Evaluation of two communication tools,slideshow and theater,to improve participants’ understanding of a clinical trial in the informed consent procedure on Pemba Island,Tanzania

BackgroundClinical trial participants are required to sign an informed consent form (ICF). However, information is lacking on the most effective methods to convey trial relevant information prior to inviting participants to sign the ICF, being particularly pertinent in low-income countries. A previous study on Pemba Island, Tanzania, found that a verbal information session (IS) was significantly better than providing an ICF alone. However, knowledge gaps remained. Building on these findings, we investigated the effect of adding a slideshow or a theater to the IS in the informed consent procedure of an anthelminthic clinical trial.Methodology/principal findingsA total of 604 caregivers were randomized into the control group that only received an ICF (n = 150) or an ICF plus one of three intervention strategies: (i) verbal IS (n = 135), (ii) verbal IS with a slideshow (n = 174) or (iii) verbal IS followed by a theater (n = 145). All modes of information covered the same key messages. Participants’ understanding was assessed using a semi-structured questionnaire. The mean score of caregivers in the control group (ICF only) was 4.41 (standard deviation = 1.47). Caregivers attending the IS alone were more knowledgeable than those in the control group (estimated difference in mean scores: 2.40, 95% confidence interval (CI) 1.95 to 2.86, p < 0.01). However, there was no evidence of an improvement compared to the IS only when participants attended a slideshow (0.09, 95% CI -0.53 to 0.35, p = 0.68) or a theater (0.28, 95% CI -0.27 to 0.82, p = 0.32). Three out of 10 key messages remained largely misunderstood, regardless of the mode of information group.Conclusions/significanceOur study confirmed that, in this setting, an ICF alone was not sufficient to convey clinical trial-related information. An IS was beneficial, however, additional theater and slideshows did not further improve understanding. Future research should explore methods to improve communication between study teams and participants for different key messages, study types and settings.     

On the anatomical definition of arterial networks in blood flow simulations: comparison of detailed and simplified models

Biomechanics and Modeling in Mechanobiology - The goal of this work is to assess the impact of vascular anatomy definition degree in the predictions of blood flow models of the arterial network. To...     

A methodological approach to assess the small mammal community diversity in the temperate rainforest of Patagonia

Assessing small mammal diversity is a common procedure, which usually employs widespread standard techniques, for gathering information for a wide range of studies. Traditional methods, however, may be biased against capturing arboreal marsupials, such as Dromiciops gliroides, an endemic marsupial currently considered a rare species in the Patagonian temperate rainforest due to the low abundances reported previously. I tested a new capturing methodology to assess the small mammal diversity of an old-growth forest in Patagonia, based on a randomized and balanced design, which incorporated a combination of different trap types, bait types, and placement heights. The proposed methodology included four trap types (two for live-capturing: wire-mesh and Sherman traps, and two sign-recording traps for tracks and hair), two types of bait (banana and rolled oats), and two trap placements (ground level and 1.5–2.5 m above the ground). Trap type, bait type, and height of placement all had significantly different effects on capturing and detecting rodents or marsupials; environmental variables at the trap location also affected the ability to detect rodents and marsupials. Traditional methods used for sampling small mammals performed well for rodents but are not effective for capturing marsupials and vice versa, showing species-specific sampling protocols. There is no single combination of trap-bait-height capable to assess the entire small mammal community, but the combination of the most effective protocol for rodents and the most effective protocol for marsupials guarantee better results.     

Tactical Voting in Plurality Elections

How often will elections end in landslides? What is the probability for a head-to-head race? Analyzing ballot results from several large countries rather anomalous and yet unexplained distributions have been observed. We identify tactical voting as the driving ingredient for the anomalies and introduce a model to study its effect on plurality elections, characterized by the relative strength of the feedback from polls and the pairwise interaction between individuals in the society. With this model it becomes possible to explain the polarization of votes between two candidates, understand the small margin of victories frequently observed for different elections, and analyze the polls'' impact in American, Canadian, and Brazilian ballots. Moreover, the model reproduces, quantitatively, the distribution of votes obtained in the Brazilian mayor elections with two, three, and four candidates.