How can we get Iraq- and Afghanistan-deployed US Veterans to participate in health-related research? Findings from a national focus group study.

BACKGROUND: Research participant recruitment is often fraught with obstacles. Poor response rates can reduce statistical power, threaten both internal and external validity, and increase study costs and duration. Military personnel are socialized to a specific set of laws, norms, traditions, and values; their willingness to participate in research may differ from civilians. The aims of this study were to better understand the views of United States (US) Veterans who served in Operation Enduring Freedom (OEF)/ Operation Iraqi Freedom (OIF) on research and motivators for participating in research to inform recruitment for a planned observational study of respiratory health in OEF/OIF Veterans. METHODS: We conducted 10 focus groups in a purposive sample of OEF/OIF Veterans (n = 89) in five US cities in 2015. Key topics included: reasons for participating or declining to participate in health-related research, logistics around study recruitment and conduct, compensation, written materials, and information sharing preferences for study results. Two authors independently coded the data using template analysis. RESULTS: Participants identified three criteria that motivated a decision to participate in health-related research: 1) adequate compensation, 2) desire to help other Veterans, and 3) significance and relevance of the research topic. For many, both sufficient compensation and a sense that the study would help other Veterans were critical. The importance of transparency arose as a key theme; Veterans communicated that vague language about study aims or procedures engendered distrust. Lastly, participants expressed a desire for studies to communicate results of their specific health tests, as well as overall study findings, back to research participants. CONCLUSIONS: OEF/OIF Veterans described trust, transparent communication, and respect as essential characteristics of research in which they would be willing to participate. Additional studies are needed to determine whether our results generalize to other US Veterans; nevertheless, our results highlight precepts that have been reported as important for recruitment in other populations. Researchers may benefit from using community-engaged research methods to seek feedback on recruitment materials and strategies prior to initiating research. For costly studies targeting a large sample (i.e. in the thousands), it may be important to test a variety of recruitment strategies.

Cheek cell-derived α-synuclein and DJ-1 do not differentiate Parkinson's disease from control.

Recently, α-synuclein (α-syn) and DJ-1, 2 proteins critically involved in Parkinson's disease (PD), have been shown to be present in saliva, suggesting their potential utility as biomarkers of PD. However, the origin and influence of demographic characteristics (e.g., age or sex) on these proteins are unknown. We identified cheek epithelium, which forms the majority of the cellular component of saliva and is readily accessible clinically, as 1 of several potential sources of salivary α-syn and DJ-1. However, no PD-related trend in the cellular component was present. In the supernatant collected from 198 healthy subjects, no correlation was seen between salivary DJ-1 or α-syn with age. When male and female subjects were analyzed separately, a weak age-dependent increase in DJ-1 level was present in male subjects, along with slightly increased α-syn in female subjects. These results, albeit largely negative, provide critical information for understanding the salivary gland pathology and saliva as a PD biomarker source, and must be considered in future investigations of salivary changes in PD.

Complications following ex-press glaucoma shunt implantation.

PURPOSE: To report post-operative course and complications in patients who underwent Ex-Press glaucoma shunt placement. DESIGN: Small case series. METHODS: Four patients were referred for management following Ex-Press shunt implantation. Patients underwent complete ophthalmologic evaluation and were appropriately managed. RESULTS: Of the four patients, two had inadequate control of intraocular pressure related to bleb failure caused by subconjunctival scar tissue formation. One patient experienced suprachoroidal hemorrhage 5 days after shunt placement followed a year later with conjunctival erosion and shunt rim exposure. Endophthalmitis from conjunctival erosion over the Ex-Press shunt rim was observed in one patient. CONCLUSION: Patients with subconjunctival implantation of the Ex-Press shunt should be monitored closely for possible conjunctival erosion that can lead to endophthalmitis and failure from fibrosis.

Natural history of acquired retinal oxalosis in a child.

We report the natural history of acquired retinal oxalosis in a child with chronic renal failure. The clinical manifestations were characterized by a transient crystalline retinopathy, but stable, diffuse, flecked retina-like changes and focal hypertropic retinal pigment epithelial lesions. The pathophysiology and previous reports of retinal oxalosis are reviewed.

Retinal vasculitis.

Retinal vasculitis represents a group of diseases characterized by inflammation affecting the retinal vasculature. It is an uncommon disorder that may occur as an isolated disease or more commonly in association with other ocular diseases or a variety of systemic diseases. With a wide variety of disease associations, a search for an underlying etiology should be undertaken based on a meticulous history, review of systems, and physical examination. The laboratory evaluation of patients with retinal vasculitis is an essential component of the work-up to facilitate detection of any underlying disease or to establish a limited differential diagnosis. The management of infectious causes of retinal vasculitis consists of antimicrobial therapy while noninfectious retinal vasculitis is managed with corticosteroids and/or immunosuppressive agents. Because retinal vasculitis is an uncommon disease, there are only a limited number of publications over the past year related to this topic.