolled in the trial, as well as challenges and lessons learned by nurses who worked at the antenatal health facilities supporting the trial. Following the e-voucher's expiration at 14 days, voluntary phone follow-up surveys were conducted for nurses who supported the trial, as well as participants in both intervention and control groups of the trial who did not redeem their e-vouchers. Survey questions asked nurses about workflow, training sessions, network connectivity, proxy phone use, and more. Surveys asked participants about reasons for not redeeming e-vouchers. Both surveys provided lists of preset answers to questions, as well as the option to provide open-ended responses. Nurses and trial participants were contacted between January and June 2016 on up to three occasions. While nurses who supported the HASA trial seemed to recognize the value of the program in their communities, some barriers identified by nurses included network connectivity, workload increase, inadequate training and on-the-ground support, and difficulty following the workflow. Several barriers identified by trial participants included personal obligations preventing them from redeeming the e-voucher on time, network connectivity issues, losing the e-voucher number, no stock of LLINs at retailers when attended, inadequate explanation of where or how to redeem the e-voucher, or not receiving an SMS text message with the e-voucher number promptly or at all. Large-scale e-voucher platforms for health-related commodity interventions, such as LLIN distribution in sub-Saharan Africa, are feasible, but challenges, including network connectivity, must be addressed. Nurses identified issues to be considered in a future scale-up, such that the number of nurses trained should be increased and the e-voucher issuance workflow should be simplified. To address some of the key barriers impacting e-voucher redemption for trial participants, the network of retailers could be expanded and the e-voucher expiration period should be extended. ClinicalTrials.gov NCT02561624; https://clinicaltrials.gov/ct2/show/NCT02561624.

The CHALO! 2.0 mHealth-Based Multilevel Intervention to Promote HIV Testing and Linkage-to-Care Among Men Who Have Sex with Men in Mumbai, India: Protocol for a Randomized Controlled Trial.

Current programs to engage marginalized populations such as gay and bisexual individuals and other men who have sex with men (MSM) in HIV prevention interventions do not often reach all MSM who may benefit from them. To reduce the global burden of HIV, far-reaching strategies are needed to engage MSM in HIV prevention and treatment. Globally, including low- and middle-income countries, MSM are now widely using internet-based social and mobile technologies (SMTs; eg, dating apps, social media, and WhatsApp [Meta]), which provides an unprecedented opportunity to engage unreached and underserved groups, such as MSM for HIV prevention and care. This study aimed to assess the effectiveness of a multilevel mobile health (mHealth)-based intervention to improve HIV testing uptake and status neutral linkage-to-care among sexually active MSM reached through internet-based platforms in Mumbai, India. In this randomized controlled trial, we will determine whether CHALO! 2.0 (a theory-based multilevel intervention delivered in part through WhatsApp) results in increased HIV testing and linkage-to-care (prevention or treatment). This study is being conducted among 1000 sexually active MSM who are unaware of their HIV status (never tested or tested >6 months ago) and are recruited through SMTs in Mumbai, India. We will conduct a 12-week, 3-arm randomized trial comparing CHALO! 2.0 to 2 control conditions-an attention-matched SMT-based control (also including a digital coupon for free HIV testing) and a digital coupon-only control. The primary outcomes will be HIV testing and status neutral linkage-to-care by 6 months post enrollment. Participants will be followed up for a total of 18 months to evaluate the long-term impact. The study was funded in 2020, with recruitment having started in April 2022 due to delays from the COVID-19 pandemic. Baseline survey data collection began in April 2022, with follow-up surveys starting in July 2022. As of April 2022, we enrolled 1004 participants in the study. The completion of follow-up data collection is expected in January 2025, with results to be published thereafter. While global health agencies have called for internet-based interventions to engage populations vulnerable to HIV who are not being reached, few proven effective and scalable models exist and none is in India, which has one of the world's largest HIV epidemics. This study will address this gap by testing a multicomponent mHealth intervention to reach and engage MSM at high priority for HIV interventions and link them to HIV testing and prevention or treatment. ClinicalTrials.gov NCT04814654; https://clinicaltrials.gov/study/NCT04814654. Clinical Trial Registry of India CTRI/2021/03/032280. DERR1-10.2196/59873.

Family care and predictors of the disabled elderly in China: A cross-sectional study based on the Anderson model.

In light of China's progressively aging population, family care with the "warmth of affection" has always been an irreplaceable form of care that meets the wishes of the majority of disabled elderly to enjoy their twilight years comfortably. Data from a follow-up survey on the influencing factors of the Chinese Longitudinal Healthy Longevity Survey from 2018 and the Anderson Model was used as a theoretical framework to analyze the influencing factors using a binary logistic regression model. Children were the main providers of care services among disabled elderly in family care. Family care for disabled elderly was influenced by the combined effects of age (P < 0.01), gender (P < 0.05), marital status (P < 0.01), number of children (P < 0.01), housing ownership (P < 0.05), primary carer preference (P < 0.05), and self-assessed health (P < 0.01) were jointly affected. As a result, it's critical to set up a strong social support network that is focused on family caregiving and includes tailored interventions based on the requirements of disabled elderly and family caregivers.

The impact of metabolic heterogeneity of obesity and transitions on cardiovascular disease incidence in Chinese middle-aged and elderly population: A nationwide prospective cohort study.

Previous studies indicated that metabolic heterogeneity of obesity would affect the risk of cardiovascular disease (CVD). However, the alterations in CVD risk associated with transitions between various metabolic health statuses influenced by obesity status remain unclear. We utilized data from the China Health and Retirement Longitudinal Study (CHARLS), a longitudinal cohort study involving Chinese residents aged 45 years and older. Baseline data were collected in 2011-2012, with follow-up surveys conducted up to 2020. Participants in the study were categorized into four body mass index-metabolic phenotypes: metabolically healthy normal weight (MHNW), metabolically healthy overweight/obesity (MHOO), metabolically unhealthy normal weight (MUNW) and metabolically unhealthy overweight/obesity (MUOO). Transitions in these phenotypes over 4 years were analysed. Cox regression models were used to assess the associations of these phenotypes and their transitions with CVD incidence. Among 7721 participants, 1353 (17.5%) developed CVD during the follow-up period. Both overweight/obese and metabolically unhealthy statuses were associated with increased CVD risk. The highest risk was observed in the MUOO group (hazard ratio [HR]: 1.74, 95% confidence interval [CI]: 1.50-2.09, p < 0.0001), followed by the MUNW (HR 1.35, 95% CI: 1.13-1.66, p < 0.001) and MHOO (HR: 1.29, 95% CI: 1.08-1.56, p = 0.002) groups compared to the MHNW group. The deteriorations of obesity and metabolic health status elevated the incidence of CVD, whereas improvements in these statuses reduced the risk of CVD. Additionally, alterations in metabolic health status conferred greater benefits in overweight/obese individuals compared to those with normal weight. The study highlights the importance of maintaining and promoting metabolic health, particularly in overweight/obese individuals, to reduce CVD risk. Metabolic health status plays a more crucial role than obesity status in predicting CVD incidence.

What Type of Self-Assessment Is Best for Your Educational Activity? A Review of Pre-Post, Now-Then, and Post-Only Designs.

In medical education, learner self-assessments are standard methods used to evaluate the impact of curricula and workshops. Due to the subjective nature of self-assessment, these measures are prone to known biases including framing, recall, social desirability, and response-shift bias. These biases can contribute to floor and ceiling effects of measurement, which can lead to false conclusions about whether the intended learning objectives were achieved. Ideal assessments of skills-based educational activities would include standardized tests and structured observations of learners demonstrating skill use before and after the educational intervention. However, educators often lack the necessary resources, time, and expertise to routinely conduct these appraisals and rely on self-assessment as a pragmatic approach to obtaining curriculum feedback and evaluation data. In this review, we describe three common designs for self-assessments: the pre-post, now-then, and post-only designs. We then give recommendations for choosing between each design to minimize bias. The choice of the best design is based on alignments with four considerations: (1) the educational objectives (e.g., demonstrate skill competency and/or change in skill level); (2) participants' prior experience and shared understanding of levels of skill performance; (3) the nature of the educational activity; and (4) available resources. For each design, we review strengths, weaknesses, and known biases and discuss examples to highlight trade-offs between options. We also discuss the use of control groups and follow-up surveys to measure retention over time as additional methods to address bias and related confounding. The guidance presented here is intended to raise educators' awareness of common pitfalls in self-assessment; minimize the impact of known biases when possible; provide evidence, examples, and rationales for optimal design choices; and increase the rigor of self-assessment evaluations.

The sustainability of a community-based learning collaborative to improve the use of trauma-informed evidence-based practices

PurposeMost youth who experience trauma do not receive evidence-based trauma intervention. Efforts to increase use oftrauma-informed evidence-based practices (EBPs) have identified the learning collaborative (LC) as an effective training and implementation model, yet few studies have evaluated sustainability outcomes. This study examined the sustainability of a community-based LC (CBLC) by describing provider, agency, and community-level use of trauma-informed EBPs, an average of 5.3 years after the training. Methods106 participants from 20 agencies completed a follow-up survey after a CBLC training. Participants were trained in Trauma-Focused Cognitive-Behavior Therapy (TF-CBT; clinical track), in Evidence-Based Treatment Planning (EBTP; broker/case manager track), or in strategies to support TF-CBT and EBTP implementation (senior leader track). Clinical and broker track participants reported on their current employment and EBP use within the past three months. Senior leaders for all 20 agencies provided information about the use of trauma-informed EBPs at their agencies. ResultsAt the provider-level, only 36.5 % of the clinical track continued to use TF-CBT and 28.1 % of the broker track continued to use EBTP. Provider promotion to supervisory and leadership positions supported EBP sustainability. Agency-level outcomes indicated that 89 % of clinical agencies and 60 % of broker agencies continued to use TF-CBT and EBTP. Although retention of providers within agencies was low, LC trained clinicians and brokers spread to twenty-four new agencies in the community providing psychotherapy and/or case management services to youth. ConclusionsFindings suggest the CBLC model resulted in some sustained community-level changes as agencies continued to use the trauma-informed EBPs and trained providers spread to other agencies within the local community. Provider promotions also increased representation of CBLC trainees in leadership positions. Results suggest that measuring sustainability as a multi-level implementation outcome can lead to a better understanding of implementation success.

Expanding access to addictions care: Implementation of a 24-hour healthcare provider support line in British Columbia, Canada

BackgroundMorbidity and mortality related to substance use have risen to catastrophic levels in North America, and treatment services are often difficult to access. In response, the province of British Columbia (BC), Canada, launched a province-wide addiction medicine support phone line that offers clinicians immediate access to phone consultation with an addictions medicine expert. The service operates 24/7 is accessible to any clinician in the province seeking assistance with an addiction-related question. We describe an evaluation of the reach and perceived impact of the service over its first two years.MethodsThe 24/7 Addiction Medicine Clinician Support Line was evaluated prospectively from June 2020 to April 2022. All provider-to-provider encounters were included. Data was collected from two primary sources: health provider demographic information collected at the time of consultation, and optional clinician surveys conducted after the consultation was complete. Descriptive data are presented as numerical values and percentages.ResultsOver the 22-month evaluation period, 1,279 consultations were requested by 631 distinct care providers across British Columbia. The service averaged 15 calls per week across the province, and 51.5% of calls were made outside of business hours. Physicians made the majority of calls to the service (n = 865, 67.6%), followed by nurse practitioners (n = 162, 12.7%). Among those who completed a follow-up survey (n = 258 calls, 20.2% total calls), 81.8% (n = 211) were “very” or “extremely” satisfied with the consultation. Of these respondents, 65.5% (n = 169) reported that the consultation led to the provision of better care for their patient, with 58.1% (n = 150) initiating a new prescription and 22.1% (n = 57) reporting expedited treatment for their patient. The consultation area of focus was most commonly opioid use (n = 417; 59.6%), followed by polysubstance use (n = 98; 14.0%).ConclusionsThe impact of the 24/7 Addiction Clinician Support Line was widespread, and the service increased accessibility to evidence-based addictions treatment across a range of care settings. Clinicians expressed a high degree of satisfaction with the service. To our knowledge, this province-wide program is the first of its kind in North America, offering a scalable and adaptable model to support access to evidence-based addictions care in under-resourced settings.

A prediction model for differential resilience to the effects of combat-related stressors in US army soldiers.

To develop a composite score for differential resilience to effects of combat-related stressors (CRS) on persistent DSM-IV post-traumatic stress disorder (PTSD) among US Army combat arms soldiers using survey data collected before deployment. A sample of n=2542 US Army combat arms soldiers completed a survey shortly before deployment to Afghanistan and then again two to three and 8-9months after redeployment. Retrospective self-reports were obtained about CRS. Precision treatment methods were used to determine whether differential resilience to persistent PTSD in the follow-up surveys could be developed from pre-deployment survey data in a 60% training sample and validated in a 40% test sample. 40.8% of respondents experienced high CRS and 5.4% developed persistent PTSD. Significant test sample heterogeneity was found in resilience (t=2.1, p=0.032), with average treatment effect (ATE) of high CRS in the 20% least resilient soldiers of 17.1% (SE=5.5%) compared to ATE=3.8% (SE=1.2%) in the remaining 80%. The most important predictors involved recent and lifetime pre-deployment distress disorders. A reliable pre-deployment resilience score can be constructed to predict variation in the effects of high CRS on persistent PTSD among combat arms soldiers. Such a score could be used to target preventive interventions to reduce PTSD or other resilience-related outcomes.

Empowering Medical Students to Address Patient-Initiated Mistreatment at the Transition to Residency: An Education Quality Improvement Study.

Mistreatment from patients is prevalent and has far-reaching negative consequences. To develop a practice-based curriculum on patient-initiated mistreatment and examine participant perceptions before and after the curriculum. Single medical school in the United States. 306 senior medical students from classes 2022 and 2023. A single patient-initiated mistreatment session delivered during specialty-specific residency preparation courses (RPCs) featuring a literature discussion, a response framework, and patient-actor skills practice. Between February 2022 and October 2023, 22 sessions occurred. Electronic surveys were delivered before, following, and approximately eight months after each session. A total of 257 (84.0%) and 174 (56.9%) participants completed pre- and post-session surveys, respectively. Significant increases in mean scores were noted for confidence in recognizing mistreatment (pre-session 4.25, post-session 4.68; p < 0.001) and comfort in addressing mistreatment personally (pre-session 2.86, post-session 4.30; p < 0.001) and as a bystander (pre-session 2.98, post-session 4.27; p < 0.001). In the follow-up survey, participants noted that the session was useful in preparing them for residency. A novel patient-initiated mistreatment curriculum empowered students, resulting in enhanced confidence in responding and sustained skill usage. Medical schools may consider including this training for all graduating students.

Utilizing machine learning to predict participant response to follow-up health surveys in the Millennium Cohort Study

The Millennium Cohort Study is a longitudinal study which collects self-reported data from surveys to examine the long-term effects of military service. Participant nonresponse to follow-up surveys presents a potential threat to the validity and generalizability of study findings. In recent years, predictive analytics has emerged as a promising tool to identify predictors of nonresponse. Here, we develop a high-skill classifier using machine learning techniques to predict participant response to follow-up surveys of the Millennium Cohort Study. Six supervised algorithms were employed to predict response to the 2021 follow-up survey. Using latent class analysis (LCA), we classified participants based on historical survey response and compared prediction performance with and without this variable. Feature analysis was subsequently conducted on the best-performing model. Including the LCA variable in the machine learning analysis, all six algorithms performed comparably. Without the LCA variable, random forest outperformed the benchmark regression model, however overall prediction performance decreased. Feature analysis showed the LCA variable as the most important predictor. Our findings highlight the importance of historical response to improve prediction performance of participant response to follow-up surveys. Machine learning algorithms can be especially valuable when historical data are not available. Implementing these methods in longitudinal studies can enhance outreach efforts by strategically targeting participants, ultimately boosting survey response rates and mitigating nonresponse.

The M-POHL Health Literacy Population Survey 2024-2026 (HLS24)

Abstract Background Inspired by the first European Health Literacy Survey (HLS-EU) and its policy impact, the WHO Action Network on Measuring Population and Organizational Health Literacy (M-POHL) was established in 2018 under the auspices of WHO Europe to monitor and strengthen health literacy (HL) in Europe. The Health Literacy Survey 2019-2021 (HLS19) was the first project of M-POHL, focusing on both general and specific aspects of HL. The follow-up survey (HLS24) builds on this work and will provide even more comprehensive data on HL by including more countries and new aspects of HL. By also focusing on NCDs and prevention, HLS24 is a key partner in the European Joint Action PreventNCD. Methods The HLS24 is a cross-sectional study based on nationally representative samples of the adult population (18+) in more than 20 participating countries. The HLS24 core questionnaire includes items on general HL, sociodemographics, health behavior, health status, and health care utilization. Some countries also include questions on prevention and early detection of chronic diseases and health problems. Five optional packages (OPs) enable countries to focus on specific aspects of HL, namely digital, communicative, navigational, vaccination and mental HL. Results HLS24 uses a harmonized set of HL instruments that provide a solid database for health policy decisions to strengthen HL and health equity in Europe. In addition to the three OPs on digital, communicative and navigational HL discussed in the following presentations, an 11-item set on vaccination literacy and a 21-item set on mental HL are provided. Conclusions Covering NCDs, prevention, digital health, immunization, and mental health, the HLS24 provides important data on current health challenges and highlights the needs of the European population regarding health information and services upon which policy and action interventions can be based.

Longitudinal and cross-sectional associations of NT-proBNP with kidney function and chronic kidney disease: results from KORA cohort studies

Abstract Background Chronic kidney disease (CKD) and cardiovascular disease (CVD) exhibit a bidirectional and complex relationship, and share common risk factors and mechanisms of disease development. Thus, important CVD-related biomarkers, such as N-terminal prohormone of B-type natriuretic peptide (NT-proBNP), may serve as a biomarker for CKD development. Purpose We aimed to investigate the cross-sectional and longitudinal associations of NT-proBNP with kidney function and CKD in data from two population-based cohort studies. Methods We included 5854 men and women, aged 25-74 years, from the Cooperative Health Research in the Region of Augsburg (KORA) cohort studies S3 and S4, and their 1-2 subsequent follow-up surveys, with a median follow-up time of 9.4 and 13.4 years, respectively. Kidney function was assessed by 3 estimated glomerular filtration rate (eGFR) assessments, calculated using creatinine (eGFRcr), cystatin C, and combined creatinine and cystatin C. Serum NT-proBNP was logarithmically transformed followed by Z-score standardization and categorized into 4 groups (G1-4), &amp;lt;48.6, 48.6-125, 125-300, and ≥300 pg/ml. In cross-sectional analysis, linear regression and logistic regression were used to estimate β/odds ratio (OR) and their 95% confidence intervals (CIs) of continuous eGFR or prevalent CKD. For longitudinal analysis of repeated eGFR measurements during follow-up (5854 participants, 11870 observations), linear mixed-effects models were used. For incident CKD associations, interval-censored Cox regression models were performed in participants free of CKD at baseline. Results In cross-sectional analyses, higher NT-proBNP levels were associated with lower eGFR and higher prevalence of CKD across all 3 eGFR assessments. For example, results based on eGFRcr showed that the fully-adjusted β (95% CIs) for per 1 SD increase in log-transformed NT-proBNP were -1.03 (-1.42, -0.64) and -7.01 (-8.93, -5.09) 60 ml/min/1.73m2 for G4 compared to G1, respectively. Corresponding OR (95% CIs) were 2.22 (1.81, 2.74) and 13.8 (5.76, 36.4), respectively. In longitudinal analyses, participants with higher baseline NT-proBNP had a faster decline in eGFR during follow-up. The fully-adjusted β (95% CIs) for 5-year eGFRcr decline were -0.67 (-0.87, -0.47) per 1 SD increase, and -0.37 (-0.79, 0.05), -1.53 (-2.18, -0.88), -4.24 (-5.57, -2.90) 60 ml/min/1.73m2/year for G2-4. Higher NT-proBNP levels were associated with higher incident CKD risks. For associations with incident creatinine-based CKD, hazard ratio (95% CIs) were 1.16 (1.00, 1.33) per 1 SD increase and 1.03 (0.77, 1.38), 1.07 (0.75, 1.52), and 1.81 (1.07, 3.04) for G2-4. Conclusions We found associations of higher NT-proBNP with lower kidney function and higher CKD prevalence. Moreover, higher baseline NT-proBNP levels were associated with faster kidney function decline and higher incident CKD risks. Our findings indicate the potential utility of NT-proBNP as a biomarker of kidney health.Figure 1.Cross-sectional associationsFigure 2.Longitudinal associations

Frailty is a risk factor for occupational falls among older workers: an internet-based prospective cohort study.

Occupational falls are a significant concern among older workers. Although recent cross-sectional studies have indicated a potential association between frailty and occupational falls among older workers, the causal relationship remains unclear. This longitudinal study aimed to investigate whether frailty is a risk factor for occupational falls among older workers using a longitudinal design. This was an Internet-based prospective cohort study. A total of 5,000 older workers (aged 60-75 years) were recruited, with 2,873 participants meeting the inclusion criteria for the follow-up survey. Frailty was assessed using a frailty screening index based on the Fried phenotype model. Occupational falls were defined as those that occurred during the follow-up period. Among the participants, 13.9% were frail. The incidence of occupational falls was higher in the frailty group (11.6%) than that in the non-frailty group (4.9%). In the multivariate-adjusted model, frailty was significantly associated with occupational falls (relative risk: 2.10, 95% confidential interval: 1.51-2.94). Frailty is a significant risk factor for occupational falls among older workers. Employers should consider implementing health-management strategies that focus on frailty to prevent occupational falls in this population.

Systematically Measuring Ultradiffuse Galaxies. VII. The H i Survey Overview

We present the results from the neutral hydrogen (H i) follow-up survey of 378 optically detected ultradiffuse galaxy (UDG) candidates from the Systematically Measuring Ultra-Diffuse Galaxies survey using the Robert C. Byrd Green Bank Telescope. We detect H i in 110 targets and determine 37 to be UDGs and 73 to be low-surface-brightness (LSB) dwarfs based on their effective radii and central surface brightnesses. In line with previous studies, we find that: (i) our H i detections have on average bluer g − r colors and more irregular morphologies than our H i nondetections, (ii) our H i detections populate the tail end of the star-forming main sequence from the ALFALFA catalog with marginally lower specific star formation rates, and (iii) H i detections are mostly in relatively isolated (i.e., field) environments, while most nondetections have at least one nearby neighbor in projection. We find that the H i mass to stellar mass ratios (i.e., gas richnesses) scale with the physical sizes for UDGs and LSB dwarfs alike, suggesting that mechanisms other than bursty star formation feedback may be at play for UDGs. However, we find a stronger trend between gas richnesses and physical sizes if we define UDGs using their effective surface brightness instead of their central surface brightness. We are in the process of using this unprecedented sample of UDG candidates to carry out detailed follow-up studies (i.e., star formation and environmental analysis, comparisons to simulations) and are obtaining resolved H i observations for several of them.

Perspectives on Drug Product Design Among Patients with Lung Cancer in the United Kingdom.

The use of oral anticancer medications has become more prevalent in cancer therapy. This is particularly the case in the management of advanced non-small cell lung cancer (NSCLC). However, when the treatment delivery interaction between the patient and the healthcare provider is removed, the risk of non-adherence increases. Insights into patient preferences can allow drug product formulation scientists to design more patient-centric medications that may promote an increase in adherence which, in turn, may lead to more beneficial health outcomes. We conducted an advisory board with patients with NSCLC in the United Kingdom to elicit and understand preferences for drug product attributes related to appearance, instructions, and modality. The advisory board was preceded by a quantitative preference survey that included three object-case best-worst scaling exercises and was followed by administering the same survey to a broader group of patients to confirm the results. Patients strongly prefer once-daily dosing over more frequent dosing, regardless of the number of pills because taking tablets or capsules multiple times each day can disrupt daily activities. In addition, patients place high importance on surface smoothness because a rough surface implies decreased swallowability. Finally, food restrictions involving directions regarding taking medication with or without food represent difficulties for patients with cancer. Results of the follow-up survey confirmed these results. Drug developers should attempt to limit the dosing of these medications to once-daily regimens, avoid surface roughness, and develop formulations that can be taken without regard to the timing of meals to the greatest extent possible.

Do apologies promote the reintegration of former combatants? Lessons from a video experiment in Colombia

Transitional justice practices frequently involve public apologies where former combatants confess their wrongdoings and ask for forgiveness, with the underlying assumption that such displays facilitate the reintegration of ex-combatants into society. However, little is known about the public response to ex-combatant apologies. In this article, we investigate the causal effect of an armed group apology on attitudes toward ex-combatant reintegration in Colombia. Our study builds on a novel experiment implemented in Meta, a conflict-ridden department of Colombia. The experiment entailed exposing a subset of participants to a video in which a former rebel group leader apologizes for violent acts committed by their armed group during the civil war. To examine the extent to which external actors influence the effectiveness of apologies, we incorporated third-party ‘encouragements to forgive’ (endorsements) in two additional treatment conditions. Our analysis demonstrates that, on average, participants do not exhibit higher reintegration attitudes when exposed to the apology, regardless of third-party endorsements. However, the absence of a treatment effect is not due to an indifference to the apology. In an exploratory heterogeneity analysis, we show that the apology induces negative effects on some indicators of reintegration attitudes among participants that did not support the peace agreement. This finding aligns with qualitative data gathered in a follow-up survey, which indicates that opponents of the peace agreement generally describe negative emotional responses to the FARC-EP apology. The results call for a reconsideration of unchallenged prescriptions of public apologies after conflict.

Drinking firsts at home and with parental knowledge: Racial/ethnic differences in associations with later alcohol outcomes among underage youth.

Prior research has shown that early alcohol experiences, such as age of initiation and speed of progression between drinking milestones, vary across racial/ethnic groups. To inform culturally tailored prevention efforts, this longitudinal study examined racial/ethnic differences in the associations of drinking firsts at home and with parental knowledge with alcohol use outcomes among underage youth. The study included baseline and five follow-up surveys, collected every 6 months, from California adolescents (ages 12-16 years at baseline). The analytic sample was composed of the 689 adolescents who reported lifetime alcohol use at baseline or a follow-up survey (5% Black, 37% Latinx, 46% White, and 12% other/mixed racial/ethnic group; 54% female). Participants who reported consumption of a full drink, intoxication, or heavy episodic drinking (HED) were asked ages and contexts of these drinking firsts, including whether the initiation was at their own home and whether their parents/guardians knew about this drinking event. Outcomes included past-6-month alcohol frequency, alcohol quantity, and number of alcohol-related problems. Multilevel negative binomial regression analyses were conducted, controlling for demographics and age of initiation by type of drinking behavior. Moderation analyses examined racial/ethnic differences. For consumption of the first full drink, both drinking at home and parental knowledge were negatively associated with all outcomes; associations did not vary by race/ethnicity. First intoxication at own home was negatively associated with the number of drinks for Latinx youth and with the number of problems for Black youth. For first HED, drinking at own home was positively associated with drinking frequency across groups, and for Black youth specifically, parental knowledge of their first HED experience was significantly associated with greater later alcohol frequency and quantity. Results suggest that the association of family contexts of drinking first with later alcohol outcomes among underage youth varied by stage of alcohol use and race/ethnicity.

Integrating climate change into state hazard mitigation plans: A five-year follow-up survey of state hazard mitigation officers

Integrating climate change into state hazard mitigation plans: A five-year follow-up survey of state hazard mitigation officers