Paying clinicians to join clinical trials : a review of guidelines and interview study of trialists

Background: The motivations of clinicians to participate in clinical trials have been little studied. This project explored the potential role of payment for participation in publicly funded clinical trials in the UK. The aims were to review relevant guidelines and to collate and analyse views of clinical trialists on the role of payments and other factors that motivated clinicians to join clinical trials. Methods: Review of guidelines governing payments to clinicians for recruitment to trials. Semistructured interviews with a range of NHS clinical trial leaders, analysed using qualititative methods. Results: While UK guidelines had little to say specifically on payments linked to recruitment, all payments have become highly regulated and increasingly transparent. Interview participants believed that expenses arising from research should be covered. Payments in excess of expenses were seen as likely to increase participation but with the risk of reducing quality. Motivations such as interest in the topic, the scope for patients to benefit and intellectual curiosity were considered more important. Barriers to involvement included bureaucracy and lack of time. Discussion: Limited scope exists for paying clinicians over-and-above the cost of their time to be involved in research. Most trialists favour full payment of all expenses related to research. Conclusion: Payment of clinicians beyond expenses is perceived to be a less important motivating factor than researching important, salient questions, and facilitating research by reducing bureaucracy and delay

The nature of ice-nucleating particles affects the radiative properties of tropical convective cloud systems

Convective cloud systems in the maritime tropics play a critical role in global climate, but accurately representing aerosol interactions within these clouds persists as a major challenge for weather and climate modelling. We quantify the effect of ice-nucleating particles (INP) on the radiative properties of a complex Tropical Atlantic deep convective cloud field using a regional model with an advanced double-moment microphysics scheme. Our results show that the domain-mean daylight outgoing radiation varies by up to 18 W m−2 depending on the bio- and physico-chemical properties of INP. The key distinction between different INPs is the temperature dependence of ice formation, which alters the vertical distribution of cloud microphysical processes. The controlling effect of the INP temperature dependence is substantial even in the presence of secondary ice production, and the effects of secondary ice formation depend strongly on the nature of the INP. Our results have implications for climate model simulations of tropical clouds and radiation, which currently do not consider a link between INP particle type and ice water content. The results also provide a challenge to the INP measurement community, since we demonstrate that INP concentration measurements are required over the full mixed-phase temperature regime, which covers around 10 orders of magnitude in INP concentration

The temperature dependence of ice-nucleating particle concentrations affects the radiative properties of tropical convective cloud systems

Convective cloud systems in the maritime tropics play a critical role in global climate, but accurately representing aerosol interactions within these clouds persists as a major challenge for weather and climate modelling. We quantify the effect of ice-nucleating particles (INPs) on the radiative properties of a complex tropical Atlantic deep convective cloud field using a regional model with an advanced double-moment microphysics scheme. Our results show that the domain-mean daylight outgoing radiation varies by up to 18 W m−2 depending on the chosen INP parameterisation. The key distinction between different INP parameterisations is the temperature dependence of ice formation, which alters the vertical distribution of cloud microphysical processes. The controlling effect of the INP temperature dependence is substantial even in the presence of Hallett–Mossop secondary ice production, and the effects of secondary ice formation depend strongly on the chosen INP parameterisation. Our results have implications for climate model simulations of tropical clouds and radiation, which currently do not consider a link between INP particle type and ice water content. The results also provide a challenge to the INP measurement community, as we demonstrate that INP concentration measurements are required over the full mixed-phase temperature regime, which covers around 10 orders of magnitude

Atmospheric Ice‐Nucleating Particles in the Dusty Tropical Atlantic

Desert dust is one of the most important atmospheric ice-nucleating aerosol species around the globe. However, there have been very few measurements of ice-nucleating particle (INP) concentrations in dusty air close to desert sources. In this study we report the concentration of INPs in dust laden air over the tropical Atlantic within a few days' transport of one of the world's most important atmospheric sources of desert dust, the Sahara. These measurements were performed as part of the Ice in Clouds Experiment-Dust campaign based in Cape Verde, during August 2015. INP concentrations active in the immersion mode, determined using a droplet-on-filter technique, ranged from around 10² m⁻³ at -12°C to around 10⁵ m⁻³ at -23°C. There is about 2 orders of magnitude variability in INP concentration for a particular temperature, which is determined largely by the variability in atmospheric dust loading. These measurements were made at altitudes from 30 to 3,500 m in air containing a range of dust loadings. The ice active site density (n s ) for desert dust dominated aerosol derived from our measurements agrees with several laboratory-based parameterizations for ice nucleation by desert dust within 1 to 2 orders of magnitude. The small variability in n s values determined from our measurements (within about 1 order of magnitude) is striking given that the back trajectory analysis suggests that the sources of dust were geographically diverse. This is consistent with previous work, which indicates that desert dust's ice-nucleating activity is only weakly dependent on source

Bullying and Victimization Among Adolescents: The Role of Ethnicity and Ethnic Composition of School Class

The present study examined the relationships between ethnicity, peer-reported bullying and victimization, and whether these relationships were moderated by the ethnic composition of the school classes. Participants were 2386 adolescents (mean age: 13 years and 10 months; 51.9% boys) from 117 school classes in the Netherlands. Multilevel analyses showed that, after controlling for the ethnic composition of school class, ethnic minority adolescents were less victimized, but did not differ from the ethnic majority group members on bullying. Victimization was more prevalent in ethnically heterogeneous classes. Furthermore, the results revealed that ethnic minority adolescents bully more in ethnically heterogeneous classes. Our findings suggest that, in order to understand bullying and victimization in schools in ethnically diverse cultures, the ethnic background of adolescents and the ethnic composition of school classes should be taken into account

In Vivo, Multimodal Imaging of B Cell Distribution and Response to Antibody Immunotherapy in Mice

BACKGROUND: B cell depletion immunotherapy has been successfully employed to treat non-Hodgkin's lymphoma. In recent years, increasing attention has been directed towards also using B-cell depletion therapy as a treatment option in autoimmune disorders. However, it appears that the further development of these approaches will depend on a methodology to determine the relation of B-cell depletion to clinical response and how individual patients should be dosed. Thus far, patients have generally been followed by quantification of peripheral blood B cells, but it is not apparent that this measurement accurately reflects systemic B cell dynamics. METHODOLOGY/PRINCIPAL FINDINGS: Cellular imaging of the targeted population in vivo may provide significant insight towards effective therapy and a greater understanding of underlying disease mechanics. Superparamagnetic iron oxide (SPIO) nanoparticles in concert with near infrared (NIR) fluorescent dyes were used to label and track primary C57BL/6 B cells. Following antibody mediated B cell depletion (anti-CD79), NIR-only labeled cells were expeditiously cleared from the circulation and spleen. Interestingly, B cells labeled with both SPIO and NIR were not depleted in the spleen. CONCLUSIONS/SIGNIFICANCE: Whole body fluorescent tracking of B cells enabled noninvasive, longitudinal imaging of both the distribution and subsequent depletion of B lymphocytes in the spleen. Quantification of depletion revealed a greater than 40% decrease in splenic fluorescent signal-to-background ratio in antibody treated versus control mice. These data suggest that in vivo imaging can be used to follow B cell dynamics, but that the labeling method will need to be carefully chosen. SPIO labeling for tracking purposes, generally thought to be benign, appears to interfere with B cell functions and requires further examination

Childhood bullying, paranoid thinking, and the misappraisal of social threat: trouble at school

Background:Experiences of bullying predict the development of paranoia in school-age adolescents. While many instances of psychotic phenomena are transitory, maintained victimization can lead to increasingly distressing paranoid thinking. Furthermore, paranoid thinkers perceive threat in neutral social stimuli and are vigilant for environmental risk. Aims:The present paper investigated the association between different forms of bullying and paranoid thinking, and the extent to which school-age paranoid thinkers overestimate threat in interpersonal situations. Methods: Two hundred and thirty participants, aged between eleven and fourteen, were recruited from one secondary school in the UK. Participants completed a series of questionnaires hosted on the Bristol Online Survey tool. All data were collected in a classroom setting in quiet and standardized conditions. Results: A significant and positive relationship was found between experiences of bullying and paranoid thinking: greater severity of bullying predicted more distressing paranoid thinking. Further, paranoid thinking mediated the relationship between bullying and overestimation of threat in neutral social stimuli. Conclusion: Exposure to bullying is associated with distressing paranoid thinking and subsequent misappraisal of threat. As paranoid thinkers experience real and overestimated threat, the phenomena may persist

Adolescents' involvement in cyber bullying and perceptions of school: the importance of perceived peer acceptance for female adolescents

Young people are spending increasing amounts of time using digital technology and, as such, are at great risk of being involved in cyber bullying as a victim, bully, or bully/victim. Despite cyber bullying typically occurring outside the school environment, the impact of being involved in cyber bullying is likely to spill over to school. Fully 285 11- to 15-year-olds (125 male and 160 female, M age = 12.19 years, SD = 1.03) completed measures of cyber bullying involvement, self-esteem, trust, perceived peer acceptance, and perceptions of the value of learning and the importance of school. For young women, involvement in cyber bullying as a victim, bully, or bully/victim negatively predicted perceptions of learning and school, and perceived peer acceptance mediated this relationship. The results indicated that involvement in cyber bullying negatively predicted perceived peer acceptance which, in turn, positively predicted perceptions of learning and school. For young men, fulfilling the bully/victim role negatively predicted perceptions of learning and school. Consequently, for young women in particular, involvement in cyber bullying spills over to impact perceptions of learning. The findings of the current study highlight how stressors external to the school environment can adversely impact young women's perceptions of school and also have implications for the development of interventions designed to ameliorate the effects of cyber bullying