PREPs Surveillance: Summary of Cognitive Interviews and Recommendations for PREPs Surveillance Measures

A review of existing research on population awareness of potentially reduced exposure tobacco products (PREPs) as well as results of cognitive interviews suggest that awareness of PREPs is quite low at this time, except in active test-markets. In order to monitor changes in awareness and perceptions of, and receptivity to these products over time, we have proposed using a set of questions as well as coding conventions that appear to result in reasonably accurate estimates of awareness of a particular group of products. The recommended items, which performed will in cognitive interviews, are presented in Appendix D of this report. It must be acknowledged that this report is limited by the need to restrict the number of respondents and by the fact that those included were of relatively high socio-economic status. Prior to any large scale use of these survey items, we recommend that further pre-tests be done using other survey modes (telephone and self-administered), and that an effort be made to include respondents with lower levels of education, and with greater cultural diversity

PREPs Surveillance: Summary of Existing Survey Measures and Recommendations for Ongoing Efforts

Over the past decade or more, tobacco companies have introduced cigarettes with lower content of some toxins than regular and light cigarettes. These new cigarettes, referred to as a class as Potential Reduced Exposure Products (PREPs), have typically been introduced into test markets, not nationwide, which means they are not yet widely known or recognized by name or description by most consumers. However, the introduction of these products is of great concern to public health advocates, who do not believe that enough research, particularly long term research, has been done to know whether or not the PREPs, even if proven to have reduced toxins, actually present a reduced health risk. The fear in the public health community is that smokers who might have been motivated to quit may reverse those quit plans if they perceive an alternative, safer smoking option exists with the PREPs. Likewise, there is concern that former smokers could be tempted back to smoking and non-smokers could be tempted to initiate smoking if they too perceive that PREPs present lower health risks than other cigarettes. Having faced a similar situation with the introduction of “light” cigarettes – i.e. new product, insufficient research about its health implications -- public health officials are feeling cautious about PREPs and have called for development of a science to evaluate PREPs, as well as ongoing surveillance. In order to obtain as complete a set of existing measures as possible, we reviewed published literature on consumer reactions to PREPs and solicited input about ongoing studies from members of the project advisory group, members of the Harm Reduction Network, and other members of the tobacco research community. Appendix A is a list of studies we have included in the summary of current data on the subject of PREPs surveillance. Appendix B is the full listing of PREPs-related questions for each included study

Measuring Patient Experience During the Covid-19 Pandemic And Beyond

Traditional patient experience measures may not fully capture the changes quickly transpiring in patient care due to COVID-19. This paper presents a questionnaire that could be a helpful starting point. The questionnaire addresses topics such as telehealth and non-visit-based care; care by non-physicians; discussion about end-of-life preferences, domestic violence, social health needs; and primary care follow-up after acute carehttps://deepblue.lib.umich.edu/bitstream/2027.42/155624/1/Patient survey development_AFM submission.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/155624/2/2019 CPC+ Beneficiary Survey (English).pdfDescription of Patient survey development_AFM submission.pdf : Main ArticleDescription of 2019 CPC+ Beneficiary Survey (English).pdf : Surve

Tributes to Professor Alan Hornstein

Tributes to Professor Alan Hornstein upon his retirement from the University of Maryland School of Law

Tributes to Professor Alice Brumbaugh

Tributes to Professor Alice Brumbaugh upon her retirement from the University of Maryland School of Law

Surveillance indicators for potential reduced exposure products (PREPs): developing survey items to measure awareness

<p>Abstract</p> <p>Background</p> <p>Over the past decade, tobacco companies have introduced cigarettes and smokeless tobacco products (known as Potential Reduced Exposure Products, PREPs) with purportedly lower levels of some toxins than conventional cigarettes and smokeless products. It is essential that public health agencies monitor awareness, interest, use, and perceptions of these products so that their impact on population health can be detected at the earliest stages.</p> <p>Methods</p> <p>This paper reviews and critiques existing strategies for measuring <it>awareness </it>of PREPs from 16 published and unpublished studies. From these measures, we developed new surveillance items and subjected them to two rounds of cognitive testing, a common and accepted method for evaluating questionnaire wording.</p> <p>Results</p> <p>Our review suggests that high levels of awareness of PREPs reported in some studies are likely to be inaccurate. Two likely sources of inaccuracy in awareness measures were identified: 1) the tendency of respondents to misclassify "no additive" and "natural" cigarettes as PREPs and 2) the tendency of respondents to mistakenly report awareness as a result of confusion between PREPs brands and similarly named familiar products, for example, Eclipse chewing gum and Accord automobiles.</p> <p>Conclusion</p> <p>After evaluating new measures with cognitive interviews, we conclude that as of winter 2006, awareness of reduced exposure products among U.S. smokers was likely to be between 1% and 8%, with the higher estimates for some products occurring in test markets. Recommended measurement strategies for future surveys are presented.</p

Mismatch Negativity (MMN) reveals inefficient auditory ventral stream function in chronic auditory comprehension impairments

Background: Auditory discrimination is significantly impaired in Wernicke’s aphasia (WA) and thought to be causatively related to the language comprehension impairment which characterises the condition. This study used mismatch negativity (MMN) to investigate the neural responses corresponding to successful and impaired auditory discrimination in WA. Methods: Behavioural auditory discrimination thresholds of CVC syllables and pure tones were measured in WA (n=7) and control (n=7) participants. Threshold results were used to develop multiple-deviant mismatch negativity (MMN) oddball paradigms containing deviants which were either perceptibly or non-perceptibly different from the standard stimuli. MMN analysis investigated differences associated with group, condition and perceptibility as well as the relationship between MMN responses and comprehension (within which behavioural auditory discrimination profiles were examined). Results: MMN waveforms were observable to both perceptible and non-perceptible auditory changes. Perceptibility was only distinguished by MMN amplitude in the PT condition. The WA group could be distinguished from controls by an increase in MMN response latency to CVC stimuli change. Correlation analyses displayed relationship between behavioural CVC discrimination and MMN amplitude in the control group, where greater amplitude corresponded to better discrimination. The WA group displayed the inverse effect; both discrimination accuracy and auditory comprehension scores were reduced with increased MMN amplitude. In the WA group, a further correlation was observed between the lateralisation of MMN response and CVC discrimination accuracy; the greater the bilateral involvement the better the discrimination accuracy. Conclusions: The results from this study provide further evidence for the nature of auditory comprehension impairment in WA and indicate that the auditory discrimination deficit is grounded in a reduced ability to engage in efficient hierarchical processing and the construction of invariant auditory objects. Correlation results suggest that people with chronic WA may rely on an inefficient, noisy right hemisphere auditory stream when attempting to process speech stimuli

The anterior temporal lobes support residual comprehension in Wernicke’s aphasia

Wernicke’s aphasia occurs following a stroke to classical language comprehension regions in the left temporoparietal cortex. Consequently, auditory-verbal comprehension is significantly impaired in Wernicke’s aphasia but the capacity to comprehend visually presented materials (written words and pictures) is partially spared. This study used fMRI to investigate the neural basis of written word and picture semantic processing in Wernicke’s aphasia, with the wider aim of examining how the semantic system is altered following damage to the classical comprehension regions. Twelve participants with Wernicke’s aphasia and twelve control participants performed semantic animate-inanimate judgements and a visual height judgement baseline task. Whole brain and ROI analysis in Wernicke’s aphasia and control participants found that semantic judgements were underpinned by activation in the ventral and anterior temporal lobes bilaterally. The Wernicke’s aphasia group displayed an “over-activation” in comparison to control participants, indicating that anterior temporal lobe regions become increasingly influential following reduction in posterior semantic resources. Semantic processing of written words in Wernicke’s aphasia was additionally supported by recruitment of the right anterior superior temporal lobe, a region previously associated with recovery from auditory-verbal comprehension impairments. Overall, the results concord with models which indicate that the anterior temporal lobes are crucial for multimodal semantic processing and that these regions may be accessed without support from classic posterior comprehension regions