Additionally, high epidemiologic risk status was associated with age at sexual debut, weak family function (living alone, having a loose bond with their biological father), loose connection in schools and to their neighborhoods (having difficulty getting along with teachers, and having fewer social interactions), and having more sexually active friends (who contracted sexually transmitted diseases, and frequently using condoms). ConClusions: The disparity noted between self-perceived and epidemiological risks for contracting HIV in our study underscore the need for effective HIV educational programs targeting young AA and their parents. The implication of ecosystemic processes at different levels within the risk statusparticularly family and school functioning, and parental social support indicate that ecodevelopmentally-based interventions may be valuable in preventing the risk of HIV transmission among AA adolescents.

BackgroundInvestigations using classical test theory support the psychometric properties of the original version of the Multiple Sclerosis Impact Scale (MSIS-29v1), a disease-specific measure of multiple sclerosis (MS) impact (physical and psychological subscales). Later, assessments of the MSIS-29v1 in an MS community-based sample using Rasch analysis led to revisions of the instrument’s response options (MSIS-29v2).ObjectiveThe objective of this paper is to evaluate the psychometric properties of the MSIS-29v1 in a clinical trial cohort of relapsing–remitting MS patients (RRMS).MethodsData from 600 patients with RRMS enrolled in the SELECT clinical trial were used. Assessments were performed at baseline and at Weeks 12, 24, and 52. In addition to traditional psychometric analyses, Item Response Theory (IRT) and Rasch analysis were used to evaluate the measurement properties of the MSIS-29v1.ResultsBoth MSIS-29v1 subscales demonstrated strong reliability, construct validity, and responsiveness. The IRT and Rasch analysis showed overall support for response category threshold ordering, person-item fit, and item fit for both subscales.ConclusionsBoth MSIS-29v1 subscales demonstrated robust measurement properties using classical, IRT, and Rasch techniques. Unlike previous research using a community-based sample, the MSIS-29v1 was found to be psychometrically sound to assess physical and psychological impairments in a clinical trial sample of patients with RRMS.

A67tal and physical component summary (MCS, PCS) and SF-6D (health utility) scores), productivity loss (Work Productivity and Activity Impairment questionnaire) and healthcare utilization in the past 6 months. Multivariable analyses were performed to adjust for baseline differences (e.g., age, gender, ethnicity, household income, insurance status, comorbidity burden, etc.). RESULTS: Among respondents with T2DM (n= 7,066; 39.5% female; 60.0 years), 63.0% were obese, 23.0% had SD, and 17.4% had obesity and SD. Multivariable analyses showed significantly worsening health status and greater productivity loss and healthcare utilization among respondents with T2DM who also had obesity or SD, or both. Respondents with T2DM/Obesity/ SD reported the poorest outcomes (vs. T2DM only): lower MCS (43.9 vs. 51.1), PCS (39.1 vs. 47.1), health utilities (0.62 vs. 0.73), greater absenteeism (5.5% vs. 2.0%), presenteeism (26.9% vs. 10.9%), overall work impairment (30.0% vs. 12.6%), activity impairment (43.5% vs. 21.9%), provider visits (7.7 vs. 4.6), and emergency room visits (0.29 vs. 0.16), all p< 0.05. CONCLUSIONS: Majority of respondents with T2DM and SD were obese, suggesting a strong link between obesity and SD. Coexistence of obesity and SD led to significantly negative impact on health status, productivity, and healthcare utilization in patients with T2DM. Interventions focusing on SD and obesity may be clinically and economically beneficial.OBJECTIVES: For patients with type 2 diabetes (T2DM), achieving optimal levels of hemoglobin A1c (HbA1c), blood pressure (BP), and LDL-cholesterol (LDL-C), or the "ABCs" of diabetes, has been linked to several health benefits, but goal attainment rates in the United States remain low. This study sought to determine how ABC goal attainment is associated with the presence of major depressive disorder (MDD) and Health-Related Quality of Life (HRQoL) among a national sample of patients with T2DM. METHODS: This study was a retrospective analysis of the National Health and Nutrition Examination Survey (NHANES) data from 2007-2012. Primary endpoints for ABC goal attainment were defined as HbA1c < 7%, BP < 130/80mmHg, and LDL-C < 100mg/dL. The study sample consisted of non-pregnant participants at least 20 years old with T2DM, stratified by presence of MDD. Comparisons between individuals who achieved and were unable to achieve simultaneous ABC goals were conducted using t-tests or chi-square analyses as appropriate. Multivariate logistic regression was used to analyze which factors potentially influence ABC goal achievement. RESULTS: A total of 808 participants with T2DM met the inclusion criteria. The mean age for all participants was 60.5 years and 51.4% were female. Based on Patient Health Questionnaire (PHQ-9) scores, 11.63% of participants met the criteria for MDD. Overall, 23.7% of total participants were at goal for all 3 ABC parameters, with no significant difference in goal attainment between patients with or without MDD. Participants with T2DM and meeting criteria for MDD reported p...

attributes: dosing frequency, blood sugar (HbA1c) change, weight change, type of delivery system, frequency of nausea, and frequency of hypoglycemia. Part-worth utilities were estimated using logit regression models and used to calculate relative importance (RI) values for each attribute. Prior to completion of the DCE, participants were queried about willingness to self-inject medication for T2DM. Following the DCE, participants were asked their willingness to take medication represented by dulaglutide and liraglutide medication profiles. Results: Final analytic samples consisted of 182 participants in Japan and 243 from the UK. In both studies, dosing frequency, type of delivery system, and frequency of nausea were the top 3 most important attributes, in rank order, with minor variation in the relative importance of each attribute across countries. Pre-study willingness to take injectable medication was significantly lower in Japan (1.7%) compared to the UK (37.9%) (p< 0.0001). Post-DCE willingness to take medication represented by dulaglutide and liraglutide medication profiles also differed, with fewer Japanese participants 'somewhat willing' or 'very willing' (dulaglutide: 42.9%; liraglutide: 4.4%) compared to their UK counterparts (dulaglutide: 77.0%; liraglutide: 30.5%). ConClusions: Rank-order of RI for treatment characteristics of dulaglutide and liraglutide were similar across countries with dosing frequency ranked highest, followed by type of delivery system. Patients from both countries were more willing to self-inject at the end of the study; UK patients were more willing than Japanese patients at both time points.

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