Estimating past hepatitis C infection risk from reported risk factor histories: implications for imputing age of infection and modeling fibrosis progression

BackgroundChronic hepatitis C virus infection is prevalent and often causes hepatic fibrosis, which can progress to cirrhosis and cause liver cancer or liver failure. Study of fibrosis progression often relies on imputing the time of infection, often as the reported age of first injection drug use. We sought to examine the accuracy of such imputation and implications for modeling factors that influence progression rates.MethodsWe analyzed cross-sectional data on hepatitis C antibody status and reported risk factor histories from two large studies, the Women’s Interagency HIV Study and the Urban Health Study, using modern survival analysis methods for current status data to model past infection risk year by year. We compared fitted distributions of past infection risk to reported age of first injection drug use.ResultsAlthough injection drug use appeared to be a very strong risk factor, models for both studies showed that many subjects had considerable probability of having been infected substantially before or after their reported age of first injection drug use. Persons reporting younger age of first injection drug use were more likely to have been infected after, and persons reporting older age of first injection drug use were more likely to have been infected before.ConclusionsIn studies of fibrosis progression, modern methods such as multiple imputation should be used to account for the substantial uncertainty about when infection occurred. The models presented here can provide the inputs needed by such methods. Using reported age of first injection drug use as the time of infection in studies of fibrosis progression is likely to produce a spuriously strong association of younger age of infection with slower rate of progression

The Fear of Pain Questionnaire-III and the Fear of Pain Questionnaire-Short Form: a confirmatory factor analysis

Sara M Vambheim,1 Peter Solvoll Lyby,1,2 Per M Aslaksen,1 Magne Arve Flaten,3 Ole Åsli,1 Laila M Martinussen4 1Department of Psychology, UiT, The Arctic University of Norway, Tromsø; 2CatoSenteret Rehabilitation Center, Son; 3Department of Psychology, NTNU, The Norwegian University of Science and Technology, Trondheim, Norway; 4Management Engineering, DTU, Technical University of Denmark, Lyngby, Denmark Background: The Fear of Pain Questionnaire-III (FPQ-III) is a widely used instrument to assess the fear of pain (FOP) in clinical and nonclinical samples. The FPQ-III has 30 items and is divided into three subscales: Severe Pain, Minor Pain and Medical Pain. Due to findings of poor fit of the original three-factor FPQ-III model, the Fear of Pain Questionnaire-Short Form (FPQ-SF) four-factor model has been suggested as an alternative. The FPQ-SF is a revised version of the FPQ-III, reduced to 20 items and subdivided into four subscales: Severe Pain, Minor Pain, Injection Pain and Dental Pain. Aims and methods: The purpose of the study was to investigate the model fit, reliability and validity of the FPQ-III and the FPQ-SF in a Norwegian nonclinical sample, using confirmatory factor analysis (CFA). The second aim was to explore the model fit of the two scales in male and female subgroups separately, since previous studies have uncovered differences in how well the questionnaires measure FOP across sex; thus, the questionnaires might not be sex neutral. It has been argued that the FPQ-SF model is better because of the higher fit to the data across sex. To explore model fit across sex within the questionnaires, the model fit, validity and reliability were compared across sex using CFA. Results: The results revealed that both models’ original factor structures had poor fit. However, the FPQ-SF had a better fit overall, compared to the FPQ-III. The model fit of the two models differed across sex, with better fit for males on the FPQ-III and for females on the FPQ-SF. Conclusion: The FPQ-SF is a better questionnaire than the FPQ-III for measurement of FOP in Norwegian samples and across sex subgroups. However, the FPQ-III is a better questionnaire for males than for females, whereas the FPQ-SF is a better questionnaire for females than for males. The findings are discussed and directions for future investigations outlined. Keywords: fear of pain, FPQ-III, FPQ-SF, confirmatory factor analysis, pain, se

Does Traffic Safety Climate Perception of Drivers Differ Depending on Their Traffic System Resilience and Driving Skills Evaluation?

Road traffic accidents are one of the most important public health problems in Turkey and all over the world. Traffic system involves many agents from a micro level, such as drivers, to a macro level, such as traffic climate. Traffic system resilience and driving skills are crucial factors that determine the road traffic accidents and their outcomes; in addition to being related to the development of sustainable and safer road traffic system. In this study, it is aimed to investigate group differences derived from traffic system resilience and driving skills with respect to traffic safety climate. For this purpose, 323 drivers (177 female, 146 male), between the ages of 19 and 57 (M = 28.56, SD = 8.96), participated in the study. Participants filled out a questionnaire including demographic information form, Driving Skills Inventory, Traffic Climate Scale, and Traffic System Resilience Scale adapted to traffic settings by the researchers. The data were analyzed by using t-test to be able to compare groups. According to the results, traffic systems that are perceived to be high in terms of resilience were also perceived to be less externally demanding and more functional. In this study, traffic system resilience was evaluated by the perception of drivers and the relationships between traffic system resilience, driving skills, and traffic safety climate were evidenced for the first time in the literature. The implication of the results is discussed by focusing on the ways the findings could be used to improve traffic safety

Personality and eating and weight disorders: an open research challenge

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