Number Of Potential Participants Research Articles

Rural employment in Russia: Present conditions and prospects for agricultural and non-agricultural sectors

Contributing to a discussion on rural employment forecast in Russia, this paper sys­tematizes the challenges for the rural labor market: population outflow, weak impulses to develop non-agricultural employment and rural entrepreneurship, changing labor needs in agriculture and a decline in the number of labor migrants. The results of the regional differentiation research show that the response strategies of Russian regions to stabilize employment differ significantly and include active intra-Russian labor migration or reliance on high agricultural state support, development of self-employment and jobs preservation in labor-intensive, low-productivity sectors of agricultural production. The article discusses rural development prospects associated with the return migration of urban residents to rural areas, which creates a new basis for rural employment growth. A theoretical implication of the rural employment perspectives discussion is the proposed concept of “out-of-urban employment” that actualizes the traditional approach of seeking employment only for indigenous rural people who have lost their jobs in agriculture, and includes new types and forms of employment for urban dwellers. Analysis of the current state support for rural employment in Russia shows that it is poorly aligned with the existing challenges. The scale of both financing and the number of potential participants is small; direct support measures are limited to the agricultural sector, while indirect ones — through support for rural infrastructure — create mainly public sector employment. The practical implications of the outcomes are some proposed ways of developing measures to support rural employment, taking into account non-agricultural rural economy needs.

Assessment of patient safety culture among the staff of the University Hospital for Gynecology and Obstetrics in Alexandria, Egypt

BackgroundPatient safety (PS) is a fundamental component of healthcare quality. Patient Safety Culture (PSC) assessment provides an organization with insight of perceptions and attitudes of its staff related to patient safety. In addition, it is meant to improve performance rather than blaming individuals. This study aimed to assess patient safety culture from the health care staff perspective in El-Shatby University Hospital for Gynecology and Obstetrics.MethodsA descriptive cross-sectional study was conducted. The study was conducted at El-Shatby University Hospital for Gynecology and Obstetrics from November 2020 to January 2021. The target participants were assistant lecturers, residents, and head nurses in charge during the field study period. The number of potential participants who fulfilled the inclusion criteria (in charge during the period of data collection and working in the hospital for more than 3 months) was 83; the twelve participants who participated in the pilot study were excluded. The total number of participants who agreed to participate in the study was 66 participants (38 residents, 18 assistant lecturers, and 10 head nurses) out of 71 potential participants representing a 92.9% response rate. A structured self-administered questionnaire format adapted from Hospital Survey on Patient Safety Culture (HSOPSC) questionnaire was distributed anonymously to the participants. The questionnaire has 42 items measuring twelve patient safety culture dimensions: teamwork within the unit, supervisors’ expectations and actions to promote patient safety, feedback and communication about error, organizational learning, communication openness, overall perception of patient safety, hands-off and transitions, teamwork across units, frequency of events reported, management support for patient safety, staffing, and management support for patient safety. Except for two items that are responded on a five-point frequency scale (never, rarely, sometimes, most of the time, and always) the majority of patient safety culture questions are answered on a five-point agreement scale (strongly disagree, disagree, neutral, agree, and strongly agree), with a higher score indicating a more favorable attitude toward patient safety.ResultsThe overall average positive percent score was 45.4%. Average positive response percentages to individual items ranged from 28.8 to 81.8%. No domain had an average positive percent score of more than 75%. Out of the twelve dimensions of patient safety culture included in the HSOPSC questionnaire, “the teamwork within unit” domain had the highest average positive percent score (62.1%) among all participants. On the other hand, the “Non-punitive response to error” domain had the lowest score (18.9%). More than half (57.6%) of the participants rated patient’s safety at the hospital as acceptable.ConclusionInvesting in practices that strengthen patient safety is crucial if the hospital is to improve overall performance and quality of services. The present study displays a frail patient safety culture (PSC) in the majority of the domains. All the domains should be considered of high priority focused areas for remark and reformative tasks. Continuous training programs of the staff on patient safety to improve their perception of safety culture are necessary. All PSC composites need improvement starting with regular assessment of PSC along with continuous monitoring and increasing the healthcare providers’ awareness of demanded PSC.

Optimising recruitment in clinical trials for progressive multiple sclerosis: observational analysis from the MS-SMART and MS-STAT2 randomised controlled trials

BackgroundSlower than planned recruitment is a major factor contributing to the delay or failure of randomised controlled trials to report on time. There is a limited evidence base regarding the optimisation of recruitment strategies. Here we performed an observational review of our experience in recruitment for two large randomised controlled trials for people with secondary progressive multiple sclerosis. We aimed to explicitly determine those factors which can facilitate trial recruitment in progressive neurodegenerative disease.MethodsRecruitment data from the sequential MS-SMART [NCT01910259] and MS-STAT2 [NCT03387670] UK randomised controlled trials was reviewed from the largest recruiting site, University College London (UCL). The trial population was similar which allowed comparison over the two recruitment periods of 2015–2016 and 2018–2021. This included sources of referral, progress through stages of recruitment, reasons for participant ineligibility and the impact of publicity events upon recruitment.ResultsIn MS-SMART, 18% of patients contacted were enrolled, compared to 27% for MS-STAT2. Online registration of interest portals provided the greatest number of referrals (76% in MS-SMART, and 51% in MS-STAT2), with publicity in national media outlets producing a demonstrable increase in the number of potential participants. The introduction of an online self-screening questionnaire for MS-STAT2 resulted in 67% of potential participants (3080 of 4605) automatically determining their own ineligibility. In both studies, however, around 60% of those directly telephoned to discuss the study were not eligible, with difficulties related to travel to trial visits, or excluded medication, being the most common issues. Eighty-four percent of those deemed potentially eligible following telephone calls were enrolled in the MS-STAT2 study, compared to only 55% for MS-SMART.ConclusionsThrough a detailed review of recruiting participants at the largest centre into two large randomised controlled trials with similar entry criteria, we have identified a number of approaches that may improve recruitment efficiency. We highlight here the importance of mandatory online self-screening questionnaires, a coordinated publicity campaign, and simple interventions such as eligibility checklists and appointment reminders. Recruitment approaches should be further assessed through a studies within a trial (SWAT) design.Trial registrationMS-SMART: NCT01910259; registered July 2013 and MS-STAT2: NCT03387670; registered Jan 2018

An on-demand service platform with self-scheduling capacity: Uniform versus multiplier-based pricing

On-demand service platforms use multiplier-based pricing to provide services via self-scheduling participants. In a multiplier-based pricing scheme, consumers pay lower prices during non-peak periods and higher prices equal to the non-peak period price multiplied by a surge multiplier during peak periods. However, the reasons underlying multiplier-based pricing and when it should be used remain unclear. In this paper, we examine the effects of two pricing schemes—uniform pricing and multiplier-based pricing—on platform profits, participant payoff, and consumer surplus by formulating game-based models, and investigate the conditions and feasible region for use of multiplier-based pricing. The results show that the non-peak price in the multiplier-based pricing scheme is lower than the uniform price, which is in line with reality. When the number of potential participants in non-peak periods is larger, the multiplier-based pricing model generates more profits if compensation ratios in the two models are higher or the compensation ratio in the multiplier-based pricing model is lower. Participants are better off joining a platform that uses uniform pricing given one of the following conditions: lower commission ratio in the two models, lower compensation ratio in the multiplier-based pricing model and higher commission ratio in the two models, and higher commission and compensation ratios in the two models. Consumers are better off in the uniform pricing model if the proportion of non-peak periods, consumer sensitivity to surge multiplier change, and the ratio of potential participants in peak and non-peak periods are higher.

Towards Demand-Driven Dynamic Incentive for Mobile Crowdsensing Systems

Incentive mechanisms have been commonly proposed to encourage people to participate in mobile crowdsensing (MCS). However, most of them set unchangeable rewards for sensing tasks, while the inherent inequality and on-demand feature of sensing tasks have been long ignored, especially for location-dependent sensing tasks (LDSTs). In this paper, we focus on location-dependent MCS systems and propose a demand-driven dynamic incentive mechanism that dynamically changes the rewards of sensing tasks at each sensing round in an on-demand way to balance their popularity. A demand indicator is introduced to characterize the demand of each sensing task by considering its deadline, completing progress, and number of potential participants. At each sensing round, we use the Analytic Hierarchy Process (AHP) to calculate the relative demands of all sensing tasks and then determine their rewards accordingly. Moreover, we consider two task selection problem with participatory users and opportunistic users, respectively, and prove that both of them are NP-hard. We propose an optimal dynamic programming based solution for participatory scenario and an optimal backtracking based solution for opportunistic scenario to help each user select tasks while maximizing its profit. Extensive experiments show that the demand-driven dynamic incentive mechanism outperforms existing incentive mechanisms.

Abstract P1-16-03: Hear our voice: Patient-driven solutions to increase participation in clinical trials

Abstract Background: The rate of participation in clinical trials is dismally low, slowing the process of drug development and increasing cost. Patients living with metastatic breast cancer (MBC) are often willing to participate in clinical trials, but are frequently faced with insurmountable barriers. There is a dire need for studies identifying actionable patient-driven solutions to help ensure that opportunities to participate in clinical trials becomes more equitable, attractive and feasible for a larger, more diverse pool of potential participants. Methods: A mixed-methods design including in-depth interviews and online surveys was used to identify barriers and solutions to participation in clinical trials. Sixty-one participants were invited to be interviewed using purposeful stratified sampling (patient race, age and geographic location; community and academic center oncologists and administrators; researchers and research staff; payers). Interview questions were designed to collect feasible solutions to barriers. Convenience sampling was used to recruit MBC patient survey participants. Online surveys were fielded via nine MBC social media groups reaching approximately 1,500 patients living with MBC. Survey questions included demographics, trial experience, perception of benefits/disadvantages and barriers to trial participation, and ideas for solutions to the barriers. In addition, a short social media poll on trial participation was used. Results: A total of 496 women living with MBC completed the online survey. The mean age of survey respondents was 53 years old and mean number of years with MBC was 4.6 years. Respondents generally reported positive attitudes toward trial participation: The opportunity to get innovative treatments, helping others with MBC and contributing to research were rated as extremely important. Potential disadvantages included fear of side effects, possibility that trial drugs may not be effective and financial toxicity. Significant barriers included strict eligibility criteria, broad exclusion criteria and lack of trials nearby. All patients responding to a social media poll indicated they would consider participating in a clinical trial. Fifty-two participants were interviewed. The most frequent themes from patients were suggestions to address rigid eligibility and exclusion criteria by consistently including patients in research design, protocol development and policy decisions. Patients felt that trials should reflect the “real world”, and that opening up eligibility criteria would increase diversity and the number of potential participants. A dominant theme from rural and community-based oncologists was the need to address geographic, logistical and financial barriers using more “portable” multi-institution trials, providing transportation and adequate reimbursement for patients’ expenses. Clinicians in academic described exclusion criteria as a significant barrier for heavily pretreated MBC patients. Health care administrators discussed solutions to high costs associated with trials. Payers shared innovative solutions to out-of-network payment barriers. Conclusions: Most patients with MBC are willing to participate in clinical trials, and many are highly motivated to do so. MBC patients generally recognize the benefits that trials can offer and are willing and able to help address the barriers to trial participation by working collaboratively across the board. Multiple sectors of health-care are ready and willing to work together. It is in all our best interests to hasten the development of new treatments, and the time is right to implement a collaborative, systematic solutions-based approach that will make it feasible for more MBC patients to participate in clinical trials. This patient led study shows how this can be done. Citation Format: Marina Kaplan. Hear our voice: Patient-driven solutions to increase participation in clinical trials [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P1-16-03.

Barriers to recruitment when conducting a commissioned randomised controlled trial of medication versus psychological therapy for generalised anxiety disorder: some lessons learned

BackgroundPoor recruitment is the most common reason for premature discontinuation of randomised controlled trials (RCTs). An RCT of medication versus psychological therapy for generalised anxiety disorder (GAD) was discontinued prematurely by the UK National Institute of Health Research funders because of recruitment failure. In order to inform future research studies, this article explores the reasons for poor recruitment and aspects which could have been improved.MethodsThe trial recruited participants via psychological well-being practitioners (PWPs) employed within local Improving Assess to Psychological Therapies (IAPT) services at four sites in England. For this study, we initially examined the recruitment data to identify reasons why potential participants were reluctant to participate in the trial. We then investigated reasons the PWPs did not identify more potential participants. Finally, we performed retrospective analyses of a computerised clinical records system used by the IAPT services in this study. These analyses aimed to establish the number of potential participants who had not been approached about the trial as well as whether there were additional factors affecting the numbers of people who might be eligible to take part. Data were obtained for all patients assessed during the period from the date on which recruitment commenced until the closure of the trial.ResultsThree quarters of those patients identified as possibly suitable for the trial declined to take part; the great majority did so because they did not want to be randomly assigned to receive medication. Our retrospective database analyses showed that only around 12% of potentially eligible patients for the trial were identified by the PWPs at the pilot sites. The results also indicated that only 5% of those noted at entry to the IAPT services to have a score of at least 10 on the GAD-7 questionnaire (a self-completed questionnaire with high sensitivity and specificity for GAD) would have been eligible for the trial.ConclusionsOur findings suggest that poor recruitment to RCTs can be significantly affected by participants’ treatment preferences and by factors influencing the recruiting clinicians. It may also be important not to include too many restrictions on inclusion criteria for pragmatic trials aiming for generalisable results.Trial registrationISCRTN14845583. Registration date: 5 February 2015.

A Stochastic Information Diffusion Model in Complex Social Networks

The number of potential participants in information diffusion is dynamically changing, and the topological structure of a real social network is affected by environment noise. In this paper, a stochastic information diffusion model considering both population perturbation and connectivity variation has been proposed. For the model on homogeneous network, we show the existence and uniqueness of the global positive solution and give a sufficient condition of extinction of information. A series of numerical simulations on Watts-Strogatz (WS) network, Barabasi-Albert (BA) network and real-world Facebook network have been conducted to verify the theoretical analysis and evaluate the sensitivity of the proposed model to relevant parameters. We find that both population perturbation and connectivity variation have great impacts on information diffusion process. In general, the connectivity variation noise promotes the spread of information, and the population perturbation noise corresponding to I-infected individuals inhibit the spread of information. In the case of large noise intensity, the population perturbation noise corresponding to I-infected individuals plays a decisive role compared with the connectivity variation noise.

Feasibility of intervention in elder self-neglecters: Setting the stage for future research

ABSTRACTObjectives: Interventions are critical to improving clinical outcomes in elder self-neglecters. This study assessed feasibility of a randomized controlled trial of oral vitamin D in Adult Protective Services-substantiated self-neglect clients ≥65 years.Methods: Participants were directly observed to consume ergocalciferol 50,000 IU (treatment) or ergocalciferol 400 IU (control), once a month, for 10 months. For months 6–10, half the control group randomly crossed into the treatment group (crossover). Intervention feasibility was measured by number of potential participants who agreed to participate and by retention rates during the study.Results: Ninety-four referrals were received and 59 (63%) agreed to participate. Forty-nine participants were enrolled after prescreening and 35 completed the two-phase trial for a 72% retention rate. The participants’ average age was 75.2 ± 6.8 years, mainly female (59%), African-American (47%), and living alone (41%).Discussion: Despite assumptions that self-neglecters are resistant to care, we have successfully conducted the first clinical intervention in this vulnerable population.

Hypergraph-Based Anomaly Detection of High-Dimensional Co-Occurrences

This paper addresses the problem of detecting anomalous multivariate co-occurrences using a limited number of unlabeled training observations. A novel method based on using a hypergraph representation of the data is proposed to deal with this very high-dimensional problem. Hypergraphs constitute an important extension of graphs which allow edges to connect more than two vertices simultaneously. A variational Expectation-Maximization algorithm for detecting anomalies directly on the hypergraph domain without any feature selection or dimensionality reduction is presented. The resulting estimate can be used to calculate a measure of anomalousness based on the False Discovery Rate. The algorithm has O(np) computational complexity, where n is the number of training observations and p is the number of potential participants in each co-occurrence event. This efficiency makes the method ideally suited for very high-dimensional settings, and requires no tuning, bandwidth or regularization parameters. The proposed approach is validated on both high-dimensional synthetic data and the Enron email database, where p > 75,000, and it is shown that it can outperform other state-of-the-art methods.

Implementation of a physical activity intervention for people with rheumatoid arthritis: A case study

To investigate the potential facilitators and barriers regarding the implementation on a larger scale of an internet-based physical activity intervention which had previously proved to be effective in a randomized, controlled trial concerning sedentary patients with rheumatoid arthritis (RA). Assuming a central delivery of the intervention by two trained physical therapists in four regions in the Netherlands, the following activities were employed: the recruitment of potential participants (RA patients), the acquisition of cooperation from referring rheumatologists and the acquisition of reimbursement from regional health insurance companies. Evaluation was done by means of the Reach, Evaluation, Adoption, Implementation and Maintenance framework, of which the following three dimensions were considered relevant: Reach (the number of potential participants), Adoption (readiness for adopting the programme in real life among rheumatologists) and Implementation (the extent to which the intervention could be delivered as intended). Evaluation measures comprised a postal survey among 927 patients with RA in two regions, a telephone survey among rheumatology centres in four regions and consultations with five regional health insurance companies. Seventy-six out of 461 responding RA patients (20%) met the original study inclusion criteria (being sedentary and having access to the internet) and were interested in participation. However, the potential costs of the purchase of a bicycle ergometer and the interference with patients' current physical therapy were obstacles for eligible patients actually to participate. Rheumatologists in four out of five rheumatology centres were willing to participate. All five health insurance companies were willing to reimburse the guidance and feedback by the physical therapist, and the costs of the internet site (estimated costs 271 euro [203 pound] per patient per year), but not the bicycle ergometer (estimated costs 350 euro [262 pound]), provided that current physical therapy would be discontinued. Facilitators for the implementation of an internet-based physical activity intervention were: (i) a considerable proportion of RA patients were eligible and interested in the programme; (ii) the majority of rheumatologists were willing to refer patients; and (iii) health insurance companies were willing partially to reimburse the intervention. Barriers were the additional costs for patients and their unwillingness to discontinue current physical therapy. These findings underscore the need for additional research into barriers to participation in physical activity interventions among patients with RA, and in reimbursement strategies in particular.

Crowding-out in productive and redistributive rent-seeking

This paper presents a general rent-seeking model in which participants decide on entry before choosing their levels of efforts. The conventional wisdom in the rent-seeking literature suggests that the rent dissipation increases with the number of potential participants and with their productivity of effort. In this paper, we show that this result of the rent-seeking literature is far from general and applies only when participants are relatively weak and enter the game with certainty. In the presence of strong competitors, the expected total dissipation actually decreases, since participation in the game is less frequent. We further consider the impact of competitors’ exit option, distinguishing between “redistributive rent-seeking” and “productive rent-seeking” situations. In redistributive rent-seeking, no social loss results from the fact that all competitors exit the race. In productive rent-seeking, instead, lack of participation creates a social loss (the “lost treasure” effect), since valuable rents are left unexploited. We show that the lost-treasure effect perfectly counterbalances the reduction in rent dissipation due to competitors’ exit. Hence, unlike redistributive rent-seeking, in productive rent-seeking the total social loss remains equal to the entire rent even when parties grow stronger or the number of players increases.

Internet Exchange Formation and Competition When Potential Participants Can Coordinate

We analyze the formation and competition of market intermediaries when there are positive participation externalities between the two sides of the market; negative participation externalities within the same side; competition with traditional market; and implicit coordination among potential participants. The impact of implicit coordination is studied in two ways. First, we develop both static models - which are appropriate when the number of potential participants is large - and dynamic models - which are appropriate when a limited number of participants observe each other's choices. Potential participants can better coordinate their decisions in the dynamic participation process. Second, we assume that participation decisions are coordinated by a pessimistic belief about formation or entry of a new intermediary. In order to overcome the pessimism, the owner of an intermediary has to offer a fee schedule that implements her preferred outcome as the unique (subgame-perfect) Nash equilibrium outcome. The theory explains when and in which direction cross-subsidization strategies appear and when the incumbent intermediary can deter entry profitably.

Binary participation and incremental provision of public goods

This paper presents a comprehensive analysis of voluntary binary participation in the provision of public goods in a full information setting where the marginal product of participation is positive but decreases with the number of participants. Our study extends Palfrey and Rosenthal's (1984) binary model. It deals with an important special case of uniform multi-person prisoner's dilemma, Schelling (1978), that might be conceived of as the discrete counterpart of the continuous model where both players' contributions and the production function of the public good are continuous, Olson (1965), Chamberlin (1974), McGuire (1974). For pure strategies, we find that as in the continuous setting, Nash equilibria are inefficient and the public good is underprovided. Surprisingly, for mixed strategies, the symmetric equilibria are inefficient, however, even in expected terms, the public good can be overprovided. The concurrence between inefficiency and underprovision of the public good reemerges, provided that one of the following holds: (i) the number of potential participants is sufficiently large, (ii) the marginal product of participation is sufficiently stable, (iii) the costs of participation are sufficiently low or sufficiently high, or (iv) the identical players are constrained to select identical strategies.