Association between enrollment factors and incident cognitive impairment in Blacks and Whites: Data from the Alzheimer's Disease Center

IntroductionWe examined the influence of enrollment factors demonstrated to differ by race on incident mild cognitive impairment and dementia using Alzheimer's Disease Center data.MethodsDifferences in rates of incident impairment between non-Latino Whites and Blacks (n = 12,242) were examined with age-at-progression survival models. Models included race, sex, education, source of recruitment, health factors, and family history of dementia.ResultsNo significant race differences in progression were observed in cognitively unimpaired participants. In those with mild cognitive impairment at baseline, Whites evidenced greater risk for progression than Blacks. Enrollment factors, for example, referral source, were significantly related to progression.DiscussionThe finding that Blacks demonstrated lower rate of progression than Whites is contrary to the extant literature. Nested-regression analyses suggested that selection-related factors, differing by race, may account for these findings and influence our ability to accurately estimate risk for progression. It is potentially problematic to make racial comparisons using Alzheimer's Disease Center data sets.     

性活动场所与男男性行为者艾滋病高危行为关系的 研究

摘要:目的　了解江苏省男男性行为人群特征,为制定切实有效的干预措施提供依据。方法　采用横断面调查研究的方法,对2013年江苏省男男性行为人群（MSM）进行匿名问卷调查,采集血液进行 HIV和梅毒抗体检测。结果　2013年共招募4208例MSM,样本量以酒吧/歌舞厅/茶室/会所（BDT）1561例最多;MSM以本地未婚青壮年为主,但各亚组间分布差异有统计学意义（P＜0.001）;同性近6个月无保护性肛交发生率以PTG组最高;异性性行为安全套坚持使用率以ELSE组最好;近1年STD患病率以BSM（9.0%）最高;HIV阳性率以ELSE（11.9%）最高;HIV相关危险因素及服务,HIV阳性率方面各亚组分布差异有统计学意义（P＜0.001）。结论　江苏省不同性活动场所的MSM人群在人口学、高危性行为、HIV阳性率方面存在显著差异,提示在制定MSM的干预措施应该有所侧重。     

Challenges in Patient Enrollment and Retention in Clinical Studies for Alcoholic Hepatitis: Experience of the TREAT Consortium

The TREAT Consortium has carried out clinical studies on alcoholic hepatitis (AH) for over 4 years. We encountered problems with participant recruitment, retention, and eligibility for specific protocols. To improve our ability to carry out such trials, we reviewed recruitment screening logs, end of study logs, and surveyed study coordinators to learn the reasons for missing patients, why patients declined enrollment, and the number of patients eligible for treatment trials. Associations of the recruited subjects’ demographics with their adherence to follow‐up appointments were examined. Three hundred eight‐seven patients (AH and heavy drinking controls) were enrolled in the observational study, and 55 AH patients were recruited into treatment trials. About half of patients identified with AH could not be recruited; no specific reason could be determined for about two‐thirds of these. Among the patients who gave a reason for not participating, the most common reasons were feeling too sick to participate, desire to concentrate on abstinence, and lack of interest in research. Approximately a quarter of the AH patients met eligibility criteria for treatment trials for moderate or severe AH and we were able to recruit half to two‐thirds of those eligible. Approximately 35% of participants in the observational study returned for both 6‐ and 12‐month follow‐up visits. We did not identify biopsychosocial or demographic correlates of retention in the study. This analysis revealed that attempts at recruitment into trials for AH miss some subjects because of structural issues surrounding their hospital admission, and encounter a high rate of patient refusal to participate. Nonetheless, more than half of the patients who met the eligibility criteria for moderate or severe AH were entered into clinical trials. Retention rates for the observational study are relatively low. These findings need to be accounted for in clinical trial design and power analysis.     

Predictors of Adolescent Participation in Sexually Transmitted Infection Research: Brief Report

We examined the effect of an institutional requirement for parental consent on adolescents' enrollment in a research study involving sexually transmitted infections. Fewer adolescents enrolled when parental consent was required compared with those who enrolled after this requirement was waived (79% vs. 94%, p = .01). Of the adolescents, 100% requested confidential test results. We conclude that requiring parental consent decreases participation in STI research.     

借鉴美国大学终身教职制度深化我国高校教师聘任制度改革

美国大学教授终身教职制度是学者与受雇大学之间签订的一种契约.这种契约保证了大学的学术自由,避免了学者的研究工作受到大学内部管理和外部因素的干扰,成为美国大学运行机制中的重要组成部分.本文介绍了美国大学教授终身教职制度的形成与发展,以期为我国高校教师聘任制度改革提供参考.     

An interim analysis of recruitment to the COLOFOL trial

Objective  To analyse the ongoing process of recruiting patients into a multicenter randomized trial on follow-up after curative surgery for colorectal cancer. The trial is registered in Clinical Trials Registration.
Method  Prospective registration of all operated patients as well as inclusions (curative resection, stage II or III disease, ≤ 75 years, clean colonand exclusions of the individual patients in eight participating departments.
Results  Between January 2006 and September 2007, 1309 patients have been operated upon. Of these 502 (38.3 %) met the inclusion criteria, 148 (29.5%) had exclusion criteria. Of the final eligible patients 241 (68.1 %) were randomized. No specific barriers to inclusion were identified.
Conclusion  Of an overall population of patients operated for colorectal cancer about one in five were randomized. Bearing the rigorous inclusion and exclusion criteria in mind, this is considered satisfactory, and the investigated population may be representative of patients meeting the inclusion criteria.     

Strategies to recruit and retain older adults in intervention studies: A quantitative comparative study

Recruitment and retention of participants in randomized controlled trials (RCTs) drawn from the older population is challenging, and studies have shown that poor recruitment and retention may lead to biased samples and results. Several strategies to improve the participation of older adults in research are outlined in the literature.