Efficiency of using community organisations as catalysts for recruitment to continence promotion trials

This article is available open access through the publisher’s website from the link below. Copyright @ 2012 The Authors.Background - A major challenge for determining the effectiveness of community-based continence promotion campaigns is recruitment of a representative sample of incontinent participants who have not previously sought care. Purpose - To evaluate the efficiency of engaging community organisations as catalysts for recruitment of community-dwelling older women with incontinence to the ‘Continence across Continents’ randomised controlled trial. Methods - Seniors’ and women’s community-based organisations throughout the United Kingdom were solicited by telephone or email to assist recruitment for an open-label cluster randomised controlled trial testing three experimental continence promotion interventions and a control intervention for incontinent older women. Women aged 60 years and older who experienced at least weekly urinary incontinence and who had never sought treatment were eligible to participate. The response rate of the organisations and enrolment rate of eligible participants attending the continence promotion workshops were recorded. Differences in recruitment efficiency by intervention group were ascertained using analysis of variance statistics. Results - We contacted 408 community organisations over a 1-year period. Seventy organisations (17%) agreed to host a workshop, 249 (61%) did not provide a response, and 89 (22%) refused. Workshops were administered in a group format to 61 organisations (15%); 667 women attended, 583 (87%) submitted the screening questionnaire, and 437 (66%) met eligibility criteria for inclusion. A total of 192 women consented to participate in the trial, yielding a 44% recruitment efficiency among workshop attendees known to be eligible, with no significant difference in enrolment rates between groups. However, the mean participant recruitment rate per number of attendees at each workshop was only 29%, varying substantially between groups from 19% to 37%, with the lowest rate observed for the control group. The mean annual recruitment rate expressed as the number of enrolled participants per community organisation contacted was 0.5. Limitations - Reasons for women’s non-response were not collected. The findings may be country specific. Conclusions - The recruitment rate for a continence promotion trial among older women known to be eligible and attending workshops hosted by local community organisations was high (44%). Strategies are needed to bolster community organisations’ involvement in health promotion trials in general and for continence issues in particular

Methods for the evaluation of alternative disaster warning systems

For each of the methods identified, a theoretical basis is provided and an illustrative example is described. The example includes sufficient realism and detail to enable an analyst to conduct an evaluation of other systems. The methods discussed in the study include equal capability cost analysis, consumers' surplus, and statistical decision theory

Methods for the evaluation of alternative disaster warning systems. Executive summary

Methods for estimating the economic costs and benefits of the transmission-reception and reception-action segments of a disaster warning system (DWS) are described. Methods were identified for the evaluation of the transmission and reception portions of alternative disaster warning systems. Example analyses using the methods identified were performed

Effectiveness of continence promotion for older women via community organisations: A cluster randomised trial

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/Objectives: The primary objective of this cluster randomised controlled trial was to compare the effectiveness of the three experimental continence promotion interventions against a control intervention on urinary symptom improvement in older women with untreated incontinence recruited from community organisations. A second objective was to determine whether changes in incontinence-related knowledge and new uptake of risk-modifying behaviours explain these improvements. Setting: 71 community organisations across the UK. Participants: 259 women aged 60 years and older with untreated incontinence entered the trial; 88% completed the 3-month follow-up. Interventions: The three active interventions consisted of a single 60 min group workshop on (1) continence education (20 clusters, 64 women); (2) evidence-based self-management (17 clusters, 70 women); or (3) combined continence education and self-management (17 clusters, 61 women). The control intervention was a single 60 min educational group workshop on memory loss, polypharmacy and osteoporosis (17 clusters, 64 women). Primary and secondary outcome measures: The primary outcome was self-reported improvement in incontinence 3 months postintervention at the level of the individual. The secondary outcome was change in the International Consultation on Incontinence Questionnaire (ICIQ) from baseline to 3-month follow-up. Changes in incontinence-related knowledge and behaviours were also assessed. Results: The highest rate of urinary symptom improvement occurred in the combined intervention group (66% vs 11% of the control group, prevalence difference 55%, 95% CI 43% to 67%, intracluster correlation 0). 30% versus 6% of participants reported significant improvement respectively (prevalence difference 23%, 95% CI 10% to 36%, intracluster correlation 0). The number-needed-to-treat was 2 to achieve any improvement in incontinence symptoms, and 5 to attain significant improvement. Compared to controls, participants in the combined intervention reported an adjusted mean 2.05 point (95% CI 0.87 to 3.24) greater improvement on the ICIQ from baseline to 3-month follow-up. Changes in knowledge and self-reported risk-reduction behaviours paralleled rates of improvement in all intervention arms. Conclusions: Continence education combined with evidence-based self-management improves symptoms of incontinence among untreated older women. Community organisations represent an untapped vector for delivering effective continence promotion interventions.Canadian Institutes of Health Research – Institute on Aging and the Economic and Social Research Council (UK

Need Fulfillment and Stay-Leave Behavior: On the Diagnosticity of Personal and Relational Needs.

Need fulfillment has been found to be associated with numerous positive relationship outcomes, but its impact on stay–leave behavior is less clear. In the current study, we considered whether the fulfillment of different needs might differentially affect stay–leave behavior. We distinguished between needs that are personal in nature and those that are relational in nature. Central to our theoretical analysis is the interdependence-based contention that the fulfillment of different kinds of needs provides diagnostic information regarding a partner’s motives and intentions regarding a relationship. Using two-wave longitudinal data obtained from romantically involved participants, we tested the relative fit of two alternative models that specified the associations between the fulfillment of different kinds of needs, commitment, and stay–leave behavior. Consistent with an interdependence approach, we found that the influence of the fulfillment of personal needs on stay–leave behavior was mediated by commitment, whereas the fulfillment of relational needs directly influenced stay–leave behavior. Implications for relationship functioning are considered

On the Benefits of Valuing Being Friends for Non-Marital Romantic Partners

Romantic relationships are, at their core, friendships. As such, it may be the case that valuing that aspect of the relationship fortifies the romantic relationship against negative outcomes and serves as a buffer against dissolution. We explored the role of valuing friendship within romantic relationships in two two-wave studies examining whether investing in the friendship aspect of the relationship (Study 1; N = 190) and placing importance on affiliative need fulfillment (Study 2; N = 184) were associated with positive concurrent outcomes and positive outcomes over time. Results revealed that valuing the friendship aspect of a romance is a strong positive predictor of concurrent romantic relationship qualities (i.e., love, sexual gratification, and romantic commitment), is associated with increases in these qualities over time and is negatively associated with romantic dissolution. Furthermore, evidence suggests that these benefits come from valuing friendship specifically, rather than any other aspect of the relationship (e.g., the sexual aspect)

Recent Developments in Methods to Characterise the Chemical and Biological Parameters of Grass Silage

Key points Chemical analysis of forages is expensive, time consuming, environmentally unfriendly and relates poorly to the feed value for production purposes. In vivo characterisation of animal feed is not a feasible option in terms of cost and analysis time. NIRS is a rapid, non destructive, environmentally friendly, multi-analytical technique which can estimate the nutritive value of the feed. NIRS predictive equations developed on a master instrument can be transferred to local and international sites. Future assessment of forages necessitates rapid, stable, instrumentation for ‘in field’ studies

Committed to Oprah, Homer, or House: Using the Investment Model to Understand Parasocial Relationships

People can develop close relationships with media figures viewed on TV. Across two studies we examined the extent to which satisfaction with, alternatives to, and investments in such parasocial relationships (PSR) account for feelings of commitment toward favored TV characters. In Study 1, satisfaction and investments positively predicted commitment to fictional TV characters, whereas the alternative of not following any TV character negatively predicted commitment to the PSR. In Study 2, we tested the bases of the investment model as predictors of commitment to fictional (e.g., Homer Simpson) versus nonfictional (e.g., Oprah Winfrey) TV characters. As in Study 1, for both fictional and nonfictional characters, commitment level was significantly predicted by levels of satisfaction and investments. However, the alternative of not following any character was significantly associated with commitment only for fictional characters. Results support the use of the investment model to understand processes underlying PSRs

Perennial Ryegrass Variety Differences in Nutritive Value Characteristics

Animal grazing performance at grass is predominately determined by herbage intake rates, with high yielding dairy cows requiring up to 20 kg/d DM within a limited grazing time (Gibb, 1998). Grass nutritional factors such as seasonal patterns in digestibility and water-soluble carbohydrate levels have been linked to animal productivity (Davies et al., 1991), while sward surface height, herbage mass, bulk density and green leaf mass have been shown to promote high grazing intake (Barrett et al., 2001). Furthermore, fatty acid profiles have been shown to improve the unsaturated fatty acid composition of milk, with potential human health benefits (Parodi, 1997). Recent CAP funding changes are expected to intensify the drive to optimise margin over costs. Given that grazed grass is the cheapest ruminant feed, it is expected that nutritive value characteristics of grass varieties will become increasingly important relative to total productivity, both as a breeding objective and as an evaluation criteria by variety testers and by farmers. This study examined the genetic diversity in such parameters among a wide range of perennial ryegrass (Lolium perenne L.) varieties, as an indicator of the heterogeneity among current varieties and the prospects for improvement by selective breeding

Whose Intentions Predict? Power over Condom Use within Heterosexual Dyads

According to major theories of behavioral prediction, the most proximal psychological predictor of an individual’s behavior is that individual’s intention. With respect to interdependent behaviors such as condom use, however, relationship dynamics influence individuals’ power to make decisions and to act. Objective: The current study examines how relationship dynamics impact 3 condom use relevant outcomes: (a) the individual forming his or her own intention to use condoms, (b) the couple forming their joint intention to use condoms, and (c) actual condom use behavior. Method: We conducted a 2-wave longitudinal study of young heterosexual adult couples at high risk for HIV infection involving the collection of both individual- and couple-derived data. Results: Results demonstrate the importance of both person (e.g., biological sex and dispositional dominance) and relational (e.g., relational power and amount of interest in the relationship, operationalized as commitment and perceived alternatives to the relationship) factors in predicting condom use intentions and behavior. Individuals who are lower in dispositional dominance are likely to incorporate their partner’s intentions into their own individual intentions; the intentions of individuals who have less interest in the relationship are more highly predictive of the couple’s joint intention; and the intentions of men and individuals higher in relationship power are more likely to exert a direct influence on condom use. Conclusions: These findings have implications for improving the health of high-risk individuals, including suggesting situations in which individuals are highly influenced by their partners’ intentions