Reactions of non-abused children aged 3–9 years to the Sexual Knowledge Picture Instrument: an interview-based study

BackgroundThe Sexual Knowledge Picture Instrument (SKPI) is a child-friendly picture book that was developed as a diagnostic tool for sexual abuse in young children and is currently being validated. The aim of the current study was to explore the verbal and non-verbal reactions of non-abused Dutch children, aged 3–9 years, to the SKPI and to assess differences in reactions between genders and age groups.Methods and analysisSubject recruitment took place at preschools and primary schools. All children underwent a recorded video semi-structured interview with the SKPI. Interview recordings were scored by an independent rater who used scoring lists for verbal and non-verbal reactions. Non-parametric tests were used in statistical analyses.ResultsOf the 90 children (median age 5 years) participating in the study, most correctly named the genitals and their non-sexual functions. Only 34 showed an understanding of the picture depicting adult sexuality, with just one child describing a sexual function. Girls (n=45) gave more correct answers (median 87%) than boys (n=45, median 78%; p=0.006). Giggling was the most frequently observed non-verbal reaction, with a total of 186 instances in 54 children.ConclusionNon-abused children up to 9 years of age showed only limited knowledge of the sexual function of the genitals and hardly any insight into adult sexuality.

Physicians’ knowledge, attitude, practice and perceived barriers to subject recruitment for randomized controlled trials in ghana.

Objectives: This study assesses the knowledge, attitude, practice and perceived barriers to subject recruitment into randomized controlled trials, and determine strategies to maximize subject recruitment and retention. Methods: A cross sectional, quantitative survey of 73 physicians working in Ghana was conducted assessing their knowledge and attitude towards randomized controlled trials, subject recruitment practices, self-reported barriers to subject recruitment and strategies to enhance subject recruitment. Results: Responses from 73 Ghanaian physicians were analyzed. 23 (31.5%) respondents knew of ongoing clinical trials in their specialty in Ghana while 32 (43.8%) physicians knew about trials in their specialties in various places in the world. 23 (31.5%) physicians responded that they had referred patients for recruitment into clinical trials before. 49 (67.1%) respondents had never referred any patient for recruitment into clinical trials. Conclusion: Most Ghanaian doctors are unaware of ongoing trials in their specialty and thus do not refer patients for recruitment.

Phase I trial compensation: How much do healthy volunteers actually earn from clinical trial enrollment?

Background/aims Financial compensation for research participation is a major focus of ethical concern regarding human subject recruitment. Phase I trials are sometimes considered to be a lucrative source of income for healthy volunteers, encouraging some people to become “professional guinea pigs.” Yet, little is known about how much these clinical trials actually pay and how much healthy volunteers earn from them. Methods As part of a mixed-methods, longitudinal study of healthy volunteers, we required participants to complete clinical trial diaries, or surveys that captured detailed information about screening and enrollment in Phase I trials. Over a 3-year period, participants provided information online or via telephone about each clinical trial for which they screened (e.g. the clinic name, the study’s therapeutic area, the length of the trial, the number of nights spent in the clinic, and the study compensation), and whether they qualified for trial inclusion. Clinical trial diaries generated data about whether participants continued to screen for and enroll in clinical trials and how much money they earned from their participation. Results 131 participants routinely completed clinical trial diaries or confirmed that they had not screened for any new clinical trials. Together, these participants screened for 1001 clinical trials at 73 research facilities during a 3-year period. Overall, the median clinical trial compensation was US$3070 (range = US$150–US$13,000). Participants seeking new healthy volunteer trials tended to screen for three studies per year, participate in one or two studies, and earn roughly US$4000 annually. Participants who were unemployed earned the most income from clinical trials compared to those with full-time or part-time jobs, and those individuals whom we label “occupational” participants because of their persistent pursuit of clinical trials earned more than people who screened occasionally. Notably, the median annual trial compensation was well below US$10,000 for all employment groups, and most occupational healthy volunteers also earned less than US$10,000 each year. The 10% of participants who earned the most had a median annual income of US$18,885 from clinical trials, and there was significant volatility in these individuals’ earnings from year to year. Conclusion Despite the perception that Phase I enrollment can generate significant earnings, it was exceedingly rare for anyone in this study to make more than US$20,000 in a single year, and unusual to earn even between US$10,000 and US$20,000. From an ethics perspective, individual trials might appear to unduly induce enrollment by offering significant sums of money, but given our findings, the larger problem for low-income participants may be the unrealistic perception that clinical trials alone could be a way of earning a living.

Multi-centre, multi-vendor 7 Tesla fMRI reproducibility of hand digit representation in the human somatosensory cortex

Whilst considerable progress has been made in using ultra-high field fMRI to study brain function at fine spatial resolution, methods are generally optimized at a single site and do not translate to studies where multiple sites are required for sufficient subject recruitment. With a recent increase in installations of human 7 T systems, there is now the opportunity to establish a framework for multi-site 7 T fMRI studies. However, an understanding of the inter-site variability of fMRI measurements is required for datasets to be combined across sites. To address this, we employ a hand digit localization task and compare across-site and within-site reproducibility of 7 T fMRI to a hand digit localization task which requires fine spatial resolution to resolve individual digit representations. As part of the UK7T Network “Travelling Heads” study, 10 participants repeated the same hand digit localization task at five sites with whole-body 7T MRI systems to provide a measure of inter-site variability. A subset of the participants (2 per site) performed repeated sessions at each site for measurement of intra-site reproducibility. Dice’s overlap coefficient was used to assess reproducibility, with hand region inter-site Dice = 0.70±0.04 significantly lower than intrasite Dice = 0.76±0.06, with similar trends for the individual digit maps. Although slightly lower than intra-site reproducibility, the inter-site reproducibility results are consistent with previous single site reproducibility measurements, providing evidence that multi-site 7 T fMRI studies are feasible. These results can be used to inform sample size calculations for future multi-site somatomotor mapping studies.

Linking Labs: Interconnecting Experimental Environments

We introduce the concept of LabLinking: a technology-based interconnection of experimental laboratories across institutions, disciplines, cultures, languages, and time zones - in other words experiments without borders. In particular, we introduce LabLinking levels (LLL), which define the degree of tightness of empirical interconnection between labs. We describe the technological infrastructure in terms of hard- and software required for the respective LLLs and present examples of linked laboratories along with insights about the challenges and benefits. In sum, we argue that linked labs provide a unique platform for a continuous exchange between scientists and experimenters, thereby enabling a time synchronous execution of experiments performed with and by decentralized user and researchers, improving outreach and ease of subject recruitment, allowing to establish new experimental designs and to incorporate a panoply of complementary biosensors, devices, hard- and software solutions.

An open prospective study on the efficacy of Navina Smart, an electronic system for transanal irrigation, in neurogenic bowel dysfunction

Background Transanal irrigation (TAI) has emerged as a key option when more conservative bowel management does not help spinal cord injured (SCI) individuals with neurogenic bowel dysfunction (NBD). Aim To investigate the short-term efficacy and safety of an electronic TAI system (Navina Smart) in subjects with NBD. Design We present an open, prospective efficacy study on Navina Smart, in individuals with NBD secondary to SCI, studied at three months. Population Eighty-nine consecutive consenting established SCI individuals (61 male; mean age 48, range 18–77) naïve to TAI treatment were recruited from ten centres in seven countries. Subjects had confirmed NBD of at least moderate severity (NBD score ≥10). Methods Subjects were taught how to use the device at baseline assisted by the Navina Smart app, and treatment was tailored during phone calls until optimal TAI regime was achieved. The NBD score was measured at baseline and at three months follow up (mean 98 days). Safety analysis was performed on the complete population while per protocol (PP) analysis was performed on 52 subjects. Results PP analysis showed a significant decrease in mean NBD score (17.8 to 10, p<0.00001). In subjects with severe symptoms (defined as NBD score ≥14), mean NBD scores decreased (19.4 to 10.9, p<0.0001). The number of subjects with severe symptoms decreased from 41 (79%) subjects at baseline to 16 (31%) at three months follow-up. Device failure accounted for the commonest cause for loss of data. Side effects possibly related to the device developed in 11 subjects (12%). Discontinuation due to failure of therapy to relieve symptoms was reported by 5 subjects (6%). Conclusion Navina Smart is effective for individuals with NBD, even those with severe symptoms; long-term data will follow. Whilst there were some device problems (addressed by the later stages of subject recruitment) the treatment was generally safe. Clinical trial (ClinicalTrials.gov number NCT02979808)

COMPARISON OF SUBLINGUAL MISOPROSTOLAND PER VAGINAL MISOPROSTOL FOR PAIN RELIEF DURING AND AFTER HSG PROCEDURE: A RANDOMIZED CONTROLLED TRIAL

Background: Misoprostol has been extensively used in obstetrics and has proved to be a very effective cervical softening agent before termination of pregnancy. The beneficial effects on cervical ripening may make misoprostol a desirable agent for helping cervical dilatation on non pregnant women. Aim: To compare the efficacy and safety of pre-procedure sublingual misoprostol versus pervaginal misoprostol for relief of pain during and after the HSG procedure. Materials and methods: Study was initiated after approval from the IEC. There after subject recruitment had done form July 2017 to June 2018 in the department of Obstetrics & Gynaecology (indoor setting) of IPGME&R & SSKM Hospital Result: We found that association of cervical resistance score vas vs. group was statistically significant (p<0.0001). Association of need for analgesics vs. group was not statistically significant (p=0.11004). Association of any adverse effect vs. group was not statistically significant (p=1.0000). Difference of mean age vs. group was not statistically significant (p=0.0717). Conclusion: There was no significant difference of pain after the HSG procedure in both the group. The patients who were received sublingual misoprostol had significantly low cervical resistance during the procedure.

The influence of digital marketing on recruitment effectiveness: a qualitative study

Purpose The purpose of this paper is to unfold how different digital marketing tools and strategies influence recruitment effectiveness. More specifically, it focusses on understanding if, and how, information sources’ credibility, content marketing, and organisational reputation influence candidates’ decision to apply for a job in the Portuguese market. Design/methodology/approach A qualitative research, aligned with a content analysis, was conducted to focus on the insights from the 21 participants interviewed, to understand their thoughts and experiences regarding the subject. Findings The results show that digital marketing tools owned by the company are seen to be more credible and more relevant for the job application decision. LinkedIn is considered to be a more credible platform for advertising job openings than Facebook. In terms of content marketing, LinkedIn has a positive influence on candidates’ decision, as well as companies’ reputation. Practical implications This study provides practical implications which are useful for both HR and marketing managers, namely, the implementation of an integrated marketing communication strategy, the reinforcement of the company’s website and LinkedIn page and a presence on universities’ platforms, and also in terms of the information that content marketing should focus on. Originality/value This research paper incorporates marketing insights into a well-known HRM subject – recruitment, and thus adds further knowledge to the literature and prepares the ground for researchers who wish to explore this subject further.

Vitamin D Deficiency is Associated with Metabolic Syndrome

Background: Metabolic syndrome (MetS), insulin resistance (IR) and diabetes mellitus (DM) are highly interrelated abnormalities seeking multidisciplinary public health interventions. Vitamin D has recently gained attention as a protective factor for MetS, IR, DM and cardiovascular diseases (CVD). However, there is no clearly defined mechanism of action, and supplementation guidelines on vitamin D (VD) in either prevention or treatment against MetS, IR, DM and CVD. The purpose of this study is to determine the strength of association between VD and MetS, IR, and DM in the general U.S. population. Methods: The study was done using the National Health and Nutrition Examination Survey (NHANES) 2005-2006 data. NHANES data represent the civilian, non-institutionalized US population. Subject recruitment was based on a multistage, stratified sampling method. Regression models were used to determine the relationship of vitamin D with DM, MetS and IR. Results: We found a consistent observation in which VD deficiency was significantly associated with DM (OR=2.16), MetS (OR=2.09) and IR (OR=1.83). Female gender, older age, and overweight - all positively associated with DM, MetS or IR. Conclusion: The inverse relationship of VD status with MetS, IR and DM indicates a strong support of increasing vitamin D intake as an inexpensive intervention strategy in the national endeavor to reduce the burden of MetS, IR, DM, and its complications.