Research Synthesis: Satisficing in Surveys: A Systematic Review of the Literature

Herbert Simon’s (1956) concept of satisficing provides an intuitive explanation for the reasons why respondents to surveys sometimes adopt response strategies that can lead to a reduction in data quality. As such, the concept rapidly gained popularity among researchers after it was first introduced to the field of survey methodology by Krosnick and Alwin (1987), and has become a widely-cited buzzword linked to different forms of response error. In this article, we present the findings of a systematic review involving a content analysis of journal articles published in English-language journals between 1987 and 2015 that have drawn on the satisficing concept to evaluate survey data quality. Based on extensive searches of online databases, and an initial screening exercise to apply the study’s inclusion criteria, 141 relevant articles were identified. Guided by the theory of survey satisficing described by Krosnick (1991), the methodological features of the shortlisted articles were coded, ncluding the indicators of satisficing analyzed, the main predictors of satisficing, and the presence of main or interaction effects on the prevalence of satisficing involving indicators of task difficulty, respondent ability and respondent motivation. Our analysis sheds light on potential differences in the extent to which satisficing theory holds for different types of response error, and highlights a number of avenues for future research

Peri-operative red blood cell transfusion in neonates and infants: NEonate and Children audiT of Anaesthesia pRactice IN Europe: A prospective European multicentre observational study

BACKGROUND: Little is known about current clinical practice concerning peri-operative red blood cell transfusion in neonates and small infants. Guidelines suggest transfusions based on haemoglobin thresholds ranging from 8.5 to 12 g dl-1, distinguishing between children from birth to day 7 (week 1), from day 8 to day 14 (week 2) or from day 15 (≥week 3) onwards. OBJECTIVE: To observe peri-operative red blood cell transfusion practice according to guidelines in relation to patient outcome. DESIGN: A multicentre observational study. SETTING: The NEonate-Children sTudy of Anaesthesia pRactice IN Europe (NECTARINE) trial recruited patients up to 60 weeks' postmenstrual age undergoing anaesthesia for surgical or diagnostic procedures from 165 centres in 31 European countries between March 2016 and January 2017. PATIENTS: The data included 5609 patients undergoing 6542 procedures. Inclusion criteria was a peri-operative red blood cell transfusion. MAIN OUTCOME MEASURES: The primary endpoint was the haemoglobin level triggering a transfusion for neonates in week 1, week 2 and week 3. Secondary endpoints were transfusion volumes, 'delta haemoglobin' (preprocedure - transfusion-triggering) and 30-day and 90-day morbidity and mortality. RESULTS: Peri-operative red blood cell transfusions were recorded during 447 procedures (6.9%). The median haemoglobin levels triggering a transfusion were 9.6 [IQR 8.7 to 10.9] g dl-1 for neonates in week 1, 9.6 [7.7 to 10.4] g dl-1 in week 2 and 8.0 [7.3 to 9.0] g dl-1 in week 3. The median transfusion volume was 17.1 [11.1 to 26.4] ml kg-1 with a median delta haemoglobin of 1.8 [0.0 to 3.6] g dl-1. Thirty-day morbidity was 47.8% with an overall mortality of 11.3%. CONCLUSIONS: Results indicate lower transfusion-triggering haemoglobin thresholds in clinical practice than suggested by current guidelines. The high morbidity and mortality of this NECTARINE sub-cohort calls for investigative action and evidence-based guidelines addressing peri-operative red blood cell transfusions strategies. TRIAL REGISTRATION: ClinicalTrials.gov, identifier: NCT02350348

Understanding family dynamics in a cross-cultural sample: a multi-national study

The Family Systems Circumplex Model posits that balanced levels of cohesion and adaptability are associated with positive familial outcomes, whereas extremely high or low levels of these factors are associated with deleterious outcomes. Despite the popularity and utility of this model in Western cultures, there is a dearth of empirical data supporting its use in more culturally diverse contexts. The current, preregistered study assessed the Family Circumplex Model, cultural factors, and emerging adult outcomes across seven countries (i.e., China, Iran, Nigeria, Switzerland, Turkey, the United Kingdom, and the United States). Participants were N = 3,593 emerging adults, mostly self-identifying as women (71.3%). Collaborators were participants in Psi Chi’s Network for International Collaborative Exchange (NICE) and administered measures related to family dynamics and cultural orientation to participants in a random order. Results indicated that the Family Circumplex Model did not fit cross-culturally. As such, a new model was adapted, the Expanded Circumplex Model, which demonstrated invariance across samples and between women and men. The Expanded Circumplex Model retained 6 constructs with differences regarding the separation of disengagement into 2 variables and the combining of adaptive flexibility and cohesion. The current study suggests that the cultural context in which family dynamics occur should be taken into consideration when conceptualizing family dynamics theory and measurement. Future work should seek to replicate and further apply the Expanded Circumplex Model to familial outcomes

The Impact of laws on norms perceptions

When opinions in a society change toward more or less tolerance of a group, people do not necessarily see it. Drawing on a quasi-representative survey (Study 1, N = 830) and a natural experiment (Study 2, N = 437), we investigated people’s perceptions of the societal norms toward sexual minorities and the influence of laws on these (mis-)perceptions. Study 1 indicated pluralistic ignorance as participants overestimated the societal disapproval toward same-sex issues. Complementing this finding, Study 2 found that informing participants about a new law legalizing stepchild adoption decreased perceived societal disapproval of same-sex parenting compared with participants not informed about the law. Pluralistic ignorance, however, was not affected by the new law. While results indicate that pluralistic ignorance may be more resilient to change, they also highlight that laws can have a dual impact on societies, changing not only the legal situation but also shifting perceptions of societal norms

Perceptions of intolerant norms both facilitate and inhibit collective action among sexual minorities

This article presents the results of three studies that examine how the perceived opinions of others are related to sexual minorities' support for social change toward greater equality. Results of two cross-sectional studies (Study 1: N = 1,220; Study 2: N = 904) reveal that perceived intolerance (i.e., perceived intolerant societal norms) is indirectly related to intentions to engage in collective action in both negative and positive ways: the negative effect was mediated by lower perceptions of perceived efficacy; positive effects were mediated by greater anger (about the legal situation and public opinion) and greater perceived need for a movement. Study 3 (N = 408) replicates this conflicting effect with a delayed outcome measure by showing that perceived intolerant norms were indirectly, both negatively and positively, associated with actual collective action engagement. We discuss the theoretical and practical implications of our expanded social identity model of collective action

Morbidity and mortality after anaesthesia in early life: results of the European prospective multicentre observational study, neonate and children audit of anaesthesia practice in Europe (NECTARINE)

Background: Neonates and infants requiring anaesthesia are at risk of physiological instability and complications, but triggers for peri-anaesthetic interventions and associations with subsequent outcome are unknown. Methods: This prospective, observational study recruited patients up to 60 weeks' postmenstrual age undergoing anaesthesia for surgical or diagnostic procedures from 165 centres in 31 European countries between March 2016 and January 2017. The primary aim was to identify thresholds of pre-determined physiological variables that triggered a medical intervention. The secondary aims were to evaluate morbidities, mortality at 30 and 90 days, or both, and associations with critical events. Results: Infants (n=5609) born at mean (standard deviation [sd]) 36.2 (4.4) weeks postmenstrual age (35.7% preterm) underwent 6542 procedures within 63 (48) days of birth. Critical event(s) requiring intervention occurred in 35.2% of cases, mainly hypotension (>30% decrease in blood pressure) or reduced oxygenation (SpO2 <85%). Postmenstrual age influenced the incidence and thresholds for intervention. Risk of critical events was increased by prior neonatal medical conditions, congenital anomalies, or both (relative risk [RR]=1.16; 95% confidence interval [CI], 1.04-1.28) and in those requiring preoperative intensive support (RR=1.27; 95% CI, 1.15-1.41). Additional complications occurred in 16.3% of patients by 30 days, and overall 90-day mortality was 3.2% (95% CI, 2.7-3.7%). Co-occurrence of intraoperative hypotension, hypoxaemia, and anaemia was associated with increased risk of morbidity (RR=3.56; 95% CI, 1.64-7.71) and mortality (RR=19.80; 95% CI, 5.87-66.7). Conclusions: Variability in physiological thresholds that triggered an intervention, and the impact of poor tissue oxygenation on patient's outcome, highlight the need for more standardised perioperative management guidelines for neonates and infants

Difficult tracheal intubation in neonates and infants. NEonate and Children audiT of Anaesthesia pRactice IN Europe (NECTARINE): a prospective European multicentre observational study

International audienceBackground: Neonates and infants are susceptible to hypoxaemia in the perioperative period. The aim of this study was to analyse interventions related to anaesthesia tracheal intubations in this European cohort and identify their clinical consequences.Methods: We performed a secondary analysis of tracheal intubations of the European multicentre observational trial (NEonate and Children audiT of Anaesthesia pRactice IN Europe [NECTARINE]) in neonates and small infants with difficult tracheal intubation. The primary endpoint was the incidence of difficult intubation and the related complications. The secondary endpoints were the risk factors for severe hypoxaemia attributed to difficult airway management, and 30 and 90 day outcomes.Results: Tracheal intubation was planned in 4683 procedures. Difficult tracheal intubation, defined as two failed attempts of direct laryngoscopy, occurred in 266 children (271 procedures) with an incidence (95% confidence interval [CI]) of 5.8% (95% CI, 5.1-6.5). Bradycardia occurred in 8% of the cases with difficult intubation, whereas a significant decrease in oxygen saturation (SpO2<90% for 60 s) was reported in 40%. No associated risk factors could be identified among co-morbidities, surgical, or anaesthesia management. Using propensity scoring to adjust for confounders, difficult anaesthesia tracheal intubation did not lead to an increase in 30 and 90 day morbidity or mortality.Conclusions: The results of the present study demonstrate a high incidence of difficult tracheal intubation in children less than 60 weeks post-conceptual age commonly resulting in severe hypoxaemia. Reassuringly, the morbidity and mortality at 30 and 90 days was not increased by the occurrence of a difficult intubation event

Incidence of severe critical events in paediatric anaesthesia (APRICOT): a prospective multicentre observational study in 261 hospitals in Europe

Background Little is known about the incidence of severe critical events in children undergoing general anaesthesia in Europe. We aimed to identify the incidence, nature, and outcome of severe critical events in children undergoing anaesthesia, and the associated potential risk factors. Methods The APRICOT study was a prospective observational multicentre cohort study of children from birth to 15 years of age undergoing elective or urgent anaesthesia for diagnostic or surgical procedures. Children were eligible for inclusion during a 2-week period determined prospectively by each centre. There were 261 participating centres across 33 European countries. The primary endpoint was the occurence of perioperative severe critical events requiring immediate intervention. A severe critical event was defined as the occurrence of respiratory, cardiac, allergic, or neurological complications requiring immediate intervention and that led (or could have led) to major disability or death. This study is registered with ClinicalTrials.gov, number NCT01878760. Findings Between April 1, 2014, and Jan 31, 2015, 31â127 anaesthetic procedures in 30â874 children with a mean age of 6·35 years (SD 4·50) were included. The incidence of perioperative severe critical events was 5·2% (95% CI 5·0â5·5) with an incidence of respiratory critical events of 3·1% (2·9â3·3). Cardiovascular instability occurred in 1·9% (1·7â2·1), with an immediate poor outcome in 5·4% (3·7â7·5) of these cases. The all-cause 30-day in-hospital mortality rate was 10 in 10â000. This was independent of type of anaesthesia. Age (relative risk 0·88, 95% CI 0·86â0·90; p<0·0001), medical history, and physical condition (1·60, 1·40â1·82; p<0·0001) were the major risk factors for a serious critical event. Multivariate analysis revealed evidence for the beneficial effect of years of experience of the most senior anaesthesia team member (0·99, 0·981â0·997; p<0·0048 for respiratory critical events, and 0·98, 0·97â0·99; p=0·0039 for cardiovascular critical events), rather than the type of health institution or providers. Interpretation This study highlights a relatively high rate of severe critical events during the anaesthesia management of children for surgical or diagnostic procedures in Europe, and a large variability in the practice of paediatric anaesthesia. These findings are substantial enough to warrant attention from national, regional, and specialist societies to target education of anaesthesiologists and their teams and implement strategies for quality improvement in paediatric anaesthesia. Funding European Society of Anaesthesiology