What impact do questionnaire length and monetary incentives have on mailed health psychology survey response?

Objectives: Response rates to health-related surveys are declining. This study tested two strategies to improve the response rate to a health psychology survey mailed through English general practices: (1) sending a shortened questionnaire and (2) offering a monetary incentive to return a completed questionnaire. Design: Randomized controlled trial. Methods: Adults (n = 4,241) aged 45–59 years, from four General Practices in South-East England, were mailed a survey on attitudes towards bowel cancer screening. Using a 2 × 4 factorial design, participants were randomized to receive a ‘short’ (four A4 pages) or a ‘long’ (seven A4 pages) questionnaire, and one of four monetary incentives to return a completed questionnaire – (1) no monetary incentive, (2) £2.50 shop voucher, (3) £5.00 shop voucher, and (4) inclusion in a £250 shop voucher prize draw. Age, gender, and area-level deprivation were obtained from the General Practices. Results: The overall response rate was 41% (n = 1,589). Response to the ‘short’ questionnaire (42%) was not significantly different from the ‘long’ questionnaire (40%). The £2.50 incentive (43%) significantly improved response rates in univariate analyses, and remained significant after controlling for age, gender, area-level deprivation, and questionnaire length. The £5.00 (42%) and £250 prize draw (41%) incentives had no significant impact on response rates compared to no incentive (38%). Conclusions: A small monetary incentive (£2.50) may slightly increase response to a mailed health psychology survey. The length of the questionnaire (four pages vs. seven pages) did not influence response. Although frequently used, entry into a prize draw did not increase response. Achieving representative samples remains a challenge for health psychology

Dual-Registration: A Multi-Informant Exploration of the Experiences of Pupils, Parents, Teachers and Educational Psychologists

There has been a 40% increase in the number of permanent exclusions in England since 2016 (House of Commons, 2018). Research investigating school exclusion has primarily considered pupils aged 11-16 years, who attend Pupil Referral Units (PRUs). Very few studies have explored the experiences of pupils aged 4-11 years who attend these settings. Even fewer have explored the experiences of primary-aged pupils who attend PRUs on a part-time basis, despite the fact that this arrangement forms a considerable part of alternative provision in England. To address this gap, this research uses a case study approach to explore dual-registration, an arrangement whereby pupils at risk of permanent exclusion attend both their mainstream setting and a PRU on a weekly basis. Semi-structured interviews were conducted with four pupils, their parents and mainstream teachers to explore their experiences of dual-registration and inform understanding of its value in supporting pupils at risk of permanent exclusion. In addition, two focus groups were conducted, one with PRU staff to enhance understanding of their experiences of working with mainstream teachers to support these pupils and the other with educational psychologists, who were asked to reflect upon their role within this system. Six overarching themes were identified: ‘Containing the Container’, ‘Containing the Pupil’, ‘Overcoming Challenges’, ‘Pupils’ Sense of Belonging’, ‘Evaluating Success’ and ‘Reclaiming the EP role’. Findings suggested that an integral part of the partnership between mainstream schools and the PRU, was the ability of PRU staff to contain the anxieties of pupils, parents and mainstream teachers. It was noted that whilst there was clear understanding of the need to respond appropriately to challenges experienced by stakeholders, dual-registration could increase the pressures placed upon pupils, parents and professionals. Within this context, a key role for the EP in supporting the emotional availability and thinking capacity of stakeholders was identified

Randomized clinical trial of therapeutic music video intervention for resilience outcomes in adolescents/young adults undergoing hematopoietic stem cell transplant: a report from the Children's Oncology Group

BACKGROUND: To reduce the risk of adjustment problems associated with hematopoietic stem cell transplant (HSCT) for adolescents/young adults (AYAs), we examined efficacy of a therapeutic music video (TMV) intervention delivered during the acute phase of HSCT to: 1) increase protective factors of spiritual perspective, social integration, family environment, courageous coping, and hope-derived meaning; 2) decrease risk factors of illness-related distress and defensive coping; and 3) increase outcomes of self-transcendence and resilience. METHODS: This was a multisite randomized, controlled trial (COG-ANUR0631) conducted at 8 Children's Oncology Group sites involving 113 AYAs aged 11-24 years undergoing myeloablative HSCT. Participants, randomized to the TMV or low-dose control (audiobooks) group, completed 6 sessions over 3 weeks with a board-certified music therapist. Variables were based on Haase's Resilience in Illness Model (RIM). Participants completed measures related to latent variables of illness-related distress, social integration, spiritual perspective, family environment, coping, hope-derived meaning, and resilience at baseline (T1), postintervention (T2), and 100 days posttransplant (T3). RESULTS: At T2, the TMV group reported significantly better courageous coping (Effect Size [ES], 0.505; P = .030). At T3, the TMV group reported significantly better social integration (ES, 0.543; P = .028) and family environment (ES, 0.663; P = .008), as well as moderate nonsignificant effect sizes for spiritual perspective (ES, 0.450; P = .071) and self-transcendence (ES, 0.424; P = .088). CONCLUSIONS: The TMV intervention improves positive health outcomes of courageous coping, social integration, and family environment during a high-risk cancer treatment. We recommend the TMV be examined in a broader population of AYAs with high-risk cancers

The Effects of Laryngeal Desiccation and Nebulized Isotonic Saline in Male Speakers

Hydration of the vocal folds is important for the production of normal voice. Dehydration makes voice production more difficult and increases vocal effort. Laryngeal desiccation has been shown to increase phonation threshold pressure (PTP) and self-perceived phonatory effort (PPE) in females. Nebulized saline may reverse or offset this effect. However, few data exist regarding the effects of laryngeal desiccation and nebulized treatments in males. Further, the dose-response relationship between laryngeal desiccation and nebulized hydration treatments is unknown. This study examined the effects of two doses of nebulized isotonic saline following a laryngeal desiccation challenge in healthy male speakers. In a double-blinded, within-subjects design, 10 male college students (age range 18-26 years) attended two data collection sessions involving a 30-minute desiccation challenge followed by 3 mL or 9 mL of nebulized isotonic saline. PTP for the 10th and 80th fundamental frequency (F0) percentiles and PPE were collected before and after the desiccation challenge and at 5, 35, and 65 minutes after the nebulized treatment. PPE increased significantly following the laryngeal desiccation challenge (p \u3c .01). Following nebulization, PPE decreased toward baseline for both doses of isotonic saline (p \u3c .01), but failed to reverse the desiccation effect completely. No statistically significant changes in PTP occurred following the laryngeal desiccation challenge or subsequent treatments. Compared with previous research involving females, these results suggest males may respond differently to laryngeal desiccation and nebulized hydration treatments

Neoadjuvant cisplatin and fluorouracil versus epirubicin, cisplatin, and capecitabine followed by resection in patients with oesophageal adenocarcinoma (UK MRC OE05): an open-label, randomised phase 3 trial.

BACKGROUND: Neoadjuvant chemotherapy before surgery improves survival compared with surgery alone for patients with oesophageal cancer. The OE05 trial assessed whether increasing the duration and intensity of neoadjuvant chemotherapy further improved survival compared with the current standard regimen. METHODS: OE05 was an open-label, phase 3, randomised clinical trial. Patients with surgically resectable oesophageal adenocarcinoma classified as stage cT1N1, cT2N1, cT3N0/N1, or cT4N0/N1 were recruited from 72 UK hospitals. Eligibility criteria included WHO performance status 0 or 1, adequate respiratory, cardiac, and liver function, white blood cell count at least 3 × 10(9) cells per L, platelet count at least 100 × 10(9) platelets per L, and a glomerular filtration rate at least 60 mL/min. Participants were randomly allocated (1:1) using a computerised minimisation program with a random element and stratified by centre and tumour stage, to receive two cycles of cisplatin and fluorouracil (CF; two 3-weekly cycles of cisplatin [80 mg/m(2) intravenously on day 1] and fluorouracil [1 g/m(2) per day intravenously on days 1-4]) or four cycles of epirubicin, cisplatin, and capecitabine (ECX; four 3-weekly cycles of epirubicin [50 mg/m(2)] and cisplatin [60 mg/m(2)] intravenously on day 1, and capecitabine [1250 mg/m(2)] daily throughout the four cycles) before surgery, stratified according to centre and clinical disease stage. Neither patients nor study staff were masked to treatment allocation. Two-phase oesophagectomy with two-field (abdomen and thorax) lymphadenectomy was done within 4-6 weeks of completion of chemotherapy. The primary outcome measure was overall survival, and primary and safety analyses were done in the intention-to-treat population. This trial is registered with the ISRCTN registry (number 01852072) and ClinicalTrials.gov (NCT00041262), and is completed. FINDINGS: Between Jan 13, 2005, and Oct 31, 2011, 897 patients were recruited and 451 were assigned to the CF group and 446 to the ECX group. By Nov 14, 2016, 327 (73%) of 451 patients in the CF group and 302 (68%) of 446 in the ECX group had died. Median survival was 23·4 months (95% CI 20·6-26·3) with CF and 26·1 months (22·5-29·7) with ECX (hazard ratio 0·90 (95% CI 0·77-1·05, p=0·19). No unexpected chemotherapy toxicity was seen, and neutropenia was the most commonly reported event (grade 3 or 4 neutropenia: 74 [17%] of 446 patients in the CF group vs 101 [23%] of 441 people in the ECX group). The proportions of patients with postoperative complications (224 [56%] of 398 people for whom data were available in the CF group and 233 [62%] of 374 in the ECX group; p=0·089) were similar between the two groups. One patient in the ECX group died of suspected treatment-related neutropenic sepsis. INTERPRETATION: Four cycles of neoadjuvant ECX compared with two cycles of CF did not increase survival, and cannot be considered standard of care. Our study involved a large number of centres and detailed protocol with comprehensive prospective assessment of health-related quality of life in a patient population confined to people with adenocarcinomas of the oesophagus and gastro-oesophageal junction (Siewert types 1 and 2). Alternative chemotherapy regimens and neoadjuvant chemoradiation are being investigated to improve outcomes for patients with oesophageal carcinoma. FUNDING: Cancer Research UK and Medical Research Council Clinical Trials Unit at University College London

The knowledge economy, the techno-preneur and the problematic future of the university

Knowledge economy policies are currently very powerful drivers of change in contemporary university approaches to research. They typically orientate universities to a national innovation system which both positions knowledge as the key factor of economic growth and sees the main purpose of knowledge as contributing to such growth. In this article, the authors explain the economic logic informing such policy interventions in university research and look at the conceptualisation of national innovation systems in various national and international policy sites around the world. Their interest is in what these particular sets of policies have in common, not in how they differ. They introduce three key themes of such systems and the academics they seek to produce. These themes are their techno-scientific orientation, network characteristics and commercial imperatives. The corresponding implied subjects are the techno-scientist, the knowledge networker and the entrepreneur. The authors make the case that evident in such constructions of the future of universities are some unacknowledged and under-acknowledged problems, one of which is a failure to recognise the power of the gift economies of academic culture.<br /

The effect of a supplementary ('Gist-based') information leaflet on colorectal cancer knowledge and screening intention: a randomized controlled trial.

Guided by Fuzzy Trace Theory, this study examined the impact of a 'Gist-based' leaflet on colorectal cancer screening knowledge and intentions; and tested the interaction with participants' numerical ability. Adults aged 45-59 years from four UK general practices were randomly assigned to receive standard information ('The Facts', n = 2,216) versus standard information plus 'The Gist' leaflet (Gist + Facts, n = 2,236). Questionnaires were returned by 964/4,452 individuals (22 %). 82 % of respondents reported having read the information, but those with poor numeracy were less likely (74 vs. 88 %, p < .001). The 'Gist + Facts' group were more likely to reach the criterion for adequate knowledge (95 vs. 91 %; p < .01), but this was not moderated by numeracy. Most respondents (98 %) intended to participate in screening, with no group differences and no interaction with numeracy. The improved levels of knowledge and self-reported reading suggest 'The Gist' leaflet may increase engagement with colorectal cancer screening, but ceiling effects reduced the likelihood that screening intentions would be affected