Recruitment of a Diverse Community-based Older Adult Cohort for a Longitudinal Aging Study: The 15104 Seniors Project.

INTRODUCTION: Enrolling individuals from underrepresented ethnoracial groups in aging research is often a challenge. METHODS: We sought a diverse sample of older adults from a small-town area for a longitudinal aging study. We employed an intensive community engagement approach encompassing a range of recruitment strategies. RESULTS: Over 4 years a steady trickle of individuals, 66% self-identifying as Black, signed up for study information; the proportion of those who eventually enroll in the study has been rising each year, from 68% to 94%. Community events, word-of-mouth referrals, and mailed postcards brought in the most contacts. The highest percentage of contacts who ultimately enrolled were from postcards, flyers, and word-of-mouth. Significantly more word-of-mouth referrals were endorsed by Black individuals than White and by Black men than other race/sex groups. CONCLUSIONS: We have had some success in building relationships and trust with the local community, enrolling Black study participants in a proportion equal to their representation in the target community using a variety of recruitment methods. Patience, immersion in the community, and partnerships with key community members alongside traditional advertisements, and the utilization of study participants as recruiters are critical to designing optimal, targeted, recruitment strategies.

Clinical measurement of pharyngeal surface electromyography: exploratory research.

BACKGROUND: Dysphagia diagnosis is limited by our inability to evaluate the underlying neuromuscular pathology of swallowing. A novel approach using pharyngeal surface electromyography (PsEMG) has been reported in the literature. OBJECTIVE: Three exploratory projects were undertaken to provide data toward the validation of PsEMG as a clinical measure of pharyngeal physiology. The first evaluates laterality of electrode placement in the pharynx. The second and third evaluate PsEMG using a circumferential and unidirectional electrode, respectively, during swallowing maneuvers. METHODS: In experiment 1, a catheter housing 3 manometric sensors and 1 bipolar PsEMG electrode was randomly inserted in each nares of 10 participants. Moving jaw radiographs were taken, and the PsEMG electrode was measured in millimeters from midline. In experiments 2 and 3, the catheter was placed in 22 and 40 research participants, respectively. Waveform characteristics were collected during swallowing maneuvers. The 2 experiments differed by type of electrode (circumferential, unidirectional) and swallowing maneuver (noneffortful and effortful swallow; noneffortful, effortful, and tongue-hold swallow). RESULTS: Midline electrode placement occurred on 20% of trials with deviation of up to 14.7 mm on all other trials. Maneuver-specific differences in amplitude were not detected with PsEMG; unacceptable levels of intrasubject and intersubject variability were identified. Temporal relationships of PsEMG and pharyngeal manometric pressure appeared appropriate. The unidirectional electrode revealed a unique bimodal PsEMG pattern that may reflect sequential contraction of muscles of the posterior pharyngeal wall. CONCLUSIONS: The current PsEMG design and procedures do not validly measure pharyngeal muscle activity. Recommendations for improved methods are provided.

Image quality and diagnostic performance of silicone-specific breast MRI.

PURPOSE: To compare the image quality of three techniques and diagnostic performance in detecting implant rupture. MATERIALS AND METHODS: The study included 161 implants for the evaluation of image quality, composed of water-saturated short TI inversion recovery (herein called "water-sat STIR"), three-point Dixon techniques (herein called "Dixon"), and short TI inversion recovery fast spin-echo with iterative decomposition of silicone and water using least-squares approximation (herein called "STIR IDEAL") and included 41 implants for the evaluation of diagnostic performance in detecting rupture, composed of water-sat STIR and STIR IDEAL. Six image quality categories were evaluated and three classifications were used: normal implant, possible rupture, and definite rupture. RESULTS: Statistically significant differences were noted for the image quality categories (p<0.001). STIR IDEAL was superior or equal to water-sat STIR in all image quality categories except artifact effects and superior to Dixon in all categories. Water-sat STIR performed the poorest for water suppression uniformity. The sensitivity and specificity in detecting implant rupture of STIR-IDEAL were 81.8 % and 77.8 % and the difference between two techniques was not statistically significant. CONCLUSION: STIR-IDEAL is a useful silicone-specific imaging technique demonstrating more robust water suppression and equivalent diagnostic accuracy for detecting implant rupture, than water-sat STIR, at the cost of longer scan time and an increase in minor motion artifacts.