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Underrepresentation of diverse populations in medical research undermines generalizability, exacerbates health disparities, and erodes trust in research institutions. This study aimed to identify a suitable survey instrument to measure trust in medical research among Black and Latino communities in Baltimore, Maryland.
Methods:
Based on a literature review, a committee selected two validated instruments for community evaluation: Perceptions of Research Trustworthiness (PoRT) and Trust in Medical Researchers (TiMRs). Both were translated into Spanish through a standardized process. Thirty-four individuals participated in four focus groups (two in English, two in Spanish). Participants reviewed and provided feedback on the instruments’ relevance and clarity. Discussions were recorded, transcribed, and analyzed thematically.
Results:
Initial reactions to the instruments were mixed. While 68% found TiMR easier to complete, 74% preferred PoRT. Key discussion themes included the relevance of the instrument for measuring trust, clarity of the questions, and concerns about reinforcing negative perceptions of research. Participants felt that PoRT better aligned with the research goal of measuring community trust in research, though TiMR was seen as easier to understand. Despite PoRT’s lower reading level, some items were found to be more confusing than TiMR items.
Conclusion:
Community feedback highlighted the need to differentiate trust in medical research, researchers, and institutions. While PoRT and TiMR are acceptable instruments for measuring trust in medical research, refinement of both may be beneficial. Development and validation of instruments in multiple languages is needed to assess community trust in research and inform strategies to improve diverse participation in research.
The Community Research Advisory Council (C-RAC) of the Johns Hopkins Institute for Clinical and Translational Research was established in 2009 to provide community-engaged research consultation services. In 2016–2017, C-RAC members and researchers were surveyed on their consultation experiences. Survey results and a 2019 stakeholder meeting proceeding helped redesign the consultation services. Transitioning to virtual consultations during COVID-19, the redesigning involved increasing visibility, providing consultation materials in advance, expanding member training, and effective communications. An increase in consultations from 28 (2009–2017) to 114 (2020–2022) was observed. Implementing stakeholder-researcher inputs is critical to holistic and sustained community-engaged research.
Despite the adversity presented by COVID-19 pandemic, it also pushed for experimenting with innovative strategies for community engagement. The Community Research Advisory Council (C-RAC) at Johns Hopkins University (JHU), is an initiative to promote community engagement in research. COVID-19 rendered it impossible for C-RAC to conduct its meetings all of which have historically been in person. We describe the experience of advancing the work of the C-RAC during COVID-19 using digital and virtual strategies. Since March 2020, C-RAC transitioned from in person to virtual meetings. The needs assessment was conducted among C-RAC members, and individualized solutions provided for a successful virtual engagement. The usual working schedule was altered to respond to COVID-19 and promote community engaged research. Attendance to C-RAC meetings before and after the transition to virtual operation increased from 69% to 76% among C-RAC members from the community. In addition, the C-RAC launched new initiatives and in eighteen months since January 2020, it conducted 50 highly rated research reviews for 20 research teams. The experience of the C-RAC demonstrates that when community needs are assessed and addressed, and technical support is provided, digital strategies can lead to greater community collaborations.
Early in the COVID-19 pandemic, the World Health Organization stressed the importance of daily clinical assessments of infected patients, yet current approaches frequently consider cross-sectional timepoints, cumulative summary measures, or time-to-event analyses. Statistical methods are available that make use of the rich information content of longitudinal assessments. We demonstrate the use of a multistate transition model to assess the dynamic nature of COVID-19-associated critical illness using daily evaluations of COVID-19 patients from 9 academic hospitals. We describe the accessibility and utility of methods that consider the clinical trajectory of critically ill COVID-19 patients.
Magnetic reconnection is explored on the Terrestrial Reconnection Experiment (TREX) for asymmetric inflow conditions and in a configuration where the absolute rate of reconnection is set by an external drive. Magnetic pileup enhances the upstream magnetic field of the high-density inflow, leading to an increased upstream Alfvén speed and helping to lower the normalized reconnection rate to values expected from theoretical consideration. In addition, a shock interface between the far upstream supersonic plasma inflow and the region of magnetic flux pileup is observed, important to the overall force balance of the system, thereby demonstrating the role of shock formation for configurations including a supersonically driven inflow. Despite the specialized geometry where a strong reconnection drive is applied from only one side of the reconnection layer, previous numerical and theoretical results remain robust and are shown to accurately predict the normalized rate of reconnection for the range of system sizes considered. This experimental rate of reconnection is dependent on system size, reaching values as high as 0.8 at the smallest normalized system size applied.
Optical tracking systems typically trade off between astrometric precision and field of view. In this work, we showcase a networked approach to optical tracking using very wide field-of-view imagers that have relatively low astrometric precision on the scheduled OSIRIS-REx slingshot manoeuvre around Earth on 22 Sep 2017. As part of a trajectory designed to get OSIRIS-REx to NEO 101955 Bennu, this flyby event was viewed from 13 remote sensors spread across Australia and New Zealand to promote triangulatable observations. Each observatory in this portable network was constructed to be as lightweight and portable as possible, with hardware based off the successful design of the Desert Fireball Network. Over a 4-h collection window, we gathered 15 439 images of the night sky in the predicted direction of the OSIRIS-REx spacecraft. Using a specially developed streak detection and orbit determination data pipeline, we detected 2 090 line-of-sight observations. Our fitted orbit was determined to be within about 10 km of orbital telemetry along the observed 109 262 km length of OSIRIS-REx trajectory, and thus demonstrating the impressive capability of a networked approach to Space Surveillance and Tracking.
Maintaining good wellbeing in older age is seen to have a positive effect on health, including cognitive and physiological functioning. This paper explores experiences of wellbeing in a particular older adult community: those who have served in the military. It aims to identify the specific challenges that ex-service personnel may have, reporting findings from a qualitative study focused on how older veterans told stories of military service and what these stories revealed about wellbeing. We used a qualitative approach; data are drawn from 30 individual interviews, and from engagement with veterans in workshops. Analysis was conducted using a data-driven constant comparison approach. Three themes are presented: how loneliness affects older adult veterans; how they draw on fictive kinship; and the role of military visual culture. Although participants had diverse experiences of military service, they felt that being a veteran connected them to a community that went beyond association with specific experiences. Using narratives of military experience to connect, both in telling stories and by stories being listened to, was vital. As veterans, older adults were able to access each other as a resource for listening and sharing. However, it was also exclusionary: civilians, because they lacked military service experience, could not empathise and be used as a resource.
Studies suggest that alcohol consumption and alcohol use disorders have distinct genetic backgrounds.
Methods
We examined whether polygenic risk scores (PRS) for consumption and problem subscales of the Alcohol Use Disorders Identification Test (AUDIT-C, AUDIT-P) in the UK Biobank (UKB; N = 121 630) correlate with alcohol outcomes in four independent samples: an ascertained cohort, the Collaborative Study on the Genetics of Alcoholism (COGA; N = 6850), and population-based cohorts: Avon Longitudinal Study of Parents and Children (ALSPAC; N = 5911), Generation Scotland (GS; N = 17 461), and an independent subset of UKB (N = 245 947). Regression models and survival analyses tested whether the PRS were associated with the alcohol-related outcomes.
Results
In COGA, AUDIT-P PRS was associated with alcohol dependence, AUD symptom count, maximum drinks (R2 = 0.47–0.68%, p = 2.0 × 10−8–1.0 × 10−10), and increased likelihood of onset of alcohol dependence (hazard ratio = 1.15, p = 4.7 × 10−8); AUDIT-C PRS was not an independent predictor of any phenotype. In ALSPAC, the AUDIT-C PRS was associated with alcohol dependence (R2 = 0.96%, p = 4.8 × 10−6). In GS, AUDIT-C PRS was a better predictor of weekly alcohol use (R2 = 0.27%, p = 5.5 × 10−11), while AUDIT-P PRS was more associated with problem drinking (R2 = 0.40%, p = 9.0 × 10−7). Lastly, AUDIT-P PRS was associated with ICD-based alcohol-related disorders in the UKB subset (R2 = 0.18%, p < 2.0 × 10−16).
Conclusions
AUDIT-P PRS was associated with a range of alcohol-related phenotypes across population-based and ascertained cohorts, while AUDIT-C PRS showed less utility in the ascertained cohort. We show that AUDIT-P is genetically correlated with both use and misuse and demonstrate the influence of ascertainment schemes on PRS analyses.
This collection of essays pays tribute to Nancy Freeman Regalado, a ground-breaking scholar in the field of medieval French literature whose research has always pushed beyond disciplinary boundaries. The articles in the volume reflect the depth and diversity of her scholarship, as well as her collaborations with literary critics, philologists, historians, art historians, musicologists, and vocalists - in France, England, and the United States. Inspired by her most recent work, these twenty-four essays are tied together by a single question, rich in ramifications: how does performance shape our understanding of medieval and pre-modern literature and culture, whether the nature of that performance is visual, linguistic, theatrical, musical, religious, didactic, socio-political, or editorial? The studies presented here invite us to look afresh at the interrelationship of audience, author, text, and artifact, to imagine new ways of conceptualizing the creation, transmission, and reception of medieval literature, music, and art.
EGLAL DOSS-QUINBY is Professor of French at Smith College; ROBERTA L. KRUEGER is Professor of French at Hamilton College; E. JANE BURNS is Professor of Women's Studies and Adjunct Professor of Comparative Literature at the University of North Carolina, Chapel Hill.
Contributors: ANNE AZÉMA, RENATE BLUMENFELD-KOSINSKI, CYNTHIA J. BROWN, ELIZABETH A. R. BROWN, MATILDA TOMARYN BRUCKNER, E. JANE BURNS, ARDIS BUTTERFIELD, KIMBERLEE CAMPBELL, ROBERT L. A. CLARK, MARK CRUSE, KATHRYN A. DUYS, ELIZABETH EMERY, SYLVIA HUOT, MARILYN LAWRENCE, KATHLEEN A. LOYSEN, LAURIE POSTLEWATE, EDWARD H. ROESNER, SAMUEL N. ROSENBERG, LUCY FREEMAN SANDLER, PAMELA SHEINGORN, HELEN SOLTERER, JANE H. M. TAYLOR, EVELYN BIRGE VITZ, LORI J. WALTERS, AND MICHEL ZINK.
Aqueous sprays of 4-ammo-3,5,6-trichloropicolinic acid (picloram) (1 lb aehg) were applied to individual plants in stands of burroweed (Haplopappus tenuisectus (Greene) Blake) and creosotebush (Larrea tridentata (DC.) Coville) August 27 to 31, 1965, to prepare the areas for seeding to fourwing saltbush (A triplex canescens (Pursh) Nutt.). By July 1967, 99% of the burroweed was dead, but 90% of the creosotebush was still alive. Samples of the surface ½ inch of soil, taken February 1, 1966, were planted to fourwing saltbush. Emergence and growth of fourwing saltbush were seriously reduced on soil taken from under the sprayed burroweed crowns. Growth of fourwing saltbush seedlings was retarded on soils from beneath sprayed creosotebushes, but emergence was not reduced significantly. The surface soil under sprayed burroweed crowns contained 0.11 ppm picloram 2 years after treatment, but the picloram test was negative on soils from the creosotebush area.
Early diagnosis of dementia allows people to access effective treatment and make advance decisions while they still have capacity. We aimed to encourage people to attend memory clinic, in order to boost rates of diagnosis. We created a patient information video about Oxford Health NHS Foundation Trust Memory Clinics, to inform and empower those awaiting assessment and to promote early diagnosis.
Fourteen people (patients, carers, and staff) were approached prior to developing the video to ascertain their views on the themes the video should cover. The video consisted of unscripted interviews with patients, carers, and staff. We surveyed participants and new patients attending memory clinic to get feedback on the video and to assess patients’ level of understanding and confidence about a memory assessment before and after watching the video. The video content was refined based on this feedback and a final version was produced.
Patient feedback demonstrated that confidence and understanding increased after watching the video.
Although this study is limited by its small sample size and lack of access to those with undiagnosed dementia, feedback suggested that the video empowered and reassured those awaiting assessment and could be used as a tool to reduce barriers to early diagnosis. Patients and carers involved in making the video found it a therapeutic activity in itself.
Evidence of surface magnetism is now observed on an increasing number of cool stars. The detailed manner by which dynamo-generated magnetic fields giving rise to starspots traverse the convection zone still remains unclear. Some insight into this flux emergence mechanism has been gained by assuming bundles of magnetic field can be represented by idealized thin flux tubes (TFTs). Weber & Browning (2016) have recently investigated how individual flux tubes might evolve in a 0.3M⊙ M dwarf by effectively embedding TFTs in time-dependent flows representative of a fully convective star. We expand upon this work by initiating flux tubes at various depths in the upper ~50-75% of the star in order to sample the differing convective flow pattern and differential rotation across this region. Specifically, we comment on the role of differential rotation and time-varying flows in both the suppression and promotion of the magnetic flux emergence process.
Various Mars missions have detected Cl atoms, chlorides and perchlorates in martian surface materials. The global soils, in particular, always contain significant levels of observable Cl. Direct evidence points to this Cl being in the form of both chlorides and perchlorates, and possibly also chlorates and other oxychlorines. The most widespread measurements have been of Cl atoms, and cannot discern the chemical form. However, from separate evidence of perchlorate obtained at high latitudes (Phoenix lander) and low latitudes (Curiosity rover), it is likely that perchlorates are widespread, albeit in varying proportions relative to the total amount of ubiquitous Cl.
Described as "a golden age of pathogens", the long fifteenth century was notable for a series of international, national and regional epidemics that had a profound effect upon the fabric of society. The impact of pestilence upon the literary, religious, social and political life of men, women and children throughout Europe and beyond continues to excite lively debate among historians, as the ten papers presented in this volume confirm. They deal with the response of urban communities in England, France and Italy to matters of public health, governance and welfare, as well as addressing the reactions of the medical profession to successive outbreaks of disease, and of individuals to the omnipresence of Death, while two, very different, essays examine the important, if sometimes controversial, contribution now being made by microbiologists to our understanding of the Black Death. Contributors: J.L. Bolton, Elma Brenner, Samuel Cohn, John Henderson, Neil Murphy, Elizabeth Rutledge, Samantha Sagui, Karen Smyth, Jane Stevens Crawshaw, Sheila Sweetinburgh
During the first half of the sixteenth century, municipal councils across northern France issued ordinances designed to combat outbreaks of plague. The measures contained in these ordinances were extensive and formed the core of urban responses to plague throughout the early modern period. These ordinances did not appear out of a vacuum; rather, they represented the codification of stratagems adopted during the second half of the fifteenth century. This article will describe and account for the growth of the public health system developed by the magistrates of towns lying in the urban belt of northern and north-eastern France from the 1450s to the 1550s. It will concentrate on the towns and cities of Abbeville, Amiens, Beauvais, Paris, Rouen and Tournai, all of which possess good administrative records for the period. In addition to the texts of plague ordinances, the most valuable documents for this study are the registers of municipal deliberations, which allow us to follow the decision-making process that lay behind the development of plague legislation.
Many of the more celebrated measures against pestilence originated in fourteenth- and fifteenth-century Italy, and the bulk of our knowledge regarding the ways in which urban administrations reacted to these outbreaks is based on studies of northern Italian cities, such as Florence and Venice. Although historians have expanded the geographical scope of such studies to consider municipal responses to plague in England, Spain, Switzerland, Germany and the Low Countries, little research has been done on France during the fifteenth and sixteenth centuries.
