Predictors of web-based follow-up response in the Prevention of Low Back Pain in the Military Trial (POLM)

<p>Abstract</p> <p>Background</p> <p>Achieving adequate follow-up in clinical trials is essential to establish the validity of the findings. Achieving adequate response rates reduces bias and increases probability that the findings can be generalized to the population of interest. Therefore, the purpose of this study was to determine the influence of attention, demographic, psychological, and health status factors on web-based response rates in the ongoing Prevention of Low Back Pain in the Military (POLM) trial.</p> <p>Methods</p> <p>Twenty companies of Soldiers (n = 4,325) were cluster randomized to complete a traditional exercise program including sit-ups (TEP) with or without a psychosocial educational program (PSEP) or a core stabilization exercise program (CSEP) with or without PSEP. A subgroup of Soldiers (n = 371) was randomized to receive an additional physical and ultrasound imaging (USI) examination of key trunk musculature. As part of the surveillance program, all Soldiers were encouraged to complete monthly surveys via email during the first year. Descriptive statistics of the predictor variables were obtained and compared between responders and non-responders using two sample t-tests or chi-square test, as appropriate. Generalized linear mixed models were subsequently fitted for the dichotomous outcomes to estimate the effects of the predictor variables. The significance level was set at .05 a priori.</p> <p>Results</p> <p>The overall response rate was 18.9% (811 subjects) for the first year. Responders were more likely to be older, Caucasian, have higher levels of education and income, reservist military status, non smoker, lower BMI, and have received individualized attention via the physical/USI examination (p < .05). Age, race/ethnicity, education, military status, smoking history, BMI, and whether a Soldier received the physical/USI examination remained statistically significant (p < .05) when considered in a full multivariate model.</p> <p>Conclusion</p> <p>The overall web based response rate during the first year of the POLM trial was consistent with studies that used similar methodology, but lower when compared to rates expected for standard clinical trials. One year response rate was significantly associated with demographic characteristics, health status, and individualized attention via additional testing. These data may assist for planning of future trials that use web based response systems.</p> <p>Trial Registration</p> <p>This study has been registered at reports at <url>http://clinicaltrials.gov</url> (<a href="http://www.clinicaltrials.gov/ct2/show/NCT00373009">NCT00373009</a>).</p

The physiological disposition and metabolic fate of cortisone in

In an earlier paper we described studies on the physiological disposition and metabolic fate of hydrocortisone in man (1). This paper describes similar studies on cortisone. Although contributing very little to the body pool of adrenal cortical steroids, cortisone has been used extensively as a therapeutic agent, and it was therefore of interest to compare its metabolism with that of hydrocortisone. Large doses of cortisone and hydrocortisone were administered intravenously and rates of disappearance from the plasma determined in normal subjects and in patients with liver disease, myxedema, thyrotoxicosis, and rheumatoid arthritis. Trace quantities of cortisone-4-C&quot; and hydrocortisone-4-C&quot; were employed in certain studies. From these studies, information was obtained regarding rate of metabolic transformation, rate of absorption, rates and routes of excretion of cortisone and its metabolites, and, to some extent, the identity and amount of these metabolites. Information was also obtained on the in vivo conversion of cortisone to hydrocortisone. MATERIALS AND METHODS Administration of steroid. The steroids were dissolved in 25 ml. ethanol and added to 500 ml. of sterile five per cent dextrose in water. This solution was administered intravenously over a period of 10 to 20 minutes. For oral or intramuscular administration the steroids were suspended in saline. Cortisone-4-C&quot; was administered intravenously in trace quantities in a small volume of five per cent ethanol in water over a period of 3 to 5 minutes, or mixed with carrier cortisone and given in 500 ml. of three per cent ethanol in five per cent dextrose in sterile distilled water. Following the administration of the steroids, blood samples were drawn in heparinized syringes every 20 or 30 minutes for 2 hours-or more. Urine samples were collected and preserved by freezing. Methods of assay. The extraction procedures for the steroids in plasma and urine were the same as those de

Genomic evidence of recent European introgression into North American farmed and wild Atlantic salmon

publishedVersio

Knowledge and attitudes about health research amongst a group of Pakistani medical students

Background Health research training is an important part of medical education. This study was conducted to assess the level of knowledge and attitudes regarding health research in a group of Pakistani medical students at Aga Khan University, Karachi. Methods It was a cross-sectional pilot study conducted among a group of Pakistani medical students. Through stratified random sampling, a pre-tested, structured and validated questionnaire was administered to 220 medical students. Knowledge and attitudes were recorded on a scale (graduated in percentages). Results Mean scores of students were 49.0% on knowledge scale and 53.7% on attitude scale. Both knowledge and attitudes improved significantly with increasing years of study in medical college [Regression coefficient 4.10 (p-value; 0.019) and 6.67 (p-value; \u3c 0.001) for knowledge and attitudes, respectively]. Conclusion Medical students demonstrate moderate level of knowledge and attitude towards health research. Intensive training in this regard is associated with significant improvement in knowledge and attitudes of students towards health research

A Computational Clonal Analysis of the Developing Mouse Limb Bud

A comprehensive spatio-temporal description of the tissue movements underlying organogenesis would be an extremely useful resource to developmental biology. Clonal analysis and fate mappings are popular experiments to study tissue movement during morphogenesis. Such experiments allow cell populations to be labeled at an early stage of development and to follow their spatial evolution over time. However, disentangling the cumulative effects of the multiple events responsible for the expansion of the labeled cell population is not always straightforward. To overcome this problem, we develop a novel computational method that combines accurate quantification of 2D limb bud morphologies and growth modeling to analyze mouse clonal data of early limb development. Firstly, we explore various tissue movements that match experimental limb bud shape changes. Secondly, by comparing computational clones with newly generated mouse clonal data we are able to choose and characterize the tissue movement map that better matches experimental data. Our computational analysis produces for the first time a two dimensional model of limb growth based on experimental data that can be used to better characterize limb tissue movement in space and time. The model shows that the distribution and shapes of clones can be described as a combination of anisotropic growth with isotropic cell mixing, without the need for lineage compartmentalization along the AP and PD axis. Lastly, we show that this comprehensive description can be used to reassess spatio-temporal gene regulations taking tissue movement into account and to investigate PD patterning hypothesis

Lethal Injection for Execution: Chemical Asphyxiation?

Data from executions in the US suggest that current lethal injection protocols do not effect death through the mechanisms intended, and that potentially aware inmates could die through pancuronium-induced asphyxiation

Undergraduate medical research: the student perspective

Background: Research training is essential in a modern undergraduate medical curriculum. Our evaluation aimed to (a) gauge students&#x2019; awareness of research activities, (b) compare students&#x2019; perceptions of their transferable and research-specific skills competencies, (c) determine students&#x2019; motivation for research and (d) obtain students&#x2019; personal views on doing research. Methods: Undergraduate medical students (N=317) completed a research skills questionnaire developed by the Centre for Excellence in Teaching and Learning in Applied Undergraduate Research Skills (CETL-AURS) at Reading University. The questionnaire assessed students&#x2019; transferable skills, research-specific skills (e.g., study design, data collection and data analysis), research experience and attitude and motivation towards doing research. Results: The majority of students are motivated to pursue research. Graduate entrants and male students appear to be the most confident regarding their research skills competencies. Although all students recognise the role of research in medical practice, many are unaware of the medical research activities or successes within their university. Of those who report no interest in a career incorporating research, a common perception was that researchers are isolated from patients and clinical practice. Discussion: Students have a narrow definition of research and what it entails. An explanation for why research competence does not align more closely with research motivation is derived from students&#x2019; lack of understanding of the concept of translational research, as well as a lack of awareness of the research activity being undertaken by their teachers and mentors. We plan to address this with specific research awareness initiatives

Individual characteristics and student's engagement in scientific research : a cross-sectional study

Background: In light of the increasing recognition of the importance of physician scientists, and given the association between undergraduate research experiences with future scientific activity, it is important to identify and understand variables related to undergraduate student’s decision to engage in scientific research activities. The present study assessed the influence of individual characteristics, including personality traits and socio-demographic characteristics, on voluntary engagement in scientific research of undergraduate medical students. Methods: For this study, all undergraduate students and alumni of the School of Health Sciences in Minho, Portugal were invited to participate in a survey about voluntary engagement in scientific research activities. Data were available on socio-demographic, personality and university admission variables, as part of an ongoing longitudinal study. A regression model was used to compare (1) engaged with (2) not engaged students. A classification and regression tree model was used to compare students engaged in (3) elective curricular research (4) and extra-curricular research. Results: A total of 466 students (88%) answered the survey. A complete set of data was available for 435 students (83%).Higher scores in admission grade point average and the personality dimensions of “openness to experience” and “conscientiousness” increased chances of engagement. Higher “extraversion” scores had the opposite effect. Male undergraduate students were two times more likely than females to engage in curricular elective scientific research and were also more likely to engage in extra-curricular research activities. Conclusions: This study demonstrated that student’s grade point average and individual characteristics, like gender, openness and consciousness have a unique and statistically significant contribution to student’s involvement in undergraduate scientific research activities.Fundação para a Ciência e a Tecnologia (FCT) - PTDC/ESC/65116/200