Für wen gebe ich mein Urteil ab? Der systematische Einfluss des Fragebogenadressaten auf Kausalattributionsgewichtungen bei geschlossenen Antwortformaten

Die Fragebogenforschung belegt, dass Respondenten durch Kontextinformationen eines Fragebogens systematisch in ihrem Antwortverhalten beeinflusst werden. So zeigten Norenzayan und Schwarz (1999), dass Probanden bei freier Antwortmöglichkeit eher persönlichkeitsbezogene Ursachen zur Erklärung von Straftaten nennen, wenn der Fragebogen scheinbar von einem Institut für Persönlichkeitsforschung (verglichen mit einem Institut für Sozialforschung) erstellt wurde. Hierzu diskutierte Erklärungen sind einerseits Konversationsmaximen, die einen Bezug zwischen Adressat und Gesagtem induzieren, andererseits kognitive Primings, die selektive kognitive Aktivierungen und damit Verfügbarkeiten bedingen sollen. Die vorliegende Studie untersucht diese Erklärungsalternativen, indem sie erstmals in einem analogen Studiendesign persönlichkeitsbezogene und soziale Gründe in geschlossenen Antwortformaten vorgibt und gewichten lässt. Mögliche Gewichtungsunterschiede sind somit nicht mittels kognitiver Verfügbarkeit erklärbar. Eine Kovarianzanalyse (Alter, Geschlecht und die Big-Five-Persönlichkeitsdimensionen als Kovariaten) belegt im Einklang mit den Konversationsmaximen eine signifikant stärkere Bedeutungszuschreibung für persönlichkeitsbezogene Ursachen unter der Bedingung „Institut für Persönlichkeitsforschung“ im Vergleich zu „Institut für Sozialforschung“ und einer Kontrollbedingung („Institut für Kriminologie“)

Persistent Gastric Colonization with Burkholderia pseudomallei and Dissemination from the Gastrointestinal Tract following Mucosal Inoculation of Mice

Melioidosis is a disease of humans caused by opportunistic infection with the soil and water bacterium Burkholderia pseudomallei. Melioidosis can manifest as an acute, overwhelming infection or as a chronic, recurrent infection. At present, it is not clear where B. pseudomallei resides in the mammalian host during the chronic, recurrent phase of infection. To address this question, we developed a mouse low-dose mucosal challenge model of chronic B. pseudomallei infection and investigated sites of bacterial persistence over 60 days. Sensitive culture techniques and selective media were used to quantitate bacterial burden in major organs, including the gastrointestinal (GI) tract. We found that the GI tract was the primary site of bacterial persistence during the chronic infection phase, and was the only site from which the organism could be consistently cultured during a 60-day infection period. The organism could be repeatedly recovered from all levels of the GI tract, and chronic infection was accompanied by sustained low-level fecal shedding. The stomach was identified as the primary site of GI colonization as determined by fluorescent in situ hybridization. Organisms in the stomach were associated with the gastric mucosal surface, and the propensity to colonize the gastric mucosa was observed with 4 different B. pseudomallei isolates. In contrast, B. pseudomallei organisms were present at low numbers within luminal contents in the small and large intestine and cecum relative to the stomach. Notably, inflammatory lesions were not detected in any GI tissue examined in chronically-infected mice. Only low-dose oral or intranasal inoculation led to GI colonization and development of chronic infection of the spleen and liver. Thus, we concluded that in a mouse model of melioidosis B. pseudomallei preferentially colonizes the stomach following oral inoculation, and that the chronically colonized GI tract likely serves as a reservoir for dissemination of infection to extra-intestinal sites

Genomic investigations of unexplained acute hepatitis in children

Since its first identification in Scotland, over 1,000 cases of unexplained paediatric hepatitis in children have been reported worldwide, including 278 cases in the UK1. Here we report an investigation of 38 cases, 66 age-matched immunocompetent controls and 21 immunocompromised comparator participants, using a combination of genomic, transcriptomic, proteomic and immunohistochemical methods. We detected high levels of adeno-associated virus 2 (AAV2) DNA in the liver, blood, plasma or stool from 27 of 28 cases. We found low levels of adenovirus (HAdV) and human herpesvirus 6B (HHV-6B) in 23 of 31 and 16 of 23, respectively, of the cases tested. By contrast, AAV2 was infrequently detected and at low titre in the blood or the liver from control children with HAdV, even when profoundly immunosuppressed. AAV2, HAdV and HHV-6 phylogeny excluded the emergence of novel strains in cases. Histological analyses of explanted livers showed enrichment for T cells and B lineage cells. Proteomic comparison of liver tissue from cases and healthy controls identified increased expression of HLA class 2, immunoglobulin variable regions and complement proteins. HAdV and AAV2 proteins were not detected in the livers. Instead, we identified AAV2 DNA complexes reflecting both HAdV-mediated and HHV-6B-mediated replication. We hypothesize that high levels of abnormal AAV2 replication products aided by HAdV and, in severe cases, HHV-6B may have triggered immune-mediated hepatic disease in genetically and immunologically predisposed children

Hypermnesia and the Role of Delay between Study and Test

Hypermnesia is increased recall across repeated tests in the absence of any further study opportunities. Although over the years many factors have been identified that influence hypermnesia, to date not much is known about the role of delay between study and test for the effect. This study addressed the issue in four experiments. Employing both words and pictures as study material, we compared hypermnesia after shorter delay (3 min or 11.5 min) and longer delay (24 h or 1 week) between study and test. Recall occurred over three successive tests, using both free recall (Experiments 1, 2, and 4) and forced recall testing (Experiment 3). In forced recall tests, subjects are instructed to recall as many items as possible, but if unable to remember all studied items, to fill in the remaining spaces with their best guesses. With free recall testing, hypermnesia increased with delay and the effect was driven mainly by reduced item losses between tests. These results suggest a link between hypermnesia and the testing effect, which shows that demanding retrieval practice, as it happens after longer delay, can improve recall by reducing the forgetting of the practiced items. In contrast, with forced recall testing, hypermnesia decreased with delay and was even absent after longer delay. The findings indicate that recall format can influence hypermnesia and different mechanisms may mediate the effects of repeated testing in the two recall conditions

What is the significance of the Hill classification?

This study aimed to investigate the significance of Hill classification to predict esophagitis, Barrett's esophagus, gastroesophageal reflux disease (GERD) symptomatology, and future prescriptions of proton pump inhibitors in clinical practice. A total of 922 patients (546 women and 376 men; mean age 54.3 [SD 18.4] years) who underwent gastroscopy between 2012 and 2015 were analyzed. Patient questionnaire regarding symptoms were compared with endoscopy findings. A medical chart review was done that focused on the prescription of PPIs, additional gastroscopies, and GERD surgery in a 3-year period before the index gastroscopy and in a 6-year period afterward. In patients naïve to PPI prescriptions (n = 466), Hill grade III was significantly associated with esophagitis (AOR 2.20; 95% CI 1.00-4.84) and > 2 PPI prescriptions 6 year after the index gastroscopy (AOR 1.95; 95% CI 1.01-3.75), whereas Hill grade IV was significantly associated with esophagitis (AOR 4.41; 95% CI 1.92-10.1), with Barrett's esophagus (AOR 12.7; 95% CI 1.45-112), with reported heartburn (AOR 2.28; 95% CI 1.10-4.74), and with >2 PPI prescriptions (AOR 2.16; 95% CI 1.02-4.55). In patients 'non-naïve' to PPI prescription (n = 556), only Hill grade IV was significantly associated with esophagitis, reported heartburn, and with >2 PPI prescriptions. The gastroscopic classification in Hill grades III and IV is important in clinical practice because they are associated with esophagitis, Barrett's esophagus, symptoms of GERD, and prescriptions of PPIs, whereas a differentiation between Hill grades I and II is not

“Clinical trials are space travel”: Factors of psychological response to recurrence among oncologists enrolling patients in treatment optimization trials

Abstract Background Cancer recurrence after treatment is a concern for patients and oncologists alike. The movement towards treatment optimization, with trials testing less than the current standard of care (SoC), complicates this experience. Our objective was to assess oncologists' psychological response to patient recurrence on optimization‐focused trials and identify factors that influence those experiences. Methods Clinical oncologists participated in a semi‐structured interview regarding patient enrollment in treatment optimization trials. We identified factors that influence the degree of psychological response that the oncologist may feel after patient recurrence. Residual agreement analysis was used to identify whether differences in reported psychological response was associated with alternative emphases on identified factors. Results Thirty‐six oncologists identified 20 factors spanning five major themes that affected their psychological response to patient recurrence. All oncologists expressed willingness to enroll patients in treatment optimization clinical trials; however, half indicated that they were more likely to experience a negative psychological response after a treatment optimization trial than after a traditional intensification trial, and a quarter reported that patient recurrence on an optimization trial would impact their recommendations for future trial enrollment. Oncologists who reported more negative psychological responses to patient recurrence after participation in an optimization trial were more likely to emphasize introspective factors, while those who reported no difference in response emphasized patient‐ and process‐focused factors. Conclusions Although most oncologists recognize the importance of treatment optimization trials, a significant proportion indicated a greater potential for psychological distress following patient recurrence in such trials and offered insight into how trial design and the process of patient enrollment can be improved to minimize those negative psychological responses

Barriers, facilitators, and recommendations for sexual orientation and gender identity data collection in community oncology practices

Abstract Background Sexual orientation and gender identity (SOGI) data collection in community oncology practices is critical to identify and address cancer inequities, but less than 20% of NCI Community Oncology Research Program (NCORP)‐affiliated practices regularly collect SOGI data despite widespread recommendations. We evaluated multilevel barriers and facilitators for SOGI data collection at NCORP practices. Methods We conducted 14 semi‐structured interviews at seven purposefully sampled NCORP oncology practices. We interviewed one clinician (oncologist, advanced practice provider) and one clinic staff member per practice. Thematic analysis informed by the Consolidated Framework for Implementation Research (CFIR) was conducted to identify barriers and facilitators. Results Thematic saturation occurred after interviews at six practices and was confirmed with interviews at an additional practice. Participants highlighted multilevel barriers including low levels of understanding, information technology infrastructure, and perceived low relative priority. Not understanding the role of SOGI data in oncology care contributed to cis‐heteronormative culture. At the clinic level, this culture coincided with a lack of processes and policies for collecting SOGI from all patients. At the care team level, perceived irrelevance to oncology care was related to discomfort asking SOGI, fear of patient discomfort, and limited awareness of SOGI in electronic health records. Suggested solutions included: normalizing asking SOGI questions, giving patients privacy to complete SOGI, and clarifying clinical relevance. Conclusions SOGI data collection barriers stemmed from perceptions that SOGI disclosure does not influence care quality. Oncology teams may benefit from training on culturally sensitive SOGI collection, education on SOGI data relevance to oncology practices, and support for implementing SOGI data collection policies