Exploring the Impact of Interviewer Perceptions and Interviewer-Respondent Interactions on the Survey of Income and Program Participation: Analysis of CARI recordings

Interviewers play a significant role in telephone and face-to-face interviews, including gaining respondent cooperation and administering survey questions. Increasingly, interviewers’ perceptions of the respondent and interview experience, such as cooperativeness and interest, are also being used to assess measurement error and make adjustments to data (West, 2013; Kirchner et al., 2017). Although interviewer perceptions are typically recorded at the end of the interview, interviewers are likely to begin forming perceptions about the household and respondent based on their first contact attempt (and continue developing them during the interview). We hypothesize that interview context factors, such as interviewer perceptions of the physical interview environment and the respondent’s reluctance, may interact with question characteristics, such as sensitivity and cognitive burden, to influence interviewer-respondent interactions. One survey that may be particularly impacted by context factors is the Survey of Income and Program Participation (SIPP). The SIPP is a multi-wave household survey that asks questions about economic well-being, family dynamics, and housing security, among other sensitive and cognitively burdensome topics. SIPP interviewers receive standardized training but they also implement individual strategies as they react to the questionnaire, respondent, and interview context. For example, interviewers may anticipate that some respondents will react sensitively to interview questions and proactively tailor questions to reduce sensitivity. The criteria that interviewers use to make these judgments may vary, resulting in differences in question-asking and probing behavior that may ultimately affect response distributions and respondent burden in unexpected ways. The purpose of the present study was to develop a framework of the interviewer-respondent interaction from the interviewer’s perspective. A primary goal was to investigate whether an interviewer’s question-asking or probing behavior differs between contexts that are sensitive or burdensome (e.g., sensitive and non-sensitive questions; reluctant and non-reluctant respondents). In addition, we identify the interviewer behaviors that appear to reduce respondent behaviors associated with measurement error. To do this, we combined several data sources from the 2014 SIPP Panel: computer audio-recorded interviewing (CARI) recordings, interviewer perceptions of the physical interview environment (Neighborhood Observation Instrument, NOI) and of respondent behaviors during contact attempts (Contact History Instrument, CHI), SIPP data including responses to survey questions and demographics, and interviewer characteristics. Three researchers independently transcribed and coded audio recordings of the full interaction for a sample of the targeted questions. Behavior codes included: whether the interviewer changed the survey question and what type of change was made (e.g., tailored the question to match the respondent’s situation), how the interviewer reacted to responses (used a suggestive probe); whether the respondent did not give a codeable response (a vague answer that does not unambiguously match a response option); and other codes that describe the interaction (pauses, interruptions). We plan to present descriptive analyses of interviewer and respondent behaviors, as well as modeling results that examine the extent to which (a) selected interview context factors predict interviewer behavior and (b) interviewing strategies predict response and interview outcomes. Implications for data quality, interviewer training, questionnaire design, and survey methods in general will be discussed

Ethnic Layers of Detroit: Experiencing Place through Digital Storytelling

Ethnic Layers of Detroit (ELD) seeks to engage students in documenting and sharing the complex layers of Detroit’s ethnic histories though an interactive digital storytelling web portal. We are requesting Level II funding to expand on our pilot project to hire student assistants to develop 20-25 additional multimedia narratives over an 18-month period.This project is innovative in that it facilitates interdisciplinary investigation and collaboration, and uses available technology in new ways to explore the multilayered connections between people, practices and the urban environment through narrative and experientially-based learning activities. By constructing a student-centered project with overlapping creative, intellectual, and technical training opportunities, our project will provide students with the transferable skills and experience to communicate with and contribute to a range of humanities, multimedia, and urban-focused colleagues and careers

Relation between body mass index and depression: a structural equation modeling approach

<p>Abstract</p> <p>Background</p> <p>Obesity and depression are two major diseases which are associated with many other health problems such as hypertension, dyslipidemia, diabetes mellitus, coronary heart disease, stroke, myocardial infarction, heart failure in patients with systolic hypertension, low bone mineral density and increased mortality. Both diseases share common health complications but there are inconsistent findings concerning the relationship between obesity and depression. In this work we used the <it>structural equation modeling </it>(SEM) technique to examine the relation between body mass index (BMI), as a proxy for obesity, and depression using the Canadian Community Health Survey, Cycle 1.2.</p> <p>Methods</p> <p>In this SEM model we postulate that 1) BMI and depression are directly related, 2) BMI is directly affected by the physical activity and, 3)depression is directly influenced by stress. SEM was also used to assess the relation between BMI and depression separately for males and females.</p> <p>Results</p> <p>The results indicate that higher BMI is associated with more severe form of depression. On the other hand, the more severe form of depression may result in less weight gain. However, the association between depression and BMI is gender dependent. In males, the higher BMI may result in a more severe form of depression while in females the relation may not be the same. Also, there was a negative relationship between physical activity and BMI.</p> <p>Conclusion</p> <p>In general, use of SEM method showed that the two major diseases, obesity and depression, are associated but the form of the relation is different among males and females. More research is necessary to further understand the complexity of the relationship between obesity and depression. It also demonstrated that SEM is a feasible technique for modeling the relation between obesity and depression.</p

Brain macrophage and extracellular vesicle response to focused ultrasound neuroimmunotherapy

In addition to protecting the brain from circulating pathogens and neurotoxins, the blood-brain barrier (BBB) limits both the delivery of drugs to the brain and the migration of neurological disease biomarkers from the brain into the blood. Focused-ultrasound blood-brain barrier opening (FUS-BBBO) addresses both of these transport limitations by transiently and noninvasively opening the BBB. Although originally designed as a drug delivery method, FUS-BBBO has also been shown to be an effective neuroimmunotherapy and method of improving liquid biopsy specificity for neurological disease. Prior to the work presented herein, the mechanism of FUS-BBBO neuroimmunotherapy remained poorly characterized and FUS-BBBO liquid biopsy remained poorly optimized. Initially, we present the temporal response of brain macrophages to FUS-BBBO. Due totheir role as the main phagocyte in the brain and the well-documented association between their dysfunction and neurodegenerative disease progression, we hypothesized that FUS-BBBO affects brain macrophage population composition and phenotype. Utilizing temporal single-cell RNA sequencing, we establish that treatment remodels the immune landscape via a number of processes including microglia proliferation, disease-associated microglia population size increase, and central-nervous-system associated macrophage recruitment. To further elucidate the functional role of the brain macrophage response to FUS-BBBO, we find that their depletion is associated with significantly decelerated BBB restoration. Secondly, we compare FUS-BBBO with two other methods of focused ultrasound neuroimmunotherapy, focused ultrasound neuromodulation (FUS-N) and focused ultrasound with microbubbles without BBBO (FUS+MB). FUS-N utilizes FUS parameters that alter neuronal connectivity via a combination of mechanosensitive receptor interactions and transient hypothermia without the injection of microbubbles (MB). FUS+MB is the combination of MB and FUS below the pressure threshold for BBBO (FUS+MB). FUS+MB has been shown to trigger morphological activation of brain macrophages and has proven efficacious as a method of immunotherapy within the peripheral nervous system. Due to the findings of brain macrophage modulation in response to FUS-BBBO, we compare brain macrophage modulation between all three paradigms both in the presence and absence of Alzheimer’s Disease (AD) pathology. We identify FUS-BBBO as the paradigm which maximizes brain macrophage modulation including an increase in the population of neuroprotective, disease-associated microglia and direct correlation between FUS cavitation dose and brain macrophage phagocytosis. Next, we combine spatial and single-cell transcriptomics with immunohistochemical validation to characterize the effect of FUS-BBBO on brain macrophage distribution in both wild-type and Alzheimer’s disease animals. Given their relevance within neurodegeneration and perturbation response, we emphasize the distribution of three brain macrophage populations - disease- and interferon-associated microglia and central-nervous-system-associated macrophages. We find a genotype-specific redistribution of each population, with an overall trend towards increased interaction with the brain-cerebrospinal fluid barrier after FUS-BBBO, an effect that is found to be more pronounced in the presence of disease pathology. Finally, we investigate the role of extracellular vesicles (EVs) in both the mechanism ofFUS-BBBO neuroimmunotherapy and as a method of improving FUS-BBBO liquid biopsy. EVs are lipid vesicles that are responsible for the transport and exchange of diverse cargo between cells and have been reported to modulate the immune system. Isolation of EVs has emerged as a method of improving biomarker detection. Prior to this study, the effect of FUS-BBBO neuroimmunotherapy on EV concentration and content remained unexplored. We investigate the concentration and content of isolated EVs from the serum of mice and Alzheimer’s Disease patients prior to and after treatment with FUS-BBBO. We illustrate a 100% increase in EV concentration one hour after treatment in both mice and patients. Furthermore, we illustrate an increase in murine EV RNA that is associated with the previously reported neuroimmunotherapeutic responses to FUS-BBBO including synaptic remodeling and neurogenesis. Finally, we illustrate an increase in AD biomarker concentration within the patient EVs three days after treatment that is proportional to the volume of blood-brain barrier opening. Overall, we establish that FUS-BBBO drug-free neuroimmunotherapy triggers complex brain macrophage modulation in a manner incomparable by other FUS neuroimmunotherapy paradigms. Furthermore, we illustrate the effect of FUS-BBBO on EV concentration and content in both preclinical and clinical experiments, indicating the role of EVs in FUS-BBBO neuroimmunotherapy and their utility as a method of improving liquid biopsy specificity. The results presented herein support the potential of FUS-BBBO as both a method of neuroimmunotherapy and a method of amplifying liquid biopsy specificity in Alzheimer’s Disease

Ultrasound-enhanced Drug Delivery for Treatment of Onychomycosis

INTRODUCTION Onychomycosis is a fungal nail disorder that can be extremely painful. In onychomycosis, the fungus lives on the nail bed. Due to the poor permeability of the nail, current antifungal drugs, which are applied to the top of the nail, are unable to reliably reach the nail bed, making them ineffective in treating the fungus. The aim of our study has been to determine the effectiveness of using ultrasound to increase the permeability of the nail with the goal of improving outcomes in the treatment of onychomycosis. MATERIALS AND METHODS Porcine nails were used for all experiments. Two sets of ultrasonic experiments were performed. In both experiments, planar ultrasound transducers were used to sonicate the nails using frequencies of 400 kHz, 600 kHz, 800 kHz, and 1 MHz, an intensity of 1 +/- 0.1 W/cm2 and a duration of 5 min in continuous mode. In the first experiment, the luminosity experiment, a piece of porcine nail was placed in a beaker beneath the ultrasound transducer. The beaker was then filled with a drug-mimicking hydrophilic blue dye. After treatment, a microscopic image of the nails’ cross section was taken. This image was analyzed to compare the average brightness - and therefore permeation of dye. In the second experiment, the diffusion cell experiment, a Franz Diffusion Cell was used. The nail was placed above a receiving compartment filled with saline and the donor compartment was filled with the same blue dye. The nail was sonicated and the absorbance of the receiving compartment was measured to determine the permeation of dye through the nail. The final experiment was a safety modeling experiment performed using PZFlex software and a model of the human toe. RESULTS AND DISCUSSION In both the luminosity and diffusion cell experiments, the nails were found to have more permeation at higher frequencies. In the luminosity experiments (n=8 per group), the 600 kHz and 800 kHz frequencies were found to be statistically significant (p\u3c0.05). The diffusion cell results found statistical significance (p\u3c0.05) at 400 kHz, 600 kHz, 800 kHz and 1 MHz tests (n=6). In the temperature modeling experiment a safe temperature increase was found at all frequencies. CONCLUSION Our ongoing study efforts focus on testing the diffusion of an antifungal nail polish drug, ciclopirox, through the porcine nails. If proven successful our method may find a clinical application due to the non-invasive nature of proposed therapeutic ultrasound treatment

Exploring the Impact of Interviewer Perceptions and Interviewer-Respondent Interactions on the Survey of Income and Program Participation: Analysis of CARI recordings

Interviewers play a significant role in telephone and face-to-face interviews, including gaining respondent cooperation and administering survey questions. Increasingly, interviewers’ perceptions of the respondent and interview experience, such as cooperativeness and interest, are also being used to assess measurement error and make adjustments to data (West, 2013; Kirchner et al., 2017). Although interviewer perceptions are typically recorded at the end of the interview, interviewers are likely to begin forming perceptions about the household and respondent based on their first contact attempt (and continue developing them during the interview). We hypothesize that interview context factors, such as interviewer perceptions of the physical interview environment and the respondent’s reluctance, may interact with question characteristics, such as sensitivity and cognitive burden, to influence interviewer-respondent interactions. One survey that may be particularly impacted by context factors is the Survey of Income and Program Participation (SIPP). The SIPP is a multi-wave household survey that asks questions about economic well-being, family dynamics, and housing security, among other sensitive and cognitively burdensome topics. SIPP interviewers receive standardized training but they also implement individual strategies as they react to the questionnaire, respondent, and interview context. For example, interviewers may anticipate that some respondents will react sensitively to interview questions and proactively tailor questions to reduce sensitivity. The criteria that interviewers use to make these judgments may vary, resulting in differences in question-asking and probing behavior that may ultimately affect response distributions and respondent burden in unexpected ways. The purpose of the present study was to develop a framework of the interviewer-respondent interaction from the interviewer’s perspective. A primary goal was to investigate whether an interviewer’s question-asking or probing behavior differs between contexts that are sensitive or burdensome (e.g., sensitive and non-sensitive questions; reluctant and non-reluctant respondents). In addition, we identify the interviewer behaviors that appear to reduce respondent behaviors associated with measurement error. To do this, we combined several data sources from the 2014 SIPP Panel: computer audio-recorded interviewing (CARI) recordings, interviewer perceptions of the physical interview environment (Neighborhood Observation Instrument, NOI) and of respondent behaviors during contact attempts (Contact History Instrument, CHI), SIPP data including responses to survey questions and demographics, and interviewer characteristics. Three researchers independently transcribed and coded audio recordings of the full interaction for a sample of the targeted questions. Behavior codes included: whether the interviewer changed the survey question and what type of change was made (e.g., tailored the question to match the respondent’s situation), how the interviewer reacted to responses (used a suggestive probe); whether the respondent did not give a codeable response (a vague answer that does not unambiguously match a response option); and other codes that describe the interaction (pauses, interruptions). We plan to present descriptive analyses of interviewer and respondent behaviors, as well as modeling results that examine the extent to which (a) selected interview context factors predict interviewer behavior and (b) interviewing strategies predict response and interview outcomes. Implications for data quality, interviewer training, questionnaire design, and survey methods in general will be discussed

Ultrasound-Enhanced Drug Delivery for Treatment of Onychomycosis

More than 32 million Americans are currently suffering from onychomycosis—an unattractive and potentially dangerous fungal nail disorder. There is currently no effective treatment for onychomycosis. The oral antifungal drugs take over 6 months to work and have overall failure rates of over 30% along with dangerous side effects including elevated liver function tests and hepatitis. The other current treatment option is the application of antifungal drugs to the top of the nail in a nail polish form. This treatment plan has been preferred by many patients as the drug has only non-serious, infrequently reported side-affects. However, the medicated nail polish also needs to be applied for 6 months and has a low cure rate of only up to 36%. Our hypothesis is that ultrasound application can lead to the increased effectiveness of delivery of topically applied antifungal drugs and reduce the necessary time of application for successful treatment. Our preliminary studies indicate that the use of ultrasound increases nail permeability by 50% for a drug mimicking compound. Additionally, we developed and tested a novel ultrasound device for treatment of onychomycosis that can be used to apply therapeutic ultrasound at different clinically-relevant parameters. Our ongoing research efforts focus on optimizing ultrasound parameters for nail drug delivery by utilizing a diffusion cell setup. People who would benefit the most from this treatment are those in their 60s or older, particularly those who suffer from diabetes, poor circulation, immunosuppressive diseases, or have cancer that is being treated with radiation

Focused Ultrasound-Mediated Blood–Brain Barrier Opening Best Promotes Neuroimmunomodulation through Brain Macrophage Redistribution

Neuroimmunomodulation is a promising form of drug-free treatment for neurological diseases ranging from Alzheimer’s disease to depression. The evidence supporting the efficacy of focused ultrasound (FUS) neuroimmunomodulation is encouraging; however, the method has yet to be standardized, and its mechanism remains poorly understood. Methods of FUS neuroimmunomodulation can be categorized into three paradigms based on the parameters used. In the first paradigm, focused ultrasound blood–brain barrier opening (FUS-BBBO) combines FUS with microbubbles (MB) to transiently and safely induce BBB opening. In the second paradigm, focused ultrasound neuromodulation (FUS-N) harnesses the acoustic effects of FUS alone (without MB). In the third paradigm, focused ultrasound with microbubbles without BBBO (FUS + MB) combines MB with FUS below the BBBO pressure threshold—harnessing the mechanical effects of FUS without opening the barrier. Due to the recent evidence of brain macrophage modulation in response to FUS-BBBO, we provide the first direct comparison of brain macrophage modulation between all three paradigms both in the presence and absence of Alzheimer’s disease (AD) pathology. Flow cytometry and single-cell sequencing are employed to identify FUS-BBBO as the FUS paradigm, which maximizes brain macrophage modulation, including an increase in the population of neuroprotective, disease-associated microglia and direct correlation between treatment cavitation dose and brain macrophage phagocytosis. Next, we combine spatial and single-cell transcriptomics with immunohistochemical validation to provide the first characterization of brain macrophage distribution in response to FUS-BBBO. Given their relevance within neurodegeneration and perturbation response, we emphasize the analysis of three brain macrophage populations—disease- and interferon-associated microglia and central-nervous-system-associated macrophages. We find and validate the redistribution of each population with an overall trend toward increased interaction with the brain–cerebrospinal fluid barrier (BCSFB) after FUS-BBBO, an effect that is found to be more pronounced in the presence of disease pathology. This study addresses the prior lack of FUS neuroimmunomodulation paradigm optimization and mechanism characterization, identifying that FUS-BBBO best modulates brain macrophage response via complex redistribution