Sources of potential bias when combining routine data linkage and a national survey of secondary school-aged children: a record linkage study

Background Linking survey data to administrative records requires informed participant consent. When linkage includes child data, this includes parental and child consent. Little is known of the potential impacts of introducing consent to data linkage on response rates and biases in school-based surveys. This paper assessed: i) the impact on overall parental consent rates and sample representativeness when consent for linkage was introduced and ii) the quality of identifiable data provided to facilitate linkage. Methods Including an option for data linkage was piloted in a sub-sample of schools participating in the Student Health and Wellbeing survey, a national survey of adolescents in Wales, UK. Schools agreeing to participate were randomized 2:1 to receive versus not receive the data linkage question. Survey responses from consenting students were anonymised and linked to routine datasets (e.g. general practice, inpatient, and outpatient records). Parental withdrawal rates were calculated for linkage and non-linkage samples. Multilevel logistic regression models were used to compare characteristics between: i) consenters and non-consenters; ii) successfully and unsuccessfully linked students; and iii) the linked cohort and peers within the general population, with additional comparisons of mental health diagnoses and health service contacts. Results The sub-sample comprised 64 eligible schools (out of 193), with data linkage piloted in 39. Parental consent was comparable across linkage and non-linkage schools. 48.7% (n = 9232) of students consented to data linkage. Modelling showed these students were more likely to be younger, more affluent, have higher positive mental wellbeing, and report fewer risk-related behaviours compared to non-consenters. Overall, 69.8% of consenting students were successfully linked, with higher rates of success among younger students. The linked cohort had lower rates of mental health diagnoses (5.8% vs. 8.8%) and specialist contacts (5.2% vs. 7.7%) than general population peers. Conclusions Introducing data linkage within a national survey of adolescents had no impact on study completion rates. However, students consenting to data linkage, and those successfully linked, differed from non-consenting students on several key characteristics, raising questions concerning the representativeness of linked cohorts. Further research is needed to better understand decision-making processes around providing consent to data linkage in adolescent populations

Safety and efficacy of Sofosbuvir/Velpatasvir in pediatric patients 6 to < 18 years old with chronic hepatitis C infection

To effectively serve minority clients, clinicians require a double understanding: of both evidence-based practice and the cultures involved. This particularly holds true when working with Asian-Americans, a diverse and growing population. The Guide to Psychological Assessment with Asians synthesizes real-world challenges, empirical findings, clinical knowledge and common-sense advice to create a comprehensive framework for practice. This informed resource is geared toward evaluation of first-generation Asian Americans and recent immigrants across assessment methods (self-report measures, projective tests), settings (school, forensic) and classes of disorders (eating, substance, sexual). While the Guide details cross-cultural considerations for working with Chinese-, Japanese-, Korean and Indian-American clients, best practices are also included for assessing members of less populous groups without underestimating, overstating or stereotyping the role of ethnicity in the findings. In addition, contributors discuss diversity of presentation within groups and identify ways that language may present obstacles to accurate evaluation. Among the areas covered in this up-to-date reference: Structured and semi-structured clinical interviews. Assessment of acculturation, enculturation and culture. IQ testing. Personality disorders. Cognitive decline and dementia. Mood disorders and suicidality. Neuropsychological assessment of children, adolescents and adults. Culture-bound syndromes. Designed for practitioners new to working with Asian clients as well as those familiar with the population, the Guide to Psychological Assessment with Asians is exceedingly useful to neuropsychologists, clinical psychologists, health psychologists and clinical social workers

The Clinical Use of Allografts, Demineralized Bone Matrices, Synthetic Bone Graft Substitutes and Osteoinductive Growth Factors: A Survey Study

The emergence of new bone grafting options and alternatives has led to significant uncertainty when determining the most appropriate product for surgical procedures requiring bone graft in orthopedics. Allografts, demineralized bone matrices, synthetic bone graft substitutes, and osteoinductive growth factors are all viable options, yet there is a lack of data reporting clinical usage of these products. This correspondence reports on the use of bone grafting products at the Hospital for Special Surgery for a 27-month period and makes recommendations based on surgical usage, safety, and cost. Approximately half (48.6%) of all bone graft substitutes were implanted during spinal surgery. Arthroplasty, trauma, and foot/hand cases all used considerable amounts of bone grafting products as well (20.1%, 19.0%, 12.1%, respectively). Considerable differences were noticed in usage of bone grafting products among each orthopedic discipline. Of all bone graft substitutes used in arthroplasty, 14.4% were demineralized bone matrices, whereas 56.8% were allografts. Demineralized bone matrix grafts were used in 82% of trauma surgery and 89% of foot/hand cases. An increase in synthetic bone graft alternatives was noticed near the end of our investigation period