Methodological Pilot Research Articles

The long-term impact of cerebellar tumor resection on executive functioning, anxiety, and fear of pain: A mixed methodology pilot study

This pilot study investigated the long-term impact of a surgery-only treatment (no exposure to other treatments, such as chemotherapy and radiation) for pediatric cerebellar low-grade gliomas on executive function, anxiety, and fear of pain (FOP) beliefs. Twelve patients who underwent surgical glioma resection during childhood (surgery age was 4–16 years, study visit age was 10–28 years), and 12 pain-free controls matched for age, sex, race, and handedness were tested. The spatial extent of resection was precisely mapped using magnetic resonance imaging (MRI). Executive function, anxiety, and FOP were assessed using validated self-report age-appropriate questionnaires for children and adults. Structured clinical interviews at a post-surgery follow-up visit were completed (average: 89 months, range: 20–99). No significant differences in FOP (FOPQ-C t[14 = 1.81, p = 0.09; FOPQ-III t[4] = 0.29, p = 0.79), executive function scores (BRIEF t[20] = 0.30, p = 0.28), or anxiety scores (MASC t[16] = 0.19, p = 0.85; MAQ t[4] = 1.80, p = 0.15) were found in pediatric or adult patients compared to pain-free controls. Clinical interviews mainly categorized pediatric patients as not anxious. One participant reported mild/subclinical anxiety, and one had moderate clinical anxiety. Neither psychologists nor patients endorsed impairments to executive functioning, anxiety, or FOP. Our pilot results suggest that pediatric cerebellar tumor survivors treated with surgery-only have favorable long-term functioning related to these themes. While these results are promising, they will need to be replicated in a larger patient sample.

Relating in-vivo Strain of the Flexor Digitorum Superficialis Tendon with Grip Force

Epidemiological studies have shown a relationship between hand exertion and risk of developing distal upper extremity musculoskeletal disorders (DUEMSDs). Recently, fatigue-failure models were proposed for estimating the risk of DUEMSD development. However, models that incorporate tendon strain are primarily based on in-vitro data and may be better informed using in-vivo data. This methodological pilot study aimed to establish an approach for correlating grip force and spatiotemporal strains of the flexor digitorum superficialis (FDS) tendon using ultrasound imaging. Three image texture correlation techniques to measure in-vivo strains were explored and compared: digital image correlation, direct deformation estimation, and StrainNet, a novel deep learning neural network for strain prediction. StrainNet resulted in more accurate strain measurements than conventional image assessment tools, enabled continuous prediction of FDS tendon strain, and allowed for comparison of median bulk tissue strain during isometric contraction to grip force. Future work will study more participants and viscoelastic behavior.

Family presence during invasive procedures: a pilot study to test a tool

BackgroundFamily Presence During Invasive Procedures (FPDI) generates controversy among healthcare professionals. Twibell and her team designed an instrument that measured nurses’ Risk-Benefit and Self-Confidence perceptions regarding family presence during resuscitation and was used in numerous studies.ObjectivesEvaluate the new tool for Family Presence Risk-Benefit and Family Presence Self-Confidence during invasive procedures and find out the opinions of the medical and nursing staff on FPDIP.MethodCross-sectional methodological pilot study. Online and paper questionnaires modified from a previous translation. A factor analysis was performed for the validity of the indices and bivariate analysis for all the variables. Ethical approvals and research permissions were obtained according to national standards.ResultsOne hundred twenty healthcare professionals (22.18%) answered the survey. Cronbach’s α on the Family Presence Risk-Benefit scale was 0.877. Cronbach’s α on the Family Presence Self-Confidence scale was 0.937. The correlation between the Risk-Benefit and Self-confidence variables is significant and with a moderate intensity of the relationship. A lower predisposition to Family Presence During Invasive Procedures is observed. Physicians are more reluctant than nurses.ConclusionsThe FPDI generates controversy as it alters health professionals’ routines when they decide whether to allow it or not. There is a tendency for younger professionals to support FPDI. In general, health professionals, mainly physicians, do not favor FPDI. Health workers who perceive fewer risks and more benefits in FPDI and have greater self-confidence are more in favor of FPDI. The psychometric properties and internal consistency of the questionnaire indicate the validity and reliability of this tool.

Three-dimensional macroscopical quantification of plaque accumulation on implant-supported fixed complete dental prostheses surfaces: A methodological pilot study

Statement of problemArea calculation is the primary method for quantitatively analyzing accumulated plaque on the intaglio surfaces of implant-supported fixed complete dental prostheses (IFCDPs). However, the classic calculation method for stained dental plaque is based on two-dimensional (2D) photographs, which could mislead the three-dimensional (3D) representation of an object’s actual morphology, especially when a surface is not flat. PurposeThis pilot in vitro study, used for methodological purposes, evaluated the repeatability and precision of a 3D area calculation method to analyze simulated accumulated biofilm on the intaglio surfaces of an IFCDP. Material and methodsThe titanium framework of an IFCDP with a smooth intaglio surface was prepared with 8 milled sites and scanned by microcomputed tomography. Out of these, 4 sites were cubic (set sides lengths=1, 2, 3, and 4 mm), and 4 sites were hemispherical (set diameters=1, 2, 3, and 4 mm). A green-colored aerosol was sprayed onto the carved-out intaglio sites. The framework intaglio surface was 3D-scanned (n=10) and 2D-photographed (n=10) at 10 different photo angles. Two raters twice measured the 3D and 2D data from the carved-out sites’ green-colored area one week apart. Intraobserver repeatability and interobserver reliability were evaluated with an independent t test. The deviation between the measurements and the microtomography values was calculated. Pearson’s correlation coefficient (r) evaluated the repeatability of multiple measurements. A standard level of significance was set at α=.05. ResultsThe differences between the 2D photographs and the microtomography values were statistically significant (P<.001), whereas the differences between the 3D scans and the microtomography values were not significant (P=.063). The overall differences between the microtomography values and the 3D measurements were smaller (2.15 ±2.30 mm2 vs. 18.91 ±22.78 mm2, P=.055) than the differences between the microtomography values and the 2D measurements. The percentage differences between the microtomography values and the 3D measurements were significantly smaller (10.41 ±8.33% vs. 65.66 ±19.22%, P<.001) than the microtomography differences values with the 2D measurements. The measurement differences between the microtomography value and the 3D measured hemispherical site data were significantly smaller than the measurement differences between the microtomography values and the 3D measured cubical site data (P=.026). The 2D method had “poor” repeatability among the 10 different shot angles (r=0.391, P<.001), whereas the 3D method had “good” repeatability among the 10 scans (r=0.999, P<.001). ConclusionsAn irregular intaglio surface of an IFCDP could accurately and repeatedly be recorded and analyzed by a 3D area calculation method. This color-matching assessment of the topological environment is expected to be adopted in future studies.

Developing and testing the GlobalSCAPE science communicator diary survey: methodological pilot research findings to improve a repeated-measures survey design

The GlobalSCAPE project is setting out to investigate the experiences, attitudes, skills, needs, challenges and professional development of science communicators around the world. This is being achieved with a diary survey, a style of survey designed to be repeated at a set interval several times. The idea of such a survey is that the unfolding nature of a phenomenon can be more effectively captured through repeated measures than through a conventional cross-sectional survey design. Because the aims, scope and approach of this study are novel, a newly developed survey design was required. This work was led by survey experts within the GlobalSCAPE consortium, with input and feedback from other partners. The results survey design contained some previously validated items, but none that had been empirically assessed for the present context and survey structure. Therefore, to assess the clarity of survey questions prepared for the GlobalSCAPE science communicator diary research, a pilot study was conducted with a sample of participants gathered by project partners (n=23). This pilot research followed a piggyback approach, where follow up questions were asked of respondents after they completed each step in the survey. Results indicate that the vast majority of the questions were already clear and easy to understand. A small number of items resulted in a minority of respondents reporting uncertainty or confusion about how to respond. To address these issues, targeted adjustments to the survey design have been made. This methodological research offers insights to others who may seek to conduct survey studies with science communicators. It may also be helpful to those conducting diary survey research with professionals more generally.

Differential tractography as a dynamic imaging biomarker: A methodological pilot study for Huntington’s disease

Huntington’s disease (HD) is a neurodegenerative disorder characterized by motor, psychiatric, and cognitive symptoms. Due to its diverse manifestations, the scientific community has long recognized the need for sensitive, objective, individualized, and dynamic disease assessment tools. We examined the feasibility of Differential Tractography as a biomarker to evaluate correlation of symptom severity and of HD progression at the individual level. Differential tractography is a novel tractography modality that maps pathways with axonal injury characterized by a decrease of anisotropic diffusion pattern. We recruited sixteen patients scanned at 0-, 6-, and 12-month intervals by diffusion MRI scans for differential tractography assessment and correlated its volumetric findings with the Unified Huntington’s Disease Rating Scale (UHDRS). Deterministic fiber tracking algorithm was applied. Longitudinal data was modeled using the generalized estimating equation (GEE) model and correlated with UHDRS scores, in addition to Spearman correlation for cross-sectional data. Our results show that volumes of affected pathways revealed by differential tractography significantly correlated with UHDRS scores in longitudinal data (p-value < 0.001), and chronological changes in differential tractography also correlated with the changes in UHDRS (p-value < 0.001). This technique opens new clinical avenues as a clinical translational tool to evaluate presymptomatic and symptomatic gene positive individuals. Our results provide support that differential tractography has the potential to be used as a dynamic imaging biomarker to assess at the individual level in a non-invasive manner, disease progression in HD. Critically important, differential tractography proves to be a quantitative tool for following degeneration in presymptomatic patients, with potential applications in clinical trials.

Detrended fluctuation analysis in the presurgical evaluation of parietal lobe epilepsy patients

ObjectiveTo examine the usability of long-range temporal correlations (LRTCs) in non-invasive localization of the epileptogenic zone (EZ) in refractory parietal lobe epilepsy (RPLE) patients. MethodsWe analyzed 10 RPLE patients who had presurgical MEG and underwent epilepsy surgery. We quantified LRTCs with detrended fluctuation analysis (DFA) at four frequency bands for 200 cortical regions estimated using individual source models. We correlated individually the DFA maps to the distance from the resection area and from cortical locations of interictal epileptiform discharges (IEDs). Additionally, three clinical experts inspected the DFA maps to visually assess the most likely EZ locations. ResultsThe DFA maps correlated with the distance to resection area in patients with type II focal cortical dysplasia (FCD) (p<0.05), but not in other etiologies. Similarly, the DFA maps correlated with the IED locations only in the FCD II patients. Visual analysis of the DFA maps showed high interobserver agreement and accuracy in FCD patients in assigning the affected hemisphere and lobe. ConclusionsAberrant LRTCs correlate with the resection areas and IED locations. SignificanceThis methodological pilot study demonstrates the feasibility of approximating cortical LRTCs from MEG that may aid in the EZ localization and provide new non-invasive insight into the presurgical evaluation of epilepsy.

Tenderness of the Skin after Chemical Stimulation of Underlying Temporal and Thoracolumbar Fasciae Reveals Somatosensory Crosstalk between Superficial and Deep Tissues.

Musculoskeletal pain is often associated with pain referred to adjacent areas or skin. So far, no study has analyzed the somatosensory changes of the skin after the stimulation of different underlying fasciae. The current study aimed to investigate heterotopic somatosensory crosstalk between deep tissue (muscle or fascia) and superficial tissue (skin) using two established models of deep tissue pain (namely focal high frequency electrical stimulation (HFS) (100 pulses of constant current electrical stimulation at 10× detection threshold) or the injection of hypertonic saline in stimulus locations as verified using ultrasound). In a methodological pilot experiment in the TLF, different injection volumes of hypertonic saline (50–800 µL) revealed that small injection volumes were most suitable, as they elicited sufficient pain but avoided the complication of the numbing pinprick sensitivity encountered after the injection of a very large volume (800 µL), particularly following muscle injections. The testing of fascia at different body sites revealed that 100 µL of hypertonic saline in the temporal fascia and TLF elicited significant pinprick hyperalgesia in the overlying skin (–26.2% and –23.5% adjusted threshold reduction, p < 0.001 and p < 0.05, respectively), but not the trapezius fascia or iliotibial band. Notably, both estimates of hyperalgesia were significantly correlated (r = 0.61, p < 0.005). Comprehensive somatosensory testing (DFNS standard) revealed that no test parameter was changed significantly following electrical HFS. The experiments demonstrated that fascia stimulation at a sufficient stimulus intensity elicited significant across-tissue facilitation to pinprick stimulation (referred hyperalgesia), a hallmark sign of nociceptive central sensitization.

Relationship between performance contracting and the implementation of strategic objectives in Kenyan public universities

This study sought to determine the link between Performance Contracting and implementation of strategic objectives in Kenyan Public Universities. The main objective was to establish the extent of utilization of the Performance Contract (PC) as a tool for implementation for strategic objectives in Kenyan public universities. The study was anchored on the Balanced Score Card theory and used a combination of descriptive survey research design and correlation research design. The target population for this study included thirty-one (31) public universities in Kenya; a sample of 62 respondents was drawn from senior management and officers in charge of PC and strategy implementation in each University as well as 10 key informants from the Ministry of Education and the Public Service Performance Management and Coordination Office. Primary data was collected using structured questionnaires. The data were analyzed using descriptive statistics; correlation and regression analysis was computed to determine the degree of association between the performance of Kenyan public universities in performance contracting and implementation of their strategic objectives. Methodological triangulation and pilot testing were adopted to test for validity while Cronbach Alpha reliability Correlation Coefficient was used to test the reliability of the data. The study established that utilization of Performance Contracts contributes to 74.2% of the changes in strategy implementation in Public Universities in Kenya. It recommends that the universities should focus on the PC as a tool to enhance strategy implementation, allocate more funds for strategy implementation and improve their financial standing by engaging in more income-generating activities.

Is the N-of-1 method applicable in bodywork research? Lessons learned using a trial as a methodological pilot

N-of-1 trial designs have rarely been used in bodywork research. Using a recent trial as a methodological pilot, critical issues related to the applicability of N-of-1 trials to bodywork are discussed. These include the issues of carry-over effects, bias-controlling approaches and statistical analysis. The discussion highlights the importance of mixed methods and draws some suggestions for a future research program. N-of-1 trials could be used to provide insights about some essential elements of bodywork modalities and their effectiveness.

Sensory Evaluation of Lighting: A Methodological Pilot

ABSTRACT Current standards for light environments are based on technical requirements, e.g. luminance, uniformity, and illuminance, and do not necessarily describe all parts of the light experience to ensure visual comfort from a user perspective. Including experience-related requirements would most likely yield better lighting comfort. To do that, new methods for specifying and measuring the user experience are needed. This paper describes a pilot study exploring a new method to analytically assess perceived lighting properties by using a trained human panel and thus make human assessments more objective. The methodology is built on established sensory methods, where the human senses are used in product assessments, traditionally applied within e.g. the food, packaging, and car industries. An analytical panel comprising eight persons fulfilling specific selection criteria were recruited and trained to assess lighting products in a multi-sensory laboratory. The results show that the panelists were able to assess lighting by distinguishing between attributes and products. Significant differences were identified between the different luminaires, both in terms of sensory and physical properties, e.g. readability and glare. Conclusively, analytical sensory methods can be applied to lighting to assess luminaires in a non-subjective way. Physical and sensory attributes do not, however, always co-vary, which shows that data from physical and sensory measuring methods provide complementary information about light quality. This knowledge may in turn be applied in tools supporting the communication between different professions in lighting design and procurement to promote light environments that are both energy efficient and desirable from an end-user perspective.

The Impact of Industry Expert Adjuncts on Students' Course Experiences

As a reality of modern higher education, the use of adjunct instructors to teach courses is a common practice, often viewed through institutional constraints. This paper uses a different lens to examine the experiences of students in courses taught by adjunct instructors who are primarily employed in industry. It explores the affordances these instructors bring into the classroom including timely knowledge and skills from outside the academic institution. This work is a methodological pilot in a longer design-based project studying industry expert adjuncts as college teachers by analyzing their impact through students' perceptions of their experiences.

Identifying the congruence among the presumed, communicated and perceived brand positioning strategies of Indian automobile brands

The incidence of congruence among presumed, communicated and perceived positioning strategies off our Indian car brands (WagonR, Santro, Spark and Figo) is examined. The triangulation research methodology (pilot survey, secondary data and content analysis) is applied to examine the three populations (expert views, advertising strategies and consumer perceptions) considered in the study. The results reveal the popularity of two positioning strategies i.e. “Visual Artistic” and “Basic Features” in case of three car brands whereas Figo stands on the positioning of “Cost and Finance.” Regarding the congruence among experts’ presumed strategies and the communication tactics employed by selected car brands, it is observed that all the communicated strategies are not presumed and thus ambiguities prevail in the process. This paper also calls the corporate attention to the fact that even positioning strategies perceived by the customers are not presumed by experts and hence there is need to re-assess the brand positioning strategies to curtail these ambiguities. However, the positioning activities highlighted in communications are successfully recognized by the target customers to some extent. The paper concludes with the discussion on managerial implications and limitations.

The incidence and management of workplace violence among medical professionals in the United States: A methodological pilot study

This study aimed to investigate workplace violence (WPV) experienced by medical professionals in the United States as well as individual and managerial actions following violent episodes and further, predict estimators of WPV. A modified version of the Workplace Violence in the Health Sector: Country Case Studies Research Instruments Survey Questionnaire was used to assess the incidence and management of workplace violence experienced by healthcare workers. Medical personnel from two social aggregation websites were recruited to participate in an online survey. 226 valid questionnaires were received. 48.5\% and 76.1\% of respondents, respectively, experienced physical and psychological violence in the past year. Risk factors for violence included occupation, patient population, ethnicity, and higher levels of anxiety regarding violence in hospitals. Overall, 17.7\% of reported incidents were investigated, 52.4\% of cases saw no consequences meted out to perpetrators and 51.7\% of victims suffered from negative emotions or aftereffects following a violent episode. Only 30.1\% of victims formally reported their experience with violence. The prevalence of violence was high and medical professionals were negatively affected by violence; however, formal reporting of episodes was low and measures combating violence were inadequate. Harsher penalties for perpetrators of violence are needed and hospitals need to implement guidelines that track the management of violence.

Comparing task-induced psychophysiological responses between persons with stress-related complaints and healthy controls: A methodological pilot study.

AimsChronic stress is an important factor for a variety of health problems, highlighting the importance of early detection of stress‐related problems. This methodological pilot study investigated whether the physiological response to and recovery from a stress task can differentiate healthy participants and persons with stress‐related complaints.Methods and ResultsHealthy participants (n = 20) and participants with stress‐related complaints (n = 12) participated in a laboratory stress test, which included 3 stress tasks. Three physiological signals were recorded: galvanic skin response (GSR), heart rate (HR), and skin temperature (ST). From these signals, 126 features were extracted, including static (eg, mean) and dynamic (eg, recovery time) features. Unsupervised feature selection reduced the set to 26 features. A logistic regression model was developed for 6 feature sets, analysing single‐parameter and multiparameter models as well as models using recovery vs response‐related features. The highest classification performance (accuracy = 78%) was obtained using the response‐related feature set, including all physiological signals and using GSR‐related features. A worse performance was obtained using single‐signal feature sets based on HR (accuracy = 66%) and ST (accuracy = 59%). Response‐related features outperformed recovery‐related features (accuracy = 63%).ConclusionParticipants with stress‐related complaints may be differentiated from healthy controls by physiological responses to stress tasks. We aimed to bring attention to new exploratory methodologies; further research is needed to validate and replicate the results on larger populations and patients on different areas along the stress continuum.

Mode Equivalence of Health Indicators Between Data Collection Modes and Mixed-Mode Survey Designs in Population-Based Health Interview Surveys for Children and Adolescents: Methodological Study.

BackgroundThe implementation of an Internet option in an existing public health interview survey using a mixed-mode design is attractive because of lower costs and faster data availability. Additionally, mixed-mode surveys can increase response rates and improve sample composition. However, mixed-mode designs can increase the risk of measurement error (mode effects).ObjectiveThis study aimed to determine whether the prevalence rates or mean values of self- and parent-reported health indicators for children and adolescents aged 0-17 years differ between self-administered paper-based questionnaires (SAQ-paper) and self-administered Web-based questionnaires (SAQ-Web), as well as between a single-mode control group and different mixed-mode groups.MethodsData were collected for a methodological pilot of the third wave of the "German Health Interview and Examination Survey for Children and Adolescents". Questionnaires were completed by parents or adolescents. A population-based sample of 11,140 children and adolescents aged 0-17 years was randomly allocated to 4 survey designs—a single-mode control group with paper-and-pencil questionnaires only (n=970 parents, n=343 adolescents)—and 3 mixed-mode designs, all of which offered Web-based questionnaire options. In the concurrent mixed-mode design, both questionnaires were offered at the same time (n=946 parents, n=290 adolescents); in the sequential mixed-mode design, the SAQ-Web was sent first, followed by the paper questionnaire along with a reminder (n=854 parents, n=269 adolescents); and in the preselect mixed-mode design, both options were offered and the respondents were asked to request the desired type of questionnaire (n=698 parents, n=292 adolescents). In total, 3468 questionnaires of parents of children aged 0-17 years (SAQ-Web: n=708; SAQ-paper: n=2760) and 1194 questionnaires of adolescents aged 11-17 years (SAQ-Web: n=299; SAQ-paper: n=895) were analyzed. Sociodemographic characteristics and a broad range of health indicators for children and adolescents were compared by survey design and data collection mode by calculating predictive margins from regression models.ResultsThere were no statistically significant differences in sociodemographic characteristics or health indicators between the single-mode control group and any of the mixed-mode survey designs. Differences in sociodemographic characteristics between SAQ-Web and SAQ-paper were found. Web respondents were more likely to be male, have higher levels of education, and higher household income compared with paper respondents. After adjusting for sociodemographic characteristics, only one of the 38 analyzed health indicators showed different prevalence rates between the data collection modes, with a higher prevalence rate for lifetime alcohol consumption among the online-responding adolescents (P<.001).ConclusionsThese results suggest that mode bias is limited in health interview surveys for children and adolescents using a mixed-mode design with Web-based and paper questionnaires.

A methodological pilot for gathering data through text-messaging to study question-asking in everyday life

How do people find answers to questions they encounter in everyday life? While extensive research has examined how people go about finding answers to questions online, there has been little work investigating the issue from a more holistic, in situ perspective that covers the various devices, resources, and contextual factors that influence everyday question-asking experiences. To address this, we developed a text-messaging-based data-collection framework. This paper details our approach including reflections on both the benefits and challenges of the methodology for researchers seeking to apply similar approaches to social science research. In doing so, we demonstrate how our methodology helps establish a contextually rich understanding of information-seeking processes. We also demonstrate our approach to analyzing data from a small but diverse group of adults across the United States about their everyday question-asking experiences.

Mixing modes in a population-based interview survey: comparison of a sequential and a concurrent mixed-mode design for public health research

BackgroundPopulation-based surveys currently face the problem of decreasing response rates. Mixed-mode designs are now being implemented more often to account for this, to improve sample composition and to reduce overall costs. This study examines whether a concurrent or sequential mixed-mode design achieves better results on a number of indicators of survey quality.MethodsData were obtained from a population-based health interview survey of adults in Germany that was conducted as a methodological pilot study as part of the German Health Update (GEDA). Participants were randomly allocated to one of two surveys; each of the surveys had a different design. In the concurrent mixed-mode design (n = 617) two types of self-administered questionnaires (SAQ-Web and SAQ-Paper) and computer-assisted telephone interviewing were offered simultaneously to the respondents along with the invitation to participate. In the sequential mixed-mode design (n = 561), SAQ-Web was initially provided, followed by SAQ-Paper, with an option for a telephone interview being sent out together with the reminders at a later date. Finally, this study compared the response rates, sample composition, health indicators, item non-response, the scope of fieldwork and the costs of both designs.ResultsNo systematic differences were identified between the two mixed-mode designs in terms of response rates, the socio-demographic characteristics of the achieved samples, or the prevalence rates of the health indicators under study. The sequential design gained a higher rate of online respondents. Very few telephone interviews were conducted for either design. With regard to data quality, the sequential design (which had more online respondents) showed less item non-response. There were minor differences between the designs in terms of their costs. Postage and printing costs were lower in the concurrent design, but labour costs were lower in the sequential design. No differences in health indicators were found between the two designs. Modelling these results for higher response rates and larger net sample sizes indicated that the sequential design was more cost and time-effective.ConclusionsThis study contributes to the research available on implementing mixed-mode designs as part of public health surveys. Our findings show that SAQ-Paper and SAQ-Web questionnaires can be combined effectively. Sequential mixed-mode designs with higher rates of online respondents may be of greater benefit to studies with larger net sample sizes than concurrent mixed-mode designs.

Circadian pattern of short-term variability of the QT-interval in primary prevention ICD patients - EU-CERT-ICD methodological pilot study.

ObjectiveShort-term variability of the QT-interval (STV-QT) was shown to be associated with an increased risk of ventricular arrhythmias. We aimed at investigating (a) whether STV-QT exhibits circadian pattern, and (b) whether such pattern differs between patients with high and low arrhythmia risk.MethodsAs part of the ongoing EU-CERT-ICD study, 24h high resolution digital ambulatory 12-lead Holter recordings are collected prior to ICD implantation for primary prophylactic indication. Presently available patients were categorized based on their arrhythmia score (AS), a custom-made weighted score of the number of arrhythmic events on the recording. STV-QT was calculated every hour in 30 patients of which 15 and 15 patients had a high and a low AS, respectively.ResultsThe overall dynamicity of STV-QT showed high intra- and inter-individual variability with different circadian patterns associated with low and high AS. High AS patients showed a prominent peak both at 08:00 and 18:00. At these times, STV-QT was significantly higher in the high AS patients compared to the low AS patients (1.22ms±0.55ms vs 0.60ms±0.24ms at 08:00 and 1.12ms±0.39ms vs 0.64ms±0.29ms at 18:00, both p < 0.01).ConclusionIn patients with high AS, STV-QT peaks in the early morning and late afternoon. This potentially reflects increased arrhythmia risk at these times. Prospective STV-QT determination at these times might thus be more sensitive to identify patients at high risk of ventricular arrhythmias.

Sexual Health questions included in the Health Behaviour in School-aged Children (HBSC) Study: an international methodological pilot investigation.

BackgroundThis paper describes the methodological developments of the sexual health items included in the Health Behaviour in School-aged Children (HBSC) study since their mandatory inclusion in the study in 2002. The current methodological, ethical and pedagogical challenges in measuring young people’s sexual health behaviours are discussed along with the issues associated with the sexual health items introduced to the HBSC study in 2002. The development and piloting of new cross-national items for use in the 2013/14 HBSC data collection are presented and discussed.MethodsAn international pilot study was undertaken to determine the impact of these proposed changes. Questionnaires and classroom discussion groups were conducted in five pilot countries in 2012/2013 (France, Hungary, Ireland, Portugal and Romania) with a total of 612 school-aged children (age M = 15.55 years, SD = 0.95).ResultsThe majority of participants in each country provided positive feedback about the appropriateness of the questions. Some small cross-national differences were found in the self-reported quantitative data relating to the appropriateness of the questions (χ2 = 22.831, df = 9, p = .007, V = .117). Qualitative feedback suggests that for the vast majority of students the phrasing and age-targeting of the questions were considered appropriate. With the exception of a small number of respondents who commented on the clarity and/or personal nature of the content, no specific issues with the questions were identified.ConclusionsThese findings provide guidance on the answerability (including the extent of missing and inconsistent data), understandability, acceptability (including in different cultures) and relevance of questions to potential participants. The findings from the pilot study suggest that in general, the questions are understandable, acceptable, and of a high priority to the target population, and that the simplification has significantly reduced the proportion of missing data. The new developments thus enhance the capacity of the questions to measure cross-nationally, sensitive aspects of young people’s sexual behaviour. These questions were included in the 2013/2014 round of the HBSC survey and will continue to be used to monitor trends in adolescent sexual health and behaviours, and to inform and influence health services and health education policy and practice at local, national and international levels.