Examination of the consistency of interviewer performance across three distinct interview contexts

The current study examined the consistency of investigative interviewers\u27 performance (n=31) across three distinct interview paradigms: (a) a mock interview where an adult actor played the role of a child recalling abuse, (b) a mock interview where a school child recalled an innocuous event that was staged at the child\u27s school, and (c) a field interview where the interviewer elicited a statement of abuse from a child. Performance was measured by calculating the proportion of open-ended and leading questions, and by eliciting expert ratings of the presence of a range of problem behaviours commonly exhibited by interviewers. Overall, the performance of individual interviewers was relatively stable across the tasks. Heterogeneity in stability, however, differed according to the type of question and the nature of the event being examined. In particular, the mock interview paradigm where the adult acted the role of an alleged child abuse victim produced a measure of performance that was more similar to the field interview than the interview where a school child recalled an innocuous event. The implications of the findings for trainers, and directions for future research, are discussed. <br /

Effect of a mobile phone intervention for female sex workers on unintended pregnancy in Kenya (WHISPER or SHOUT): a cluster-randomised controlled trial

Background: Female sex workers in low-income and middle-income countries face high risks of unintended pregnancy. We developed a 12-month, multifaceted short messaging service intervention (WHISPER) for female sex workers in Kenya who had the potential to become pregnant, to improve their contraceptive knowledge and behaviours. The aim of this study was to assess the effectiveness of the intervention to reduce the incidence of unintended pregnancy among sex workers in Kenya compared with an equal-attention control group receiving nutrition-focused messages (SHOUT). Methods: Our two-arm, cluster-randomised controlled trial was done in sex-work venues in two subcounties of Mombasa, Kenya (Kisauni and Changamwe). Participants, aged 16–34 years, not pregnant or planning pregnancy, able to read text messages in English, residing in the study area, and who had a personal mobile phone with one of two phone networks, were recruited from 93 randomly selected sex-work venues (clusters). Random cluster allocation (1:1) to the intervention or control group was concealed from participants and researchers until the intervention started. Both groups received text messages in English delivered two to three times per week for 12 months (137 messages in total), as well as additional on-demand messages. Message content in the intervention group focused on promotion of contraception, particularly long-acting reversible contraception and dual method contraceptive use; message content in the control group focused on promotion of nutritional knowledge and practices, including food safety, preparation, and purchasing. The primary endpoint, analysed in all participants who were randomly assigned and attended at least one follow-up visit, compared unintended pregnancy incidence between groups using discrete-time survival analysis at 6 and 12 months. This trial is registered with Australian New Zealand Clinical Trials Registry, ACTRN12616000852459, and is closed to new participants. Findings: Between Sept 14, 2016, and May 16, 2017, 1728 individuals were approached to take part in the study. Of these, 1155 were eligible for full screening, 1035 were screened, and 882 were eligible, enrolled, and randomly assigned (451 participants from 47 venues in the intervention group; 431 participants from 46 venues in the control group). 401 participants from the intervention group and 385 participants from the control group were included in the primary analysis. Incidence of unintended pregnancy was 15·5 per 100 person-years in the intervention group and 14·7 per 100 person-years in the control group (hazard ratio 0·98, 95% CI 0·69–1·39). Interpretation The intervention had no measurable effect on unintended pregnancy incidence. Mobile health interventions, even when acceptable and rigorously designed, are unlikely to have a sufficient effect on behaviour among female sex workers to change pregnancy incidence when used in isolation. Funding: National Health and Medical Research Council of Australia

Reasons for not commencing direct-acting antiviral treatment despite unrestricted access for individuals with HIV and hepatitis C virus: a multinational, prospective cohort study.

BACKGROUND Individuals with HIV and hepatitis C virus (HCV) who remain untreated with direct-acting antivirals can contribute to HCV transmission and HCV-related mortality. We aimed to compare rates of uptake of direct-acting antivirals following unrestricted access to this treatment in high-income countries and examine factors associated with remaining untreated. METHODS This multinational, prospective cohort study used data from the International Collaboration on Hepatitis C Elimination in HIV Cohorts (InCHEHC). We analysed data from nine observational cohorts participating in the InCHEHC, including data from six high-income countries (Australia, Canada, France, the Netherlands, Spain, and Switzerland). We included individuals aged 18 years and older, with HIV and HCV (ie, HCV-RNA positive without evidence of spontaneous clearance) during unrestricted access to interferon-free direct-acting antiviral treatment in each country. We calculated the cumulative proportion of participants who remained untreated with direct-acting antivirals, with follow-up starting after the date of unrestricted access or cohort inclusion, whichever occurred most recently. Factors associated with the commencement rate of direct-acting antiviral treatment were assessed using competing-risks regression with the Fine-Gray method. FINDINGS The date of unrestricted access to direct-acting antiviral treatment for people with HIV ranged from Nov 1, 2014, in France to Nov 1, 2017, in Switzerland. We included 4552 individuals with HIV-HCV, mainly men who have sex with men (MSM; n=2156 [47%]) and people who inject or have injected drugs (n=1453 [32%]). 1365 (30%) of 4552 participants remained untreated with direct-acting antivirals. For individuals treated with direct-acting antivirals, median time from start of follow-up to treatment was 5 months (IQR 2-12). For individuals who were not treated with direct-acting antivirals, median follow-up was 22 months (8-30). Being linked to care in Australia, France, or the Netherlands, on antiretroviral therapy, having undetectable HIV RNA, and shorter duration since first positive HCV test were independently associated with higher commencement rate of direct-acting antiviral treatment. Compared with MSM, male heterosexuals and females with unknown or other routes of HIV transmission (ie, neither injection drug use nor heterosexual transmission) had lower rates of commencement. INTERPRETATION Despite unrestricted access, almost a third of individuals with HIV-HCV remained untreated with direct-acting antivirals during follow-up, with variation in commencement rate of HCV treatment between countries and key populations. Increased efforts are required to reach the remaining individuals with HIV who are HCV-viraemic to achieve HIV-HCV micro-elimination. FUNDING None

Targeted hepatitis C antibody testing interventions: a systematic review and meta-analysis

Testing for hepatitis C virus (HCV) infection may reduce the risk of liver-related morbidity, by facilitating earlier access to treatment and care. This review investigated the effectiveness of targeted testing interventions on HCV case detection, treatment uptake, and prevention of liver-related morbidity. A literature search identified studies published up to 2013 that compared a targeted HCV testing intervention (targeting individuals or groups at increased risk of HCV) with no targeted intervention, and results were synthesised using meta-analysis. Exposure to a targeted testing intervention, compared to no targeted intervention, was associated with increased cases detected [number of studies (n) = 14; pooled relative risk (RR) 1.7, 95 % CI 1.3, 2.2] and patients commencing therapy (n = 4; RR 3.3, 95 % CI 1.1, 10.0). Practitioner-based interventions increased test uptake and cases detected (n = 12; RR 3.5, 95 % CI 2.5, 4.8; and n = 10; RR 2.2, 95 % CI 1.4, 3.5, respectively), whereas media/information-based interventions were less effective (n = 4; RR 1.5, 95 % CI 0.7, 3.0; and n = 4; RR 1.3, 95 % CI 1.0, 1.6, respectively). This meta-analysis provides for the first time a quantitative assessment of targeted HCV testing interventions, demonstrating that these strategies were effective in diagnosing cases and increasing treatment uptake. Strategies involving practitioner-based interventions yielded the most favourable outcomes. It is recommended that testing should be targeted at and offered to individuals who are part of a population with high HCV prevalence, or who have a history of HCV risk behaviour

What are we looking at, and how big is it?

Some of the most important outcomes of physical therapy treatment have to do with behaviour and quality of life. This article involves examining what it is we are measuring in physical therapy research and what those measurements mean. In looking at differences between groups (e.g. placebo-control) or strength of association between variables (e.g. correlation, regression) the practitioner/researcher must consider what are meaningful magnitudes of effects. Depending on the variable that one measures, a medium effect size (e.g. Cohen\u27s d=0.50) may, in the real world, be insignificant, or in the case of elite athletic performance such an effect size might be gigantic. A major problem in the sports sciences is the confusion of p values and significance testing with the results of interest, the magnitudes of effects. Also, the prevalence of possible Type II errors in the sports sciences and medicine may be quite high in light of the small sample sizes and the paucity of power analyses for non-significant results. We make an appeal for determining a priori minimal meaningful differences (or associations) to use as the primary metrics in discussing results.<br /

An investigation of RPE-heart rate and the RPE-lactate relationships in elite athletes

This thesis investigated the relationship of ratings of perceived exertion (RPE) with heart rate (HR) and blood lactate (La) that involved four studies. The first study concerned comparing RPE relationships with elite swimmers during exercise tests performed during in-season (IS) and off-season (OS) periods of training. The second study examined the effect of high ambient temperatures on the HRRPE and La-RPE relationship in elite cyclists during self-paced cycle tests. The third study investigated the effect of acute simulated moderate altitude (1800m) exposure on the HR-RPE and La-RPE relationship in highly trained cross-country skiers during incremental ski-striding treadmill tests. The fourth, and final study, was concerned with RPE relationships during upper and lower body work with elite kayakers and elite cyclists

The sanctity of p < .05 obfuscates good stuff: A comment on Kerr and Goss

Sports injuries can be a major source of both personal and financial hardship, and Kerr and Goss (1996) in their article “The Effects of a Stress Management Program on Injuries and Stress Levels” have conducted important research that has implications for the health and welfare of many athletes. Besides suggesting some potential avenues for reducing the incidence of injury, Kerr and Goss have presented a study that offers an opportunity to discuss some issues related to statistical inference, null hypothesis testing, power, and the requirement that p be less than .05. Past research and writings on psychosocial factors and athletic injury have focused on two major areas: antecedents and consequences of injury (Brewer, 1994; Petrie, 1992; Williams, Hogan, & Andersen, 1993). The literature has been noticeably bereft of studies directed at what most sport psychologists, coaches, athletic trainers, and athletes would probably consider the central issue, and that is reducing injury risk in sport. In 1991, Davis presented results that suggested a simple program of progressive relaxation could decrease injury rates. In turn, it was 5 years before another such injury prevention study appeared in the literature (i.e., Kerr & Goss, 1996)

Modelling the impact of condom distribution on the incidence and prevalence of sexually transmitted infections in an adult male prison system

No grant i

Examination of the stability and consistency of investigative interviewer performance across similar mock interview contexts

Purpose. Three studies examined the degree to which investigative interviewers&rsquo; adherence to best-practice guidelines is consistent across similar mock interviews.Method. In each study, two interviews were administered within a period of several hours. Further, group and individual stability of interviewer performance was analysed, and performance was measured by calculating the proportion of open-ended and leading questions as well as the presence of predetermined problem behaviours. The studies varied depending on the type of interview paradigm employed. Interviewer performance in Study 1was measured in a group context where participants rotated between the role of interviewer, child respondent, and observer. In Study 2, an adult played the role of a child recalling abuse but this occurred in isolation (participants did not observe others or play the child). Study 3 was similar to Study 2 except that in each interview an unfamiliar child aged 5&ndash;7 years recalled an innocuous event.Results. Interviewer performance was relatively stable across tasks, although the strength of the relationship between measures varied across analyses. Improvement in open-ended question usage occurred in Study 1 but not Studies 2 and 3. Irrespective of the assessment context, the dichotomous rating scale yielded greater consistency than when questions were tallied. Further, group stability overestimated individual stability. The practical implications of these findings for trainers and researchers are discussed.<br /

The Sociospatial Network: Risk and the Role of Place in the Transmission of Infectious Diseases

Control of sexually transmitted infections and blood-borne pathogens is challenging due to their presence in groups exhibiting complex social interactions. In particular, sharing injection drug use equipment and selling sex (prostitution) puts people at high risk. Previous work examining the involvement of risk behaviours in social networks has suggested that social and geographic distance of persons within a group contributes to these pathogens’ endemicity. In this study, we examine the role of place in the connectedness of street people, selected by respondent driven sampling, in the transmission of blood-borne and sexually transmitted pathogens. A sample of 600 injection drug users, men who have sex with men, street youth and homeless people were recruited in Winnipeg, Canada from January to December, 2009. The residences of participants and those of their social connections were linked to each other and to locations where they engaged in risk activity. Survey responses identified 101 unique sites where respondents participated in injection drug use or sex transactions. Risk sites and respondents’ residences were geocoded, with residence representing the individuals. The sociospatial network and estimations of geographic areas most likely to be frequented were mapped with network graphs and spatially using a Geographic Information System (GIS). The network with the most nodes connected 7.7% of respondents; consideration of the sociospatial network increased this to 49.7%. The mean distance between any two locations in the network was within 3.5 kilometres. Kernel density estimation revealed key activity spaces where the five largest networks overlapped. Here, the combination of spatial and social entities in network analysis defines the overlap of vulnerable populations in risk space, over and above the person to person links. Implications of this work are far reaching, not just for understanding transmission dynamics of sexually transmitted infections by identifying activity “hotspots” and their intersection with each social network, but also for the spread of other diseases (e.g. tuberculosis) and targeting prevention services