Questionnaires in clinical trials: guidelines for optimal design and administration.

A good questionnaire design for a clinical trial will minimise bias and maximise precision in the estimates of treatment effect within budget. Attempts to collect more data than will be analysed may risk reducing recruitment (reducing power) and increasing losses to follow-up (possibly introducing bias). The mode of administration can also impact on the cost, quality and completeness of data collected. There is good evidence for design features that improve data completeness but further research is required to evaluate strategies in clinical trials. Theory-based guidelines for style, appearance, and layout of self-administered questionnaires have been proposed but require evaluation

States Face Fiscal Crunch after 1990s Spending Surge

Across the nation, large budget gaps are forcing state governments to make tough policy choices. While some states are trying to control spending, others are turning to tax increases to balance their budgets. Some state officials are trying to pass the buck for their poor fiscal management by pleading for a bailout from Washington. But a bailout would encourage states to continue overspending, which is the source of the current fiscal mess. The states' mistake was to allow rapid tax revenue growth during the 1990s to fuel an unsustainable expansion in spending. Between fiscal years 1990 and 2001, state tax revenue grew 86 percent--more than the 55 percent of inflation plus population growth. If states had limited spending growth to that benchmark, budgets would have been $93 billion smaller by FY01--representing savings roughly twice the size of today's state budget gaps. If revenue growth higher than the benchmark had been given back to taxpayers in permanent tax cuts and annual rebates, rebates could have been temporarily suspended during FY02 and FY03 to provide a cushion with which to balance state budgets. Current budget gaps provide policymakers an opportunity to weed out the budget excesses built up during the past decade. Yet overall state spending continues to grow. After soaring 8.0 percent in FY01, state general fund spending has not been cut in FY02 or FY03 even as large budget gaps have appeared. States should impose tax and spending growth caps to prevent budgets from growing too quickly during the next boom. Revenue growth above a benchmark would be given back in tax cuts and tax rebates. That would prevent spending from increasing too quickly and provide the option of suspending rebates during slowdowns to close budget gaps without the damage caused by tax rate increases

Willingness to Pay for Weather Derivatives by Australian Wheat Farmers

A theoretical optimal hedging model is developed to determine potential demand from Australian farmers for a hedging tool to remove the economic consequences of climate related variability in wheat yield. In the past, financial instruments have been developed to hedge price risk on capital markets; however, in more recent times new financial instruments, weather derivatives, have been developing that hedge the volumetric risk associated with unfavourable weather. Weather derivatives have the ability to effectively hedge weather related volume risk for the agricultural, mining, energy and manufacturing industries, while also providing a risk management tool for construction firms and special events organisers, although there are still many hurdles to implementing agricultural weather derivative contracts in Australia. The optimal hedging ratio is found to be quite sensitive to the degree of risk aversion of the farmer and to the cost of obtaining the contracts.weather derivatives, risk, hedging, wheat, Crop Production/Industries, Risk and Uncertainty,

Personally addressed hand-signed letters increase questionnaire response: a meta-analysis of randomised controlled trials

BACKGROUND: Postal questionnaires are commonly used to collect data for health studies, but non-response reduces study sample sizes and can introduce bias. Finding ways to increase the proportion of questionnaires returned would improve research quality. We sought to quantify the effect on response when researchers address participants personally by name on letters that accompany questionnaires. METHODS: All randomised controlled trials in a published systematic review that evaluated the effect on response of including participants' names on letters that accompany questionnaires were included. Odds ratios for response were pooled in a random effects meta-analysis and evidence for changes in effects over time was assessed using random effects meta-regression. RESULTS: Fourteen randomised controlled trials were included covering a wide range of topics. Most topics were unrelated to health or social care. The odds of response when including participants' names on letters were increased by one-fifth (pooled OR 1.18, 95% CI 1.03 to 1.34; p = 0.015). When participants' names and hand-written signatures were used in combination, the effect was a more substantial increase in response (OR 1.45, 95% CI 1.27 to 1.66; p < 0.001), corresponding to an absolute increase in the proportion of questionnaires returned of between 4% and 10%, depending on the baseline response rate. There was no evidence that the magnitude of these effects had declined over time. CONCLUSION: This meta-analysis of the best available evidence indicates that researchers using postal questionnaires can increase response by addressing participants by name on cover letters. The effect appears to be enhanced by including hand-written signatures

Who's that talking in my class?: What does research say about pupil to pupil exploratory talk that leads to learning?

This paper explores the literature to determine if exploratory talk could aid pupil learning and understanding in secondary schools and, if so, how it could best be utilised and what the roles of the ‘teacher’ and the ‘learner’ are in the process. We found five main themes related to talk and learning: exploratory talk is educationally valuable but not easy to implement; ‘initiation-response-feedback’; is much more commonly used; there are other types of talk which are generally less good for developing thinking; exploratory talk is good for collaborative learning; and exploratory talk is best organised with a set of ‘ground rules’. It became apparent to us that agreeing and setting the ground rules was a very important factor in generating successful pupil to pupil talk for learning and that there is a strong relationship between adherence to ground rules for talking together and improving children’s ability to solve problems. For consistency of a whole-school approach, we found that these group-specific ground rules should be set within an overall framework developed through teachers developing ways to work collaboratively with colleagues to investigate ways of promoting exploratory talk with all classes. Finally we highlight to school leaders the importance of developing and supporting a whole school approach to exploratory talk

Effect of emotional content on online video sharing among health care professionals and researchers (DIFFUSION): results and lessons learnt from a randomised controlled trial.

OBJECTIVES: We assessed the effect of emotional content on the extent to which online videos are shared among health professionals. SETTING: We conducted a two-arm randomised controlled trial. We sent a link to one of two videos by email to participants asking them to watch the video and forward it to their colleagues. PARTICIPANTS: Health professionals and researchers (obstetrics, gynaecology and midwifery) with an email address apart from those in countries where access to YouTube is banned. We estimated that 7000 participants were required. INTERVENTIONS: We compared two online videos providing background information about the WOMAN trial. The videos were the same length and had the same content. However, the intervention video had more emotional impact than the control video. OUTCOME MEASURES: The primary outcome was video sharing and the secondary outcome was views generated by participants. We conducted a χ2 test for the primary outcome and t-test for the secondary outcome. RESULTS: We randomly allocated 8353 email addresses, 4178 to the intervention video and 4175 to the control. Of these, 221 (5.3%) watched the intervention video and 215 (5.1%) watched the control. In the intervention group, 44 (1.1%) forwarded the video compared with 37 (0.9%) in the control group (risk ratio 1.2 [95% CI 0.8 to 1.8], p=0.44). Mean number of views generated by participants allocated to the intervention video was 0.04 and the control video was 0.03 (mean difference 0.01 [95% CI -0.02 to 0.04], p=0.53). CONCLUSIONS: We found no evidence that emotional content increased forwarding. The trial had low power due to the low video watching rate and the small number of outcome events. A key challenge for online dissemination is ensuring recipients watch the video. TRIAL REGISTRATION NUMBER: NCT02109159; Results

Controlling for exposure changes the relationship between ethnicity, deprivation and injury: an observational study of child pedestrian injury rates in London.

BACKGROUND: Research has suggested that inequalities in risk exposure may help explain identified ethnic inequalities in child pedestrian injury risk. However, addressing risk exposure in epidemiological research presents theoretical and methodological challenges. This article conceptualises the risk of child pedestrian injury as related to both exposure levels (the quantity of time children spend as pedestrians) and the probability of a hazard where that exposure takes place (the quality of the road environment). OBJECTIVE: To investigate the sensitivity of results on ethnic inequalities in child pedestrian injury risk in London to control for exposure and hazard levels. METHODS: Using police records of injury 2000-2009, we modelled the relationship between ethnicity, deprivation and child pedestrian injury rates in London using characteristics of the road environment to control for hazard levels and restricting the analysis to the time of the weekday morning commute (7.00-9.00 am), when most children must make a journey to school, to control for exposure levels. RESULTS: Controlling for risk exposure in this way fundamentally changed the nature of the relationship between ethnicity, deprivation and child pedestrian injury. During the time of the morning commute to school, 'Black' children were found to have higher pedestrian injury rates in the least-deprived areas. CONCLUSIONS: To inform effective strategies for reducing injury inequality, it is vital that exposure to risk is both acknowledged and considered