Predictors of non-response to a questionnaire survey of a volunteer twin panel: findings from the Australian 1989 twin cohort.

Questionnaire surveys, while more economical, typically achieve poorer response rates than interview surveys. We used data from a national volunteer cohort of young adult twins, who were scheduled for assessment by questionnaire in 1989 and by interview in 1996-2000, to identify predictors of questionnaire non-response. Out of a total of 8536 twins, 5058 completed the questionnaire survey (59% response rate), and 6255 completed a telephone interview survey conducted a decade later (73% response rate). Multinomial logit models were fitted to the interview data to identify socioeconomic, psychiatric and health behavior correlates of non-response in the earlier questionnaire survey. Male gender, education below University level, and being a dizygotic rather than monozygotic twin, all predicted reduced likelihood of participating in the questionnaire survey. Associations between questionnaire response status and psychiatric history and health behavior variables were modest, with history of alcohol dependence and childhood conduct disorder predicting decreased probability of returning a questionnaire, and history of smoking and heavy drinking more weakly associated with non-response. Body-mass index showed no association with questionnaire non-response. Despite a poor response rate to the self-report questionnaire survey, we found only limited sampling biases for most variables. While not appropriate for studies where socioeconomic variables are critical, it appears that survey by questionnaire, with questionnaire administration by telephone to non-responders, will represent a viable strategy for gene-mapping studies requiring that large numbers of relatives be screened.     

Cross-cultural adaptation and preliminary validation of a zygosity determination questionnaire for twins in Sri Lanka.

We report the process of adaptation into Sinhala of a questionnaire given to mothers of twins to determine zygosity. Adaptation and validation was carried out in three stages. Firstly, we used a nominal group to translate the English version and to assess the extent of agreement (consensus measurement) on the appropriateness of the translation and resolve disagreement (consensus development). Secondly we used a qualitative interview with 25 mothers of twins. The three main stems of the translated questionnaire were used as a semi-structured interview, and the responses noted verbatim. These were categorised and analysed, and the translated full questionnaire was then presented as closed questions with fixed choice responses. The categorised responses generated during the qualitative interview were compared with the responses to the fixed choices in the full questionnaire. The third stage was the appraisal of the questionnaire by 17 bilingual parents of twins. The source and translated version of the questionnaire were given to them at least 3 days apart. The responses were rated and the total scores were computed to determine the zygosity. This step was carried out to measure the validity and reliability of the Sinhala version. A perfect correlation between the original and adapted version was obtained, with a kappa of 1. The results suggest that the Sinhala version of the questionnaire is conceptually equivalent to the original questionnaire. Comparison of the zygosity determination by using this adapted questionnaire with results from analysis of genetic markers on Sri Lankan twins is needed for final validation of the translated questionnaire.     

Perceived environmental threats as a factor in reproductive behavior: an examination of American youth

This study presents a test of general life history theory by estimating the association between perceived environmental threat (PET) and reproductive outcomes among American youth. Data for the study came from the National Longitudinal Survey of Youth 1997–2009, which consists of a nationally representative sample of youth. Analyses were based on a subsample of N= 4748 respondents who were aged 12–14 years in 1997; reported having no biological children in 1997; and, for females, were not pregnant at the time of the 1997 interview. PET was measured using 11 questionnaire items that asked respondents about experiences with violent assaults from peers, witnessing violent assaults, and nonviolent crime victimization. First childbirth occurred earlier among respondents who reported higher PET in 1997. Average fertility during the study period was also higher among respondents with higher PET. Male and female respondents' reproductive behaviors were similarly associated with PET. However, only among female respondents was the association between PET and fertility moderated by the quality of the household environment.     

Adverse life events and breast cancer: case-control study.

OBJECTIVE--To investigate the strength of association between past life events and the development of breast cancer. DESIGN--Case-control study. A standardised life events interview and rating was administered before a definitive diagnosis. SETTING--Breast Cancer Screening Assessment Unit and surgical outpatient clinics at King''s College Hospital, London. SUBJECTS--119 consecutive women aged 20-70 who were referred for biopsy of a suspicious breast lesion. MAIN OUTCOME MEASURES--Odds ratio of the risk of developing breast cancer after life events in the preceding five years after adjustment for confounders. RESULTS--41 women were diagnosed as having malignant disease while the remainder had benign conditions. Severe life events increased the risk of breast cancer. The crude odds ratio was 3.2 (95% confidence interval 1.35 to 7.6). After adjustment for age and the menopause and other potential confounders this rose to 11.6 (3.1 to 43.7). Multiple logistic regression analysis showed that all severe events and coping with the stress of adverse events by confronting them and focusing on the problems significantly predicted a diagnosis of breast cancer. Non-severe life events and long term difficulties had no significant association. CONCLUSION--These findings suggest an aetiological association between life stress and breast cancer.     

Association between Specific Diurnal Preference Questionnaire Items and PER3 VNTR Genotype

Although there are significant intra‐individual differences in self‐reported diurnal preference, as measured by validated questionnaires, the relative contribution of exogenous and endogenous factors to self‐reported diurnal preference largely remains to be investigated. The present study examined which items from the Horne‐Östberg (HÖ) questionnaire of diurnal preference were better at predicting genotypes in the variable number tandem polymorphism (VNTR) in the coding region of the gene PER3. This polymorphism has previously been reported to associate with diurnal preference, sleep parameters, and cognitive performance markers following sleep deprivation. Participants (n=240, selected from a previously studied population) had completed the HÖ questionnaire and provided a DNA sample, which was genotyped with regard to the PER3 VNTR. A multinomial logistic regression showed that four items significantly increased prediction accuracy between the two homozygotic genotypes, with homozygotes for the longer variant of the gene (PER3^5/5) associated with answers indicating a stronger morning preference than those chosen by homozygotes for the shorter variant (PER3^4/4). Only one item, the question of whether the respondent required an alarm clock, discriminated between all three genotypes. Moreover, when the items were divided into those with the strongest versus the weakest genetic association, there was a significant relationship between age and the questions not predicting genotype, but not between age and genotype‐predictive questions. This may explain previous findings regarding age‐related differences in self‐reported diurnal preference. These findings could facilitate the future development of diurnal preference scales especially tailored to the study of specific biological parameters.     

Assessing Impact of Weight on Quality of Life

This paper is a preliminary report on the development of a new instrument, the Impact of Weight on Quality of Life (IWQOL) questionnaire, that assesses the effects of weight on various areas of life. We conducted two studies utilizing subjects in treatment for obesity at Duke University Diet and Fitness Center. The first study describes item development, assesses reliability, and compares pre- and post-treatment scores on the IWQOL. In the second study we examined the effects of body mass index (BMI), gender, and age on subjects' perceptions of impact of weight on quality of life. Results indicate adequate psychometric properties with test-retest reliabilities averaging .75 for single items, and .89 for scales. Scale internal consistency averaged .87. Post-treatment scores differed significantly from pre-treatment scores on all scales, indicating that treatment produced positive changes in impact of weight on quality of life. The results of the second study indicate that the impact of weight generally worsened as the patients' size increased. However for women there was no association between BMI and impact of weight on Self-Esteem and Sexual Life. Even at the lowest BMI tertile studied, women reported that weight had a substantial impact in these areas. There were also significant gender differences, with women showing greater impact of weight on Self-Esteem and Sexual Life compared with men. The impact of age was a bit surprising, with some areas showing positive changes and others showing no change.     

Stress and relapse of breast cancer.

To elucidate the association between stressful life events and the development of cancer the influence of life stress on relapse in operable breast cancer was examined in matched pairs of women in a case-control study. Adverse life events and difficulties occurring during the postoperative disease free interval were recorded in 50 women who had developed their first recurrence of operable breast cancer and during equivalent follow up times in 50 women with operable breast cancer in remission. The cases and controls were matched for the main physical and pathological factors known to be prognostic in breast cancer and sociodemographic variables that influence the frequency of life events and difficulties. Severely threatening life events and difficulties were significantly associated with the first recurrence of breast cancer. The relative risk of relapse associated with severe life events was 5.67 (95% confidence interval 1.57 to 37.20), and the relative risk associated with severe difficulties was 4.75 (1.58 to 19.20). Life events and difficulties not rated as severe were not related to relapse. Experiencing a non-severe life event was associated with a relative risk of 2.0 (0.62 to 7.47), and experiencing a non-severe difficulty was associated with a relative risk of 1.13 (0.38 to 3.35). These results suggest a prognostic association between severe life stressors and recurrence of breast cancer, but a larger prospective study is needed for confirmation.     

Metazoan arasites of fish from the Smallwood Reservoir, Labrador, Canada

Three-hundred and thirty-two fish of eight species (5 Salmo salar , 68 Salvelinus fontinalis , 32 S. namaycush , 102 Coregonus clupeaformis , 1 Prosopium cylindraceum , 107 Esox lucius , 14 Catostomus catostomus , 3 Couesius plumbeus ) from the Smallwood Reservoir, Labrador, Canada, were examined for metazoan parasites, using conventional parasitological techniques.
Fifteen genera of parasites were recovered (two of Monogenea, two of Digenea, four of Cestoda, three of Nematoda, two of Acanthocephala and two of Copepoda), these including seven new host records.
Significant differences were noted in the prevalence of the various parasites which were common to the different species of fish examined. No differences were recorded in the parasite burden of male and female fish. There was no correlation between the number of parasite species per infected fish and host age except in the case of Salvelinus namaycush . Food items of the fish examined were also noted.     

Dimensions of life stress in psychiatric patients

A combined checklist and interview methodology was developed to assess the occurrence of life events among psychiatric patients. In addition to identifying events, patients were asked to rate them on 11 dimensions assumed to be important in mediating the impact of life stress. A factor analysis of ratings of 479 events from 64 patients, yielded three factors, reflecting the desirability of events, perceived control over their occurrence, and the readjustment required by events. However, ratings of social support available for help in coping with events and prior experience with similar events did not load on any of these factors. These dimensions should be treated as separate and potentially important influences. Three judges, blind to the patients' ratings, also made "normative" judgements of a subset of 154 events on the dimensions of desirability, control, and readjustment. Agreement among judges and between judges and patients was high with regard to desirability and control but low when rating readjustment. Judges tended to overestimate the amount of readjustment as described by patients.     

Associations between Parent-Adolescent Attachment Relationship Quality,Negative Life Events and Mental Health

Purpose

The aim of this study was to examine the association of negative life events and parent-adolescent attachment relationship quality with mental health problems and to explore an interaction between the parent-adolescent attachment relationship and one or multiple negative life events on the mental health of adolescents.

Methods

A two-year longitudinal study was conducted among first-year secondary school students (N = 3181). The occurrence of life events and the quality of parent-adolescent attachment were assessed at baseline and mental health status at two-year follow-up by means of self-report questionnaires. Binary logistic regression analyses were conducted to assess associations between life events, parent-adolescent attachment and mental health problems. Relative Excess Risk due to Interaction techniques were used to determine the interaction effects on the additive scale.

Results

Life events were related to mental health status, as was parent-adolescent attachment. The combined effect of an unfavourable parent-adolescent attachment with life events on mental health was larger than the sum of the two individual effects. Among adolescents with one life event or multiple life events, an unfavourable parent-adolescent attachment increased the risk of mental health problems at follow-up compared to the group without life events.

Conclusion

Results supported an interaction effect between parent-adolescent attachment and negative life events on mental health. Especially adolescents with one or multiple life events and an unfavourable parent-adolescent attachment seems to be a vulnerable group for mental health problems. Implications for further research are discussed.     

The Views of Healthcare Professionals,Drug Developers and Regulators on Information about Older People Needed for Rational Drug Prescription

Background

The ICH E7 guideline intends to improve the knowledge about medicines in geriatric patients. As a legislative document, it might not reflect the needs of healthcare professionals. This study investigated what information healthcare professionals, regulatory agencies and pharmaceutical industries consider necessary for rational drug prescribing to older individuals.

Methods and Findings

A 29-item-questionnaire was composed, considering the representation in trials, pharmacokinetics, efficacy, safety, and convenience of use in older individuals, with space for additions. Forty-three European professionals with an interest in medication for older individuals were included. In order to investigate their relevance, five items were included in a second questionnaire, with 11 control items. Median scores, differences between clinical and non-clinical respondents and response consistency were analysed. Consistency was present in 10 control items. Therefore, all items of the first questionnaire and the five additional items were analysed. Thirty-seven (86%) respondents returned the first questionnaire; 31/37 (84%) the second. Information about age-related differences in adverse events, locomotor effects, drug-disease interactions, dosing instructions, and information about the proportion of included 65+ patients was considered necessary by most respondents. Clinicians considered information significantly more important than the non-clinical respondents about the inclusion of 75+, time-until-benefit in older people, anticholinergic effects, drug-disease interactions, and convenience of use. Main study limitations are the focus on information for daily practice, while the ICH E7 guideline is a legislative document focused on market approval of a new medicine. Also, a questionnaire with a Likert scale has its limitations; this was addressed by providing space for comments.

Conclusions

This study reveals that items considered necessary are currently not included in the ICH E7 guideline. Also, clinicians’ and non-clinicians’ opinions differed significantly in 15% of the items. Therefore, all stakeholders should collaborate to improve the availability of information for the rational prescribing to older individuals.     

Anxiety and depression in twin and sib pairs extremely discordant and concordant for neuroticism: prodromus to a linkage study.

Multivariate modelling of anxiety and depression data in twins has suggested that the two phenotypes are largely underpinned by one genetic factor, while other studies have indicated a relationship between these disorders and the neuroticism personality trait. As part of a study to identify quantitative trait loci for anxiety and depression, questionnaire responses and interviews of 15,027 Australian twins and 11,389 of their family members conducted during the past 20 years were reviewed to identify individuals with neuroticism, anxiety and depression scores in the upper or lower deciles of the population. This information was then used to identify extreme discordant and concordant (EDAC) sib pairs. 1373 high-scoring and 1571 low-scoring subjects (2357 sib pairs) were selected for participation, and extremely high participation rates were achieved, with over 90% of contactable prospective participants completing the interview phase, and over 90% of these providing blood or buccal samples. Participation bias arising from the nature of the selection variables was minimal, with only a small difference between rates of interview participation among prospective participants with high and low selection scores (89.4% vs 91.6%). The interview permitted the diagnosis of depression and several anxiety disorders (OCD, agoraphobia, panic disorder, generalised anxiety disorder) in this sample according to DSM-IV criteria. The methodology for selection of prospective subjects was demonstrated to be extremely successful, with highly significant differences in depression and anxiety disorder prevalence rates between individuals in the two selection groups. The success of this EDAC sampling scheme will enhance the power for QTL linkage and association analysis in this sample.     

The influence of gender, athletic events, and athletic experience on the subjective dominant hand and the determination of the dominant hand based on the laterality quotient (LQ) and the validity of the LQ

This study aimed to reveal the influence of gender, athletic events and athletic experience on the subjective dominant hand and the dominant hand based on the laterality quotient (LQ). It also aimed to examine the validity of the Edinburgh Inventory (Oldfield, 1971). Males and females (n=3,726) living in 7 prefectures in Japan (age: 16-45 yrs) participated in this survey. Analysis was performed on 3,557 separate datasets with high reliability. The reliability of the survey was examined using a test-retest method consisting of 100 people selected randomly from all participants. All participants provided the same answers for each question. The influence of gender, event and experience was examined for the subjective and LQ-based dominant hands. In addition, concordance rates of the subjective dominant hand and the LQ-based dominant hand and both dominant hands were examined. Differences of concordance rates between hands used in the 10 movement questions of the Inventory and the subjective dominant hand were tested using the chi(2) test. The frequency differences among items were tested using Ryan's method (multiple comparisons). Significant gender differences were found between rates of the LQ-based dominant hand (males: 94.4%; females: 96.6%) and the subjective dominant hand (males: 91.6%; females: 94.0%), but the degree was only 2.0-4.0%. Insignificant differences were found among athletic events, two groups of different athletic experience, and gender according to each athletic event. The subjective dominant hand almost always agreed with the LQ-based dominant hand (complete concordance rate=0.96, kappa=0.67). Of the 10 question items, inexperienced answers were found only in the item "Knife (without fork)". The "Toothbrush", "Broom (upper hand)", and "Opening box (lid)" items had significantly lower correspondence with the subjective dominant hand (79.7-87.0%) than the other items (92.1-95.7%).In conclusion, athletic experience appears to have little influence on handedness, although there is a slight gender difference. The subjective dominant hand almost always agrees with the dominant hand based on the Inventory. A more efficient handedness inventory may be constructed by excluding the above 4 items.     

Eveningness diurnal preference associated with poorer socioemotional cognition and social functioning among healthy adolescents and young adults

Recently there has been growing interest in associations between sleep, emotion, and social functioning. Less is known about relationships between chronotype preference and socioemotional cognition and functioning, particularly among adolescents, who experience dramatic normative shifts in diurnal preference, affective functioning, and social competence. Fifty-five healthy adolescents and young adults completed a self-report chronotype preference measure, a computerized measure of socioemotional cognition, and a semi-structured clinical interview assessing interpersonal functioning. Greater eveningness preference was associated with poorer socioemotional cognition and social functioning in this age group. Future studies should assess these relationships across development and using objective measures of circadian timing.     

Weight Status,Quality of Life,and Self‐concept in African American,Hispanic, and White Fifth‐grade Children

This study examined the association between weight status and quality of life (QOL) in fifth‐grade African American, Hispanic, and white children and the potential mediation of this relationship by self‐concept. A sample was recruited from fifth‐grade public school students in three sites, of whom 599 were African American (40%), Hispanic (34%), or white (26%). During a home interview, physical and psychosocial QOL and global and body‐specific self‐concept were measured. Measured height and weight were used to calculate BMI. In this sample, 57% were classified by BMI as not overweight, 17%, overweight, and 26%, obese. Although there was no significant interaction between weight classification and race/ethnicity for QOL, obese children reported significantly lower psychosocial but not physical QOL than those classified as not overweight. There was a significant association between BMI (measured continuously) and psychosocial QOL, but only 2% of the variance was accounted for. Both global self‐concept and body dissatisfaction independently mediated significant portions of the association between BMI and psychosocial QOL. Being obese in childhood may have negative psychosocial effects.     

The measurement of subjective response to stressful life events

A scale was developed to assess subjective responses to stressful life events. Over 400 subjects (divided between psychiatric patients and nonpatients) completed the 14-item response-to-stress scale for events perceived as personally important. Optimal scale item weights were assigned on the basis of Nishisato's dual scaling procedure. Four items, typically associated with responses to stress, did not contribute to the item-weight solution and were dropped from the scale. Factor analyses showed that responses to stress loaded on one bipolar factor composed of four emotional distress items and six control-management items. In contrast to previous methods developed to assess response to stress, there was less than 4% overlap between the subjective response to stress mean scores and the total number of events endorsed by each subject. Also, the correlations between simple event counts and symptom index scores were smaller than those between the subjective stress-response scores and the symptom variable. The influence of demographic factors on both the patients' and nonpatients' responses to stress were analyzed.     

Zygosity diagnosis in young twins by questionnaire for twins' mothers and twins' self-reports.

The present study deals with the determination of zygosity in twins of childhood age by simple questionnaire. The subjects were 224 twin pairs and their mothers, consisting of 159 monozygotic and 65 same-sex dizygotic pairs, identified by genetic markers including DNA samples. Mothers of twins responded to 19 questionnaire items dealing with twin similarity in 16 items about physical features and 3 items about the degree of similarity and frequency of being mistaken (confusion of identity) when twins were about 1 year of age. The twins themselves responded to three questionnaire items dealing with only confusion of identity items. The results of stepwise logistic regression analysis were as follows: the total accuracy of the mothers' questionnaire was 91.5% when using only the items dealing with confusion of identity. This accuracy was slightly lower than that obtained by twins' self-reports dealing with nearly the same question items of confusion of identity, answered by both twins separately with 93.3% accuracy. The total accuracy of mothers' questionnaire responses rose to 95.1% when we used all 19 items. In addition to "the frequency of being mistaken", two physical features, namely "shape of fingers" and "shape of eyebrow", were very informative. In conclusion, twin zygosity can be estimated by the use of the mothers' simple questionnaire with sufficient accuracy even in very young twins about 1 year of age.     

Socioeconomic position at different stages of the life course and its influence on body weight and weight gain in adulthood: a longitudinal study with 13-year follow-up

Socioeconomic inequalities in body weight have been demonstrated in numerous cross-sectional studies; however, little research has investigated these inequalities from a life course and longitudinal perspective. We examined the association between child- and adulthood socioeconomic position (SEP) and BMI and overweight/obesity in 1991 (baseline) and changes in BMI and the prevalence of overweight and obesity between 1991 and 2004. Data from the 1991 and 2004 waves of the longitudinal Dutch GLOBE study were used. Participants (n = 1,465) were aged 40-60 years at baseline. BMI was calculated from self-reported height and weight collected by postal questionnaire. Retrospective recall of father's occupation was used as childhood socioeconomic indicator, and adulthood SEP was measured by the occupation of the main income earner of the household. The findings showed that among women, childhood SEP exerted a greater influence on body weight than SEP in adulthood: at baseline, women from disadvantaged backgrounds in childhood had a higher BMI and were more likely to be overweight or obese, and they gained significantly more weight between baseline and follow-up. In contrast, adult SEP had a greater impact than childhood circumstances on men's body weight: those from disadvantaged households had a higher mean BMI and were more likely to be overweight or obese at baseline, and they gained significantly more weight between 1991 and 2004. The findings suggest that exposure to disadvantaged circumstances at critically important periods of the life course is associated with body weight and weight gain in adulthood. Importantly, these etiologically relevant periods differ for men and women, suggesting gender-specific pathways to socioeconomic inequalities in body weight in adulthood.     

Sources of individual differences in stressful life event exposure in male and female twins.

The roles of genetic and environmental influences on stressful life events were examined in 3938 twin pairs (MZ, same-sex DZ, and opposite-sex DZ) using a sex-limitation model. Life events were assessed by personal interview, and were categorized as being either personal (i.e., events that occur directly to the individual) or network (i.e., events that occur to someone within the individual's social network, thus affecting the individual indirectly). Consistent with previous reports, genetic factors were found to exert more influence on personal events than network events. Genetic correlations between males and females suggest that many of the same genetic factors are acting within both genders.