Food safety in the aging population: Qualitative findings on what to communicate and how

The present study investigated older adults’ risk perception, beliefs, and self-perception in the field of kitchen hygiene and food safety. A qualitative study with semi-structured focus groups was conducted. A total of 37 older adults (60–80 years of age) from Germany participated in four focus groups that were stratified by gender. Focus groups covered older adults’ food-handling practices, their perceptions of vulnerability, and their informational needs in the field of food safety. A thematic analysis approach was adopted. The coding categories and subcategories were developed inductively by the researchers based on the data. The coded data were then used to identify overarching themes and subthemes. Main results showed that older adults had confidence in their knowledge and skills with regard to food safety, perceived their post-war generation overall to be resistant and other so-called at-risk groups to be more vulnerable. Moreover, they expressed low informational needs in the area of food safety. The results suggest that age-specific aspects play a role in older adults’ risk perception and highlight the need to develop age-specific risk communication strategies that take into account older adults’ beliefs, knowledge, and informational needs.     

Statistical considerations in a delayed‐start design to demonstrate disease modification effect in neurodegenerative disorders

There has been a paradigm shift in diagnostic conceptualization of Alzheimer's disease (AD) based on the current evidence suggesting that structure and biology changes start to occur before clinical symptoms emerge. Consequently, therapeutic drug development is also shifting to treat early AD patients using biomarkers for enrichment in clinical trials. A similar paradigm shift is occurring for Parkinson disease. In the absence of acceptable biomarkers that could be combined with a clinical endpoint to demonstrate a disease modification (DM) effect in neurodegenerative disorders, a delayed‐start design can be applied to demonstrate a lasting effect on the disease course. The delayed‐start design includes two treatment periods, where in period 1, patients are randomized to receive an active treatment or placebo, and in period 2, placebo patients are switched to the active treatment while patients in the active treatment arm will continue the same treatment. The hypothesis is that patients who start the active treatment later will fail to catch up to the treatment benefit achieved by patients who receive the active treatment in both periods. A usual analytical approach has sought to demonstrate the divergence of slope during period 1 and the parallelism of slopes during period 2 as the DM effect. However, due to heterogeneity in timing and the magnitude of maximal effect among patients, nonlinear response over time could be observed within the two treatment arms in both periods. We propose an approach to evaluate the DM effect with the linearity assumption for treatment differences, but not for each arm separately.     

Uncertainties in Pharmacokinetic Modeling for Perchloroethylene. I. Comparison of Model Structure, Parameters, and Predictions for Low-Dose Metabolism Rates for Models Derived by Different Authors

In recent years physiologically based pharmacokinetic models have come to play an increasingly important role in risk assessment for carcinogens. The hope is that they can help open the black box between external exposure and carcinogenic effects to experimental observations, and improve both high-dose to low-dose and interspecies projections of risk. However, to date, there have been only relatively preliminary efforts to assess the uncertainties in current modeling results. In this paper we compare the physiologically based pharmacokinetic models (and model predictions of risk-related overall metabolism) that have been produced by seven different sets of authors for perchloroethylene (tetrachloroethylene). The most striking conclusion from the data is that most of the differences in risk-related model predictions are attributable to the choice of the data sets used for calibrating the metabolic parameters. Second, it is clear that the bottom-line differences among the model predictions are appreciable. Overall, the ratios of low-dose human to bioassay rodent metabolism spanned a 30-fold range for the six available human/rat comparisons, and the seven predicted ratios of low-dose human to bioassay mouse metabolism spanned a 13-fold range. (The greater range for the rat/human comparison is attributable to a structural assumption by one author group of competing linear and saturable pathways, and their conclusion that the dangerous saturable pathway constitutes a minor fraction of metabolism in rats.) It is clear that there are a number of opportunities for modelers to make different choices of model structure, interpretive assumptions, and calibrating data in the process of constructing pharmacokinetic models for use in estimating "delivered" or "biologically effective" dose for carcinogenesis risk assessments. We believe that in presenting the results of such modeling studies, it is important for researchers to explore the results of alternative, reasonably likely approaches for interpreting the available data--and either show that any conclusions they make are relatively insensitive to particular interpretive choices, or to acknowledge the differences in conclusions that would result from plausible alternative views of the world.     

Log-linear models for mutations in the HIV genome

We discuss a general application of categorical data analysis to mutations along the HIV genome. We consider a multidimensional table for several positions at the same time. Due to the complexity of the multidimensional table, we may collapse it by pooling some categories. However, the association between the remaining variables may not be the same as before collapsing. We discuss the collapsibility of tables and the change in the meaning of parameters after collapsing categories. We also address this problem with a log-linear model. We present a parameterization with the consensus output as the reference cell as is appropriate to explain genomic mutations in HIV. We also consider five null hypotheses and some classical methods to address them. We illustrate methods for six positions along the HIV genome, through consideration of all triples of positions.     

Methods for one-sided testing of the difference between proportions and sample size considerations related to non-inferiority clinical trials

Assessment of non-inferiority is often performed using a one-sided statistical test through an analogous one-sided confidence limit. When the focus of attention is the difference in success rates between test and active control proportions, the lower confidence limit is computed, and many methods exist in the literature to address this objective. This paper considers methods which have been shown to be popular in the literature and have surfaced in this research as having good performance with respect to controlling type I error at the specified level. Performance of these methods is assessed with respect to power and type I error through simulations. Sample size considerations are also included to aid in the planning stages of non-inferiority trials focusing on the difference in proportions. Results suggest that the appropriate method to use depends on the sample size allocation of subjects in the test and active control groups.     

Qualitative research strategies in rehabilitation

This article presents an overview of the qualitative research methods that social scientists use to explore human phenomena. The authors describe the philosophical and historical foundations of qualitative research, coupled with illustrations of specific qualitative designs. Applications of qualitative methods in the contemporary rehabilitation literature are also presented.     

Career development interventions for transition-age youths with disabilities

Youths with disabilities are often precluded from participating in career exploration and planning activities that prepare them for meaningful employment. They do not always have the same opportunities as their non-disabled peers to learn about different career options and to develop important work-related skills. This article presents experientially-based career development interventions that can be incorporated into the transition planning process to guide these youths in (a) career exploration and decision-making, (b) career planning, (c) job development and placement, and (e) career maintenance.