Initial Participation Rate Research Articles

Promotive factors associated with reduced anxiety and depression across three years in a prospective clinical cohort of adolescents: Examining compensatory and protective models of resilience.

The rates of anxiety and depression increase across adolescence, many experience recurrence after treatment, yet longitudinal studies examining promotive factors are scarce. We prospectively examined the role of the promotive factors structured style, personal and social competencies, family functioning, and social resources in homotypic and heterotypic continuity and discontinuity of anxiety and depression across three years in a clinical sample. Participants were adolescents with anxiety or depressive disorders aged 13-18 years at T1 (N = 717, 44% initial participation rate) and aged 16-21 years at T2 (N = 549, 80% follow-up participation rate). At T1, diagnoses were collected from medical records and participants responded to questionnaires. At T2, semi-structured diagnostic interviews were conducted. Higher levels of all promotive factors were associated with reduced probability of anxiety or depression three years later. The promotive factors were not associated with homotypic continuity of anxiety, whereas personal competence beliefs, social competence, and, less strongly, family functioning were associated with reduced homotypic continuity of depression and heterotypic continuity from depression to anxiety. Analyses with interaction terms did not indicate moderation by the promotive factors. Our findings suggest that bolstering promotive factors may be vital for increasing treatment success and preventing recurrence of anxiety and depression in the transition toward adulthood.

Population-based Organised Prostate Cancer Testing: Results from the First Invitation of 50-year-old Men

BackgroundThe European Union recently recommended evaluation of the feasibility of organised prostate cancer screening. In Sweden, regional population-based organised prostate cancer testing (OPT) programmes were introduced in 2020. ObjectiveTo describe initial participation rates and diagnostic outcomes. Design, setting, and participantsThe three most populated Swedish regions invited all men aged 50 yr to OPT by a letter in 2020–2022. Men with prostate-specific antigen (PSA) ≥3 ng/ml were referred for prostate magnetic resonance imaging (MRI). PSA assays differed across regions. Men with Prostate Imaging Reporting and Data System (PI-RADS) 1–3 and PSA density ≥0.15 ng/ml/cm3 or PI-RADS 4–5 were referred for a biopsy. Data were obtained from the Swedish Register for Organised Prostate Cancer Testing. Outcome measurements and statistical analysisOverall and regional participation rates, PSA distributions, PI-RADS score distributions, cancer detection, and treatment were evaluated. Results and limitationsA total of 23 855 (35%) of 68 060 invited men participated; 696 (2.9%) had PSA ≥3 ng/ml, and of them, 306 (44%) had a biopsy indication and 221 (32%) had a biopsy. On biopsy, 93 (42%) had Gleason grade group ≥2 (0.39% of PSA-tested men) and 44 (20%) Gleason grade group 1 cancer. Most men with cancer had treatment with curative intent (70%) or were under active surveillance (28%). Across regions, proportions of men with PSA ≥3 ng/ml ranged from 2.3% to 4.0%, and those with PI-RADS score 4–5 ranged from 12% to 21%. A limitation is that results are applicable only to first testing of men in their early 50s. ConclusionsThe OPT programmes are feasible with good compliance to the diagnostic pathway. The use of MRI and PSA density avoided a biopsy for over half of the men with PSA ≥3 ng/ml. Inter-regional differences in diagnostic outcomes show a need for standardisation of the diagnostic pathway’s components. Patient summaryWe report the diagnostic outcomes of inviting 68 000 50-yr-old men to organised prostate cancer testing.

Game Analysis of the Influence of the Miner under Carbon Emotion on the Intelligent Development Strategies of the SMEE in Coal Mines

The intelligent development of coal mines is a crucial way to achieve the safe, efficient, green, and low-carbon transformation of the coal industry and to reach the “double carbon” target, which is related to the life and health of miners, the stable development of enterprises and the national energy reform. As directly affected subjects, the cooperative attitudes of miners in different emotional states have a significant impact on the smooth implementation of intelligent coal mine renovation projects. Hence, we combined the RDEU theory and game theory, constructed a three-party evolutionary game model of the small and medium-sized energy enterprises (SMEE), the government, and the miner, considered the influence of the strategies made by the miner on the equilibrium strategy choices of other game subjects in the intelligent coal mine construction under the rational and irrational emotional states of the miner, and finally used MATLAB 2021 to simulate and analyze the impact of the evolution of the gaming system from 3 key elements: initial participation rate, construction costs, and government support. The study found the following: (1) The government will insist on actively promoting intelligent coal mine construction regardless of the miner’s emotional state. (2) Both moderate pessimism and optimism will, to a certain extent, give a positive impetus to the development of intelligent coal mine construction. (3) The miner’s emotions have a greater impact on SMEE than on the government’s strategic behavior. (4) Excessive construction costs or low government support will make SMEE may reduce the enthusiasm of SMEE to carry out an intelligent construction of coal mines. Accordingly, corresponding suggestions and countermeasures are put forward, aiming to provide targeted and practical ideas for the efficient construction of intelligent coal mines in China, thereby accelerating the green and low-carbon transformation of energy.

Early childhood respiratory tract infections according to parental subfertility and conception by assisted reproductive technologies.

STUDY QUESTIONAre children conceived by ART or born to subfertile parents more susceptible to upper or lower respiratory tract infections (URTI, LRTI)?SUMMARY ANSWERART-conceived children had a higher frequency of and risk of hospitalization for respiratory infections up to age 3, which was only partly explained by parental subfertility.WHAT IS KNOWN ALREADYSome studies report increased risks of infections in children conceived by ART. Results for URTIs and LRTIs are inconclusive, and the contribution of underlying parental subfertility remains unclear.STUDY DESIGN, SIZE, DURATIONWe included 84 102 singletons of the Norwegian Mother, Father and Child Cohort Study (MoBa) born between 1999 and 2009. Mothers reported time-to-pregnancy at recruitment and child history of, frequency of and hospitalization for, respiratory infections when the child was 6, 18 and 36 months old by questionnaires. Subfertility was defined as having taken 12 or more months to conceive. The Medical Birth Registry of Norway (MBRN) provided information on ART. URTI included throat and ear infections, while LRTI included bronchitis, bronchiolitis, respiratory syncytial virus and pneumonia.PARTICIPANTS/MATERIALS, SETTING, METHODSWe used log-binomial regression to estimate risk ratios (RR) and 95% CI of any respiratory tract infection and hospitalization, and negative-binomial regression to calculate incidence rate ratios (IRR) and 95% CI for number of infections. We compared children conceived by ART, and naturally conceived children of subfertile parents, to children of fertile parents (<12 months to conceive) while adjusting for maternal age, education, BMI and smoking during pregnancy and previous livebirths. We accounted for dependency between children born to the same mother.MAIN RESULTS AND THE ROLE OF CHANCEA total of 7334 (8.7%) singletons were naturally conceived by subfertile parents and 1901 (2.3%) were conceived by ART. Between age 0 and 36 months, 41 609 (49.5%) of children experienced any URTI, 15 542 (18.5%) any LRTI and 4134 (4.9%) were hospitalized due to LRTI. Up to age 3, children conceived by ART had higher frequencies of URTI (adjusted IRR (aIRR) 1.16; 95% CI 1.05–1.28) and hospitalizations due to LRTI (adjusted RR (aRR) 1.25; 95% CI 1.02–1.53), which was not seen for children of subfertile parents. Children conceived by ART were not at higher risks of respiratory infections up to age 18 months; only at age 19–36 months, they had increased risk of any LRTI (aRR 1.16; 95% CI 1.01–1.33), increased frequency of LRTIs (IRR 1.22; 95% CI 1.02–1.47) and a higher risk of hospitalization for LRTI (aRR 1.35; 95% CI 1.01–1.80). They also had an increased frequency of URTIs (aIRR; 1.19; 95% CI 1.07–1.33). Children of subfertile parents only had a higher risk of LRTIs (aRR 1.09; 95% CI 1.01–1.17) at age 19–36 months.LIMITATIONS, REASONS FOR CAUTIONSelf-reported time-to-pregnancy and respiratory tract infections by parents could lead to misclassification. Both the initial participation rate and loss to follow up in the MoBa limits generalizability to the general Norwegian population.WIDER IMPLICATIONS OF THE FINDINGSART-conceived children might be more susceptible to respiratory tract infections in early childhood. This appears to be only partly explained by underlying parental subfertility. Exactly what aspects related to the ART procedure might be reflected in these associations need to be further investigated.STUDY FUNDING/COMPETING INTEREST(S)Funding was received from the Swiss National Science Foundation (P2BEP3_191798), the Research Council of Norway (no. 262700), and the European Research Council (no. 947684). All authors declare no conflict of interest.TRIAL REGISTRATION NUMBERN/A.

Cooperative Spectrum Sensing Algorithm Based on Evolutionary Game Theory

To address the inert behavior of cognitive users who do not sense to increase their throughput in the collaborative spectrum sensing process, a spectrum sensing model with a contribution reward and punishment mechanism is proposed to increase the motivation of spectrum sensing. The whole spectrum sensing process is normalized to the number of transmitted bits, and the energy consumption in the sensing phase is considered comprehensively and a reward and punishment function with a reward and punishment strength of 0.25 is introduced in the transmission phase to create an evolutionary game model for spectrum sensing, further select an evolutionarily stable strategy, and use a distributed algorithm to deal with the convergence problem for a given initial participation rate. The simulation results show that the stability of Dual-User cooperative spectrum sensing is the game strategy obtained by the fixed small penalty factor (perception, perception), and the game strategy obtained by the fixed large penalty factor (perception, nonperception) and (nonperception, perception). The superiority of the present reward mechanism is verified in the multi-user case, which can significantly improve the spectrum-aware participation rate and increase spectrum-aware motivation.

Abstract PO-012: Acceptance and refusal among multi-lingual safety net patients to participate in a trial comparing genetic counseling delivery modes

Abstract Introduction While still low, diversity among clinical trial participants has improved in recent years due to efforts to eliminate health disparities. Here we present and endeavor to explain participation rates in our multicenter partially randomized preference noninferiority trial comparing the effectiveness of phone, video, and in person genetic counseling among high-risk English-, Spanish-, and Chinese-speaking patients. Methods High-risk patients were identified using a family history screener in clinics and via physician referrals. After reviewing forms received, bilingual/bicultural clinical research coordinators (CRC) called patients considered eligible in their preferred language (English, Spanish or Cantonese, Mandarin or Toisanese). Patients were informed that their hospital was conducting the study in conjunction with an academic institution. The CRC went over each patient’s family history of cancer to confirm eligibility and to explain the study components, including free genetic counseling. Because previous research had significant refusals due to patients’ preferences for a single mode, our consented patients were asked if they would accept random assignment to phone, video, or in person counseling or if they had a strong preference. Patients who declined were asked their reasons. Results Out of 1,403 patients reached (70% English-, 26% Spanish-, and 3% Chinese- speaking), 86% agreed to participate. The highest acceptance rate was among Spanish-speakers (94%), followed by English-speakers (83%) and Chinese-speakers (67%). Among the 201 patients who declined, 49% did so upon contact, while 51% declined after eligibility was confirmed. Reasons for declining are available for 71% of decliners as follows: 22% not interested; 19% no time; 10% cited no benefit them or family members; 7% did not want to talk about cancer; 7% had too many other medical issues; and 6% provided a range of other reasons. Discussion and Conclusions We believe that our study’s high initial participation rate for patients contacted was due to the purpose which was particularly meaningful to those with a family history of cancer. Also, patients trusted their own hospitals which co- sponsored the study. It was helpful that providers in the 3 public hospitals strongly supported the research which provided much needed genetic counseling and pursued questions important to access to genetic services. Importantly, our study design addressed significant known barriers to minority and low SES participation in clinical trials through the use of bilingual/bicultural investigators, multi-language study materials, and strong, positive working relationships with gatekeeper medical and clinic support staff. Reasons given for declining may indicate the existence of a socio-economic structural ceiling for participation due to patient vulnerabilities and societal burdens, causes outside the investigative scope of our study that are likely to continue to hamper efforts to improve participation if not addressed. Citation Format: Robin Lee, Miya Frick, Celia Kaplan, Galen Joseph, Janice Tsoh, Selina Flores, Niharika Dixit, Heather Cedermaz, Lly Wang, Amal Khoury, Brittany Campbell, Rena Pasick, Claudia S. Guerra, Susan L. Stewart. Acceptance and refusal among multi-lingual safety net patients to participate in a trial comparing genetic counseling delivery modes [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-012.

Preventive Impacts of Group Homes in Higher Income Neighborhoods: Retrospective Cohort of Youths in Ontario Group Home Care, 2012 to 2016

Conduct problem is an ongoing concern among youth placed in group homes. The concern could sometimes become more challenging due to negative peer influences. The risks associated with negatively influential peers are well-known across diverse residential treatment contexts in the USA, but not in Canada. This 3-year retrospective cohort study observed the influence of positive and negative peers on conduct problems among 173 youths in Ontario group home care between 2012 and 2016 (initial participation rate = 90.0% and follow-up rate = 95.1%). Having previously observed that group home resources matter (Osei in Peer influences on antisocial and prosocial behaviors in group home foster care: Evidence of greater protections in better resourced homes and higher income neighborhoods, Doctoral thesis, University of Windsor, Windsor, Ontario, Canada, 2019, https://scholar.uwindsor.ca/etd/7727/ ), here it was hypothesized that neighborhood income also matters. Specifically, that neighborhood income would moderate peer influences such that low-income neighborhoods would be relatively risky places, while higher-income neighborhoods would be relatively protective places. Positive and negative peer influences were, respectively, protective and risky, but the main effect of neighborhood income was null. As hypothesized, a significant negative peer influence by neighborhood income interaction was also observed. Higher income neighborhoods attenuated the negative peer influence-youth conduct problem association. Negative peers were less risky in higher income neighborhoods. The main protective influence of positive peers was robust across socioeconomically diverse neighborhoods. Clinical, policy and future research implications are discussed.

What Factors Are Associated With Response Rates for Long-term Follow-up Questionnaire Studies in Hand Surgery?

Long-term follow-up studies are an important tool in the evaluation of orthopaedic illness and its treatment options. However, a patient's participation in a follow-up study may be affected by several factors, leading to variability in response rates and the risk of selection bias. (1) What is the average response rate in hand surgery questionnaire studies? (2) What factors are associated with higher and lower response rates to research questionnaires? (3) What factors are associated with higher and lower contact, initial participation, and completion rates? We included 798 adult patients who were enrolled in one of 12 questionnaire follow-up studies in the hand and upper extremity service of our institution. All included studies evaluated patient-reported outcomes for the surgical treatment of upper extremity conditions using questionnaires and all used the same enrollment design. Patients were invited by letter to ask if they would be willing to participate, and we informed them that they would be contacted by telephone at least three times if they did not respond to the letter. Patients were contacted at a median of 6.6 years (interquartile range [IQR] 3.7 to 11) after surgery. The successful response rate was 49% (390 of 798 patients). We manually reviewed records to collect data on patient characteristics, and we performed bivariate analysis and multivariable logistic regression analysis to identify factors associated with the contact rate (percentage of patients reached by either mail, phone, or email), initial response rate (percentage of reached patients who initiated participation), completion rate (percentage of patients who initiated participation and completed the entire follow-up questionnaire), and our primary outcome successful response rate (percentage of patients who were contacted and who completed the entire questionnaire). The average response rate in hand surgery questionnaire studies was 49% (390 of 798 patients). In the multivariable analysis, enrollment of women (odds ratio 1.43 [95% confidence interval 1.03 to 1.97]; p = 0.031) was independently associated with higher response rates. On the contrary, a longer follow-up time from surgery (OR 0.95; 95% CI 0.92 to 0.99]; p = 0.015) and multiple researchers contacting patients (OR 0.51 [95% CI 0.37 to 0.71]; p < 0.001) were independently associated with lower response rates. The contact rate was higher for women (OR 1.46 [95% CI 1.03 to 2.06]; p = 0.034) and patients with higher income (OR 1.000007 [95% CI 1.000001 to 1.000013]; p = 0.019). The contact rate was lower in patients with a longer follow-up time from surgery (OR 0.93 [95% CI 0.90 to 0.97]; p = 0.001). The initial participation rate was lower when patients were contacted by multiple researchers (OR: 0.34 [95% CI 0.23 to 0.52]; p < 0.001). Studies with a lower number of questions (36; IQR 22 to 46) were completed more frequently than studies with a higher number of questions (51; IQR 39 to 67; p = 0.044). Studies assessing long-term outcomes that have a large proportion of men and longer follow-up time tend to have lower response rates. When performing a follow-up study, it seems beneficial to have one researcher contact the patients and use a shorter questionnaire. Results of this study can help clarify the response rates in hand surgery follow-up questionnaire studies and help with the planning of future follow-up studies. Level II, prognostic study.

Supporting Our Lifelong Engagement: Mothers and Teens Exercising (SOLE MATES); a feasibility trial

ABSTRACT This study aimed to examine the feasibility of the Supporting Our Lifelong Engagement; Mothers and Teens Exercising (SOLE MATES) program. SOLE MATES, a single-arm six-week feasibility trial, comprised six face-to-face sessions. Participants were mothers (n = 27) with daughters (n = 31) aged 12–16 years. Data were collected in Ireland between January 2018 and March 2018. Feasibility benchmarks examined recruitment, data collection, acceptability, resources and participant responses. The primary outcome was daughters’ step counts, measured via sealed pedometer for seven consecutive days at baseline and six weeks. Secondary outcomes included mothers’ step counts, measures of communication, co-participation in activity, health-related quality of life and parenting practices. Feasibility benchmarks were reached or exceeded, except for retention. Eligibility rates were 93.4%, and baseline activity levels were low. Program content, measures and facilitators were acceptable, demonstrated through a mean score of 4.14 (SD 0.3) on a 5-point Likert Scale. Daily steps increased in mothers (2,875 increase, p = .009) and daughters (1,393 increase, p = .007). Positive feasibility metrics demonstrated the program’s appeal. Participant responses for outcome measures also indicated program success. However, the relatively homogenous sample and relatively poor initial participation rate were study limitations. The intervention should be evaluated in a randomized controlled trial.

How to investigate and adjust for selection bias in cohort studies.

Longitudinal cohort studies can provide important evidence about preventable causes of disease, but the success relies heavily on the commitment of their participants, both at recruitment and during follow up. Initial participation rates have decreased in recent decades as have willingness to participate in subsequent follow ups. It is important to examine how such selection affects the validity of the results. In this article, we describe the conceptual framework for selection bias due to nonparticipation and loss to follow up in cohort studies, using both a traditional epidemiological approach and directed acyclic graphs. Methods to quantify selection bias are introduced together with analytical strategies to adjust for the bias including controlling for covariates associated with selection, inverse probability weighting and bias analysis. We use several studies conducted in the Danish National Birth Cohort as examples of how to quantify selection bias and also understand the underlying selection mechanisms. Although women who chose to participate in this cohort were typically of higher social status, healthier and with less disease than all those eligible for study, differential selection was modest and the influence of selection bias on several selected exposure-outcome associations was limited. These findings are reassuring and support enrolling a subset of motivated participants who would engage in long-term follow up rather than prioritize representativeness. Some of the presented methods are applicable even with limited data on nonparticipants and those lost to follow up, and can also be applied to other study designs such as case-control studies and surveys.

Developmental course of anxiety and depression from adolescence to young adulthood in a prospective Norwegian clinical cohort.

Anxiety and depression are often co-occurring disorders, reflecting both homotypic and heterotypic continuity as possible developmental pathways. The present study aimed to examine homotypic and heterotypic continuities of anxiety and depression across 3years in adolescence and young adulthood. Participants included patients presenting to psychiatric care with diagnoses of anxiety and/or depressive disorders aged 13-18 at T1 (N=717, 44% initial participation rate) and aged 16-21 at T2 (N=549, 80% follow-up participation rate). McNemar's mid-p test and ordinal proportional odds logistic regression analyses were used to assess changes in prevalence within and across diagnostic categories, respectively. More adolescents had an anxiety disorder (+11%), whereas fewer had a depressive disorder (-11%), at T2 compared to T1. Of adolescents with anxiety and/or depression at T1, only 25% recovered or were non-symptomatic 3years after referral to a psychiatric clinic. Homotypic continuity was observed for anxiety disorders in general (OR=2.33), for phobic anxiety disorders (OR=7.45), and for depressive disorders (OR=2.15). For heterotypic continuity, depression predicted later anxiety (OR=1.92), more specifically social anxiety (OR=2.14) and phobic anxiety disorders (OR=1.83). In addition, social anxiety predicted later generalized anxiety disorder (OR=3.11). Heterotypic continuity was thus more common than homotypic continuity. For adolescents presenting with anxiety or depression, treatment should, therefore, target broad internalizing symptom clusters, rather than individual diagnoses. This may contribute to prevent future mental illness, particularly anxiety, in clinical samples.

Sample selection, recruitment and participation rates in health examination surveys in Europe--experience from seven national surveys.

BackgroundHealth examination surveys (HESs), carried out in Europe since the 1950’s, provide valuable information about the general population’s health for health monitoring, policy making, and research. Survey participation rates, important for representativeness, have been falling. International comparisons are hampered by differing exclusion criteria and definitions for non-response.MethodInformation was collected about seven national HESs in Europe conducted in 2007–2012. These surveys can be classified into household and individual-based surveys, depending on the sampling frames used. Participation rates of randomly selected adult samples were calculated for four survey modules using standardised definitions and compared by sex, age-group, geographical areas within countries, and over time, where possible.ResultsAll surveys covered residents not just citizens; three countries excluded those in institutions. In two surveys, physical examinations and blood sample collection were conducted at the participants’ home; the others occurred at examination clinics. Recruitment processes varied considerably between surveys. Monetary incentives were used in four surveys. Initial participation rates aged 35–64 were 45 % in the Netherlands (phase II), 54 % in Germany (new and previous participants combined), 55 % in Italy, and 65 % in Finland. In Ireland, England and Scotland, household participation rates were 66 %, 66 % and 63 % respectively. Participation rates were generally higher in women and increased with age. Almost all participants attending an examination centre agreed to all modules but surveys conducted in the participants’ home had falling responses to each stage. Participation rates in most primate cities were substantially lower than the national average. Age-standardized response rates to blood pressure measurement among those aged 35–64 in Finland, Germany and England fell by 0.7-1.5 percentage points p.a. between 1998–2002 and 2010–2012. Longer trends in some countries show a more marked fall.ConclusionsThe coverage of the general population in these seven national HESs was good, based on the sampling frames used and the sample sizes. Pre-notification and reminders were used effectively in those with highest participation rates. Participation rates varied by age, sex, geographical area, and survey design. They have fallen in most countries; the Netherlands data shows that they can be maintained at higher levels but at much higher cost.

Headache yesterday in Europe.

BackgroundSurveys enquiring about burden of headache over a prior period of time (eg, 3 months) are subject to recall bias. To eliminate this as far as possible, we focused on presence and impact of headache on the preceding day (“headache yesterday”).MethodsAdults (18-65 years) were surveyed from the general populations of Germany, Italy, Lithuania, Luxembourg and the Netherlands, from a work-force population in Spain and from mostly non-headache patient populations of Austria, France and UK. A study of non-responders in some countries allowed detection of potential participation bias where initial participation rates were low.ResultsParticipation rates varied between 11% and 59% (mean 27%). Non-responder studies suggested that, because of participation bias, headache prevalence might be overestimated in initial responders by up to 2% (absolute). Across all countries, 1,422 of 8,271 participants (15-17%, depending on correction for participation bias) had headache yesterday lasting on average for 6 hours. It was bad or very bad in 56% of cases and caused absence from work or school in 6%. Among those who worked despite headache, 20% reported productivity reduced by >50%. Social activities were lost by 24%. Women (21%) were more likely than men (12%) to have headache yesterday, but impact was similar in the two genders.ConclusionsWith recall biases avoided, our findings indicate that headache costs at least 0.7% of working capacity in Europe. This calculation takes into account that most of those who missed work could make up for this later, which, however, means that leisure and social activities are even more influenced by headache.

Pain catastrophizing and employment histories

Studies examining pain catastrophizing and employment have had mixed findings. No study of pain catastrophizing has examined its relationship to lifetime employment status in a general clinical population. To examine pain catastrophizing in relationship to lifetime employment functioning in a sample of US primary care patients (rather than injured workers). A cross-sectional anonymous self-report survey of consecutive adults in a US internal medicine outpatient clinic. We assessed pain catastrophizing using the Pain Catastrophizing Scale and employment histories using a four-item author-developed measure. There were 239 participants and an initial participation rate of 70%. While pain catastrophizing was not related to the number of different full-time jobs held or the percentage of time employed in adulthood, pain catastrophizing was statistically significantly associated with ever having been paid 'under the table' [F(1,236) = 27.89, P < 0.001] and ever having been fired from a job [F(1,237) = 50.78, P < 0.001], as well as with not getting along with fellow employees [F(1,60) = 7.48, P < 0.01]. In this clinical sample, pain catastrophizing demonstrated varying relationships with different aspects of lifetime employment, rather than exerting an overall global effect on employment.

A Comparison of the Incidence Rate in MTSS Tiers

The Multi-Tier System of Supports (MTSS) is an evolutionary educational method recently introduced to schools in Kansas. As part of an ongoing investigation into the deployment and effectiveness of the MTSS system, this pilot study established initial participation rates in the program. This project sought to define the incidence rate among males and females in MTSS tiers in the study region. The study also sought initial teacher satisfaction with support for their development and training into the new MTSS system. A survey consisting of 13 items was sent to 600 randomly selected elementary public school teachers in the Kansas First Congressional District. As expected, students placed in Benchmark constituted the highest number of participants. Students across MTSS tiers in Central and Western Kansas schools are distributed according to MTSS guidelines and are gender neutral. An implication of this study is that it is vital for effective instruction in reading and mathematics to approach instruction based on students’ assessment results which are gained by frequent progress monitoring and assessment. A second implication is the need for leaders in school districts to provide teachers with MTSS professional development during their first through third year of teaching.

Implementation of population screening for colorectal cancer by repeated Fecal Immunochemical Test (FIT): third round

BackgroundColorectal cancer (CRC) is the most common cancer in Europe with a mortality rate of almost 50%. The prognosis of patients is largely determined by the clinical and pathological stage at the time of diagnosis. Population screening has been shown to reduce CRC-related mortality rate. Most screening programs worldwide rely on fecal immunochemical testing (FIT). The effectiveness of a FIT screening program is not only influenced by initial participation rate, but also by program adherence during consecutive screening rounds. We aim to evaluate the participation rate in and yield of a third CRC screening round using FIT.Methods and designFour years after the first screening round and two years after the second round, a total number of approximately 11,000 average risk individuals (50 to 75 years of age) will be invited to participate in a third round of FIT-based CRC screening. We will select individuals in the same target area as in the previous screening rounds, using the electronic database of the regional municipal administration registrations. We will invite all FIT-negatives and all non-participants in previous screening rounds, as well as eligible first time invitees who have moved into the area or have become 50 years of age.FITs will be analyzed in the special technique laboratory of the Academic Medical Center of the University of Amsterdam. All FIT-positives will be invited for a consultation at the outpatient clinic. In the absence of contra-indications, a colonoscopy will follow at the Academic Medical Center or at the Flevohospital. The primary outcome measures are the participation rate, defined as the proportion of invitees that return a FIT in this third round of FIT-screening, and the diagnostic yield of the program.ImplicationsThis study will provide precise data on the participation in later FIT screening rounds. This enables to estimate the effectiveness of CRC screening programs that rely on repeated FIT- screening, such as the one that will be implemented in the Netherlands in 2013.

Predictors of Adolescent Participation in Organized Activities: A Five‐Year Longitudinal Study

This study examined (a) growth curves of youth participation in sports, performance and fine arts, and youth clubs throughout the high school years and (b) the associations between a series of predictors and the initial participation rates and growth over time. The predictors included individual, friend, and family factors. The moderating effect of youths' gender was also examined. Study participants were 272 youths (55% girls,Mage=12.4 years) and their parents. The predictors were assessed in Grade 6 and were based on reports by youths, parents, teachers, and classmates. Participation in organized activities was assessed annually from Grades 7 to 10. Altogether, the findings revealed that participation in sports, performance and fine arts, and youth clubs remains stable across the high school years. However, interindividual differences were found in the participation growth curves. This variation was predicted by individual, friend, and family factors, mostly with respect to sports activities.

Telephone Counseling to Improve Osteoporosis Treatment Adherence: An Effectiveness Study in Community Practice Settings

Treatment nonadherence is a recognized problem, but most practice settings use education alone to address it. Psychological counseling methods generate greater behavior change but are not widely used. Telehealth nursing can be used to integrate these methods into routine clinical practice. This study was a nonrandomized trial of a telehealth program that used motivational interviewing and cognitive- behavioral techniques to improve osteoporosis medication adherence. Registered nurses delivered the intervention to 402 participants recruited from provider offices across the United States. Initial participation rates were high in this community-based sample, although attrition also was high. Six-month adherence based on pharmacy and clinical interview data was significantly higher than the general population rate. A comparison with nonparticipants approached significance, and there was a significant dose-response effect. Most reasons given for nonadherence were psychological. The results support the use of psychological techniques to improve adherence and the use of telehealth to disseminate evidence-based patient counseling.

Transitioning From a Pen-and-Paper Health Risk Appraisal to an Online Health Risk Appraisal at a Petroleum Company

Chevron Texaco's Health and Medical Services Department made the decision to use existing technology and transition from a paper health risk appraisal (HRA) to an online questionnaire. A cross-functional team was formed and a year was spent researching online tools to find a vendor who could supply a product best suited to Chevron Texaco's employee workforce. The purpose of this article is to describe the evolution of a paper-based HRA to an online tool as well as describe the project scope and strategy that a team of employees used in selecting the vendor. The article also describes implementation successes, challenges, and lessons learned in using the online tool with an industrial workforce. The strategy that was followed in deploying the Web site along with initial participation rates for this group of industrial employees are described.

Non-attendance at re-examination 20 years after screening in the British Regional Heart Study.

Maintenance of high participation rates in longitudinal studies is critical to their validity because of the possibility of bias associated with non-participation, which may differ between studies. This paper examines factors associated with participation status over time, by comparing the characteristics of non-attenders and attenders at a 20 year follow-up examination in a cardiovascular cohort study with an initial participation rate of 78 percent. A baseline examination was carried out between 1978 and 1980 and subjects have been followed up through regular reviews of general practice records, postal questionnaires, and a clinical re-examination of survivors in 1998-2000. Data obtained by questionnaire in 1996 (Q96) and at baseline examination have been used to compare the characteristics of these recent non-attenders and attenders who remain in the cohort for further follow-up. The non-attendance rate of available survivors at re-examination was 23 per cent (n = 1313). Rates of non-attendance were highest in Scotland and lowest in Southern England. Non-attenders were older than attenders, more likely to smoke, and reported more disabling conditions and greater use of multiple medications at Q96, but recalled similar rates of diagnosed coronary heart disease. Marked differences in social factors were identified. Total mortality rates within 1 year of re-examination were over three times higher amongst non-attenders than attenders. Non-attendance is related to health status, risk factor status and social circumstances and may affect some estimates of disease prevalence, but does not appearto have a major impact on the estimated prevalence of coronary heart disease. Information collected on non-attenders in longitudinal studies helps to estimate, adjust and minimize these effects.