The social and behavioral influences (SBI) study: study design and rationale for studying the effects of race and activation on cancer pain management

Background Racial disparities exist in the care provided to advanced cancer patients. This article describes an investigation designed to advance the science of healthcare disparities by isolating the effects of patient race and patient activation on physician behavior using novel standardized patient (SP) methodology. Methods/design The Social and Behavioral Influences (SBI) Study is a National Cancer Institute sponsored trial conducted in Western New York State, Northern/Central Indiana, and lower Michigan. The trial uses an incomplete randomized block design, randomizing physicians to see patients who are either black or white and who are “typical” or “activated” (e.g., ask questions, express opinions, ask for clarification, etc.). The study will enroll 91 physicians. Discussion The SBI study addresses important gaps in our knowledge about racial disparities and methods to reduce them in patients with advanced cancer by using standardized patient methodology. This study is innovative in aims, design, and methodology and will point the way to interventions that can reduce racial disparities and discrimination and draw links between implicit attitudes and physician behaviors

Molecular gas and star formation in early-type galaxies

We present new mm interferometric and optical integral-field unit (IFU) observations and construct a sample of 12 E and S0 galaxies with molecular gas which have both CO and optical maps. The galaxies contain 2 x 10^7 to 5 x 10^9 M\odot of molecular gas distributed primarily in central discs or rings (radii 0.5 to 4 kpc). The molecular gas distributions are always coincident with distributions of optically-obscuring dust that reveal tightly-wound spiral structures in many cases. The ionised gas always approximately corotates with the molecular gas, evidencing a link between these two gas components, yet star formation is not always the domi- nant ionisation source. The galaxies with less molecular gas tend to have [O III]/H{\beta} emission-line ratios at high values not expected for star formation. Most E/S0s with molecular gas have young or intermediate age stellar populations based on optical colours, ultraviolet colours and absorption linestrengths. The few that appear purely old lie close to the limit where such populations would be undetectable based on the mass fractions of expected young to observed old stars. The 8{\mu}m polycyclic aromatic hydrocarbon (PAH) and 24{\mu}m emission yield similar star formation rate estimates of E/S0s, but the total infrared overpredicts the rate due to a contribution to dust heating from older stars. The radio-far infrared relation also has much more scatter than for other star-forming galaxies. However, despite these biases and additional scatter, the derived star formation rates locate the E/S0 galaxies within the large range of the Schmidt-Kennicutt and constant efficiency star formation laws. Thus the star formation process in E/S0s is not overwhelmingly different than in other star-forming galaxies, although one of the more reliable tracers (24{\mu}m) points to a possible lower star-formation efficiency at a given gas surface density.Comment: submitted to MNRA

AEGIS: Demographics of X-ray and Optically Selected AGNs

We develop a new diagnostic method to classify galaxies into AGN hosts, star-forming galaxies, and absorption-dominated galaxies by combining the [O III]/Hbeta ratio with rest-frame U-B color. This can be used to robustly select AGNs in galaxy samples at intermediate redshifts (z<1). We compare the result of this optical AGN selection with X-ray selection using a sample of 3150 galaxies with 0.3<z<0.8 and I_AB<22, selected from the DEEP2 Galaxy Redshift Survey and the All-wavelength Extended Groth Strip International Survey (AEGIS). Among the 146 X-ray sources in this sample, 58% are classified optically as emission-line AGNs, the rest as star-forming galaxies or absorption-dominated galaxies. The latter are also known as "X-ray bright, optically normal galaxies" (XBONGs). Analysis of the relationship between optical emission lines and X-ray properties shows that the completeness of optical AGN selection suffers from dependence on the star formation rate and the quality of observed spectra. It also shows that XBONGs do not appear to be a physically distinct population from other X-ray detected, emission-line AGNs. On the other hand, X-ray AGN selection also has strong bias. About 2/3 of all emission-line AGNs at L_bol>10^44 erg/s in our sample are not detected in our 200 ks Chandra images, most likely due to moderate or heavy absorption by gas near the AGN. The 2--7 keV detection rate of Seyfert 2s at z~0.6 suggests that their column density distribution and Compton-thick fraction are similar to that of local Seyferts. Multiple sample selection techniques are needed to obtain as complete a sample as possible.Comment: 24 pages, 14 figures, submitted to ApJ. Version 2 matches the ApJ accepted version. Sec 3 was reorganized and partly rewritten with one additional figure (Fig.3

Evaluating relationships among clinical working memory assessment and inattentive and hyperactive/impulsive behaviors in a community sample of children

Objective This study examined relationships between inattentive and hyperactive/impulsive behaviors and working memory (WM) functioning, and the utility of WM in categorical diagnosis of ADHD versus considering ADHD symptoms on a continuum. Method The study included 50 male children (6–12 years). Inattentive and hyperactive/impulsive behaviors were measured by the Conners-3P parent report, and WM was assessed by the WISC-IV WM subtests and Working Memory Index (WMI). Results WISC-IV Arithmetic and Digit Span Backward were most consistently related to inattentive behaviors, and no WM measure was consistently related to ADHD hyperactive/impulsive behaviors. Arithmetic and Digit Span Backward also accounted for significant variance in inattentive behaviors and ADHD inattention symptoms, respectively. Neither the WMI nor the Arithmetic subtest correctly classified individuals diagnosed with ADHD. Conclusion Measurement of inattentive behaviors on a continuum best characterized relationships between symptoms of ADHD and WM functioning; WM functioning did not have utility in categorical understanding of ADHD

An examination of the relationships among gender, health status, social support, and HIV-related stigma

This secondary analysis used E. Goffman\u27s (1963) model of stigma to examine how social support and health status are related to HIV stigma, after controlling for specific sociodemographic factors, and how these relationships differed between men and women living with HIV. Baseline data from 183 subjects in a behavioral randomized clinical trial were analyzed using multigroup structural equation modeling. Women reported significantly higher levels of stigma than men after controlling for race, history of injection drug use, and exposure category. HIV-related stigma was negatively predicted by social support regardless of gender. The theorized model explained a significant amount of the variance in stigma for men and women (24.4% and 44%, respectively) and may provide novel and individualized intervention points for health care providers to effect positive change in perceived stigma for the person living with HIV. The study offers insight into understanding the relationships among gender, health status, social support, and HIV-related stigma. © 2010 Association of Nurses in AIDS Care

The ATLAS project - X. On the origin of the molecular and ionized gas in early-type galaxies

The definitive version can be found at: http://onlinelibrary.wiley.com/ Copyright Royal Astronomical SocietyWe make use of interferometric CO and Hi observations, and optical integral-field spectroscopy from the ATLAS survey, to probe the origin of the molecular and ionized interstellar medium (ISM) in local early-type galaxies. We find that 36 ± 5 per cent of our sample of fast-rotating early-type galaxies have their ionized gas kinematically misaligned with respect to the stars, setting a strong lower limit on the importance of externally acquired gas (e.g. from mergers and cold accretion). Slow rotators have a flat distribution of misalignments, indicating that the dominant source of gas is external. The molecular, ionized and atomic gas in all the detected galaxies are always kinematically aligned, even when they are misaligned from the stars, suggesting that all these three phases of the ISM share a common origin. In addition, we find that the origin of the cold and warm gas in fast-rotating early-type galaxies is strongly affected by environment, despite the molecular gas detection rate and mass fractions being fairly independent of group/cluster membership. Galaxies in dense groups and the Virgo cluster nearly always have their molecular gas kinematically aligned with the stellar kinematics, consistent with a purely internal origin (presumably stellar mass loss). In the field, however, kinematic misalignments between the stellar and gaseous components indicate that at least 42 ± 5 per cent of local fast-rotating early-type galaxies have their gas supplied from external sources. When one also considers evidence of accretion present in the galaxies' atomic gas distributions, ≳46 per cent of fast-rotating field ETGs are likely to have acquired a detectable amount of ISM from accretion and mergers. We discuss several scenarios which could explain the environmental dichotomy, including preprocessing in galaxy groups/cluster outskirts and the morphological transformation of spiral galaxies, but we find it difficult to simultaneously explain the kinematic misalignment difference and the constant detection rate. Furthermore, our results suggest that galaxy mass may be an important independent factor associated with the origin of the gas, with the most massive fast-rotating galaxies in our sample (M≲-24mag; stellar mass of ≈8 × 10 M) always having kinematically aligned gas. This mass dependence appears to be independent of environment, suggesting it is caused by a separate physical mechanism.Peer reviewe

The social and behavioral influences (SBI) study: study design and rationale for studying the effects of race and activation on cancer pain management.

BackgroundRacial disparities exist in the care provided to advanced cancer patients. This article describes an investigation designed to advance the science of healthcare disparities by isolating the effects of patient race and patient activation on physician behavior using novel standardized patient (SP) methodology.Methods/designThe Social and Behavioral Influences (SBI) Study is a National Cancer Institute sponsored trial conducted in Western New York State, Northern/Central Indiana, and lower Michigan. The trial uses an incomplete randomized block design, randomizing physicians to see patients who are either black or white and who are "typical" or "activated" (e.g., ask questions, express opinions, ask for clarification, etc.). The study will enroll 91 physicians.DiscussionThe SBI study addresses important gaps in our knowledge about racial disparities and methods to reduce them in patients with advanced cancer by using standardized patient methodology. This study is innovative in aims, design, and methodology and will point the way to interventions that can reduce racial disparities and discrimination and draw links between implicit attitudes and physician behaviors.Trial registrationhttps://clinicaltrials.gov/ , #NCT01501006, November 30, 2011