Browsing by Subject "Questionnaire"
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Item Agreement Between a Daily Electronic Headache Diary and Self-Report Questionnaire from a Dose-Response Randomized Controlled Trial of Spinal Manipulation Therapy for Cervicogenic Headache(2016-07) Hanson, LindaObjective: To determine if a minimally burdensome, easy to administer self-report questionnaire based on recall can be used interchangeably with a gold-standard headache diary to measure headache outcomes in an adult cervicogenic headache (CGH) population. Design: Secondary analysis of outcomes collected in a prospective, parallel group, observer blinded dose-response randomized controlled trial of spinal manipulation for CGH (R01AT006330). Setting: General population in Minneapolis/St. Paul metropolitan region (MN, USA) Participants: 18 years of age and older with a history of chronic CGH (5 headache days per month for three months) and a pain intensity of ≥ 3 (0-10) who are otherwise in good health at baseline. Measurements: A daily, electronic headache diary (gold standard) and self-report questionnaire based on recall are used to ascertain headache frequency, measured in days, and intensity, measured using the 11 point Likert scale (0-10), collected over four weeks at baseline. Analysis: Baseline characteristics are summarized using descriptive statistics. The Bland Altman method is used to assess agreement, including limits of agreement (mean difference ± 2SDs). Linear regression is used to evaluate the presence of proportional bias. A two-tailed t-test is used as a measure of inference for mean differences between measures. Results: 87 participants are included in this analysis. The mean difference (SD) and limits of agreement (LOA) for CGH frequency and intensity are 0.77 (4.3) days (LOA: -7.6 - 9.1) and 0.14 (0.8) points (LOA: -1.43 - 1.70), respectively. Linear regression shows evidence of proportional bias for headache intensity (β=0.286, 95% CI 0.01-0.27, p=0.000). Group differences between the questionnaire and diary were not statistically significant: frequency t(86) = 1.69, p=0.09 and intensity t(86)=1.6, p=0.11. Conclusions: There is a lack of agreement between the questionnaire and electronic diary for measuring headache frequency and intensity. It is not recommended to use the questionnaire in lieu of the gold-standard daily headache diary for measuring headache outcomes in clinical research. A self-report questionnaire based on recall may be appropriate however to inform CGH management in clinical settings.Item Bisphenol A, Diet and Obesity: Exposure Measurement and the Relationship Between Diet and Bisphenol A(2014-01) Oppeneer, SarahDiet is considered the primary source of BPA exposure, due to the use of BPA in polycarbonate plastics and epoxy resins used in food packaging. Existing human research has major limitations and the cost of serum and urinary BPA assay remains a challenge in evaluating BPA exposure and chronic disease outcomes. Despite the fact that diet is a vehicle for BPA exposure, few studies have considered whether dietary composition alters the toxicokinetics of BPA. Epidemiological studies have also not addressed diet as a potential confounder or effect modifier even though diet is associated with both disease risk and BPA exposure. The Urinary Biomarkers of Dietary Intake (UB-Diet Study) was developed to evaluate the feasibility of using questions that target intake of known dietary sources of BPA to estimate BPA exposure. Predicted BPA exposure levels from the BPA exposure assessment module (BEAM) were compared to multiple spot urine samples. Food records were also collected on the days that urine samples were collected to further evaluate the relationship between diet and urinary BPA levels. Reported macronutrient and food group servings were compared to urinary BPA levels. The BEAM data was not able to accurately predict participants' urinary BPA levels. Recent canned food intake was associated with urinary BPA levels, but only explained approximately one-fifth of the variability in urinary BPA levels and several participants who reported consuming no canned foods had high urinary BPA levels. The study findings suggest that BPA levels may be positively associated with higher caloric and fiber intake, and intakes of vegetables, refined grains and red meats, and inversely associated with total fat intake. More research is needed to characterize sources of BPA exposure, to evaluate the role of diet in the toxicokinetics of BPA and to determine if chronic low level BPA exposure poses any health risk.Item The Oswestry Disability Index and back pain(2012-07-24) Germscheid, Jonathan