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Purpose: The primary purpose of this article is to explore the speech-language pathology (SLP) Praxis test, a barrier to culturally and linguistically diverse (CLD) individuals entering the profession, by investigating first-time pass rates and mean scores by test taker race/ethnicity. Other potential barriers to licensure and certification, as well as solutions for mitigating these barriers, will also be addressed. Method: SLP Praxis test data from two windows of time, 2008–2011 and 2014–2020, were compared for the following: (a) proportions of test taker race/ethnicity relative to U.S. demographic estimates of racial/ethnic group proportions overall, (b) proportions of racial/ethnic groups, and (c) trends in test-taker mean scores by race/ethnicity. First-attempt pass rates by racial/ethnic groups were also calculated for the 2014–2020 testing window. Results: The percentage of some CLD SLP Praxis test-taker groups increased since the 2008–2011 testing window but is still not representative of U.S. racial/ethnic demographics. The first-attempt pass rates and overall mean scores of CLD test-taker groups remained substantially lower than White non–Hispanic/Latinx test takers. Conclusions: Despite the encouraging trends in SLP Praxis test-taker racial/ethnic diversity, disparities persist between the racial/ethnic makeup of SLP Praxis test takers and the demographic makeup of the United States. Consequently, these disparities have implications for the continued lack of cultural representativeness seen in our workforce.

We aimed to analyze the representativeness of women surgeons in academic and leadership positions in Brazil. We investigated women representativeness across surgical departments of 25 Brazilian universities (2020); across boards of 10 Brazilian surgical societies (2020), and, as speakers, in 281 surgical events (Jan-2014 to Dec-2020). From 383 individuals in university departments, 43 (11.2 %) were women (p 0.001). Only three universities had women as department chairs. From 163 positions in surgical societies, only 14 positions (8.6 %) were held by women (p 0.001). The underrepresentation is worse in prestigious positions (presidency and vice-presidency), in which only 1 (5 %) were women. In 281 surgical events, there were 6686 speakers, of which only 886 (13.3 %) of these were women (p 0.001). Further studies are needed to elucidate the possible causes for the gender gap in these scenarios in Brazil, so as to implement effective strategies to improve gender representativeness in surgery in the country.

Fixed site monitoring is the primary method of measuring surface ozone pollution for health advisories and pollutant reduction, but the spatial scale may not reflect the current population distribution or its future growth. Moreover, formal methods for the placement of ozone monitoring sites within populations regions omit important spatial criteria producing monitoring locations that could unintentionally bias the exposure burden. Because ozone pollution endangers human health, triggering shortness of breath, causing asthma attacks and mortality, a need exists for assessing the spatial representativeness and data gaps of existing pollution monitors and to evaluate future placement strategies of additional monitors. A new metric, the potency index, for assessing the placements of monitors in relation to population distribution was developed. This index was used to evaluate the configuration of the ozone pollution monitoring network in relation to the population distribution in Dallas-Fort Worth (DFW). Location-allocation models were used to optimize future sensor quantity and placement. Finally, we propose the development of a decision support system that uses evaluation and optimization methods to improve air pollution monitoring objectives.

In the VerICiguaT Global Study in Subjects with Heart Failure with Reduced Ejection Fraction (VICTORIA) trial, vericiguat reduced the risk of mortality due to cardiovascular problems and of hospitalization due to heart failure (HF) among patients with HF with reduced ejection fraction (HFrEF) and recent worsening HF events (WHFEs). The representativeness of the VICTORIA population of patients with WHFE in clinical practice is unknown.Patients with HF and ejection fraction45% were identified in the Practice Innovation And Clinical Excellence (PINNACLE) registry and were stratified by the occurrence of WHFEs. Characteristics and outcomes of patients in the PINNACLE registry with and without WHFEs were compared to the VICTORIA population. Of the 14,180 PINNACLE patients identified with HFrEF, 26.5% had had a WHFE. The VICTORIA population was similar to PINNACLE patients with WHFEs in mean age (67.3 vs 66.7), ejection fraction (28.9% vs 28.3%), body mass index (26.8 vs 27.6), and comorbidity burden. The rate of hospitalization because of HF at 1 year was 29.6% in the placebo group of VICTORIA, compared to 35.8% in PINNACLE patients with WHFEs and 13.3% in patients without WHFEs.The PINNACLE patients with WHFEs meeting the VICTORIA definition resembled the VICTORIA population in characteristics and outcomes, suggesting that VICTORIA's population may be generalizable to patients with WHFEs in clinical practice.

Team-based models that use medical assistants (MAs) to provide self-management support for adults with type 2 diabetes (T2D) have not been pragmatically tested in diverse samples. This cluster-randomized controlled trial compares MA health coaching with usual care in adults with T2D and poor clinical control (“MAC Trial”). The purpose was to conduct a multi-method process evaluation of the MAC Trial using the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework. Reach was assessed by calculating the proportion of enrolled participants out of the eligible pool and examining representativeness of those enrolled. Key informant interviews documented adoption by MA Health Coaches. We examined implementation from the research and patient perspectives by evaluating protocol adherence and the Patient Perceptions of Chronic Illness Care (PACIC-SF) measure, respectively. Findings indicate that the MAC Trial was efficient and effective in reaching patients who were representative of the target population. The acceptance rate among those approached for health coaching was high (87%). Both MA Health Coaches reported high satisfaction with the program and high levels of confidence in their role. The intervention was well-implemented, as evidenced by the protocol adherence rate of 79%; however, statistically significant changes in PACIC-SF scores were not observed. Overall, if found to be effective in improving clinical and patient-reported outcomes, the MAC model holds potential for wider-scale implementation given its successful adoption and implementation and demonstrated ability to reach patients with poorly controlled T2D who are at-risk for diabetes complications in diverse primary care settings.

Background: The Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS) is an international, prospective study following persons treated by peritoneal dialysis (PD) to identify modifiable practices associated with improvements in PD technique and person survival. The aim of this study was to assess the representativeness of the Australian cohort included in PDOPPS compared to the complete Australian PD population, as reported to the Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry. Methods: Adults with at least one PD treatment reported to ANZDATA Registry during the census period of PDOPPS Phase I (November 2014 to April 2018) were compared to the Australian PDOPPS cohort. The primary outcomes were the representativeness of centres and persons. Secondary outcomes explored the association of person characteristics with consent to study participation. Results: After data linkage, 511 PDOPPS participants were compared to 5616 Australians treated with PD. Within centres eligible for PDOPPS, selected centres were similar to other Australian centres. The PDOPPS participants’ cohort tended to include older persons, more males, a higher proportion of Caucasians and more persons with higher socioeconomic advantage compared to the Australian PD population. Differences in distribution across sex and ethnicities between the PDOPPS cohort and the overall PD population were in part due to the selection and consent processes, during which females and non-Caucasians were more likely to not consent to PDOPPS participation. Conclusion: Sampling methods used in PDOPPS allowed for good national representativeness of the included centres. However, representativeness of the unweighted PDOPPS sample was suboptimal in regard to some participant characteristics.

Background. According to the Center for Medical Statistics of the Ministry of Health of Ukraine, the number of children with ophthalmic diseases has increased significantly over the last decade. The purpose of the study was to determine the awareness of teachers of secondary schools (schools, lyceums) on the problem of visual impairment among schoolchildren with the identification of their willingness to participate in preventive measures. Materials and methods. The materials of the study were the results of a sociological survey of teachers of schools and lyceums in Ukraine (a total of 6215 questionnaires were subject to analysis). We used the method of sociological research and methods of medical statistics, in particular to calculate the representativeness and reliability of the survey results. The study complied with modern European requirements for anonymity; each of the respondents was involved in the survey only after prior oral voluntary consent. The results revealed a lack of awareness of teachers in the prevention of visual impairment among schoolchildren, their willingness to participate in prevention activities and the high need for information support for modern prevention technologies. The majority of respondents supported the need to introduce regular vision testing in childhood, including in the framework of the relevant state prevention program. Conclusions. The majority of teachers (99.40 ± 0.10 %) supporting the expediency of introducing regular vision testing in children, (97.38 ± 0.20 %) support the introduction of a state prevention program to preserve vision from childhood. Based on the results of the study, promising for further research is the study of the possibility of involving teachers in preventive measures and participation in comprehensive programs for the prevention of ophthalmic pathology among students. It is also important to find effective ways of information support for educators on modern prevention technologies, risk factors for the formation of visual impairments in schoolchildren in order to prevent the formation of stigma against children with visual impairments and disorders in their environment.

Introduction Pressure ulcer indicators are among the most frequently used performance measures in long-term care settings. However, measurement systems vary and there is limited knowledge about the international comparability of different measurement systems. The aim of this analysis was to identify possible avenues for international comparisons of data on pressure ulcer prevalence among residents of long-term care facilities. Material and methods A descriptive analysis of the four point prevalence measurement systems programs used in 28 countries on three continents was performed. The criteria for the description and analysis were based on the scientific literature on criteria for indicator selection, on issues in international comparisons of data and on specific challenges of pressure ulcer measurements. Results The four measurement systems use a prevalence measure based on very similar numerator and denominator definitions. All four measurement systems also collect data on patient mobility. They differ in the pressure ulcer classifications used and the requirements for a head-to-toe resident examination. The regional or country representativeness of long-term care facilities also varies among the four measurement systems. Conclusions Methodological differences among the point prevalence measurement systems are an important barrier to reliable comparisons of pressure ulcer prevalence data. The alignment of the methodologies may be improved by implementing changes to the study protocols, such as aligning the classification of pressure ulcers and requirements for a head-to-toe resident skin assessment. The effort required for each change varies. All these elements need to be considered by any initiative to facilitate international comparison and learning.

We analyzed the behavior of forest fires for daily prediction purposes in one of the regions with the highest fire incidence in Mexico. The main objective was to build logistic regression models (LRMs) for daily prediction of forest fire ignition based on meteorological drought indices. We built 252 LRMs for seven types of vegetation cover of greater representativeness and interest for the study area. Three dynamic variables were considered to estimate daily dryness in combustible fuels based on the effective drought index and the standardized precipitation-evapotranspiration index. Additionally, two weather data sources were included in drought indices: conventional weather stations (CWS) and automatic weather stations (AWS). Prediction efficiency assessment for LRMs was done through the relative operating characteristic (ROC) and model precision efficiency (MPE). The results show that LRMs using data from CWS performed relatively better than those based on data from AWS, as the former data sources have higher spatial density and thus generate predictions with higher accuracy (ROC ≥ 0.700, MPE ≥ 0.934). For both data sources, the use of standardized precipitation-evapotranspiration index as a fuel dryness estimator is recommended, as it reflects an atmospheric moisture balance between precipitation and reference evapotranspiration (ROC ≥ 0.734, MPE = 1). Such predictive models can be used as inputs in early warning systems for forest fire prevention or mitigation.

BACKGROUND: High blood pressure self-care profile (HBP-SCP) is one of the instruments that needed to evaluate education program among hypertension patients. AIM: The purpose of the study was to translate and validate HBP-SCP into Indonesian version. METHODS: This study involved translation, content validation, and psychometric testing. The first instrument was conducted forward and backward translation by experts. Seven expert reviewed the contents for consistency, clarity, difficulty, representativeness, and suitability for inclusion. Finally, instrument was tested for reliability and validity on 40 hypertensive patients using Cronbach’s alpha and Pearson’s moment product. RESULTS: The final Indonesian version of HBP-SCP included behavior, motivation, and self-efficacy that each consists of 20 items questions were valid and reliable with positive expert review ratings (content validity index 0.964), internal consistency reliability coefficient ranged from 0.911 to 0.955. Items questionnaire of Indonesian version of HBP-SCP had strong correlation and significant validity (p ≤ 0.05). CONCLUSION: Indonesian version of HBP-SCP is a valid and reliable instrument to assess behavior, motivation, and self-efficacy among hypertension patients and evaluate group based hypertension education programs in Indonesia.

Electronic health records (EHRs) are widely used in epidemiological research, but the validity of the results is dependent upon the assumptions made about the healthcare system, the patient, and the provider. In this review, we identify four overarching challenges in using EHR-based data for epidemiological analysis, with a particular emphasis on threats to validity. These challenges include representativeness of the EHR to a target population, the availability and interpretability of clinical and non-clinical data, and missing data at both the variable and observation levels. Each challenge reveals layers of assumptions that the epidemiologist is required to make, from the point of patient entry into the healthcare system, to the provider documenting the results of the clinical exam and follow-up of the patient longitudinally; all with the potential to bias the results of analysis of these data. Understanding the extent of as well as remediating potential biases requires a variety of methodological approaches, from traditional sensitivity analyses and validation studies, to newer techniques such as natural language processing. Beyond methods to address these challenges, it will remain crucial for epidemiologists to engage with clinicians and informaticians at their institutions to ensure data quality and accessibility by forming multidisciplinary teams around specific research projects.

Background The TTO task involves giving up life years, i.e. living a shorter life, to avoid an undesirable health state. Despite being a hypothetical task, some respondents take other life factors into account when completing the task. This study explored the effect of having children and/or a partner on TTO valuations of hypothetical EQ-5D-5L health states in a valuation study of the general population. Methods The study used TTO data collected in a Norwegian EQ-5D-5L valuation study in 2019–2020, by one-to-one pc-assisted interviews following the EQ-VT protocol. We used regression modelling to determine the effect of significant others (having children or a partner) on disutility per health state from the TTO valuations. Results 430 respondents were included [mean age 43.8 (SD 15.9) years, 58% female, 48% with children, 68% with a partner, 25% with neither children nor partner]. Having children and/or a partner was associated with lowered willingness to trade life years translating to higher elicited health state utilities (p Conclusion Having significant others, or the lack of having significant others, was associated with respondents’ valuation of hypothetical health states using TTO, more so than traditional sampling variables such as age and sex. Inadequate representativeness in terms of having significant others could bias health state preference values in valuation studies.

Background: FluWatch is Canada’s national surveillance system that monitors the spread of influenza. Its syndromic surveillance component monitors the spread of influenza-like illness (ILI) in near-real time for signals of unusual or increased activity. Syndromic surveillance data are collected from two main sources: the Sentinel Practitioner ILI Reporting System and FluWatchers. We evaluated the representativeness of the most recent participant population to understand changes in representativeness since 2015, to identify demographic and geographic gaps and correlates/determinants of participation to characterize a typical participant. Methods: In this serial cross-sectional study, characteristics of participants during four consecutive influenza seasons (2015–2016, 2016–2017, 2017–2018 and 2018–2019) were compared with the 2016 Canadian Census and the 2015–2016, 2016–2017, 2017–2018 and 2018–2019 National Seasonal Influenza Vaccination Coverage Surveys. Associations between demographic factors and the level of user participation were also analyzed among the 2018–2019 FluWatchers population. Results: Infants (0–4 years) and older adults (65 years and older) were under-represented in FluWatchers across all four influenza seasons. Female and urban participants were significantly over-represented. Vaccination coverage remained significantly higher among the FluWatchers populations from the past four influenza seasons across all age groups. Level of participation among FluWatchers was associated with age and vaccination status, but not with sex or geography. Over its four years of implementation, the FluWatchers participant population became more representative of the Canadian population with respect to age and geography (urban/rural and provincial/territorial). Conclusion: FluWatchers participants under-represent the tails of Canada’s age distribution and over-represent those who engage in health promoting behaviours as indicated by high influenza vaccine coverage, consistent with typical volunteer-based survey response biases. Representativeness would likely improve with targeted recruitment of under-represented groups, such as males, older adults and Canadians living in rural areas.

Introdução: No ponto de vista organizativo do Sistema Único de Saúde, a descentralização e a regionalização visam ampliar a resolutividade em nível local, reduzindo a desigualdade na assistência à saúde da população. Em meio às dificuldades de financiar os serviços dos três níveis de complexidades assistenciais em todos os municípios, opta-se pela formação de Regiões de Saúde (RS). No Rio Grande do Norte (RN), seus 167 municípios dividem-se em oito Regiões de Saúde. Objetivo: Identificar os procedimentos obstétricos e Estado que mais frequentemente ocasionou as invasões territoriais na assistência à saúde na VI região de saúde do Rio Grande do Norte em 2018. Metodologia: Estudo quantitativo, de caráter exploratório e descritivo realizado com dados secundários, referentes a 2018, captados no TABWIN, TabNet, CNES e banco de dados da programação pactuada e produção hospitalar cedido pela Secretaria Estadual de Saúde Pública do Rio Grande do Norte (SESAP). Resultados: Indicaram a existência da invasão territorial na região de saúde, Afirmando maior representatividade dessa invasão pelos Estados limítrofes. Conclusões: A invasão territorial se mostra presente na região de saúde e no Estado, despertando olhares sobre tal questão e suas implicações, potencializando novas inquietações.

Background Clinical trials are the gold standard for generating robust medical evidence, but clinical trial results often raise generalizability concerns, which can be attributed to the lack of population representativeness. The electronic health records (EHRs) data are useful for estimating the population representativeness of clinical trial study population. Objectives This research aims to estimate the population representativeness of clinical trials systematically using EHR data during the early design stage. Methods We present an end-to-end analytical framework for transforming free-text clinical trial eligibility criteria into executable database queries conformant with the Observational Medical Outcomes Partnership Common Data Model and for systematically quantifying the population representativeness for each clinical trial. Results We calculated the population representativeness of 782 novel coronavirus disease 2019 (COVID-19) trials and 3,827 type 2 diabetes mellitus (T2DM) trials in the United States respectively using this framework. With the use of overly restrictive eligibility criteria, 85.7% of the COVID-19 trials and 30.1% of T2DM trials had poor population representativeness. Conclusion This research demonstrates the potential of using the EHR data to assess the clinical trials population representativeness, providing data-driven metrics to inform the selection and optimization of eligibility criteria.

Despite the developments in cancer research over years, cancer is still one of the leading causes of death worldwide. In Brazil, the number of cancer cases for the several next years (2020-2022) is expected to increase up to 625,000. Thus, translational research has been vital to determine the potential risk, prognostic, and predictive biomarkers in cancer. Therefore, Barretos Cancer Hospital implemented a biobank (BB-BCH) in 2006, which is responsible for processing, storage, and provision of biological materials from cancer and non-cancer participants. Hence, this article aimed to describe BB-BCH's history, experiences, and outcomes and explore its impact on Brazilian translational oncology research scenario. BB-BCH has a multidisciplinary team who are responsible for guaranteeing the quality of all processes as recommended by international guidelines for biobanks. Furthermore, BB-BCH has ample equipment to ensure the quality of all material requested by researchers as genetic material (DNA and RNA) and/or entire biospecimens. From 2006 to 2019, BB-BCH contained 252,069 samples from 44,933 participants, the whole collection is represented by 15 different types of biospecimens collected from them. According to our data, the most collected and stored topography in men is head and neck (29%); in women is breast (28%); and in children is torso and limb (27%) samples. Finally, we supported national and international consortia and projects such as The Cancer Genome Atlas. BB-BCH is a vital knowledge source for scientific community, enabling the development of high-quality studies, with a wide variety of tumor categories and high national representativeness of Brazilian population.

Despite its increasing use, few studies have reported on demographic representativeness and costs of research recruitment via social media. It was hypothesized that cost, reach, enrollment, and demographic representativeness would differ by social media recruitment approach. Participants were 18–25 year-olds at moderate to high risk of skin cancer based on phenotypic and behavioral characteristics. Paid Instagram, Facebook, and Twitter ads, unpaid social media posts by study staff, and unpaid referrals were used to recruit participants. Demographic and other characteristics of the sample were compared with the 2015 National Health Interview Survey (NHIS) sample. Analyses demonstrated significant differences among recruitment approaches regarding cost efficiency, study participation, and representativeness. Costs were compared across 4,274 individuals who completed eligibility screeners over a 7-month period from: Instagram, 44.6% (of the sample) = 1,907, $9 (per individual screened); Facebook, 31.5% = 1,345, $8; Twitter, 1% = 42, $178; unpaid posts by study staff, 10.6% and referred, 6.5%, $1. The lowest rates of study enrollment among individuals screened was for Twitter. Most demographic and skin cancer risk factors of study participants differed from those of the 2015 NHIS sample and across social media recruitment approaches. Considering recruitment costs and number of participants enrolled, Facebook and Instagram appeared to be the most useful approaches for recruiting 18–25 year-olds. Findings suggest that project budget, target population and representativeness, and participation goals should inform selection and/or combination of existing and emerging online recruitment approaches.

INTRODUCTION: Representativeness of research populations impacts the ability to extrapolate findings. The Burn Model System (BMS) National Database is one of the largest prospective, longitudinal, multi-center research repositories collecting patient-reported outcomes after burn injury.. OBJECTIVE: This study aimed to assess if the BMS Database is representative of the population that is eligible to participate. DESIGN: Data on adult burn survivors who were eligible for the BMS Database from 2015 to 2019 were analyzed. SETTING: N/A PARTICIPANTS: Burn survivors treated at BMS centers meeting eligibility criteria for the BMS Database. Eligibility for the database is based on burn size and receipt of autografting surgery. INTERVENTIONS: N/A MAIN OUTCOME MEASURE(S): Race, ethnicity, gender, and age were compared between individuals who did and did not enroll. Regression analysis examined the correlation between demographic characteristics and study enrollment.. Additional regression analysis examined the association between enrollment and the intersection of race, ethnicity, and gender. RESULTS: A total of 982 adult burn survivors were eligible for the BMS database during the study period. Of those who were eligible, 72.1% Enrolled and 27.9% were Not Enrolled. The Enrolled group was more female and younger compared to the Not Enrolled group. In regression analyses, Black/African American burn survivors were less likely and individuals identifying as female were more likely to enroll in the BMS Database. Further, when looking at groups by race and gender and ethnicity and gender, White men and women were more likely to enroll compared to Black/African American men and women and non-Hispanic/Latino men were more likely to enroll compared to Hispanic/Latino men. CONCLUSIONS: This study found differences in BMS Database enrollment by race, ethnicity, and gender. Further research is warranted to investigate causes for the disparities found in this study. Additionally, strategies are needed to improve enrollment to ensure future representativeness.

To assess trends in gender, racial, and ethnic diversity of applicant pools and subsequent resident cohorts in neurosurgical residency programs in the United States.Applicant and residency data from 2009 to 2018 were analyzed from the Electronic Residency Application Service, Journal of the American Medical Association, and National Resident Matching Program to evaluate trends in diversity.There was no statistically significant difference between applicant sex from 2009 to 2013 compared with 2014 to 2018 (P0.05). From 2009 to 2018, the percentage of female residents saw a statistically significant increase from 12.9% to 17.5% but remained less reflective of women's representativeness in the United States (50.8%). The percentage of Black and Hispanic applicants decreased across the observed period (4% and 1%, respectively). While Black people represented 5.2% of the resident pool in 2009, this decreased to 4.95% by 2018. Hispanic residents saw a2% net increase (5.5% to 7.2%) in resident representation but still fell behind when compared with census statistics. The application pool did not see a significant change in the percentage of White and Asian applicants; however, the percentage of residents did decrease slightly over the observed decade.Current efforts to improve racial and ethnic diversity have not been sufficient in generating parity in the recruitment and retention of racially underrepresented groups in neurosurgery. Although the presence of women in applicant and resident pools has increased, not much is known about the impact on women who also identify within racially underrepresented groups. More proactive measures for recruitment and retention are needed to reach equity in the future neurosurgical workforce.

This systematic review synthesizes the empirical literature examining pragmatic language in children diagnosed with attention-deficit/hyperactivity disorder (ADHD). Using a taxonomy of pragmatic language, we compared the pragmatic language profiles of children with ADHD to those of typically developing (TD) children and children with autism. Three databases were searched up to October 2019: PsychInfo; PubMed; and CSA Linguistics and Language Behavior Abstracts. We included 34 studies reporting on 2,845 children (ADHD = 1,407; TD = 1,058; autism = 380). Quality and risk of bias assessments included sample size and representativeness; measure reliability and validity; and missing data management. Children with ADHD were found to have higher rates of pragmatic difficulties than their TD peers. Specific difficulties were identified with inappropriate initiation, presupposition, social discourse, and narrative coherence. Children with ADHD appear to differ from those with autism in the degree of their pragmatic language impairments. General language skills contribute to, but do not explain, pragmatic difficulties in samples of children with ADHD. Though the extant evidence is limited, a preliminary profile of the pragmatic language impairments in children with ADHD is indicated. This supports a call for evidence-based interventions that include pragmatic language skills training.

Objectives Oral health values, the degree to which one places importance on or demonstrates investment in improving or maintaining one's dental status, are believed to vary across individuals. Research on this construct is in its infancy, so a new Oral Health Values Scale (OHVS) was developed and validated. The aim was to create a multidimensional measure of oral health values that could be used in future epidemiological or behavioural investigations involving determinants of dental treatment‐seeking behaviour and/or oral health. Methods The OHVS was developed in three cross‐sectional phases. A 45‐item pool was developed, and 12 expert raters from various oral health professions rated the items for their representativeness and relevance, as well as specificity and clarity. Based on the expert feedback, an initial 30‐item scale was subsequently established and administered to a developmental sample (N = 306) using Amazon's Mechanical Turk (MTurk). The scale was further refined to be 12 items and its structure was confirmed in a validation sample (N = 308), also using MTurk. Correlations among OHVS scores and other oral health‐related constructs were examined in the developmental and validation samples. Results Expert review of items for the oral health values construct and the OHVS provided initial evidence of content validity. The final 12‐item scale exhibited a four‐factor structure with good internal consistency, α = 0.84. The psychometric properties of the final scale were confirmed in a second sample using confirmatory factor analysis, although evidence for the OHVS's four‐factor structure was mixed. Overall, OHVS scores were consistently related to other oral health constructs in anticipated ways, providing evidence of construct validity. Conclusions The OHVS demonstrated content validity, internal consistency, and construct validity. Results suggest that the OHVS is a psychometrically sound instrument.

This publication is a continuation of the article published in the 4 th issue of the journal Russian family doctor for 2020 “Heuristics, language and medical errors”, which described the ways of making medical decisions that can lead to errors in patient management tactics, in particular “affect of heuristics / visceral bias”, “attribution error”, “frame of reference”, “availability bias”, “one-word-one-meaning-fallacy”. This article discusses additional sources of diagnostic error, including “diagnosis momentum”, “confirmation bias”, “representativeness”, and “premature closure” also the conflict that arises from diagnostic uncertainty is discussed. All errors in the tactics and the diagnostic process are illustrated by clinical cases from the personal practice of the author of the article.

Background Low recruitment in clinical trials is a common and costly problem which undermines medical research. This study aimed to investigate the challenges faced in recruiting children and adolescents with obsessive-compulsive disorder and autism spectrum disorder for a randomized, double-blind, placebo-controlled clinical trial and to analyze reasons for non-participation. The trial was part of the EU FP7 project TACTICS (Translational Adolescent and Childhood Therapeutic Interventions in Compulsive Syndromes). Methods Demographic data on pre-screening patients were collected systematically, including documented reasons for non-participation. Findings were grouped according to content, and descriptive statistical analyses of the data were performed. Results In total, n = 173 patients were pre-screened for potential participation in the clinical trial. Of these, only five (2.9%) were eventually enrolled. The main reasons for non-inclusion were as follows: failure to meet all inclusion criteria/meeting one or more of the exclusion criteria (n = 73; 42.2%), no interest in the trial or trials in general (n = 40; 23.1%), and not wanting changes to current therapy/medication (n = 14; 8.1%). Conclusions The findings from this study add valuable information to the existing knowledge on reasons for low clinical trial recruitment rates in pediatric psychiatric populations. Low enrollment and high exclusion rates raise the question of whether such selective study populations are representative of clinical patient cohorts. Consequently, the generalizability of the results of such trials may be limited. The present findings will be useful in the development of improved recruitment strategies and may guide future research in establishing the measurement of representativeness to ensure enhanced external validity in psychopharmacological clinical trials in pediatric populations. Trial registration EudraCT 2014-003080-38. Registered on 14 July 2014.

This study aimed to assess the feasibility of recruiting injured pedestrians from the emergency department of a major trauma centre, using an in-depth interview shortly post collision. Convenience sampling was used to prospectively recruit injured pedestrians from the Alfred Hospital Emergency and Trauma Centre. Of the 102 injured pedestrians, 39 met eligibility criteria and of these, 30 (77%) consented and completed the questionnaire. Over half of the collisions occurred at an intersection (57%), and of these the most common pre-impact vehicle manoeuvre was a vehicle turning into the street the pedestrian was crossing. In-depth interview during the early post-crash period was a feasible and effective method of collecting detailed data in an accessible sample. However, only 38% of patients met eligibility criteria. To enhance representativeness, supplementing interview data with police-reported crash data, recruiting from hospital wards and crash location assessment is recommended.

Aim: To determine feasibility and acceptability of completing PROs questionnaires at completion and 1 year after curative cancer treatment. Methods: Patients assessed in a nurse-led end of treatment survivorship clinic, at a tertiary referral centre, recruited between October 2015 and July 2016 were mailed a survey at baseline and at 12-month follow-up. The survey included validated PRO questionnaires. A target response rate for feasibility, defined as the proportion of the eligible population approached that completed the survey, was set at 70%. Qualitative feedback regarding the survey was collected from participants. Results: Of the 47 eligible patients approached, 34 (72.4%) agreed to participate with 29 (61.9%) completing the survey at baseline, and 21 (44.7%) at follow-up. Respondents lost to follow-up at 12 months had clinically meaningful lower scores on all QLQ-C30 functioning scales and 8 out of 9 symptom scales/items. Qualitative feedback from survey respondents indicated the content was relevant and acceptable. Participants expressed willingness to complete a similar survey approximately once per year and a higher preference for completing the survey in hard copy compared with online. Conclusions: Cancer survivors are willing to provide information on a range of PROs, but those with higher needs were the ones less likely to complete surveys. There is scope to improve the response rate and representativeness of the patient cohort captured. Future research should identify strategies to optimise recruitment when collecting PROs data from cancer survivors. Refereed/Peer-reviewed

Mental health (MH) and illness reflect bio-psycho-social balance/imbalance and extend into multidimensional space. In the current pandemic, the entire area of MH/illness is at increased risk of contamination not only by infection, but also by numerous other aspects of this complex public health crisis. There are at least three mechanisms by which the COVID-19 pandemic can create new-onset mental conditions: 1) Psychological factor - increased degree of emotional suffering after extremely severe traumatic events or long-term life-threatening exposures; 2) Social factor - risks related to interaction with the environment: a) emotional deprivation; b) cognitive disintegration related to infodemia and c) existential, primarily economic fears that destabilize relationships (within the family and beyond); and 3) Biological factor - neuropsychiatric effects of the virus itself. In addition to the new-onset conditions, the pandemic also has an impact on people who already have a history of mental disorders. This review paper will present the most important information from relevant sources related to mental health and the COVID-19 pandemic related to the first year of exposure. Emphasis will be on research that has attracted attention with sample size and representativeness, as well as a reliable methodology, with the aim of not losing sight of the heterogeneity of the pandemic effects on mental health.

Two polls were conducted by an independent polling firm in September 2018 and July 2020 to assess public perceptions of public health departments and services among voters in the United States. The poll also sought to uncover changes in perception before and after the onset of COVID-19. A random sample was drawn from state voter files proportional to the national registered voter population by state, with quotas set by specific demographics to ensure representativeness. Overall, 1800 individuals participated between the 2 polls and weights were used in the analysis to adjust for nonresponse. From 2018 to 2020, respondents' familiarity with local public health departments rose 11% and their perception of the importance of the public health department to community health increased by 16%. In addition, support for public health departments and services differed significantly by political affiliation. In 2020, 85% of Democrats perceived the public health department to be very important while only 62% of their Republican counterparts felt similarly. Public health advocates have a unique opportunity to demand sustained funding for public health as American voters are more familiar and supportive of public health departments now than they were before the pandemic. In addition, policy makers, elected officials, and political candidates have the opportunity to leverage these data to fight for the health of their communities.

Background Progress towards viral hepatitis elimination goals relies on accurate estimates of chronic hepatitis B virus (HBV)-infection prevalence. We compared existing sources of country-level estimates from 2013 to 2017 to investigate the extent and underlying drivers of differences between them. Methods The four commonly cited sources of global-prevalence estimates, i.e. the Institute for Health Metrics and Evaluation, Schweitzer et al., the World Health Organization (WHO) and the CDA Foundation, were compared by calculating pairwise differences between sets of estimates and assessing their within-country variation. Differences in underlying empirical data and modelling methods were investigated as contributors to differences in sub-Saharan African estimates. Results The four sets of estimates across all ages were comparable overall and agreed on the global distribution of HBV burden. The WHO and the CDA produced the most similar estimates, differing by a median of 0.8 percentage points. Larger discrepancies were seen in estimates of prevalence in children under 5 years of age and in sub-Saharan African countries, where the median pairwise differences were 2.7 percentage and 2.4 percentage points for all-age prevalence and in children, respectively. Recency and representativeness of included data, and different modelling assumptions of the age distribution of HBV burden, seemed to contribute to these differences. Conclusion Current prevalence estimates, particularly those from the WHO and the CDA based on more recent empirical data, provide a useful resource to assess the population-level burden of chronic HBV-infection. However, further seroprevalence data in young children are needed particularly in sub-Saharan Africa. This is a priority, as monitoring progress towards elimination depends on improved knowledge of prevalence in this age group.

Objectives: The availability of information on healthy products does not ensure the empowerment of people with the knowledge on how to choose or avoid food products or dishes depending on unhealthy factors. Public knowledge and beliefs of unhealthy food effects on health needs to be evaluated so that appropriate measures can be taken to properly inform people and relevant socio-demographic groups. Methods: The original survey questionnaire containing questions about specific food groups and various health effects was compiled. A total of 1,007 respondents, Lithuanian residents aged 18-75 years, were surveyed in March 2019. Multilevel stratified probability sampling method was used for data representativeness. Results: Almost half of respondents (46.2%) knew that deep-fried food could cause cancer. The majority of respondents (68.4%) were aware that sugar causes obesity and 61.7% were aware that sugar increases the risk of diabetes mellitus; 41.6% (more often those living in non-rural areas) know that grilled meat may cause cancer. More than half of respondents (57.2%) (more likely those living in non-rural areas and those with a university degree) were aware that smoked meat products may cause cancer. Only 46.4% were aware of the fact that salt raises blood pressure and the risk of cardiovascular diseases. Conclusion: Only about half of Lithuanian residents aged 18-75 were aware of the scientifically proven harmful effects of unhealthy food groups. Socio-demographic factors influence the knowledge and beliefs of the population.

Effectiveness of psychotherapy and of clinico-psychological interventions depends on different factors: skills and characteristics of a specialist; diagnosis and extent of severity of symptoms; social and personal peculiarities of patient/client; parameters of psychotherapeutic contact. Therapygenetics is a trend of applied research at the interface of molecular genetics and psychotherapy, which considers molecular-genetic predictors of success/failure of psychotherapeutic interventions. The aim of the article is analysis and summarization of the current research works in the field of therapygenetics, substantiation of their theoretical and practical significance for psychiatry, psychotherapy and clinical psychology, discussion of the existing limitations and requirements to the design of the respective applied research works. By the moment, contra-dictory, but at the same promising positions in therapygenetics can be outlined. In the given article the results of therapygenetic research performed mostly in accordance with methods of identification of candidate genes, are systematized. Gene-environment correlations in psycho-therapy of anxiety and depressive disorders in children and adults are described. Scarce studies of genetic predictors of effectiveness of psychotherapy in posttraumatic stress-related disorders are summarized. While planning a therapygenetic study, the following methodological, methodical and organizational aspects should be taken into consideration: sufficient representativeness of an experimental sample both from the point of view of socio-demographic characteristics and from the point of view of the diagnosis and used therapy; existence of the control group; use of assessment scales and semi-structured diagnostic interviews for assessment of functioning of respondents; universalization of protocols of assessment of the results of application of methods of psychotherapy; use of polygenomic search for associations; observance of confidentiality and provision of respondents with minimally effective ways of rendering psychological assistance.

Background Stigmatized behaviours are often underreported, especially in pregnancy, making them challenging to address. The Alcohol and Child Development Study (ACDS) seeks to inform prevention of foetal alcohol harm, linking self-report as well as a maternal blood alcohol biomarker with child developmental outcomes. Samples were requested using passive, generic consent. The success of this approach at minimizing bias is presented comparing characteristics of women who provided samples to those who did not. Methods All pregnant women in the study city were sent a Patient Information Sheet (PIS) with their first NHS obstetric appointment letter. The PIS informed them that the NHS would like to take an extra blood sample for research purposes, unless they opted out. Neither the women nor the midwives were informed that the samples might be tested for an alcohol biomarker. This paper examines the extent to which women who provided the extra sample were representative of women where no sample was provided, in terms of routinely collected information: age; body mass index; area-based deprivation; previous pregnancies, abortions and caesarians; smoking status and carbon monoxide level; self-reported alcohol use, gestation and birth weight of their baby. Chi-square and Mann-Whitney U tests were used to compare groups. Results 3436 (85%) of the 4049 pregnant women who attended their appointment provided the extra sample. Women who did not were significantly younger (p p p Conclusions The use of passive consent without disclosure of the specific research focus resulted in a high level of sample provision. There was no evidence that study blinding was breached, and women who provided a sample were more likely to report alcohol consumption. Passive consent to draw additional blood for research purposes at routine antenatal venipuncture reduced sampling bias compared to asking women to give blood for an alcohol study. This methodology may be useful for other stigmatised behaviours.

Objective To analyze the content validity and the test-retest reliability of the Questionnaire for Screen Time of Adolescents (QueST). Methods A study was conducted with high school adolescents from Southern Brazil enrolled in public education (2019). The QueST measures screen time across five constructs: studying, working/internship-related activities, watching videos, playing games, using social media/chat applications. Content validation involved consulting with experts and adolescents to evaluate whether the five constructs were clear and representing screen time behaviors, all ratings were quantified. The experts’ evaluation provided Content Validity Indexes (CVI) for clarity and representativeness of the questionnaire. Students answered the QueST twice (1-week apart), and differences between applications were verified. Test-retest reliability was assessed using Intraclass Correlation Coefficients (ICC) and Bland-Altman analyses. Results Among the experts, the CVI indicated 94% and 98% of clarity and representativeness, respectively. All items were highly clear for at least 70% of the students. Test-retest reliability was assessed with 104 students (16.3 ± 1.02 years; 66.3% girls). The ICC ranged from 0.41 (95%CI 0.24–0.56) for videos to 0.76 (95%CI 0.66–0.83) for social media/chat applications on weekdays; and from 0.24 (95%CI 0.04–0.41) for videos to 0.67 (95%CI 0.54–0.77) for social media/chat applications on weekends. The lowest mean difference was -4.6 min for working on weekdays, while the highest was 40.6 min for videos on weekends. Conclusions The QueST proved to be fair to excellent for measuring different screen time constructs. However, the item of videos (weekends) showed poor stability. The QueST demonstrates satisfactory content validity attested by the experts and adolescents.

Providing the public with relevant and reliable statistical information about the impact of COVID-19 on vulnerable populations is a crucial weapon in effective public health system response This article examines the reporting challenges confronted by local public health agencies based on a case study of farmworker communities of the San Joaquin Valley, Eastern Coachella Valley, and Salinas Valley The analysis includes a quantitative estimate of the impact COVID-19 has on farmworker households and highlights how socioeconomic factors and housing conditions give rise to health disparities The importance of local data collection and reporting as the foundation for a national epidemiological tracking system is emphasized Current shortcomings stemming from flawed national guidance and local political pressures are noted The discussion includes detailed recommendation for improved reporting including: more systematic tabulations of available data, an expanded set of indicators to monitor public health system response, promising approaches to improve representativeness of test-derived data on COVID-19 by making it easier to access testing and support services, coupled with messaging to broaden farmworkers' and other socio-politically marginalized populations' willingness to seek testing Understanding the challenges faced and lessons learned in the San Joaquin Valley region have practical implications for a wide range of countries © 2020 - IOS Press and the authors All rights reserved

Background A major goal of tuberculosis (TB) epidemiological studies is to obtain results that can be generalized to the larger population with TB. The ability to extrapolate findings on the determinants of TB treatment outcomes is also important. Methods We compared baseline clinical and demographic characteristics and determinants of anti-TB treatment outcomes between persons enrolled in the Regional Prospective Observational Research in Tuberculosis (RePORT)-Brazil cohort between June 2015 and June 2019, and the registry of TB cases reported to the Brazilian National TB Program (Information System for Notifiable Diseases [SINAN]) during the same time period. Multivariable regression models adjusted for the study site were performed using second-generation p-values, a novel statistical approach. Associations with unfavorable treatment outcomes were tested for both RePORT-Brazil and SINAN cohorts. Findings A total of 1,060 culture-confirmed TB patients were enrolled in RePORT-Brazil and 455,873 TB cases were reported to SINAN. Second-generation p-value analyses revealed that the cohorts were strikingly similar with regard to sex, age, use of antiretroviral therapy and positive initial smear sputum microscopy. However, diabetes, HIV infection, and smoking were more frequently documented in RePORT-Brazil. Illicit drug use, the presence of diabetes, and history of prior TB were associated with unfavorable TB treatment outcomes; illicit drug use was associated with such outcomes in both cohorts. Conclusions There were important similarities in demographic characteristics and determinants of clinical outcomes between the RePORT-Brazil cohort and the Brazilian National registry of TB cases.

Objective: The aim of the present study was to examine selection in a general practice-based pregnancy cohort. Design: Survey linked to administrative register data. Setting and subjects: In spring 2015, GPs were recruited from two Danish regions. They were asked to invite all pregnant women in their practice who had their first prenatal care visit before 15 August 2016 to participate in the survey. Outcome measures: The characteristics of GPs and the pregnant women were compared at each step in the recruitment process–the GP’s invitation, their agreement to participate, actual GP participation, and the women’s participation–with an uncertainty coefficient to quantify the step where the largest selection occurs. Results: Significant differences were found between participating and non-participating practices with regards to practice characteristics such as the number of patients registered with the practice, the age and sex of doctors, and the type of practice. Despite these differences, the characteristics of the eligible patients differed little between participating and non-participating practices. In participating practices significant differences were, however, observed between recruited and non-recruited patients. Conclusion: The skewed selection of patients was mainly caused by a high number of non-participants within practices that actively took part in the study. We recommend that a focus on the sampling within participating practices be the most important factor in representative sampling of patient populations in general practice.Key points Selection among general practitioners (GPs) is often unavoidable in practice-based studies, and we found significant differences between participating and non-participating practices. These include practice characteristics such as the number of GPs, the number of patients registered with the GP practice, as well as the sex and age of the GPs. •Despite this, only small differences in the characteristics of the eligible patients were observed between participating and non-participating practices. •In participating practices, however, significant differences were observed between recruited and non-recruited patients. •Comprehensive sampling within participating practices may be the best way to generate representative samples of patients.

In the past decade a large body of evidence has accumulated on risk factors for dementia, primarily from Europe and North America. Drawing on recent integrative reviews and a consensus workshop, the International Research Network on Dementia Prevention developed a consensus statement on priorities for future research. Significant gaps in geographical location, representativeness, diversity, duration, mechanisms, and research on combinations of risk factors were identified. Future research to inform dementia risk reduction should fill gaps in the evidence base, take a life-course, multi-domain approach, and inform population health approaches that improve the brain-health of whole communities.

It is important to study the trends of e-cigarette use among various subgroups to understand which populations may be more susceptible to increased use and, therefore, are at risk for potential long-term health effects.We used cross-sectional data from the 2016-2017 Behavioral Risk Factor Surveillance System, a nationally representative U.S. telephone-based survey of adults aged 18 years or older. The 2017 dataset also includes data from participant interviews that had been conducted in the year 2018. Current e-cigarette use was defined as use of e-cigarettes every day or on some days. We analyzed data using survey weights to ensure representativeness of the data to the US population.The study population consisted of 936,319 individuals, of whom 28,917 were current e-cigarette users, and corresponded to 10.8 million U.S. adults. Thirty percent were aged between 18 and 34 years. Forty-nine percent were men; 63% were white, 12% black, and 17% Hispanic. The overall prevalence of current e-cigarette use increased from 4.3% in 2016 to 4.8% in 2018. E-cigarette use significantly increased among middle-aged adults (from 3.9% to 5.2%; P = .004), women (from 3.3% to 4.3%; P.001), and former smokers (from 5.2% to 7.9%; P = .02), but decreased among current smokers (from 14.5% to 13.8%; P = .02).In a nationally representative sample, we found important trends in e-cigarette use in a relatively short time frame. A significantly increasing prevalence of e-cigarette use was noted among middle-age adults, women, and former smokers. Our study provides important information about e-cigarette trends that can be used by clinicians when counselling patients and by regulatory agencies to develop public policies.

Attrition is a frequently observed phenomenon in panel studies. The loss of panel members over time can hamper the analysis of panel survey data. Based on data from the Survey of Health, Ageing and Retirement in Europe (SHARE), this study investigates changes in the composition of the initially recruited first-wave sample in a multi-national face-to-face panel survey of an older population over waves. By inspecting retention rates and R-indicators, we found that, despite declining retention rates, the composition of the initially recruited panel sample in Wave 1 remained stable after the second wave. Thus, after the second wave there is no further large decline in representativeness with regard to the first wave sample. Changes in the composition of the sample after the second wave over time were due mainly to mortality-related attrition. Non-mortality-related attrition had a slight effect on the changes in sample composition with regard to birth in survey country, area of residence, education, and social activities. Our study encourages researchers to investigate further the impact of mortality- and non-mortality-related attrition in multi-national surveys of older populations.

Despite widespread recommendations for involving patient research partners (PRPs), there is little information about how patients have been involved in research. Our aim was to describe and assess the contributions of four PRPs in a project on communication-skills training funded by Deutsche Rheuma-Liga Bundesverband e. V. (German League Against Rheumatism [GLR] is a patient organisation for people with rheumatic and musculoskeletal diseases). The PRPs' participation was beneficial with regards to content and organisation. Thanks to their participation, we could enlarge our sample by over a third, and they contributed their own ideas to the training. Four PRPs added their perspective of various regional organisations. Outside this project, they were also very active within GLR and experienced in managing their rheumatic disease. To achieve more representativeness, future studies might also employ strategies to engage individuals with less experience in dealing with their disease, e.g. newly diagnosed patients. While the collaboration between PRPs and researchers proved very successful, more regular discussions about tasks and responsibilities would be worthwhile.Obwohl die Einbeziehung von Patient*innen als Forschungspartner*innen (FP) in wissenschaftlichen Forschungsprojekten weithin befürwortet wird, gibt es bisher wenig Erfahrungsberichte über die konkrete Umsetzung partizipativer Forschungsprojekte. Dieser Beitrag beschreibt die Mitarbeit von 4 FP im Rahmen eines von der Deutschen Rheuma-Liga Bundesverband e. V. (DRL) geförderten Projekts zur Entwicklung einer Kommunikationsschulung und bewertet die Mitarbeit systematisch. Die Mitwirkung der FP ging mit inhaltlichen und organisatorischen Vorteilen einher: So konnte die Teilnehmerzahl um über ein Drittel erhöht werden. Außerdem ergänzten die FP die im Projekt entwickelte Schulung um eigene Ideen. Die 4 FP brachten ihre Erfahrungen in Bezug auf verschiedene Landesverbände ein. Sie waren unabhängig vom Projekt sehr engagiert in der DRL und hatten viel Vorerfahrung bezüglich des Umgangs mit ihrer jeweiligen rheumatischen Erkrankung. Zur Erreichung einer besseren Repräsentativität sollten künftige Studien versuchen, auch neu erkrankte und somit in Bezug auf das Krankheitsmanagement unerfahrenere Patient*innen zu beteiligen. Obwohl sich die Zusammenarbeit zwischen den FP und den Forschern als sehr erfolgreich erwies, wird ein regelmäßigerer Austausch über Aufgaben und Verantwortlichkeiten als vorteilhaft angesehen.

Road crashes are the leading cause of death among people aged 15 and above. The routine health information system is used to monitor common hospital illnesses, including road traffic injuries. The objective of this study was to evaluate its performance in the surveillance of road traffic injuries in Benin in 2019. This was an evaluative study, based on updated guidelines from the Centre for Disease Prevention and Control to evaluate a public health surveillance system. Performance was assessed on the basis of utility and quality criteria (simplicity, flexibility, acceptability, completeness, exhaustiveness, stability, responsiveness, representativeness and reactivity). The data collection techniques used was document review and interview. The system was considered useful and produced indicators on road traffic injuries each year within an average of five months. Its strengths were its representativeness (100%), stability (100%) and simplicity (83%). Acceptability, exhaustiveness and completeness were the main areas for improvement in the system with scores of 51.4, 38.07 and 16.27%, respectively. The routine health information system presents indicators of insufficient acceptability and low integration with other existing collection systems for road traffic injuries. Improving performance for better planning in road safety requires a more holistic approach in the implementation and functionality of the system. Key words: Traffic, injury, evaluations, intervention.

Background The Oregon Occupational Public Health Program (OOPHP) monitors occupational health indicators (OHIs) to inform occupational safety and health (OSH) surveillance. In 2018, OOPHP evaluated the performance of the OSH surveillance system and identified areas for future improvement. Methods Following the Centers for Disease Control and Prevention (CDC) updated guidelines for evaluating public health surveillance systems, the OOPHP evaluation team engaged internal and external stakeholders using a mixed‐methods approach. Operational measures for ten surveillance attributes were developed. Multiple data collection methods resulted in credible evidence for evaluation conclusions. Analyses included summary statistics and qualitative analysis of interviews, a focus group, and online surveys. Results Twenty stakeholders took part in this evaluation, with an average participation rate of 55%. Results showed the Oregon OSH surveillance system was simple, flexible, and highly accepted by its stakeholders. Funding security presents challenges for stability. A lack of timeliness of OHIs, low relevance of OHIs to local OSH issues, and the system's ineffectual data dissemination all limit the usefulness of the OSH surveillance system. A review of key data sources for the system showed good data quality and predictive value positive, but relatively poor sensitivity and representativeness. Conclusions The evaluation team successfully adapted attributes and examples in the CDC guidelines to this Oregon OSH surveillance evaluation. The evaluation findings have informed the development of recommendations for improvements to OOPHP's OSH surveillance. Future research is needed to develop guidance specific to OSH surveillance evaluation.

Among the different providers of health care big data in Korea, the data provided by the National Health Insurance Database include the medical information of all the citizens who have subscribed to medical insurance. As such, the data have representativeness and completeness. In order to conduct research using these National Health Insurance Database data, it is necessary to understand the characteristics of the claim data to avoid various biases, and to control confounding variables when making various operational definitions in the planning stage of the research. Moreover, without a proper understanding of the big data, it is possible during the analysis and data interpretation to mistakenly interpret the correlation between variables as a causal relationship. Therefore, in order to help advanced medical science, which reflects the medical reality such as medical expenses and number of hospital visits by clearly recognizing and analyzing the characteristics and limitations of health care big data, this author has dealt with the use of data sharing services provided by the National Health Insurance Database.

Objective To develop Austrian, Italian, and Polish general population value sets for the EORTC QLU-C10D, a cancer-specific utility instrument based on the EORTC QLQ-C30, and to descriptively compare their index scores for distinct health states. Methods The QLU-C10D descriptive system comprises 10 health attributes and each can take on 4 levels. A standardised and pre-tested methodology has been applied for valuations including a web-based discrete choice experiment (DCE). It was administered in 1000 general population respondents per country recruited via online panels, aiming at representativeness for core socio-demographic variables. Results In all three countries, the attributes with the largest impact on utility were physical functioning, pain, and role functioning. Cancer-specific dimensions with the largest impact were nausea and fatigue or bowel problems. Utility values of the worst health state (i.e. severe problems on all 10 dimension) were -0.111 (Austria), 0.025 (Italy), and 0.048 (Poland). Country-specific utilities differed for a selection of health states across the continuum. Austrian utilities were systematically lower for moderately and severely impaired health states. Conclusion QLU-C10D cancer-specific utilities can now be calculated in three more countries. Differences between countries indicate that careful consideration is required when using non-country-specific value sets in economic evaluations.

Background The COVID-19 pandemic has evolved into one of the most impactful health crises in modern history, compelling researchers to explore innovative ways to efficiently collect public health data in a timely manner. Social media platforms have been explored as a research recruitment tool in other settings; however, their feasibility for collecting representative survey data during infectious disease epidemics remain unexplored. Objectives This study has two aims 1) describe the methodology used to recruit a nationwide sample of adults residing in the United States (U.S.) to participate in a survey on COVID-19 knowledge, beliefs, and practices, and 2) outline the preliminary findings related to recruitment, challenges using social media as a recruitment platform, and strategies used to address these challenges. Methods An original web-based survey informed by evidence from past literature and validated scales was developed. A Facebook advertisement campaign was used to disseminate the link to an online Qualtrics survey between March 20–30, 2020. Two supplementary male-only and racial minority- targeted advertisements were created on the sixth and tenth day of recruitment, respectively, to address issues of disproportionate female- and White-oriented gender- and ethnic-skewing observed in the advertisement’s reach and response trends. Results In total, 6602 participant responses were recorded with representation from all U.S. 50 states, the District of Columbia, and Puerto Rico. The advertisements cumulatively reached 236,017 individuals and resulted in 9609 clicks (4.07% reach). Total cost of the advertisement was $906, resulting in costs of $0.09 per click and $0.18 per full response (completed surveys). Implementation of the male-only advertisement improved the cumulative percentage of male respondents from approximately 20 to 40%. Conclusions The social media advertisement campaign was an effective and efficient strategy to collect large scale, nationwide data on COVID-19 within a short time period. Although the proportion of men who completed the survey was lower than those who didn’t, interventions to increase male responses and enhance representativeness were successful. These findings can inform future research on the use of social media recruitment for the rapid collection of survey data related to rapidly evolving health crises, such as COVID-19.

Funder: FP7 Ideas: European Research Council; doi: http://dx.doi.org/10.13039/100011199; Grant(s): HEALTH-F2-2010-241909, Purpose: The EUropean Network of National Schizophrenia Networks Studying Gene–Environment Interactions (EU-GEI) study contains an unparalleled wealth of comprehensive data that allows for testing hypotheses about (1) variations in incidence within and between countries, including by urbanicity and minority ethnic groups; and (2) the role of multiple environmental and genetic risk factors, and their interactions, in the development of psychotic disorders. Methods: Between 2010 and 2015, we identified 2774 incident cases of psychotic disorders during 12.9 million person-years at risk, across 17 sites in 6 countries (UK, The Netherlands, France, Spain, Italy, and Brazil). Of the 2774 incident cases, 1130 cases were assessed in detail and form the case sample for case–control analyses. Across all sites, 1497 controls were recruited and assessed. We collected data on an extensive range of exposures and outcomes, including demographic, clinical (e.g. premorbid adjustment), social (e.g. childhood and adult adversity, cannabis use, migration, discrimination), cognitive (e.g. IQ, facial affect processing, attributional biases), and biological (DNA via blood sample/cheek swab). We describe the methodology of the study and some descriptive results, including representativeness of the cohort. Conclusions: This resource constitutes the largest and most extensive incidence and case–control study of psychosis ever conducted.

BackgroundSurvey research, indispensable for assessing subjective outcomes in anesthesiology, can nonetheless be challenging to undertake and interpret.ObjectiveTo present a user-friendly guide for the appraisal of survey-derived evidence, and to apply it to published survey research in the anesthesia literature.MethodsSynthesizing published expert guidance regarding methodology and reporting, we discuss five essential criteria (with subcomponents) for evaluating survey research: (1) relevance of survey outcome to research objective, (2) trustworthiness of the instrument (testing/validation, availability), (3) collecting information well (sampling, administration), (4) representativeness (response rate), and (5) guidance towards interpretation of survey findings (generalizability, interpretation of numerical outcomes). These criteria were subsequently applied by two independent assessors to original research articles reporting survey findings, published in the five highest impact general anesthesia journals (‘Anaesthesia’, ‘Anesthesia & Analgesia’, ‘Anesthesiology’, ‘British Journal of Anaesthesia’ and ‘European Journal of Anaesthesiology’) between July 01, 2016, and December 31, 2017, which were identified using a prespecified PubMed search strategy.ResultsAmong 1107 original articles published, we identified 97 reporting survey research either employing novel survey instruments (58%), established surveys (30%), or sets of single-item scores (12%). The extent to which reader-oriented benchmarks were achieved varied by component and between survey types. Results were particularly mixed for validation (mentioned for 41% of novel and 86% of established surveys) and discussion of generalizability (59% of novel survey reports, 45% of established surveys, and 17% of sets of single-item scores).ConclusionSurvey research is not uncommon in anesthesiology, frequently employs novel survey instruments, and demonstrates mixed results in terms of transparency and interpretability. We provide readers with a practical framework for critical interpretation of survey-derived outcomes.

Aim. To assess the attitude to the professional activities of neonatologists in St. Petersburg. Methods. A questionnaire of 179 neonatologists working in state medical organizations of St. Petersburg was conducted. The representativeness of this sample was checked using the method of Professor A.M. Merkov, with the error not exceeding 4%. Statistical processing was performed using Microsoft Office Excel software. Results. Among neonatologists of St. Petersburg, women are prevalent (95.2%), with an average age of 44.130.13 years. The majority of doctors work at the neonatal departments of obstetric hospitals, they have 18.100.11 years of professional experience. 37.4% of neonatologists hold more than one rate. Of the sections of work prescribed in the job descriptions, 91.2% of doctors most like clinical work, 85.2% do not like medical document management mostly, which 32.1% of doctors would like to exclude from their duties completely. According to 37.8% of neonatologists, the professional standard does not fully reflect their job responsibilities. When assessing labour functions, doctors on the first place put the providing of medical care for newborns and premature babies immediately/directly after birth (in the delivery room), and the last analysis of medical and statistical information and medical records management. More than 80% of neonatologists use additional professional education, trainings in simulation centres and participation in meetings, congresses, conferences, master classes and other educational events for professional growth and qualification category assignment. Almost all neonatologists feel fully responsible for the quality of their work (99.4%). Most doctors do not want to change their medical speciality (91.4%) and they are satisfied with the professional choice (91.6%). Conclusion. In their professional activities, most neonatologists feel responsible for the quality of their work, they put providing of medical care to newborns on the first place and use all the opportunities for professional growth in most cases; the most negative reaction of doctors is caused by medical document management, which they consider the least important in their work.